Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether contraception advice is provided in postnatal care; and if so, what consideration they give as to when to provide such advice.
Answered by Baroness Blackwood of North Oxford
The National Health Service advises women of the importance of using some form of contraception during sex after giving birth, including the first time, if they do not wish to become pregnant. Women will usually have had a chance to discuss contraception before leaving hospital after birth, and again at their postnatal check at six-eight weeks. They can also talk about contraception with their general practitioner or health visitor, or go to a family planning or local contraception clinic, at any time, including whilst still pregnant.
National Institute for Health and Care Excellence guidance for postnatal care specifically recommends that methods and timing of resumption of contraception should be discussed within the first week of the birth. The coordinating healthcare professional should provide proactive assistance to women who may have difficulty accessing contraceptive care. This includes providing contact details for expert contraceptive advice.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether the NHS provides post-natal examinations of mothers and babies.
Answered by Baroness Blackwood of North Oxford
Commissioners and providers should ensure that services offer a review of a woman’s physical, emotional and social wellbeing by a healthcare professional at the end of the postnatal period (six-eight weeks). National Institute for Health and Care Excellence guidelines on postnatal care stipulate that a documented, individualised postnatal care plan should be developed with the woman ideally in the antenatal period or as soon as possible after birth.
All parents are also offered a thorough physical examination for their baby within 72 hours of giving birth. This examination includes screening tests to find out if a baby has any problems with their eyes, heart, hips and, in boys, the testicles (testes). Parents are offered another physical examination for their baby at the end of the postnatal period, as some of the conditions the NHS screens for can take time to develop. This second examination is usually done at a general practitioner’s (GP) surgery.
GPs may combine the two checks, for parent and baby, at the same appointment.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government who is responsible for enabling that women have post-natal examinations to detect any birth injury which may have gone unnoticed at delivery.
Answered by Baroness Blackwood of North Oxford
Commissioners and providers should ensure that services offer a review of a woman’s physical, emotional and social wellbeing by a healthcare professional at the end of the postnatal period (six-eight weeks).
Relevant National Institute for Health and Care Excellence guidelines stipulate that postnatal care for women needs to address any deviation from expected recovery after birth and any symptoms reported by the woman or identified through clinical observations should be assessed. Women should be advised of the signs and symptoms of potentially life-threatening conditions, including those that may arise as a result of birth injury, and to contact their healthcare professional immediately or call for emergency help if any signs and symptoms occur. Signs and symptoms of infection, inadequate repair, wound breakdown or non-healing should be evaluated and urgent action taken. Additionally, women may be offered an examination to see if their stitches have healed if they had an episiotomy or caesarean section.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many home births there were in each region of England in each year since 2000.
Answered by Baroness Manzoor
The data requested are not held centrally.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Statement by the Parliamentary Under-Secretary for Public Health and Primary Care on 20 December 2018 (HCWS1221), what assessment they have made of the adequacy of public health service provision, in particular the provision of sexual and reproductive health services, following their recently announced financial cuts in specialist public health services.
Answered by Baroness Manzoor
Local authorities will receive over £3 billion in 2019/20, ring-fenced exclusively for use on public health.
Over the five years of the current spending review period we are making over £16 billion of grant funding available to local authorities in England exclusively for use on improving health. The grant is only a proportion of the total spending on public health: for example, NHS England commissions national screening and immunisation programmes with a budget of £1,205 million for 2018/19, and many other interventions occur in National Health Service primary care settings.
Public Health England monitors progress against the wide-ranging set of indicators published in the Public Health Outcomes Framework (PHOF) which shows that, as a whole, for the majority of PHOF indicators the trends in England are either broadly constant or have improved in comparison with 2014. In 2017 there was a total of 3.3 million attendances at specialist sexual health services. This represents a 13% increase in overall attendances since 2013. Attendances at community sexual and reproductive health services have reduced but there has been an increase in use of long-acting reversible contraception methods which require far fewer follow up appointments and which may account for some of the reduction in these attendances.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many NHS midwives there were in England, broken down by age, (1) in the latest year for which figures are available, and (2) ten years earlier.
Answered by Baroness Manzoor
NHS Digital publishes Hospital and Community Health Services (HCHS) workforce statistics. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in primary care, local authorities or other providers.
The following table shows the headcount number of midwives employed by the National Health Service in England, by five-year age band as at 30 September for the years specified. Comparisons between these data sets is not possible due to changes in headcount methodology.
