Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans she has to update the Building the Right Support action plan.
Answered by Maria Caulfield
There are no current plans to update the Building the Right Support Action Plan as this is a live document and contains a number of commitments which are due to complete after March 2024.
The Building the Right Support Delivery Board continues to monitor both the implementation of the action plan and the relevant data to drive progress on reducing the number of people with a learning disability and autistic people in mental health inpatient settings, identifying new actions and mitigations as appropriate.
Asked by: Robert Buckland (Conservative - South Swindon)
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 25 October 2023 to Question 202692 on Autism and Learning Disability: Community Care, what the allocation was to each Integrated Care Board for Community/ CYP key workers.
Answered by Maria Caulfield
NHS England made a funding allocation for learning disability and autism services, otherwise known as community and children and young people keyworker services, totalling £121.7 million in 2023/24. The following table shows the breakdown of this funding allocation by integrated care board (ICB):
ICB | Organisation Region | Funding allocation 2023/24 (£’000) |
Healthier Lancashire and South Cumbria ICB | North West | 3,964 |
South Yorkshire and Bassetlaw ICB | North East and Yorkshire | 3,044 |
Herefordshire and Worcestershire ICB | Midlands | 1,618 |
Mid and South Essex ICB | East of England | 2,427 |
Bedfordshire, Luton and Milton Keynes ICB | East of England | 1,963 |
Birmingham and Solihull ICB | Midlands | 3,197 |
Cumbria and North East ICB | North East and Yorkshire | 6,929 |
Joined Up Care Derbyshire ICB | Midlands | 2,276 |
Suffolk and North East Essex ICB | East of England | 2,119 |
Devon ICB | South West | 2,584 |
Lincolnshire ICB | Midlands | 1,627 |
Leicester, Leicestershire and Rutland ICB | Midlands | 2,119 |
Our Healthier South East London ICB | London | 3,954 |
Kent and Medway ICB | South East | 3,862 |
Hertfordshire and West Essex ICB | East of England | 2,969 |
East London Health and Care Partnership ICB | London | 4,356 |
North London Partners In Health and Care ICB | London | 3,287 |
Norfolk and Waveney Health and Care Partnership ICB | East of England | 2,280 |
Staffordshire and Stoke On Trent ICB | Midlands | 2,394 |
Frimley Health and Care ICB | South East | 1,435 |
Sussex Health and Care Partnership ICB | South East | 3,629 |
Shropshire and Telford and Wrekin ICB | Midlands | 1,074 |
Greater Manchester Health and Social Care Partnership ICB | North West | 6,623 |
Humber, Coast and Vale ICB | North East and Yorkshire | 3,618 |
Bath and North East Somerset, Swindon and Wiltshire ICB | South West | 1,848 |
Northamptonshire ICB | Midlands | 1,545 |
Gloucestershire ICB | South West | 1,267 |
Hampshire and The Isle Of Wight ICB | South East | 3,744 |
North West London Health and Care Partnership ICB | London | 4,924 |
Somerset ICB | South West | 1,242 |
Nottingham and Nottinghamshire Health and Care ICB | Midlands | 2,501 |
Cornwall and The Isles Of Scilly Health and Social Care Partnership ICB | South West | 1,304 |
Buckinghamshire, Oxfordshire and Berkshire West ICB | South East | 3,425 |
The Black Country and West Birmingham ICB | Midlands | 2,691 |
Cambridgeshire and Peterborough ICB | East of England | 1,769 |
Bristol, North Somerset and South Gloucestershire ICB | South West | 2,067 |
Dorset ICB | South West | 1,705 |
South West London Health and Care Partnership ICB | London | 3,031 |
West Yorkshire and Harrogate (Health and Care Partnership) ICB | North East and Yorkshire | 5,232 |
Coventry and Warwickshire ICB | Midlands | 2,011 |
Surrey Heartlands Health and Care Partnership ICB | South East | 2,034 |
Cheshire and Merseyside ICB | North West | 6,003 |
Asked by: Robert Buckland (Conservative - South Swindon)
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 adequacy of the (a) implementation of the Care Act 2014 for autistic adults and (b) extent to which statutory provisions for such adults under that Act are being met.
