Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to increase the allocation of funding for palliative care services for children.
Answered by Caroline Dinenage
As with the vast majority of NHS services, the funding and commissioning of palliative and end of life care is a local matter, over which individual clinical commissioning groups (CCGs) have responsibility. CCGs are best placed to understand the needs of local populations and commission services to meet those needs accordingly, and as such, decisions to fund an increase for palliative care services or hospice provision are for the local National Health Service.
Much of the palliative care patients receive will be provided either in outpatient or community settings, by nurses, community teams or general practitioners (GPs) as part of general NHS services provision, rather than as an identified palliative care service. In such services, data are either not available or does not identify palliative treatment. In addition, social and voluntary sector organisations can provide additional support to patients and the end of life. Therefore, figures for the total cost of palliative care service for children nationally, or across boroughs, is not available.
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the average length of time between a referral to an Approved Mental Health Professional and a section being carried out under the Mental Health Act 1983 was in (a) the London Borough of Southwark and (b) London in each of the last three years.
Answered by Jackie Doyle-Price
The information requested could only be provided at disproportionate cost.
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of whether the availability of inpatient beds in acute psychiatric hospitals in south London has had an effect on the time taken to carry out sections under the Mental Health Act 1983.
Answered by Jackie Doyle-Price
NHS England (London) has developed the Mental Health Compact which sets out the minimum expectations for mental health patients requiring an inpatient admission to an acute psychiatric bed. The Compact outlines the roles and responsibilities of individual organisations along patient pathways to admission and details principles for a London-wide approach to capacity management and escalation (when required) to prevent the sometimes, lengthy waits to inpatient beds.
In South London, in particular, work is underway with acute and mental health providers to review activity, service models and pathways to understand recent increasing demand and any system-wide capacity constraints. This is to develop a common understanding of the challenges and enable joint working to improve flow through mental health and emergency care pathways, meet the needs of people presenting with mental health problems and reduce system pressures.
The Five Year Forward View for Mental Health is clear that everyone should be able to receive the care they need in the least restrictive setting and as close to home as possible. This means a local acute inpatient bed should always be available if required. To support this aim NHS England and NHS Improvement have put in place a clinically-led national programme of support for areas experiencing high bed pressures and consequent reliance on acute mental health out of area placements. The programme supports areas to identify and address the key causes of their capacity pressures, focusing on effective pathway management and the availability of community-based alternatives to inpatient care. South London is one of 16 areas which have received support from this programme to date, and every sustainability and transformation partnership nationally now has a trajectory in place to eliminate acute out of placements due to local bed pressures by 2021.
The Care Quality Commission reported in January on the reasons for the rise in detentions under the Mental Health Act 1983. Its report, ‘The rise in the use of the MHA to detain people in England’, found that changes in mental health service provision and bed management were one reason for the rise, with “delays in admission due to a bed not being available may mean that a patient, who might have consented to be admitted informally at an earlier stage, may deteriorate and become unwilling or unable to agree to an admission, and therefore need to be detained under the MHA”. This report is available at the following link:
https://www.cqc.org.uk/sites/default/files/20180123_mhadetentions_report.pdf
The Government has asked Professor Sir Simon Wessely to lead an Independent Review of the Mental Health Act 1983, to make recommendations on legislation and practice to improve how the Act functions in a modern mental health system. The Independent Review is considering how to address delays in the system and it will report in the autumn. It published an interim report in May, ‘The Independent Review of the Mental Health Act interim reports’, which is available at the following link:
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of whether the availability of police in south London has had an effect on the time taken to carry out sections under the Mental Health Act 1983.
Answered by Jackie Doyle-Price
We have made no such assessment.
The availability of police in local areas is a matter for the Home Department and for regional police and crime commissioners. Police powers under the Mental Health Act 1983 are limited to short term emergency sections under s135 and s136. For formal sections to hospital the police have no role, these are decisions made by Approved Mental Health Professionals on the advice of doctors.
The Government has asked Professor Sir Simon Wessely to lead an Independent Review of the Mental Health Act 1983, to make recommendations on legislation and practice to improve how the Act functions in a modern mental health system. The Independent review is considering how to address delays in the system. The Independent Review will report in the autumn. It published an interim report in May, which is available at the following link:
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps are being taken to ensure the availability of inpatient beds in acute psychiatric hospitals in south London.
Answered by Jackie Doyle-Price
The Five Year Forward View for Mental Health is clear that everyone should be able to receive the care they need in the least restrictive setting and as close to home as possible. This means a local acute inpatient bed should always be available if required. To support this aim NHS England and NHS Improvement have put in place a clinically-led national programme of support for areas experiencing high bed pressures and consequent reliance on acute mental health out of area placements. The programme supports areas to identify and address the key causes of their capacity pressures, focusing on effective pathway management and the availability of community-based alternatives to inpatient care. South London is one of 16 areas which have received support from this programme to date, and every sustainability and transformation partnership nationally now has a trajectory in place to eliminate acute out of placements due to local bed pressures by 2021.
