Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will take steps to ensure that best practice in palliative and end of life care is shared across the NHS.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Government recognises that access to high-quality palliative and end of life care can make all the difference to individuals and their loved ones. NHS England meets regularly with regional and system leaders, providing a forum for the sharing of best practice. In addition, there is a palliative and end of life care workspace available on the FutureNHS Collaborative Platform, which includes a range of resources, case studies, and discussion fora, with access to the platform available for anyone with a NHS.net email account.
NHS England has developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of their local population, enabling integrated care boards (ICBs) to put plans in place to address and track the improvement of health inequalities, and ensure that funding is distributed fairly, based on prevalence.
As of April 2024, NHS England is including palliative and end of life care in the list of topics for regular performance discussions between national and regional leads. These meetings will provide an additional mechanism for supporting ICBs to continue improving palliative and end of life care for their local population.
The Ambitions Framework, refreshed by the National Palliative and End of Life Care Partnership, which is made up of NHS England and 34 partner organisations with experience of, and responsibility for, end of life care, sets out the vision to improve end of life care through partnership and collaborative action between organisations at local level throughout England, by setting out six key ambitions.
Furthermore, the National Institute for Health and Care Excellence (NICE) has published guidance and quality standards on end of life care for adults, and children and young people. These are based on best practice in developing and delivering care and, while not statutory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to ensure that integrated care boards have clear accountability over their funding decisions for (a) hospices and (b) palliative and end of life care services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.
The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.
In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.
The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.
From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.
NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will provide financial support to integrated care boards to tackle regional inequalities in (a) hospice, (b) palliative and (c) end of life care services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.
The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.
In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.
The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.
From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.
NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions she has had with (a) clinicians, (b) hospice leaders and (c) academics on future funding requirements for hospice and end of life care.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.
The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.
In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.
The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.
From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.
NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she is taking steps to increase health literacy for services to support people at the end of life.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The National Health Service website and the NHS App are our main digital tools available to citizens, to support them in accessing services and making decisions about their health. Clinicians across the NHS also support patients’ health literacy by providing clear information, increasing patients’ knowledge, and sharing decision-making on their care.
Additionally, through the Voluntary Community Social Enterprise (VCSE) Health and Wellbeing Programme, the Department, NHS England, and the UK Health Security Agency work together with VCSE organisations to drive transformation of health and care systems, promote equality, address health inequalities, and help people, families, and communities to achieve and maintain wellbeing. The current projects include increasing health literacy through intersectional considerations at the end of life, digital inclusion, and barriers for those likely to be in the last year of life without a life-limiting diagnosis.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to encourage pregnant women to undertake smoking cessation programmes.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Smoking is the number one entirely preventable cause of ill-health, disability, and death in this country. It is responsible for 80,000 yearly deaths in the United Kingdom, and one in four of all UK cancer deaths. Smoking in pregnancy increases the risk of stillbirth, miscarriage, and sudden infant death.
As set out in Stopping the Start: our new plan to create a smokefree generation, we are establishing a financially incentivised scheme to help pregnant smokers and their partners to quit smoking, with smoking cessation support. This evidence-based intervention will encourage pregnant women to give up smoking, and remain smokefree throughout pregnancy and beyond, helping to improve the health and wellbeing of both mother and baby.
The objective is to have all maternity trusts that wish to participate in the scheme signed up by the end of 2024, so that all pregnant women who smoke in participating areas will be offered the opportunity to join the incentive scheme by December 2024.
This financial incentive scheme builds upon the NHS Long Term Plan’s ambition to ensure that all pregnant smokers can access behavioural support to quit from within maternity services, as well as additional funding for mass marketing campaigns on stopping smoking.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
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 vaping on the health of pregnant women; and whether she plans to take steps to encourage pregnant women to stop vaping.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Our health advice on vaping is clear, if you smoke, it is better to vape, but if you don’t smoke, you should never vape. Evidence to date suggests vaping is less harmful than smoking. Research funded by the National Institute for Health and Care Research finds that pregnant women who vaped, when compared to women who used Nicotine Replacement Therapy, were twice as likely to quit, and that both approaches were safer than smoking. Further information is available at the following link:
https://www.nature.com/articles/s41591-022-01808-0
To help pregnant smokers quit smoking, the Government is providing up to £10 million of investment over 2023/24 and 2024/25 via a financial incentives scheme. This evidence-based intervention, supported by behavioural support, will encourage pregnant women to quit smoking, and remain smokefree throughout pregnancy and beyond, helping to improve the health and wellbeing of both mother and baby.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
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 ensure that intensive therapy unit patients have access to rehabilitative therapies on their discharge from hospital.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Rehabilitation, and therapy-led reablement, are critical in ensuring that patients discharged on intermediate care pathways from acute settings receive appropriate support to recover.
As set out in the hospital discharge and community support guidance, local authorities and integrated care boards should ensure that, where appropriate, they commission rehabilitation, including therapy-led reablement, for those who need it.
Every acute hospital now has access to a care transfer hub. These hubs bring together professionals from the National Health Service and social care to ensure that patients with more complex needs have in place the most appropriate support package for their safe discharge.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will develop a (a) rehabilitation strategy and (b) single accountable lead in every NHS Trust and Integrated Care Board area.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
National Health Service bodies and local authorities should ensure local recovery, rehabilitation, and reablement services are commissioned effectively and sustainably, and meet the needs of their local population. This may be provided as part of intermediate care services, and should be done in collaboration with relevant organisations, including the voluntary and community sector, and care providers.
NHS England has published the Intermediate care framework for rehabilitation, reablement and recovery following hospital discharge, which recommends systems identify an Allied Health Professional lead to progress implementation of the new model, both within the hospital and in the community.
Integrated care boards have flexibility over the arrangements of their own governance, including board membership, and are able to go beyond the statutory minimums to appoint more local authority, NHS provider, or primary care representatives to board membership, in order to tackle local priority issues.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
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 (a) stigma and (b) gender norms on trends in the number of men accessing mental health services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS England’s Advancing Mental Health Equalities Strategy launched in September 2020, to assess inequalities in access, including those based on gender, and to set out guidance on how services should be taking this into account.
Fundamentally, this strategy aims to ensure that access to the timely, high-quality mental healthcare as described in the NHS Long Term Plan is equitable, by equipping systems with the tools and enablers they need to bridge the gaps between people, such as men, faring worse than others in mental health services.
Middle-aged men are identified in Suicide prevention in England: 5-year cross-sector strategy, as a priority group for action. The strategy acknowledges that stigma can be a barrier to people seeking support, and it encourages local government, the National Health Service, and voluntary sector organisations to work together to encourage the reduction of this stigma.