Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what consideration was given by the West Midlands Ambulance Service to upgrading the role of Community First Responders in other parts of its area to bring the roles into line with the role in Staffordshire before the decision was taken to downgrade the role of Community First Responders in Staffordshire and bringing that role into line with other parts of the West Midlands Ambulance Service area.
Answered by Lord Bethell
Ambulance services have operated with Community First Responders (CFRs) for many years in mainly rural areas and they play a vital role in responding to the highest priority 999 calls whilst paramedics are en-route.
West Midland Ambulance Service (WMAS) recognise that Community First Responders (CFRs) play a key role in protecting local communities and they want to enhance that by increasing the number of CFRs, using a consistent model of response, so that even more lives can be saved.
Since the introduction of the Ambulance Response Programme, ambulance services have a clearer indication of the severity of each 999 call and so can assign the most appropriate response to that call, which may include the dispatch of a CFR, to ensure that each patient receives the right response for their clinical need.
WMAS plan to use their CFRs to target the most seriously ill patients, in the way that CFR schemes were originally set up.
The Government are content with the approach WMAS are taking regarding CFRs and have no concerns regarding their future plans.
In 2015, the Association of Ambulance Chief Executives published a document on the use of CFRs. The document seeks to reduce national variation in the governance of CFR schemes and aims to addresses the deployment of CFRs across all categories of calls. A copy of Volunteer Responders Governance Framework is attached.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether the current enhanced role of Community First Responders in Staffordshire has proved more effective in terms of (1) quality, and (2) safety, when compared to the work of Community First Responders in other parts of the West Midlands Ambulance Service area.
Answered by Lord Bethell
Ambulance services have operated with Community First Responders (CFRs) for many years in mainly rural areas and they play a vital role in responding to the highest priority 999 calls whilst paramedics are en-route.
West Midland Ambulance Service (WMAS) recognise that Community First Responders (CFRs) play a key role in protecting local communities and they want to enhance that by increasing the number of CFRs, using a consistent model of response, so that even more lives can be saved.
Since the introduction of the Ambulance Response Programme, ambulance services have a clearer indication of the severity of each 999 call and so can assign the most appropriate response to that call, which may include the dispatch of a CFR, to ensure that each patient receives the right response for their clinical need.
WMAS plan to use their CFRs to target the most seriously ill patients, in the way that CFR schemes were originally set up.
The Government are content with the approach WMAS are taking regarding CFRs and have no concerns regarding their future plans.
In 2015, the Association of Ambulance Chief Executives published a document on the use of CFRs. The document seeks to reduce national variation in the governance of CFR schemes and aims to addresses the deployment of CFRs across all categories of calls. A copy of Volunteer Responders Governance Framework is attached.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what guidance they provide on the role of Community First Responders.
Answered by Lord Bethell
Ambulance services have operated with Community First Responders (CFRs) for many years in mainly rural areas and they play a vital role in responding to the highest priority 999 calls whilst paramedics are en-route.
West Midland Ambulance Service (WMAS) recognise that Community First Responders (CFRs) play a key role in protecting local communities and they want to enhance that by increasing the number of CFRs, using a consistent model of response, so that even more lives can be saved.
Since the introduction of the Ambulance Response Programme, ambulance services have a clearer indication of the severity of each 999 call and so can assign the most appropriate response to that call, which may include the dispatch of a CFR, to ensure that each patient receives the right response for their clinical need.
WMAS plan to use their CFRs to target the most seriously ill patients, in the way that CFR schemes were originally set up.
The Government are content with the approach WMAS are taking regarding CFRs and have no concerns regarding their future plans.
In 2015, the Association of Ambulance Chief Executives published a document on the use of CFRs. The document seeks to reduce national variation in the governance of CFR schemes and aims to addresses the deployment of CFRs across all categories of calls. A copy of Volunteer Responders Governance Framework is attached.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they will publish their response to the report by the Independent Commission on Adult Acute Psychiatric Care in England Old Problems, New Solutions, published in February 2016; and if so, when.
Answered by Lord O'Shaughnessy
NHS England intends to publish a formal response to the Independent Commission on Adult Acute Psychiatric Care in England as soon as the contents of the acute mental healthcare pathway have been finalised.
An acute mental health care pathway for adults, including best practice case studies, has been developed. This is currently being reviewed to ensure that it is in line with and supports the wider Five Year Forward View for Mental Health and the long-term plan for the National Health Service (which is currently in development following the Government’s announcement of a new five-year funding settlement for the NHS, which would deliver an average annual growth of 3.4% over the next five years). The aim is to ensure that the pathway provides the most helpful and relevant guidance to both commissioners and providers within the current context.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of reports that 50 per cent of Clinical Commissioning Groups in England are planning to reduce the proportion of their budgets spent on mental health support in 2017–18, compared to 2016–17.
