Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what preparations have been made to achieve the safe and effective transfer of responsibility for Tier 4 obesity services from NHS England to Clinical Commissioning Groups.
Answered by Lord Prior of Brampton
Specialised commissioning teams at NHS England are in contact with clinical commissioning groups (CCGs) and a formal process has been agreed to transfer the technical and service aspects of the commissioning responsibility.
This process includes NHS England leading on the contract negotiation for 2016/17 on behalf of CCGs based on the current service provision. Although the transfer is effective from April 2016 in terms of the contract values, the timing of the handover will be agreed between local specialised commissioning teams and CCGs, in line with their preparedness.
NHS England will continue to work with CCGs to provide support as appropriate.
NHS England does not expect the services patients receive to be affected following the transfer of obesity surgery commissioning responsibilities to CCGs from April 2016, as the change is primarily to commissioning responsibilities.
No service changes are included as part of the transfer process. The transfer process will include providing information to CCGs on pathways, provider performance and any quality issues relating to this service.
The transfer should support better integration between Tier 3 and Tier 4 services (which include obesity services) which in turn should improve access for eligible patient and streamline pathways. Clinical teams remain responsible for the quality of their services.
NHS England through its clinical reference group has finalised clinical guidance to support commissioners and clinical teams. We would also look to leadership from royal colleges and professional groups to promote best practice in this area. CCGs already have mechanisms in place to monitor provider performance and quality through the existing quality assurance processes.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the case for requiring NHS Trusts to conduct reviews of deaths of people with learning disabilities as part of investigating all unexpected deaths, as suggested by the recent Mazars report, in addition to the National Learning Disabilities Mortality Review process.
Answered by Lord Prior of Brampton
The revised Serious Incident Framework published in March 2015 has sought to simplify the incident management process and ensure that serious incidents are identified correctly, investigated thoroughly and, most importantly, learned from to prevent the likelihood of similar incidents happening again. The NHS England Serious Incident Framework 2015 applies to NHS-commissioned services for those with learning disabilities. A copy is attached.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they will link GP registers of people with learning disabilities and ONS mortality data to enable comparisons of age and cause of death between people with learning disabilities and the general population at a national level, and to measure change over time.
Answered by Lord Prior of Brampton
The Department of Health is currently working with Public Health England, NHS England, the Health and Social Care Information Centre and the Learning Disability Mortality Review Programme to consider the feasibility of linking different datasets in order to compare outcomes for people with learning disabilities with the general population. This aims to help reduce inequalities and poor outcomes, including premature mortality, in people with learning disabilities.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether the remit and funding of the National Learning Disabilities Mortality Review of premature deaths in people with learning disabilities includes a review of the investigations carried out by NHS Trusts into unexpected deaths for that patient group; and if not whether they intend to alter the remit.
Answered by Lord Prior of Brampton
The Learning Disabilities Mortality Review Programme is managed by the University of Bristol on behalf of NHS England. The contract with the University focusses on supporting local reviews of premature deaths of people with learning disabilities; the investigation processes and draws together learning from the reviews. The remit for this work does not include a review of the investigations undertaken by NHS trusts into unexpected deaths for this patient group. There is no current intention to alter this remit.
The current programme is piloting local reviews of premature deaths of people with learning disabilities, as the first stage of rolling these out across England by 2018. These reviews will be the key first step to ensure local processes are in place to inform the co-ordination of future investigations of premature deaths of people with learning disabilities by NHS trusts. There will be clear protocols put in place to ensure that any unexpected deaths are subject to a multidisciplinary review, covering the totality of the person's care, to assess the causes of death and any actions which could have been taken to prevent that death.
