Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps their Department is taking to support the Disability Confident scheme; how many officials in their Department work directly on supporting that scheme; what assessment they have made of the effectiveness of that work in supporting the (a) recruitment and (b) retention of disabled people in their Department; and what further steps they are taking to support their Department’s recruitment and retention of disabled people.
Answered by Andrew Stephenson
The Department proudly supports the Disability Confident Scheme, and has renewed its status as a Disability Confident employer. No single official works directly on the scheme, and in line with Civil Service guidance, we have moved away from standalone roles and teams to embed equality, diversity, and inclusion activities within existing human resource portfolios and roles. Activity to support the recruitment and retention of colleagues with a disability is undertaken across our recruitment, talent, and employee experience teams.
In the last calendar year, 11.3% of successful applicants applied under the Disability Confident Scheme. This is a slight increase from last year, at 10.9%. We additionally review our disability representation rates on a regular basis to monitor the impact of our recruitment practices and policy changes. We also have dedicated staff networks to support our disabled employees and celebrate achievements. Turnover of permanent employees who have declared they have a disability is currently approximately 6%, which is significantly lower than the average permanent staff turnover of colleagues who do not have a declared disability.
In 2023, we launched a new Workplace Adjustments policy, process, and passport. The new process is designed to ensure everyone in the Department can access the support they need as easily and quickly as possible via a person-centred approach that identifies and seeks to remove workplace barriers.
We also delivered several talent schemes that can assist in supporting the retention and development of disabled colleagues. This includes Beyond Boundaries, a 12-month programme for the Senior Executive Officer grade and below, to support candidates in reaching their full potential. As part of the programme, to support disability positive action, last year we ringfenced six job places out of 30, based on the proportionality of our disabled workforce, the People Survey, and recruitment data. We expect to take similar action this year.
In addition, the Future Leaders Scheme (FLS) is a 12-month accelerated development scheme for Grade 6 or 7 colleagues, who have the potential to progress to the Civil Service’s most senior and critical leadership roles. There is an option for those candidates who declare a disability or long-term health condition, or both, to enrol on the Disability Empowers Leadership Talent Association (DELTA) integrated scheme. In 2022, we had four candidates participate in DELTA out of the 21 successful FLS candidates, and two out of 26 in 2021, as per the data from the Cabinet Office. It should be noted that due to the sensitive nature of the programmes, not all participants are comfortable in being open about participation in DELTA, especially those with disabilities who have yet to disclose this to their colleagues or managers.
Finally, the Department’s mutual mentoring programme encourages underrepresented groups, including colleagues with disabilities, to mentor senior civil service colleagues to help increase the engagement and retention of underrepresented staff, and increase cultural intelligence in senior leaders.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many learning disability nurse vacancies there are as of 30 April 2024.
Answered by Andrew Stephenson
The Department does not hold vacancy rates that are granular enough to identify rates for learning disability nurses. However, NHS England publishes quarterly vacancy statistics for registered nurses working in National Health Service trusts, which are available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-survey
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department takes to involve people with learning disabilities in the development and implementation of measures to reduce their health inequalities.
Answered by Maria Caulfield
We recognise the importance of involving people with a learning disability in policy development and implementation to support in reducing the health inequalities they experience. We aim to do this in a range of ways within the Department, some of which are set out below.
Experts by experience are members of governance structures, such as the Oliver McGowan Code of Practice Board. This Board has supported the development of the Oliver McGowan Code of Practice. The Code will guide registered health and care providers to meet their statutory requirement to ensure their staff receive learning disability and autism training appropriate to their role. The Code sets an expectation that training is co-produced and co-delivered by people with a learning disability and autistic people. The draft Code was publicly consulted on, including an easy read version to ensure accessibility.
In developing the Building the Right Support (BtRS) Action Plan, published in July 2022, we sought expertise, advice and challenge from experts by experience. The Plan brings together actions across government and public services to strengthen community support and reduce overall reliance on specialist mental health inpatient care for people with a learning disability and autistic people.
