Acquired Brain Injury

Debate between John Hayes and Caroline Dinenage

Thursday 6th February 2020 Westminster Hall

[Caroline Dinenage]

The hon. Gentleman is absolutely right to raise that issue. NHS England has a veterans trauma network, which delivers comprehensive medical care to veterans, including those suffering from brain trauma. It does excellent work, but there are also many individual charities up and down the country that work to support veterans who may not have been diagnosed; they may have been diagnosed with post-traumatic stress disorder or something else, but never actually had the original head injury diagnosed.

Almost as if to highlight the fact that this is a hugely cross-Government issue and the inadequacy of Ministers working in their individual silos, I will today be able to focus massively only on the issues relevant to our health service, but I will try to come on to a lot of the questions that right hon. and hon. Members asked.

[Sir John Hayes]

I am extremely grateful to the Minister for giving way. We had meetings as an all-party group with the former Chancellor of the Duchy of Lancaster, the former right hon. Member for Aylesbury. I believe that at that point there were suggestions, at least, that a Cabinet Office piece of work would be initiated. Can we take it from the Minister’s assurances that she will write to the Cabinet Office colleagues who are now responsible for these matters and copy that letter to participants in this debate?

[Caroline Dinenage]

Yes, I am very happy to commit to doing that.

Before I go on to talk about the health implications of ABI, I want to deal with a couple of other things. They are not within my realm of expertise, but I want to touch on them.

The hon. Member for Mitcham and Morden spoke about the Headway brain injury identity cards—how important they are and how important it is that they are recognised across the criminal justice system. I wanted to mention how Headway has been integral in partnering NHS England’s health and justice liaison and diversion services programme team, to provide workshops in London and Leeds to raise the awareness of the prevalence of ABI within criminal justice populations. The objectives were designed in a “train the trainer” format, so that the attendees could return to their services and cascade the learning on how to identify people with brain injury, how to identify the brain injury cards that Headway has brought forward and how to understand the implications. I thought that was quite positive.

My right hon. Friend the Member for Hemel Hempstead was right to mention the positive progress that has been made in some sports. The Rugby Football Union’s Headcase campaign and the British Horseracing Authority have also made great strides in this area. However, he was also right to say that other sports have a long way to go.

The hon. Member for Rhondda spoke about trauma centres. As he knows, in 2012 22 regional trauma networks were developed across England to ensure that those with the most serious brain injuries received the best care. Two years after their introduction, an independent audit showed that patients had a 30% improved chance of surviving severe injuries. Since then, as he says, the network has saved literally hundreds of lives.

For people who have ABI, neurorehabilitation that is timely and appropriate to their circumstances is a massively important part of their care. Access to high-quality rehabilitation saves money and, more importantly, significantly improves outcomes for patients. NHS England commissions specialised rehabilitation services nationally for those patients with the most complex level of need. As we have already heard, trauma unit teams work to assess and develop a rehabilitation prescription for brain-injured patients. At the unit, patients can access care from specialists in rehabilitation medicine, whose expert assessment helps to inform the prescription.

These rehabilitation prescriptions are an important component of rehabilitation care, because they reflect the assessment of the physical, functional, vocational, educational, cognitive, psychological and social rehabilitation needs of a patient. The APPG argued that all patients should benefit from an RP; as I understand it, at discharge, all patients should have a patient-held record of their clinical information and treatment plan from admission as they move to specialist or local rehabilitation, supported by the RP. However, I take on board what the hon. Gentleman says about ensuring that the letter and the prescription itself are written in language that people can understand, are easily accessible and are available to them and their family members.

The “National Clinical Audit of Specialist Rehabilitation for Patients with Complex Needs Following Major Injury”, published in 2016, found that, on average, 81% of patients had a record of a rehabilitation prescription. That audit appears to have had a significant impact, because the latest data shows a rise to an average 95% completion rate. In April 2019, the third and final report of the Audit Commission to NHS England’s audit programme was published, and it is encouraging to see that 94% of patients accessing specialist rehabilitation have evidence of functional improvement.

However, the audit report also suggests that much more work needs to be done to ensure that all patients who could benefit from specialist rehabilitation can access it. Using data provided from participating centres, the audit’s authors estimate that the current provision caters for about 40% of those who need the services. To address the capacity issues highlighted, the audit makes a range of recommendations.

It is important to recognise that these audits play a massively valuable role in helping services to improve. They shine a light on variation and help to support services to best meet the needs of patients. However, there will always be different models of improving access to specialist rehabilitation, depending on the set-up of the services around the country. Therefore, local service providers and commissioners should review capacity in the pathways for specialist rehabilitation in the light of this audit, taking action where they can.

