Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help reduce (a) assessment and (b) diagnosis waiting times for ADHD.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
It is the responsibility of integrated care boards to make appropriate provision available, to meet the health and care needs of their local population, including access to attention deficit hyperactivity disorder (ADHD) assessments, in line with relevant National Institute for Health and Care Excellence (NICE) guidelines. The NICE’s guidelines for ADHD diagnosis and management aim to improve the diagnosis of ADHD, as well as the quality of care and support people receive. The NICE’s guidelines do not recommend a maximum waiting time standard for ADHD diagnosis, either from referral for an assessment to receiving an assessment, a diagnosis, or a first contact appointment.
There is, at present, no single, established dataset that can be used to monitor waiting times for the assessment or treatment for ADHD nationally. The Department is exploring options to improve data collection and reporting on ADHD assessment waiting times, to help improve access to ADHD assessments in a timely way and in line with the NICE’s guideline. In support of this, the National Institute for Health and Care Research’s Policy Research Programme has commissioned a research project to provide insights into local ADHD diagnosis waiting time data collection.
NHS England is establishing a new ADHD taskforce alongside the Government, to improve care for people living with the condition. The new taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD, and help provide a joined up approach in response to concerns around rising demand for assessments and support.
Alongside the work of the taskforce, NHS England has announced that it will continue to work with stakeholders to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems who are trialling innovative ways of delivering ADHD services, to ensure best practice is captured and shared across the system.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her department is taking to improve retention rates of NHS maternity staff.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The NHS Long Term Workforce Plan sets out how to improve culture and leadership, to ensure that up to 130,000 fewer staff leave the National Health Service over the next 15 years. This includes: implementing actions from the NHS People Plan that have been shown to be successful; implementing plans to improve flexible opportunities for prospective retirees, and delivering the actions needed to modernise the NHS pension scheme; and committing to ongoing national funding for continuing professional development for nurses, midwives, and allied health professionals, so NHS staff are supported to meet their full potential. These measures apply across staff groups, including maternity staff.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she has taken to ensure that effective support is provided to autistic women (a) during and (b) after childbirth.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Health and Care Act 2022 requires Care Quality Commission registered providers, which includes maternity services, to ensure their staff receive specific training on learning disability and autism, appropriate to their role. We are rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to support this. This training will help to ensure that staff have the right skills and knowledge to provide safe and compassionate care, including how to provide reasonable adjustments for autistic people.
NHS England is also working to improve the use and recording of reasonable adjustments to make it easier for autistic people to use health services, by ensuring care is tailored appropriately. This includes the development of a Reasonable Adjustment Digital Flag, which will enable the recording of key information about a patient, including if a person is autistic, and their reasonable adjustment needs, to ensure support can be tailored appropriately.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many women and girls are waiting for (a) autism and (b) ADHD assessments in the London Borough of Lewisham; and what the average waiting time is for such assessments.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The information requested is not held centrally, but may be held by individual providers or integrated care boards (ICBs). However, some relevant information is available for autism assessments. In the NHS South East London ICB, in December 2023, there were a total of 1425 patients with an open suspected autism referral. The median waiting time of patients in this ICB with an open suspected autism referral, where their first care contact was in the quarter, was 545 days. Across England, in December 2023, 80,718 female patients had an open suspected autism referral.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to assess the healthcare needs of women with autism and ADHD during menopause.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
No specific assessment has been made. Menopause is a priority area within the Women’s Health Strategy, and the Department and National Health Service are implementing an ambitious programme of work to improve menopause care so all women, including those with autism and attention deficit hyperactivity disorder (ADHD), can access the support they need.
Integrated care boards (ICBs) are responsible for providing services that meet the needs of their local population. Every ICB is expected to have an Executive Lead for learning disability and autism, whose remit includes supporting the board in addressing the health inequalities that autistic people and people with a learning disability experience, and supporting equal access to care across all health services.
