Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment has been made of the mental health problems being experienced by children in the United Kingdom; and what action they plan to take, if any, to reduce the number of children aged under 10 who suffer from severe depression.
Answered by Lord Prior of Brampton
The last prevalence survey, published in 2004, found that around 10% of children were suffering from a diagnosable medical condition. Around one in a thousand children was a child aged under 10 suffering from severe depression. Based on these figures, the charity Young Minds has estimated that around 8,000 children aged under 10 suffer from severe depression.
This Government is committed to improving children and young people’s mental health and wellbeing as a major priority. All clinical commissioning groups (CCGs) have been asked to work with their local partners to develop plans to transform their offer through the development of local transformation plans. These plans, alongside existing investment, should include the full spectrum of interventions: from prevention and resilience building, to support and care for existing and emerging mental health problems, as well as transitions between services and addressing the needs of the most vulnerable. This local transformation will be supported by a national programme of work, which includes piloting single points of contact so that young people have access to mental health advice and support in schools and the extension and expansion of the Children and Young People's Improving Access to Psychological Therapies programme.
Additionally, the Department is commissioning a new comprehensive prevalence survey of children and young people’s mental health. The programme is on track to announce a contractor in autumn 2015, and final publication is expected in 2018. The findings of the survey will help identify where best to target improvements.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many children aged under 18 were detained in police custody during the past 12 months, after being sectioned under the Mental Health Act 1983; and what action they plan to take, if any, to prevent such detention in future.
Answered by Lord Prior of Brampton
In 2014-15 there were 145 cases of children under the age of 18 being detained in police cells after being sectioned under the Mental Health Act 1983; this represents a 40% decrease from the previous year, and a 55% decrease since the figures began to be collected in 2011-12.
The Crisis Care Concordat was launched in February 2014 seeking to improve the experience of those in crisis, and in particular, prevent those detained under section 136 of the Mental Health Act being held in police cells. All localities signed up to the principles of the Concordat before the end of 2014. Detailed action plans are now in place across England setting out how local partners will work together to improve service responses for people in crisis. The Department of Health, NHS England and Mind continue to work with local areas to strengthen and improve their “local Concordat action plans”.
As announced by the Home Secretary in May earlier this year, this Government will also be reforming the law on the use of police cells to end this practice altogether for under 18s. This will be backed by £15 million to improve the provision of health-based places of safety so that there is better availability of alternatives to police cells for people of all ages.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how they plan to ensure an increase in physical leisure activity among the population in order to tackle the rise in obesity among adults and children.
Answered by Lord Prior of Brampton
Tackling obesity is of great concern to this Government and tackling childhood obesity is a major priority. Physical activity has an important role to play in weight management, and can bring important physical and mental health benefits, but there is no single solution to the problem.
While some progress has been made in recent years, there is much further to go. We will put forward our plans in due course.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what support they provide to individuals who stop working to care for elderly and infirm family members.
Answered by Lord Prior of Brampton
Under the Care Act 2014, local authorities have legal duties to support carers and this will include many carers who stop working to care for family members. This includes a duty on local authorities to provide information and advice and universal preventative services for carers, as well as individual rights to carers to get an assessment on the appearance of needs for support, plus a right to support to meet any needs assessed as eligible against the national minimum eligibility threshold. The Department has provided £104 million of funding to local authorities for these rights in 2015-16.
Also, the Department has provided funding of £400 million to the National Health Service between 2011 and 2015 to enable carers to take breaks from their caring responsibilities, including £130 million in 2015-16 that is included in the Better Care Fund.
People who care for a disabled person over 35 hours a week who are not in full-time employment or education can be entitled to Carer’s Allowance, as well as income support benefits.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how they intend to respond to the assessment of the standards of domiciliary care in the report from the Burstow Commission on the future of the home care workforce.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Government is taking a variety of actions to drive up the quality of home care services and improve the working conditions of staff.
The Care Quality Commission (CQC) has introduced a new system of inspection of social care providers. The new inspections are structured around five key questions that matter most to people – are services safe, caring, effective, well-led and responsive to people’s needs?
From 1 April 2015, providers will be under a legal duty to meet a new set of registration requirements that include new fundamental standards. The CQC has a range of enforcement powers it can employ to ensure providers comply with these standards, including the ability to prosecute both providers and directors that are responsible for unacceptable standards of care. We are also introducing a “fit and proper person” test for directors. Where a director is deemed by the CQC to be unfit for the role, it will be able to insist upon his/her removal.
The Department worked with the Association of Directors of Adult Social Services, the Local Government Association and the Health Services Management Centre at the University of Birmingham to develop a set of commissioning standards for local authorities. The standards were launched successfully at the National Children’s and Adults’ Services conference in October 2014 and will now be piloted by a number of local authorities.
Local authorities will be encouraged to use them to support improvement in their commissioning practices, including those which impact on the social care workforce, such as provider compliance with National Minimum Wage requirements and fair employee contracting terms.
The Government is also naming and shaming employers that break National Minimum Wage laws and helping staff to recover the pay owed to them.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what are the implications of changes in available social care to support hospital patients ready for discharge but having no one to look after them at home.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The current budget pressures are challenging. There are a number of changes in social care that address the needs of people leaving hospital including those that live alone.
The initiatives necessary to enable safe and timely discharge are included in the Operational Resilience and Capacity Planning Guidance and in the conditions for the Better Care Fund. For example they both require the National Health Service and local government to implement seven day working to facilitate timely discharge. Both require the effective engagement of the voluntary sector.
System Resilience plans and Better Care Fund plans take forward the rapid commissioning of care and support services to enable people who live alone to receive support and to recover. These place a significant emphasis on integration, making sure that vulnerable people have joined up care plans in which their own self-care is supported, and ensuring good communication and engagement of family and friends who may well not live with the patient. In many cases this involves collaboration with voluntary and community based networks that can provide timely voluntary assistance for people who may live alone.
The Government has provided £700 million this year to help the NHS cope with winter pressures. This funding will provide more bed space and pay for additional clinical staff, as well as measures to prevent delayed discharges of patients. A percentage of this money is being spent to secure joint health and care solutions to safe discharge. The Government has created the Better Care Fund, now worth £5.3 billion, to promote integration across health and care. Better Care Fund plans will also contribute to reduced admissions and delayed discharge. The Social Care Action fund has committed £2 million to scale up and test social action that impacts on admissions and discharge.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they will require the Care Quality Commission to publish specific ethnic data about detainees under the Mental Health Acts in its next Annual Report due to be laid before Parliament in February 2015; and if not, why not.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. The CQC is required to publish an annual report on the use of the powers of detention in the Mental Health Act 1983. In its role as an independent regulator it is for CQC to use its expertise to determine how it assesses and reports on the use of these powers.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they have made any assessment of the extent of bed blocking in the National Health Service, its impact on the ability of hospitals to make essential admissions and the appropriate initiatives necessary to enable the discharge of patients from hospital.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The numbers of delayed transfers from hospital is closely monitored. The impact of delays on wider hospital performance is assessed by System Resilience Groups in each local area and used in the development of their plans. The initiatives necessary to enable timely discharge and reduce admissions are included in the Operational Resilience and Capacity Planning Guidance and in the conditions for the Better Care Fund. For example both require the National Health Service and local government to implement seven day working to facilitate timely discharge.
The Government has provided £700 million this year to help the NHS cope with winter pressures, which will provide more bed space and pay for additional clinical staff, as well as measures to prevent delayed discharges of patients. This means the NHS can better plan for seasonal peaks and troughs in demand whilst recognising the need to balance its books and put in place sustainable services that deliver for patients year round. The Government has created the Better Care Fund, now worth £5.3 billion, to promote integration across health and care. Better Care Fund plans will also contribute to reduced admissions and delayed discharge.
Asked by: Lord Ouseley (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 causes of suicides among young people; and what action they propose to reduce such fatalities by providing more effective and quicker access to mental health services.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The causes of suicides are not currently collected but the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness at the University of Manchester will be setting up a national investigation into suicides by young people under 25, which will be covering antecedents such as bullying, use of social media & contact with services. This investigation will be funded by National Health Service England and is due to begin in April 2015.
NHS England and the Department have set up a Taskforce to look into the complex system of provision and commissioning of children and young people’s mental health services. The Taskforce is considering ways to improve access and create services that are more responsive to children’s needs. Additional funding this year is being invested into improving specialised, in-patient mental health services for children and young people. This will help to fund additional bed capacity and case management will also be improved.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government why waiting times for children referred to Child and Adolescent Mental Health Services have increased; and what action they will take to reduce waiting times.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Information on waiting times for Child and Adolescent Mental Health Services is not collected centrally. There is anecdotal evidence of increasing waiting times in some areas. We do not know whether or not this is due to an increase in referrals or the prevalence of mental health conditions but will be seeking further information by commissioning a survey into the prevalence of mental illness in children and young people.
NHS England and the Department have set up a Taskforce to look into the complex system of provision and commissioning of children and young people’s mental health services. The Taskforce is considering ways to improve access and create services that are more responsive to children’s needs. Additional funding this year is being invested into improving specialised, in-patient mental health services for children and young people. This will help to fund additional bed capacity and case management will also be improved.
Achieving Better Access to Mental Health Services by 2020 announced improvements that will be made to services for patients with emerging psychosis, including setting the first ever waiting time standard in mental health from April 2015. It also sets out a longer term ambition to extend waiting time standards across all mental health services by 2020.