The majority of rehabilitation care is commissioned and managed locally, and NHS England has produced some documentation and services plans to help with that. “The Principles and Expectations for Good Adult Rehabilitation” describes what good rehabilitation care looks like and offers a national consensus on the services that people should expect. The NHS long-term plan has also set out some key actions on this, designed to improve care, treatment and support for people with long-term conditions such as ABI.

Community services, which play a crucial role in helping people remain as independent and well supported as possible, are going to receive significant investment, with £4.5 billion of new investment in primary and community care. Furthermore, NHS England has set out plans to roll out the NHS comprehensive model of personalised care, which includes self-care care planning, personal health budgets and social prescribing. It will reach 2.5 million people by 2023-24 and is particularly relevant to people with acquired brain injury. The model is currently implemented across one third of England, but by September 2018, more than 200,000 people had already joined the personalised care programme.

The hon. Member for Mitcham and Morden asked about free car parking. From April, all hospital trusts will be expected to provide parking to groups who may be frequent visitors. I interpret that to mean families visiting people who are in hospital for a long period of time, which I think is what she was asking me.

Oral Answers to Questions

Debate between John Hayes and Caroline Dinenage

Tuesday 29th October 2019 Commons Chamber

[Caroline Dinenage]

The hon. Lady is absolutely to raise that. CCGs are responsible for the commissioning of NHS audiology services, including the provision of hearing aids. We expect all CCGs to have regard to the NICE clinical guidance when commissioning services for their local population.

[Sir John Hayes (South Holland and The Deepings) (Con)]

With the Sheffield Children’s Hospital last night, I was reminded again that in childhood, dreams are made and die are cast, and through our senses, we come to terms with the world around us. As Dickens said, the best of all stories is a child’s story. Sometimes those stories are not happy ones initially, and deaf children in particular struggle and suffer as they come to terms with the world about them. Will the Minister ensure that every deaf child in Lincolnshire has not only an education, health and care plan, but all the innovations and technology that allow them to live their life to the full and cast a future as glorious as any of ours?

[Caroline Dinenage]

I certainly could not have put that more articulately than my right hon. Friend did, and he is absolutely right. In 2018, the Government provided contracts worth more than £25 million to help children with special educational needs and disability to access the right support. The Department for Education is reviewing the SEND commitment within that Department, but we are supporting it to do that in the Department of Health and Social Care to ensure that children get the care and support and educational support plans that they need.

Oral Answers to Questions

Debate between John Hayes and Caroline Dinenage

Thursday 31st January 2013 Commons Chamber

[Mr Hayes]

I never confirm what I am going to do about amendments until I have heard the arguments, and as I am sure the hon. Gentleman knows, it would be premature for me to consider his amendment in the House at this time and not in Committee. On the specifics of the issue, we have allowed an overlap between the renewables obligation and the new arrangements, specifically and particularly because we want businesses to be able to adapt to the new system.

[Caroline Dinenage (Gosport) (Con)]

4. What steps his Department is taking to tackle fuel poverty.

Oral Answers to Questions

Debate between John Hayes and Caroline Dinenage

Monday 18th June 2012 Commons Chamber

[Mr Hayes]

The Connexions service was roundly criticised for doing none of that. Connexions, over which the last Government presided, failed according to Ofsted, the Skills Commission inquiry into information, the Panel on Fair Access to the Professions, and the Edge survey. We will do better, because we understand that good-quality advice and guidance help people to change their lives by changing their life chances. Of course this is a challenge; it is a catharsis leading from failure to success.

[Caroline Dinenage (Gosport) (Con)]

Given the number of young people who are still not in education, employment or training, does the Minister agree that it is vital for young people to be made aware, throughout the education process, of the apprenticeships and the vocational and other opportunities that are available to them?

[Mr Hayes]

As I have said in the House before, for too long we convinced ourselves that the only means of gaining prowess came through academic accomplishment. Like William Morris and John Ruskin, I believe that technical tastes and talents deserve their place in the sun, and the careers service will highlight that so that people with such aspirations can achieve their full potential.

Oral Answers to Questions

Debate between John Hayes and Caroline Dinenage

Thursday 17th February 2011 Commons Chamber

[The Minister for Further Education, Skills and Lifelong Learning (Mr John Hayes)]

Volunteering is an important way of giving people a taster, which can then lead to employment or to further learning. I agree that we need to do more work on the matter, and I am very happy to discuss it further. As a result of the hon. Lady’s question, I shall ask my officials to come back to me, and then I shall return to the issue, through her, and to the House.

[Caroline Dinenage (Gosport) (Con)]

T8. What efforts is the Minister’s Department making to support and to promote the marine industry in the UK?