From 1 July 2022, the Health and Care Act 2022 requires Care Quality Commission registered providers to ensure their staff receive specific training on learning disability and autism, appropriate to their role. Since November 2022, over 1.7 million people have completed the first part of Oliver McGowan Mandatory Training on Learning Disability and Autism. In addition, NHS England is improving the use and recording of reasonable adjustments to ensure care is tailored appropriately for disabled people, including people with autism and ADHD.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of maternity staff leaving NHS employment on services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Department works with NHS England on a regular basis to review the numbers of staff working in National Health Service maternity services, and to identify any issues which could potentially impact services.
Growing, retaining, and supporting the maternity workforce to ensure that there are staff with the capacity and the right skills to deliver safe, personalised, and equitable care for women and babies is a key theme of NHS England’s Three Year Delivery Plan for Maternity and Neonatal Services. NHS England is also delivering a nursing and midwifery retention programme, supporting organisations in assessing themselves against a bundle of interventions aligned to the NHS People Promise, and to develop high-quality local retention improvement plans.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has had discussions with paediatricians on trends in the number of women diagnosed with (a) autism and (b) ADHD.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
My Rt hon. Friend, the Secretary of State for Health and Social Care has regular discussions on a wide range of matters with a wide range of people, including clinical staff. The National Institute for Health and Care Excellence’s (NICE) guidelines for autism and attention deficit hyperactivity disorder (ADHD) recognise that autism and ADHD may be under-diagnosed in women and girls. The NICE’s guideline on autism diagnosis for under 19-year-olds and the NICE’s guideline on ADHD, both set out that clinicians should pay attention to the under-diagnosis of girls, when assessing for suspected autism and ADHD. We expect integrated care boards (ICBs) and health professionals to have due regard to these guidelines. In April 2023, NHS England published all age autism guidance, which aims to improve outcomes and the quality of autism assessment pathways for everyone. This guidance is available at the following link:
https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/
With respect to autism, data shows that we are now seeing an increase in referrals for female diagnoses, suggesting that there is an increased awareness of the presentation of autism in women and girls. In England, as of December 2023, of the 172,022 patients with an open suspected autism referral, 52% were male and 47% were female. The number of female patients with an open referral for suspected autism is increasing more than for male patients, with the proportion of female patients having increased steadily from 36% in June 2020.
There is, at present, no single, established dataset that can be used to monitor waiting times for assessments and diagnosis of ADHD nationally. Although data is not held centrally, it may be held locally by individual National Health Service trusts or ICBs. NHS England is establishing a new ADHD taskforce alongside the Government, to improve care for people living with the condition. Alongside the work of the taskforce, NHS England has also announced that it will continue to work with stakeholders to develop a national ADHD data improvement plan.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will commission research into the reasons for which autistic women are more likely to suffer from premenstrual dysphoric disorder throughout their lives.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is not currently funding any specific research to understand the reasons why autistic women are more likely to suffer from premenstrual dysphoric disorder, but welcomes funding applications for research into any aspect of human health. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will commission research into the impact of (a) autism and (b) ADHD on women.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is currently funding research to address measurement bias in the assessment of the presentation of autism in women, and to develop a new psychometric tool assessing the female-dominant phenotype of autism. The NIHR previously funded a study to improve the accuracy and efficiency of autism assessment for adults which, while not specific to women, will be relevant to their experiences of receiving a diagnosis. The NIHR has also funded research into topics that impact autistic individuals differently, for example how to adapt suicide safety plans to address self-harm, suicidal ideation, and suicide behaviours in autistic adults.
The NIHR welcomes funding applications for research into any aspect of human health, including the impact of autism and attention deficit hyperactivity disorder on women. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. In all disease areas, the amount of NIHR funding depends on the volume and quality of scientific activity.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will commission research into the impact of hormonal changes on neurodiverse women throughout their lives.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is not currently funding any specific research into the impact of hormonal changes on neurodiverse women, but welcomes funding applications for research into any aspect of human health. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.