Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what criteria apply to NHS hospitals when requesting patients to sign a 'do not resuscitate' form.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
There are no set criteria applied to National Health Service hospitals when requesting patients sign do not resuscitate forms. Doctors are required to make do not attempt cardiopulmonary resuscitation (DNACPR) decisions based on the individual circumstances of a patient, and with the involvement of the person concerned or, where the person lacks capacity, their family, or any other legally recognised advocate.
Patient facing guidance setting out how DNACPR decisions should be made, and how individuals or their families can get support about a DNACPR, is provided on the NHS website, in an online only format.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many 'do not resuscitate' forms have been signed in each of the past five years.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold this data.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to address barriers to discharge from mental health inpatient units for autistic people and people with learning disabilities related to the provision of (1) suitable housing, and (2) social care support.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
On 26 January 2024, we published statutory guidance on discharge from mental health inpatient settings. This guidance sets out key principles for how National Health Service bodies and local authorities across adult and children’s services should work together to support people to be discharged from mental health inpatient services, including mental health inpatient services for people with a learning disability and for autistic people. This guidance states that strong links should be made with relevant community services prior to, and during, the person’s stay in hospital, and that this should include links in relation to meeting the person’s needs related to health, social care, education, housing, and any other individual needs.
In 2023/24, we are investing an additional £121 million to improve community support, as part of the NHS Long Term Plan. This includes funding for children and young people’s keyworkers. We continue to support the delivery of new supported housing by providing capital subsidies to providers, through the Care and Support Specialised Housing Fund and the Affordable Homes Programme in England. We have also made available up to £8.6 billion over this and next financial year, to support adult social care and discharge.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the effectiveness of the dynamic support register and Care (Education) and Treatment Review policy for autistic people without a learning difficulty in (1) preventing hospital admissions, and (2) speeding up hospital discharges.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England published updated policy and guidance on both Care (Education) and Treatment Reviews (C(E)TRs) and Dynamic Support Registers (DSRs) on 25 January 2023, for implementation from 1 May 2023, to help ensure people get the support they need to stay well in their communities. This includes guidance on the timescales for C(E)TRs and on ensuring that actions are taken forward.
NHS England produced the updated policy and guidance following a process of reviewing the learning since the inception of C(E)TRs and DSRs, including consultation and engagement with people with lived experience. This process included drawing on the findings of the Norfolk Safeguarding Adults Board’s review of the deaths of Joanna, Jon and Ben at Cawston Park in Norfolk, and the subsequent safe and wellbeing reviews for all people with a learning disability and autistic people in mental health hospitals.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that Care (Education) and Treatment Reviews are taking place within recommended timeframes, and that recommendations arising from those reviews are being acted on.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England published updated policy and guidance on both Care (Education) and Treatment Reviews (C(E)TRs) and Dynamic Support Registers (DSRs) on 25 January 2023, for implementation from 1 May 2023, to help ensure people get the support they need to stay well in their communities. This includes guidance on the timescales for C(E)TRs and on ensuring that actions are taken forward.
NHS England produced the updated policy and guidance following a process of reviewing the learning since the inception of C(E)TRs and DSRs, including consultation and engagement with people with lived experience. This process included drawing on the findings of the Norfolk Safeguarding Adults Board’s review of the deaths of Joanna, Jon and Ben at Cawston Park in Norfolk, and the subsequent safe and wellbeing reviews for all people with a learning disability and autistic people in mental health hospitals.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government why social service departments are discharging hospital patients to residential care for the first time when they are self-funding, while encouraging those patients (1) to contract with, (2) to be charged by, and (3) to be added to, social services’ admissions to private care, instead of contracting directly with the residential home; what impact this practice has on patients’ contractual rights; and what assessment they have made of the impact of this on the viability of the private care home sector.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
It is our priority to ensure that patients are discharged at the right time and to the right place, and to ensure that people receive appropriate care and support after they have been discharged. We believe it is crucial to ensure that the discharge process remains person-centred and driven by the patient’s fully informed decisions of the available options, including their own home or a residential care setting after they are discharged, with the support of their family or unpaid carers.
Whether or not a person qualifies for any financial support towards their care costs depends on their capital assets. Anyone who has assets above the upper capital limit, £23,250, is expected to meet the full cost of their own care. A person with more in capital than the upper capital limit can nonetheless ask their local authority to arrange their care and support for them.
Where the person’s needs are to be met by care in a care home, the local authority may choose to arrange the care, but is not required to do so. In supporting self-funders to arrange care, the local authority may choose to enter into a contract with the preferred provider or may broker the contract on behalf of the person.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government how many cases of suicide have been reported by (1) coroners, and (2) other sources, since the establishment of the coroner focal point in March 2016.
Answered by Viscount Younger of Leckie - Parliamentary Under-Secretary (Department for Work and Pensions)
The Department for Work and Pensions (DWP) has recorded 22 contacts related to possible suicides via its Coroner focal point since 2016.
Coroners determine the cause of death, including whether it is by suicide. Coroners do not routinely inform the department when they return a conclusion of suicide in a case where the deceased person was claiming benefits. There is no requirement for them to do so, unless they have named it as an Interested Person at that inquest, or they decide to send it a Prevention of Future Deaths report.
DWP becomes aware of the majority of deaths through the Tell Us Once (TUO) service. It is offered by all 391 councils across England, Scotland and Wales on behalf of DWP. This service lets citizens report a death to most government organisations in one go. Once verified, the Customer Information System (CIS), a cross-government system, is updated and DWP will take the appropriate action on a case.
However, this service does not notify DWP of the cause or circumstances of a death, and DWP has no legitimate business reason to obtain or record this information.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government how many reviews the Serious Case Panel has conducted into the death by suicide of benefits claimants since its establishment.
Answered by Viscount Younger of Leckie - Parliamentary Under-Secretary (Department for Work and Pensions)
The Serious Case Panel does not discuss individual cases, but the panel considers specific themes that emerge from internal process reviews (IPRs). The IPR process is how the DWP investigates individual cases to document the learning. Whilst several themes will have been drawn from serious cases where suicide featured in some of the customer journeys, the specific cases would not be discussed during the meeting.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government how many times the Department for Work and Pension's Serious Case Panel has met since its establishment in March 2020.
Answered by Viscount Younger of Leckie - Parliamentary Under-Secretary (Department for Work and Pensions)
The Serious Case Panel has convened, since March 2020, on 13 occasions with the 14th Panel due to meet on 20/6/23.
The minutes are available on GOV.UK: DWP Serious Case Panel - GOV.UK (www.gov.uk).
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government how many Prevention of Death reports the Department for Work and Pensions has received from coroners in each year from 2019 to 2022 inclusive.
Answered by Viscount Younger of Leckie - Parliamentary Under-Secretary (Department for Work and Pensions)
I am happy to provide a breakdown by year as follows: