Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what measures are in place to support the carers and family members of those people with Parkinson's disease who have experienced distressing hallucinations during the COVID-19 pandemic.
Answered by Lord Bethell
As set out in the National Institute for Health and Care Excellence guideline Parkinson’s disease in adults, published in July 2017, symptoms such as hallucinations are an increased risk for people taking some Parkinson’s disease medications. The guidance sets out that people with Parkinson’s disease should have a comprehensive care plan agreed between themselves, their family members and carers and specialist and secondary healthcare providers. A copy of the guidance is attached.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what additional support is in place for the carers and family members of those people with Parkinson's disease dementia and dementia with Lewy bodies who may be experiencing greater levels of distress following the COVID-19 lockdown.
Answered by Lord Bethell
We recognise the crucial role that unpaid carers play in supporting people with conditions like dementia, especially during the pandemic.
On 8 April we published COVID-19 guidance for unpaid carers in an online only format on GOV.UK to support carers during the pandemic, which includes general advice on infection control and caring where someone has symptoms.
We have commissioned research through the National Institute for Health Research on the best ways to mitigate the psychological and social impact of COVID-19 on people with dementia living in the community and their family carers. Work has already started with phased outputs to August 2020.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, following the COVID-19 pandemic, (1) what measures are in place to restart outpatient clinics while ensuring that those who visit do not contract the virus, and (2) how these measures are being communicated to patients.
Answered by Lord Bethell
Whilst routine treatments were suspended to provide capacity to treat COVID-19 patients, we are now working closely with the National Health Service and other partners to restart these in a safe way, with excellence in infection prevention and control as a key principle. Guidance has already been issued on this, and approaches are being tailored at local level according to local capacity and local demand, with the most urgent services being restarted first.
The NHS ‘Help us to help you’ media campaign encourages all patients in need of urgent or emergency medical care to seek appropriate treatment.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what percentage of Improving Access to Psychological Therapies (IAPT) services have provided telephone and video appointments in place of face-to-face appointments between the start of the COVID-19 lockdown on 23 March and 15 June.
Answered by Lord Bethell
We are unable to provide the data as requested.
The information on whether appointments take place face-to-face or by phone or video is only available in the Improving Access to Psychological Therapies annual publications. This information covering the period 1 April 2019 - 31 March 2020 is due to be published on 30 July 2020.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they will take to ensure that people with Parkinson's disease will have continued access to psychological therapies until the end of the COVID-19 pandemic.
Answered by Lord Bethell
National Health Service mental health services have remained open for business throughout the COVID-19 outbreak, including delivering support digitally and over the phone where possible. In doing so, the NHS has been clear on the importance of maintaining face to face care for those patients who need it, and of patient choice in determining suitability for digital appointments.
When delivering face to face appointments, mental health services are expected to follow the latest guidance on the use of personal protective equipment in healthcare settings to support infection prevention and control. Services will be further enabled by the roll out of the NHS Test and Trace service to reduce transmission risk and deliver face to face services in as safe a way as possible.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what measures are in place to ensure that people with Parkinson's disease who are digitally excluded and have symptoms of the motor speech disorder dysarthria can access psychological therapies during the COVID-19 pandemic.
Answered by Lord Bethell
Throughout the COVID-19 outbreak, the National Health Service has been clear on the importance of maintaining face to face care for those patients who need it, and of patient choice in determining suitability for digital appointments.
When delivering face to face appointments, mental health services are expected to follow the latest guidance on the use of personal protective equipment in healthcare settings to support infection prevention and control. Services will be further enabled by the roll out of the NHS Test and Trace service to reduce transmission risk and deliver face to face services in as safe a way as possible.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the impact of the suspension of new Local Government and Social Care Ombudsman investigations on the mental health of (1) informal carers, and (2) people accessing social care.
Answered by Lord Bethell
The Local Government and Social Care Ombudsman has restarted suspended complaints and anticipates reopening for new complaints in the coming weeks. Members of the public will not lose their right of appeal, and complaints regarding the COVID-19 outbreak period will be considered in due course. The Ombudsman is not an emergency service, and members of the public are required by law to first have their complaints investigated by their council or care provider. The Ombudsman has also opened up a helpline to give advice and support to concerned members of the public.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to improve services for people with neurological conditions such as Parkinson’s.
Answered by Baroness Manzoor
NHS England established the National Neurology Advisory Group (NNAG) with the Neurological Alliance which led the development of a national collaborative clinical leadership model, bringing together key stakeholders such as Parkinson’s UK, a range of national clinical leaders and patient groups with the aim to seek alignment between programmes in NHS England, arm’s length bodies and system partners and to guide the strategic development of work to improve outcomes for people living with neurological conditions including Parkinson’s.
Throughout 2018, the NNAG has organised a number of condition specific meetings with the aim of defining what good neurology looks like for patients with neurological conditions including Parkinson’s, and identifying the barriers to achieving that.
NHS England also supports local transformation through their national programmes, as highlighted in the NHS Long Term Plan. NHS RightCare has published a number of intelligence tools and resources to support reduction in unwarranted variation in neurology services. For 2018/19, 37 of 195 clinical commissioning groups submitted delivery plans that include neurological problems as improvement projects as part of their NHS RightCare programmes. Of these 37, six systems have explicitly referenced Parkinson’s in their delivery plans. Interventions in these plans primarily focus on ensuring that patients are linked into end of life care recording and reviewing effective primary prescribing of Parkinson’s disease drugs.
NHS England Specialised Commissioning has also recently approved a national review of specialised adult neuroscience services, working alongside and closely with the Getting It Right First Time programme.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what recent discussions have taken place between the NHS and the Department of Health and Social Care about the costed breakdown of proposed cuts to the national budget of NHS Continuing Healthcare; whether they intend to provide a detailed rationale to account for the planned reductions in spending; and if so, whether they will publish that rationale.
Answered by Baroness Manzoor
The Department works closely with NHS England and has regular discussions about NHS Continuing Healthcare.
NHS Continuing Healthcare expenditure is forecast to increase over the period to 2020/21. The identified £855 million efficiency opportunity is not predicated on changes to the National Framework in respect of eligibility or on limiting the care packages available.
There should be no quota or cap on access to NHS Continuing Healthcare funding and NHS England does not aim to reduce spending on NHS Continuing Healthcare, but to reduce the rate of growth of expenditure. NHS England understands that there is variation on how individual clinical commissioning groups (CCGs) are commissioning these services, and the NHS Continuing Healthcare Strategic Improvement Programme will be developing a range of commissioning tools to support CCGs in this role to deliver more efficient services.
The detailed rationale is published in the Treasury Minutes: Government response to the Committee of Public Accounts on the Twelfth to the Nineteenth reports from Session 2017-19. The extract is as follows:
“CHC expenditure (after efficiencies) is forecast to increase over the period to 2020/21, and the identified efficiency opportunity is not predicated on changes to the National Framework in respect of eligibility or on limiting the care packages available.
How any efficiency is delivered in practice will of course be determined by CCGs locally, consistent with their statutory duties and national guidance in respect of access to CHC. National modelling based on variations in CHC expenditure and practice suggests the following notional efficiency opportunities in 2020/21, amounting to circa £855 million, which it is anticipated will inform local commissioning decisions:
A copy of the Treasury Minutes is attached.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what percentage of people in England receive free prescriptions.
Answered by Baroness Manzoor
The information is not available in the format requested. Information collected by the NHS Business Services Authority relates to prescription items dispensed in the community.