Answered by Maria Caulfield
We have not made any specific assessments. Under the Care Act 2014, it is the responsibility of local authorities to assess individuals’ care and support needs, including those of autistic adults, and, where eligible, for meeting those needs. A new duty on the Care Quality Commission (CQC) to assess local authorities’ delivery of their Care Act 2014 duties went live on 1 April 2023 and the formal assessment period has started. The CQC will examine how well local authorities deliver their Care Act duties, including those that apply to autistic people. This will increase transparency and accountability and, most importantly, drive improved outcomes for people who draw on care and support.
Our national autism strategy, published in July 2021, acknowledges the importance of autistic people being able to access community support, including social care, and that this should be available at the right time and tailored to their needs. The strategy was informed by a national call for evidence. A summary of the call for evidence findings was published alongside the strategy and included reported barriers to autistic people accessing social care.
We are currently updating the Autism Act Statutory Guidance to support the National Health Service and local authorities to deliver improved outcomes for autistic people. This will include setting out what local authorities must and should be doing to meet their duties under the Care Act for autistic adults. We expect to publish the updated statutory guidance this year, following public consultation.
Asked by: Robert Buckland (Conservative - South Swindon)
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 prevalence of barriers to autistic people accessing social care.
Answered by Maria Caulfield
We have not made any specific assessments. Under the Care Act 2014, it is the responsibility of local authorities to assess individuals’ care and support needs, including those of autistic adults, and, where eligible, for meeting those needs. A new duty on the Care Quality Commission (CQC) to assess local authorities’ delivery of their Care Act 2014 duties went live on 1 April 2023 and the formal assessment period has started. The CQC will examine how well local authorities deliver their Care Act duties, including those that apply to autistic people. This will increase transparency and accountability and, most importantly, drive improved outcomes for people who draw on care and support.
Our national autism strategy, published in July 2021, acknowledges the importance of autistic people being able to access community support, including social care, and that this should be available at the right time and tailored to their needs. The strategy was informed by a national call for evidence. A summary of the call for evidence findings was published alongside the strategy and included reported barriers to autistic people accessing social care.
We are currently updating the Autism Act Statutory Guidance to support the National Health Service and local authorities to deliver improved outcomes for autistic people. This will include setting out what local authorities must and should be doing to meet their duties under the Care Act for autistic adults. We expect to publish the updated statutory guidance this year, following public consultation.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will have discussions with her international counterparts on mutual recognition of dentistry schemes.
Answered by Andrea Leadsom
To practise in the United Kingdom, dentists and dental care professionals (DCPs) are required to hold registration with the General Dental Council (GDC). To be entered into the dentists register, an individual must hold a recognised UK dentistry qualification; an European Economic Area qualification recognised under European Union exit standstill arrangements; hold one of a small number of overseas qualifications awarded before 2001 and recognised under legacy arrangements; or they must sit the Overseas Registration Exam or Licence in Dental Surgery examinations to demonstrate they have suitable skill and experience to practise in the UK. Under legislative changes which came into force in March 2023, the GDC was granted the flexibility to recognise additional overseas qualifications as sufficient to achieve registration to practise in the UK. The Department will continue to discuss whether there are other qualifications or registration routes that could be considered with the GDC and other relevant partners as appropriate.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has had recent discussions with the General Dental Council on increased investment in the applications process for dentists with overseas qualifications.
Answered by Andrea Leadsom
The Department meets regularly with the General Dental Council (GDC) to discuss application and registration processes for dentists with overseas qualifications. The Department welcomes the GDC’s recent announcements that it is increasing the number of places available to sit the Overseas Registration Exam (ORE). The GDC has tripled the number of places on sittings of ORE Part 1 for all sittings from August 2023 to the end of 2024. The GDC has also added an additional sitting of ORE Part 2 in 2024, bringing the total number of sittings up to four.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many people with (a) autism and (b) a learning disability reside in a mental health inpatient unit that has most recently been rated as inadequate by the CQC; and for how many of those people have additional (i) safeguards and (ii) mitigations been put in place to monitor their (A) safety, (B) wellbeing and (C) treatment.