The BtRS Advisory Group was established to improve direct engagement with experts by experience. The Group developed an independent, co-produced report on ‘What Good Looks Like’ in terms of community services. The final report has a specific focus on actions that integrated care systems should take to ensure the best possible community support for people with a learning disability and autistic people.
Additionally, the Department jointly manages the Health and Wellbeing Alliance which is a partnership between representatives in the health and care system and sector. This enables the sector, including people with a learning disability, to share their expertise at a national level with the aim of improving services and policy development.
Integrated care boards are now expected to have an Executive Lead on learning disability and autism. As part of their role, the Executive Lead will support the Board in championing co-production of policies and service delivery and recognising the value of people’s lived experiences. NHS England has published guidance on this role, which is available at the following link:
https://www.england.nhs.uk/long-read/executive-lead-roles-within-integrated-care-boards/
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 30 April 2024 to Question 23729 on the National Learning Disability Board, for what reason the National Learning Disability Board was disbanded in 2016.
Answered by Maria Caulfield
In 2016, following a reorganisation and re-prioritisation exercise within the Department, the decision was made to disband the National Learning Disability Board and integrate its objectives into wider programmes and activities aimed at improving outcomes for this population. The Department keeps its governance structures under periodic review.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much her Department spent on autism assessments in each of the last five years; how much funding her Department has allocated to autism assessments in each of the next three years; and what recent assessment her Department has made of the adequacy of that funding in meeting the target waiting time for such an assessment.
Answered by Maria Caulfield
Information on the total spend on autism assessments is not held centrally. NHS England is responsible for funding allocations to integrated care boards (ICBs), which are responsible for commissioning services using these core allocations to meet the needs of their local populations, including autism assessment services. The following table shows the total baseline expenditure in ICBs for learning disability and autism services over the last five years, disaggregated for autism services where possible:
| Learning disability | Autism services | Unseparated learning disability and autism services | Total |
2019/20 | N/A | N/A | £1,809,200,000 | £1,809,200,000 |
2020/21 | N/A | N/A | £2,285,600,000 | £2,285,600,000 |
2021/22 | £85,800,000 | £3,700,000 | £2,268,300,000 | £2,357,900,000 |
2022/23 | £625,800,000 | £27,100,000 | £1,928,800,000 | £2,581,700,000 |
2023/24 | £926,000,000 | £47,100,000 | £1,928,800,000 | £2,904,600,000 |
In addition, specific funding has been allocated to ICBs in 2023/4 and 2024/25 from the Service Development Funding, to improve autism assessment waiting lists and pathways. The following table shows information on the additional national funding allocated to ICBs by NHS England, over each of the last five years, to improve autism assessment waiting lists and pathways:
| Service Development Funding via the NHS Long Term Plan Transformation Funding | Spending Review 2021 via the COVID-19 Recovery Fund | Total funding for autism assessment pathways |
2019/20 | N/A | N/A | N/A |
2020/21 | N/A | N/A | N/A |
2021/22 | £2,500,000 | £14,500,000 | £17,000,000 |
2022/23 | £5,000,000 | N/A | £5,000,000 |
2023/24 | £4,200,000 | N/A | £4,200,000 |
2024/25 | £4,300,000 | N/A | £4,300,000 |
Notes:
The NHS Operational and Planning Guidance 2024/25 asks local systems to improve autism assessment pathways, through implementation of the NHS England autism assessment national framework. Allocations from 2025/26 onwards are subject to future decisions on spending. Further information on the operational and planning guidance and national framework is available respectively at the following links:
https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/
A specific assessment of the adequacy of funding in meeting the National Institute for Health and Care Excellence’s waiting time standard for autism assessments has not been made. However, autism waiting times statistics are published on a quarterly basis. The total number of people with an open referral, where the diagnosis not yet completed, for suspected autism has increased by 47%, from 117,032 in December 2022 to 172,022 in December 2023. In December 2023, it was estimated that only 5.9% of patients whose referrals have been open in the system for at least 13 weeks received their first contact appointment within 13 weeks.