Asked by: Iain Wright (Labour - Hartlepool)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the average waiting time is for autistic diagnosis in each clinical commissioning group area.
Answered by Alistair Burt
The Department has discussed with NHS England the difficulties that people on the autistic spectrum can have in getting an appropriate diagnosis in a timely manner. With support from the Department, NHS England and the Association of Directors of Social Services will undertake a series of visits to clinical commissioning groups (CCGs) to gather information that can be shared between areas that have arrangements in place to meet National Institute for Health and Care Excellence (NICE) Quality Standard 51 Autism: support for commissioning, and those that do not, with the aim of supporting more consistent provision. These NICE guidelines already recommend that there should be a maximum of three months between a referral and a first appointment for a diagnostic assessment for autism. We expect the National Health Service to be working towards meeting the recommendations.
NHS England has also been working with the Health and Social Care Information Centre to develop the Mental Health Minimum Data Set. This will include provision for the diagnosis of autism to be recorded. This mandatory data set will, for the first time, provide data about diagnosis rates. The data will be published and available for everyone to use to support and develop services. NHS England has a commitment, over the next five years, to improve waiting times and this data will be invaluable for this. Information on average waiting times for autistic diagnosis in each clinical commissioning group area is not collected centrally.
The Department issued new statutory guidance in March this year for local authorities and NHS organisations to support the continued implementation of the 2010 Autism Strategy, as refreshed by its 2014 Think Autism update. This guidance sets out what people seeking an autism diagnosis can expect from local authorities and NHS bodies including general practitioners.
We are due to consult on how we set the mandate to NHS England prior to publication of the mandate itself. The mandate will be published following the Government’s Spending Review which is due to complete on 25 November.
Asked by: Iain Wright (Labour - Hartlepool)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will make it his policy to introduce a target of a maximum of three months between being referred for a diagnostic assessment for autism and a first appointment.
Answered by Alistair Burt
The Department has discussed with NHS England the difficulties that people on the autistic spectrum can have in getting an appropriate diagnosis in a timely manner. With support from the Department, NHS England and the Association of Directors of Social Services will undertake a series of visits to clinical commissioning groups (CCGs) to gather information that can be shared between areas that have arrangements in place to meet National Institute for Health and Care Excellence (NICE) Quality Standard 51 Autism: support for commissioning, and those that do not, with the aim of supporting more consistent provision. These NICE guidelines already recommend that there should be a maximum of three months between a referral and a first appointment for a diagnostic assessment for autism. We expect the National Health Service to be working towards meeting the recommendations.
NHS England has also been working with the Health and Social Care Information Centre to develop the Mental Health Minimum Data Set. This will include provision for the diagnosis of autism to be recorded. This mandatory data set will, for the first time, provide data about diagnosis rates. The data will be published and available for everyone to use to support and develop services. NHS England has a commitment, over the next five years, to improve waiting times and this data will be invaluable for this. Information on average waiting times for autistic diagnosis in each clinical commissioning group area is not collected centrally.
The Department issued new statutory guidance in March this year for local authorities and NHS organisations to support the continued implementation of the 2010 Autism Strategy, as refreshed by its 2014 Think Autism update. This guidance sets out what people seeking an autism diagnosis can expect from local authorities and NHS bodies including general practitioners.
We are due to consult on how we set the mandate to NHS England prior to publication of the mandate itself. The mandate will be published following the Government’s Spending Review which is due to complete on 25 November.
Asked by: Iain Wright (Labour - Hartlepool)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what choice NHS England gives patients at risk of self-harm to refuse to accept treatment from psychiatrists on the ground of their gender; and if he will make a statement.
Answered by Alistair Burt
The Department has not issued such guidance. However, the National Institute for Health and Care Excellence published ‘Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care’ in July 2004. The guidance states that: “All people who have self-harmed should be assessed for risk”. It also sets out that that: “Following psychosocial assessment for people who have self-harmed, the decision about referral for further treatment and help should be based upon a comprehensive psychiatric, psychological and social assessment, including an assessment of risk, and should not be determined solely on the basis of having self-harmed”.
NHS England will do its best to facilitate patient choice. Most mental health care is provided by a multidisciplinary team made up of a number of members. The psychiatrist may be able to work jointly with a professional of another gender or through/via that professional in order to provide acceptable and appropriate care.