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to reduce the length of time between (a) a section of someone living in the community under the Mental Health Act 1983 being recommended and (b) that section carried out in south London.
Answered by Jackie Doyle-Price
NHS England (London) has developed the Mental Health Compact which sets out the minimum expectations for mental health patients requiring an inpatient admission to an acute psychiatric bed. The Compact outlines the roles and responsibilities of individual organisations along patient pathways to admission and details principles for a London-wide approach to capacity management and escalation (when required) to prevent the sometimes, lengthy waits to inpatient beds.
In South London, in particular, work is underway with acute and mental health providers to review activity, service models and pathways to understand recent increasing demand and any system-wide capacity constraints. This is to develop a common understanding of the challenges and enable joint working to improve flow through mental health and emergency care pathways, meet the needs of people presenting with mental health problems and reduce system pressures.
The Five Year Forward View for Mental Health is clear that everyone should be able to receive the care they need in the least restrictive setting and as close to home as possible. This means a local acute inpatient bed should always be available if required. To support this aim NHS England and NHS Improvement have put in place a clinically-led national programme of support for areas experiencing high bed pressures and consequent reliance on acute mental health out of area placements. The programme supports areas to identify and address the key causes of their capacity pressures, focusing on effective pathway management and the availability of community-based alternatives to inpatient care. South London is one of 16 areas which have received support from this programme to date, and every sustainability and transformation partnership nationally now has a trajectory in place to eliminate acute out of placements due to local bed pressures by 2021.
The Care Quality Commission reported in January on the reasons for the rise in detentions under the Mental Health Act 1983. Its report, ‘The rise in the use of the MHA to detain people in England’, found that changes in mental health service provision and bed management were one reason for the rise, with “delays in admission due to a bed not being available may mean that a patient, who might have consented to be admitted informally at an earlier stage, may deteriorate and become unwilling or unable to agree to an admission, and therefore need to be detained under the MHA”. This report is available at the following link:
https://www.cqc.org.uk/sites/default/files/20180123_mhadetentions_report.pdf
The Government has asked Professor Sir Simon Wessely to lead an Independent Review of the Mental Health Act 1983, to make recommendations on legislation and practice to improve how the Act functions in a modern mental health system. The Independent Review is considering how to address delays in the system and it will report in the autumn. It published an interim report in May, ‘The Independent Review of the Mental Health Act interim reports’, which is available at the following link:
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will collate data on GP waiting times in CCG areas in England.
Answered by Steve Brine
The average waiting time for a general practitioner (GP) appointment is not collected or held centrally. NHS England is working with NHS Digital to consider ways of improving the availability and quality of GP data, including waiting times. In the 2017 GP patient survey 70.8% of respondents (who could remember whether or not they were able to get an appointment, and when they wanted the appointment) stated they saw or spoke to someone at a time they wanted to or sooner. The latest National Health Service planning guidance, issued by NHS England in February 2018, requires clinical commissioning groups to provide extended access to general practice to their whole population by 1 October 2018, to ensure additional capacity is in place ahead of winter 2018.
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discounted rates for dental treatment are available for people on the basis of (a) protected characteristics, (b) pregnancy and (c) low income.
Answered by Steve Brine
Exemptions to National Health Service dental charges ensure that cost is not a barrier to accessing NHS dental treatement for the most vulnerable.
Protected characteristics include age, disability, gender reassignment, pregnancy and maternity, race, religion, sex, sexual orientation. Not all individuals with protected characteristics are automatically entitled to help with health costs for NHS dental treatment as a result of their protected characteristics alone. However individuals with protected characteristics may qualify for help with health for other reasons.
People who are aged under 18, under 19 in full time education and for those who are pregnant or have had a baby in the previous 12 months are exempt from NHS dental patient charges.
Individuals who are on low incomes and are claiming Income Support, Income-related Employment and Support Allowance, Income-based Jobseeker's Allowance, Pension Credit Guarantee Credit, Universal Credit are also exempt from dental charges.
The NHS Low Income Scheme may also provide full or partial help with the cost of treatment for those who do not qualify for free NHS dental treatments but have a low income.
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what range of dental treatment was available on the NHS free of charge for people on low incomes in each of the last seven years.
Answered by Steve Brine
Dentists delivering National Health Service primary care dental treatment are required to provide all treatment that is clinically necessary to a patient regardless of whether the patient is exempt from dental charges or a fee payer. The NHS makes no distinction in treatment offered between these two groups. Dentists collect charges, where applicable, on behalf of the NHS. They pass these charges raised on to the NHS, they do not retain them.
Asked by: Baroness Harman (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many people working in the NHS are employed by third party companies in (a) Camberwell and Peckham constituency and (b) England.
Answered by Steve Barclay
Neither the Department nor its arm’s length bodies hold this information.