Answered by Lord O'Shaughnessy
It is for clinical commissioning groups (CCGs) to determine the level of spend on specific services. CCGs are required to achieve the Mental Health Investment Standard (MHIS) - i.e. to increase their spend on mental health services in excess or equal to the growth in their programme allocation and to deliver on the operational targets laid out in the Five Year Forward View for Mental Health.
NHS England now publishes CCG mental health spend. Over 80% of CCGs met the MHIS in 2016/17 and are forecast to achieve the standard in 2017/18. Assurance processes are in place centrally and regionally to review and to validate reported spend. For 2018/19 all CCGs will be required to meet the MHIS and this will be subject to confirmation by their auditors.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of whether Clinical Commissioning Groups are allocating the additional investment promised by Her Majesty's Government for mental health to mental health services.
Answered by Lord O'Shaughnessy
It is for clinical commissioning groups (CCGs) to determine the level of spend on specific services. CCGs are required to achieve the Mental Health Investment Standard (MHIS) - i.e. to increase their spend on mental health services in excess or equal to the growth in their programme allocation and to deliver on the operational targets laid out in the Five Year Forward View for Mental Health.
NHS England now publishes CCG mental health spend. Over 80% of CCGs met the MHIS in 2016/17 and are forecast to achieve the standard in 2017/18. Assurance processes are in place centrally and regionally to review and to validate reported spend. For 2018/19 all CCGs will be required to meet the MHIS and this will be subject to confirmation by their auditors.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they will consider ring-fencing existing levels of funding for mental health services in 2018–19.
Answered by Lord O'Shaughnessy
The Department does not generally ring-fence budgets within the National Health Service. The Health and Social Care Act 2012 gave clinical commissioning groups (CCGs) the autonomy to make decisions about the health services that best meet the health needs of their population.
They do this based on evidence of patient needs locally. However, NHS England’s Mental Health Investment Standard requires the local NHS to increase mental health investment by the same proportion as overall allocations. This is planned to be met across England as a whole in 2017/18 and 2018/19. For 2018/19 all CCGs will be required to meet the Mental Health Investment Standard and this will be subject to confirmation by their auditors.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what progress has been made in ensuring that mental health has parity of esteem with physical health with regard to funding.
Answered by Lord O'Shaughnessy
The Government set parity of esteem in physical and mental health in law in the Health and Social Care Act 2012. The independent Mental Health Taskforce’s Five Year Forward View for Mental Health report in February 2016 and July 2016 Implementing the Five Year Forward View for Mental Health plan set out detailed recommendations for achieving parity of esteem between physical and mental healthcare. Copies of both reports are attached. The Government’s response to the Five Year Forward View for Mental Health report accepted all the report’s recommendations in January 2017 and created a detailed action plan for taking forward the recommendations, including how we will monitor progress and report transparently. A copy of the Government’s response is attached. The report set out a strategy for change in four key areas to drive forward improvements in mental health: promoting good mental health and helping people lead the lives they want to live, integrating care, creating a seven day National Health Service for mental health and hard wiring mental health across health and social care.
NHS England’s Mental Health Investment Standard also requires the local NHS to increase mental health investment by at least the same proportion as overall allocations. This is planned to be met across England as a whole in 2017/18 and 2018/19. For 2018/19 all clinical commissioning groups will be required to meet the Mental Health Investment Standard and this will be subject to confirmation by their auditors.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government when they intend to publish proposals for eliminating out of area placements for non-specialised services for acute adult psychiatric care.
Answered by Lord O'Shaughnessy
In February 2016, the independent Commission on Acute Adult Psychiatric Care described widespread problems with finding acute inpatient beds. As a result, the Commission made a recommendation to eliminate the practice of sending people out of the area for care due to local acute bed pressures.
NHS England has, in collaboration with all arms’ length bodies, prepared a response to all of the recommendations. It is currently in the final stages of clearance and is intended to be published shortly.
Asked by: Lord Crisp (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government when they intend to publish proposals for introducing a maximum four hour wait for acute adult mental health care and bringing greater parity between mental and physical health.
Answered by Lord O'Shaughnessy
NHS England has made significant progress in relation to the development of a comprehensive set of mental health care pathways, including an acute mental health care pathway.
Whilst much of the pathway content has been finalised, the material is currently being reviewed to ensure that it is in line with the wider Five Year Forward View strategy and that it provides the most helpful guidance to both commissioners and providers in relation to the commissioning and implementation of services to improve access and outcomes for people with mental health problems.