The provision of such choice must be placed in the context of the management of a specific patient. The capacity of the patient to make such a choice may need to be considered. If the patient is at high risk and is assessed to lack capacity to refuse appropriate treatment then it may be in their best interest to override that particular choice.
Patients, or parents of children, may refuse treatment on the grounds religious or moral beliefs. The General Medical Council states that where this happens, clinicians should discuss their concerns and look for treatment options that will accommodate their beliefs.
Patients must provide consent prior to receiving medical interventions. Under the Mental Capacity Act (2005), where a patient lacks capacity to consent, healthcare professionals can provide treatment if they believe it is in the person’s best interests. However, the clinicians must take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.
Under the Mental Health Act (1983), people with certain mental health conditions can be compulsorily detained and treated at a hospital or psychiatric clinic without their consent, if deemed necessary.
If the person lacks capacity, which is defined as the ability to understand information and use it to make a decision, and has not previously expressed their wishes, their mental health condition may be treated without consent, as may any related conditions, such as those resulting from self-harm.
In an emergency, clinicians can provide treatment that is immediately necessary to save life or prevent deterioration in health without consent.
With regard to patient choice in mental health, since 2014, patients have been able to exercise choice in mental health on a similar basis to physical health. Patients who are referred for a first outpatient appointment, have the right to choose the provider, and a team led by a named consultant or mental health professional. The guidance can be found on the NHS England website at:
http://www.england.nhs.uk/ourwork/qual-clin-lead/pe/bp/guidance/
More information about patient consent can be found on the NHS Choices website, at:
http://www.nhs.uk/Conditions/Consent-to-treatment/Pages/Capacity.aspx
Asked by: Iain Wright (Labour - Hartlepool)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what guidance his Department has issued to NHS organisations on patient safety checks for patients at risk of self-harm; and what steps his Department takes to ensure such guidance is complied with.
Answered by Alistair Burt
The Department has not issued such guidance. However, the National Institute for Health and Care Excellence published ‘Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care’ in July 2004. The guidance states that: “All people who have self-harmed should be assessed for risk”. It also sets out that that: “Following psychosocial assessment for people who have self-harmed, the decision about referral for further treatment and help should be based upon a comprehensive psychiatric, psychological and social assessment, including an assessment of risk, and should not be determined solely on the basis of having self-harmed”.
NHS England will do its best to facilitate patient choice. Most mental health care is provided by a multidisciplinary team made up of a number of members. The psychiatrist may be able to work jointly with a professional of another gender or through/via that professional in order to provide acceptable and appropriate care.
The provision of such choice must be placed in the context of the management of a specific patient. The capacity of the patient to make such a choice may need to be considered. If the patient is at high risk and is assessed to lack capacity to refuse appropriate treatment then it may be in their best interest to override that particular choice.
Patients, or parents of children, may refuse treatment on the grounds religious or moral beliefs. The General Medical Council states that where this happens, clinicians should discuss their concerns and look for treatment options that will accommodate their beliefs.
Patients must provide consent prior to receiving medical interventions. Under the Mental Capacity Act (2005), where a patient lacks capacity to consent, healthcare professionals can provide treatment if they believe it is in the person’s best interests. However, the clinicians must take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.
Under the Mental Health Act (1983), people with certain mental health conditions can be compulsorily detained and treated at a hospital or psychiatric clinic without their consent, if deemed necessary.
If the person lacks capacity, which is defined as the ability to understand information and use it to make a decision, and has not previously expressed their wishes, their mental health condition may be treated without consent, as may any related conditions, such as those resulting from self-harm.
In an emergency, clinicians can provide treatment that is immediately necessary to save life or prevent deterioration in health without consent.
With regard to patient choice in mental health, since 2014, patients have been able to exercise choice in mental health on a similar basis to physical health. Patients who are referred for a first outpatient appointment, have the right to choose the provider, and a team led by a named consultant or mental health professional. The guidance can be found on the NHS England website at:
http://www.england.nhs.uk/ourwork/qual-clin-lead/pe/bp/guidance/
More information about patient consent can be found on the NHS Choices website, at:
http://www.nhs.uk/Conditions/Consent-to-treatment/Pages/Capacity.aspx