Answered by Maria Caulfield
The latest published Assuring Transformation data shows that there are 80 people with a learning disability and autistic people reported in a mental health inpatient setting which the Care Quality Commission (CQC) rates as inadequate. This is based on inpatient data at the end of August 2023, and CQC inspection ratings as of 2 October 2023.
Where, by exception, a person with a learning disability or autistic person is admitted into a setting rated as inadequate at the point of admission, additional safeguards and mitigations should be put in place. NHS England has established a process whereby any such admission should be notified to the relevant integrated care bord (ICB) Chief Executive Officer, National Health Service regional team and Host Commissioner and reported as an exception to the ICB Quality Board or equivalent. Information on specific safeguards and mitigations for individuals is not held centrally.
Each person with a learning disability and autistic person in a mental health hospital should have regular Care (Education) and Treatment Reviews in line with national policy.
Commissioner Oversight Guidance was published in February 2021, which sets out that people with a learning disability and autistic people who are in hospital outside their local area will be visited by the commissioner of their care regularly every six weeks for children and every eight weeks for adults.
In June 2023, we updated the Host Commissioner Guidance, this guidance sets out expectations for ICBs to act as a ‘host’ commissioner to provide additional oversight of care in mental health hospitals in their geographical area, where people with a learning disability and autistic people are cared for.
Asked by: Robert Buckland (Conservative - South Swindon)
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 15 May 2023 to Question 183773 on Autism and Learning Disability: Community Care, what analysis his Department undertook to identify the £121 million of funding allocation for the Building the right support programme in the 2023-24 financial year; and what estimate he has made of funding requirements for subsequent financial years.
Answered by Maria Caulfield
The £121 million of funding to improve community support for people with a learning disability and autistic people forms part of the wider NHS Long Term Plan (LTP) funding. The £121m allocation in 2023/24 was determined based upon consideration of the following:
Additionally, the following table shows a distribution to integrated care boards on a ‘fair shares’ basis, in line with the LTP trajectory for the learning disability and autism programme, increasing year on year up to the end of the LTP funding cycle:
Financial Year | 2020/21 (£) | 2021/22 (£) | 2022/23 (£) | 2023/24 (£) |
Community/CYP Keyworkers | 18,000 | 39,000 | 69,000 | 119,000 |
HOPE(S) | 1,000 | 2,000 | 2,000 | 2,000 |
Total | 19,000 | 41,000 | 71,000 | 121,000 |
Note: HOPE(S) is a training model commissioned by NHS England, which aims to embed good practice across inpatient services and reduce the use of long-term segregation and restrictive practices for people with a learning disability and autistic people.
Funding for 2024/25 will be confirmed in due course.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he plans to publish his Department's response to the independent report by RedQuadrant, entitled Building the Right support: an analysis of funding flows, published by his Department on 14 July 2022.
Answered by Maria Caulfield
There are no plans to publish a response to this report. The primary recommendations made in this report by RedQuadrant were used to inform the Building the Right Support Action Plan published in July 2022.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he plans to take to reduce the waiting list for autism assessments in Avon and Wiltshire.
Answered by Maria Caulfield
We expect integrated care boards (ICBs) to have due regard to relevant National Institute for Health and Care Excellence guidelines on autism when commissioning services. It is the responsibility of ICBs to make available appropriate provision
Each ICB in England is expected to have an Executive Lead for learning disability and autism, supporting the board in planning to meet the needs of its local population of people with a learning disability and autistic people, including in relation to appropriate autism assessment pathways. NHS England has published guidance on these roles.
On 5 April 2023, NHS England published a national framework and operational guidance for autism assessment services. This guidance will help the National Health Service improve autism assessment pathways and improve the experience for people referred to an autism assessment service.
In addition, NHS England publish quarterly data on how many people are waiting for an autism assessment and for how long. These are experimental statistics; however, the data does provide useful information nationally and locally to support local areas to improve their performance and to reduce assessment waiting times.