The Mortality Review Programme will provide strategic support for the local review process, develop a core data set for use by local review teams and support both the development of action plans in response to a death and the identification of recurrent themes at local, regional and national levels. The case reviews will support health and social care professionals, and others, to identify, and take action on, the avoidable contributory factors leading to premature deaths by people with learning disabilities whilst the identification of regional and national themes will inform wider action.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether, in the light of Mazars' report investigating unexpected deaths at Southern Healthcare, they intend to establish a national review into premature deaths for people with mental illness, in addition to those with learning disabilities.
Answered by Lord Prior of Brampton
Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 requires registered mental health providers to notify the Care Quality Commission (CQC) about deaths of people detained or liable to be detained under the Mental Health Act 1983. In addition, the CQC monitors data provided by the Health and Social Care Information Centre through the Mental Health Minimum Data Set on deaths of mental health hospital patients.
The CQC will be undertaking a wider review into the investigation of deaths in a sample of all types of National Health Service trust (acute, mental health and community trusts) in different parts of the country. As part of this review, the CQC will assess whether opportunities for prevention of death have been missed, for example by late diagnosis of physical health problems.
There are currently no plans to establish a national review into premature deaths of people with mental illness.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what adjustments are anticipated to personalised budgets for vulnerable people in order to allow them to pay personal assistants and carers the proposed National Living Wage.
Answered by Lord Prior of Brampton
The impact of the new National Living Wage on local authority finances will be considered during the Spending Review as part of an overall assessment of spending pressures on local authorities.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how much was spent on general practitioner and community services for children and young people as a proportion of the total 2013–14 budget for general practitioner and community services.
Answered by Lord Prior of Brampton
This information is not held centrally. NHS England and the Department do not monitor the proportion of expenditure on emergency and urgent care, acute care in hospitals and general practitioner and community services for children and young people, as a proportion of the overall National Health Service expenditure on these services.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how much was spent on acute care in hospitals for children and young people as a proportion of the total 2013–14 budget for acute care in hospitals.
Answered by Lord Prior of Brampton
This information is not held centrally. NHS England and the Department do not monitor the proportion of expenditure on emergency and urgent care, acute care in hospitals and general practitioner and community services for children and young people, as a proportion of the overall National Health Service expenditure on these services.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how much was spent on emergency and urgent care for children and young people as a proportion of the total 2013–14 budget for emergency and urgent care.
Answered by Lord Prior of Brampton
This information is not held centrally. NHS England and the Department do not monitor the proportion of expenditure on emergency and urgent care, acute care in hospitals and general practitioner and community services for children and young people, as a proportion of the overall National Health Service expenditure on these services.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many people with a learning disability completed talking therapy treatment through the Improving Access to Psychological Therapies programme in 2014–15, in the light of measures implemented by NHS England to improve uptake among that group.
Answered by Earl Howe - Deputy Leader of the House of Lords
This information is not available in the format requested. The table below shows the number of referrals with a learning disability who finished a course of treatment in Improving Access to Psychological Therapies (IAPT) services, in Quarter 1 and Quarter 2 2014/15. These data are based upon a count of referrals within IAPT services, not distinct people.
| All referrals finishing a course of treatment
| Referrals with a learning disability finishing a course of treatment
|
Quarter 2 2014/15 | 114,697 | 2,786 |
Quarter 1 2014/15 | 110,450 | 1,187 |
Source: Improving Access to Psychological Therapies (IAPT) Dataset
This Government has invested over £400 million over the course of this spending review to make a choice of psychological therapies available for people who need them in all parts of England; this includes people with a learning disability.
In the new five-year plan for mental health, Achieving Better Access to Mental Health Services by 2020, we freed up £80 million for 2015-16. This will, for the first time ever, enable the setting of access and waiting time standards in mental health services, including for people with mental health problems and learning disabilities. The standards will include:
- treatment within six weeks for 75% of people referred to the IAPT programme, with 95% of people being treated within 18 weeks; and
- treatment within two weeks for more than 50% of people experiencing a first episode of psychosis.
The IAPT programme is working with the Foundation for People with Learning Disabilities to update its Positive Practice Guide. The update is due later this year.