2008 | 2018 | |
All midwives | 23,659 | 25,866 |
Of which: |
|
|
Under 25 | 640 | 1,242 |
25 to 29 | 2,187 | 3,437 |
30 to 34 | 2,401 | 3,372 |
35 to 39 | 2,968 | 3,367 |
40 to 44 | 4,787 | 2,990 |
45 to 49 | 4,757 | 3,137 |
50 to 54 | 3,313 | 4,225 |
55 to 59 | 1,798 | 2,846 |
60 to 64 | 717 | 1,079 |
65 and over | 91 | 171 |
Source: NHS HCHS workforce statistics, NHS Digital
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking, if any, to strengthen leadership within the midwifery profession at (1) national, (2) regional, and (3) local level.
Answered by Baroness Manzoor
As part of the delivery of Workstream 5 (Transforming the Workforce) of the NHS England Maternity Transformation Programme, Health Education England is working with the NHS Leadership Academy to develop a leadership training offer to Local Maternity Systems to support those working in maternity services to develop the collaborative, compassionate and inclusive leadership that evidence demonstrates is most effective in delivering improvements to care and better health outcomes.
Health Education England is also working collaboratively with key stakeholders including NHS England, NHS Improvement, the Royal College of Midwives and Local Maternity System Leaders to ensure alignment with work that is already taking place to develop midwifery leaders and to ensure that the training offer meets the ongoing needs of those who will be delivering and supporting improvement across maternity services.
Additionally, the NHS Leadership Academy works to support excellent leadership across the National Health Service. The Academy provides tools, programmes and expertise to support individuals to improve as leaders. Midwives can access all these resources, whether taking their first steps in healthcare leadership or working at a senior/executive level. The Academy also has ten local leadership academies who connect services on a regional level and provide bespoke support to leaders at every level across the country.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many support workers were employed in maternity care in the NHS in England in each of the last three years, expressed as (1) a headcount, and (2) a full-time equivalent basis; and what was the age profile of such workers in each of those years.
Answered by Baroness Manzoor
NHS Digital publishes Hospital and Community Health Services workforce statistics. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in primary care, local authorities or other providers.
The information requested is attached due to the size of the data. The table shows the number of support workers employed within the care setting of maternity services, in the National Health Service in England, in each of the last three years in headcount and full-time equivalents, by five-year age band, as at September 30 for the years specified.
In March last year, the former Secretary of State for Health and Social Care (Rt. hon. Jeremy Hunt MP) announced that there will be further investment in maternity support staff. This would include working with the Royal College of Midwives and other partners to develop new training routes into midwifery – this will help talented support workers to develop and move quickly to become registered midwives and help the midwifery profession attract and retain talented staff.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the uptake in cervical smear tests; how they will encourage women to take such tests; and how they will increase the availability of such tests.
Answered by Baroness Manzoor
NHS England has reviewed the data from 2013 showing the gradual national and international decline in the five-year coverage. Assessments for the decline were done in partnership with key stakeholders Public Health England (PHE) and Jo’s Cervical Cancer Trust.
Following Jo’s Cervical Cancer Trust report published in January 2018, NHS England and PHE have modified the commissioning levers and communication processes, for example through supporting Jo’s Trust in the Time to Screen campaign and the launch of its first national multimedia cervical screening campaign ‘Be Clear on Cancer’ in March 2019 promoting uptake of cervical screening.
NHS England has supported the Cancer Alliances who bring together local senior clinical and managerial leaders representing the whole cancer patient pathway across a specific geography, and have a general role in improving early diagnosis. In turn they have developed specific plans to improve uptake rates in screening programmes as part of that agenda with cervical screening considered a priority area.
Cancer Research UK and Macmillan general practitioners (GPs) are also being utilised to provide awareness and training, with work and focus groups to target reducing inequalities among women over 50 and women from Eastern European countries a specific focus in one region.
Training of GP receptionists is underway to improve ease of access to a screening appointment, while a toolkit has been developed to reduce the inequality in uptake among women with a learning disability. In addition, NHS England recently announced that Professor Sir Mike Richards has been asked to lead a review of cancer screening programmes which will consider ways to increase uptake of cervical screening and the NHS Long Term Plan confirms that using human papillomavirus testing as the primary screen for cervical cancer will be implemented across England by 2020.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 20 December (HL12267), whether there has been an increase or decrease in contraceptive uptake in the UK in recent years; and if so, (1) which kinds of contraceptives have been affected, and (2) what age groups demonstrate the most change.
Answered by Baroness Manzoor
Data covering all contraception provision by age and method in the United Kingdom or England is not held centrally.