Asked by: Derek Twigg (Labour - Halton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many children in the Borough of Halton are waiting for (a) autism and (b) ADHD assessments; and what the average waiting times are for such assessments.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Data on the number of children on a waiting list for an assessment for attention deficit hyperactivity disorder (ADHD) is not held centrally, but may be held locally by individual National Health Service trusts or commissioners. The Cheshire and Merseyside integrated care board (ICB) has provided data on the number of children awaiting an ADHD assessment, and state that at the end of January 2024, there were 230 children awaiting an assessment in Halton. The longest wait time for an ADHD assessment in Halton is 53 weeks, with an average wait time for assessment and outcome or diagnosis of 46 weeks.
The Department is exploring options for improving national data collection and reporting on waiting times for ADHD assessments, to help improve access to ADHD assessments in a timely way, and in line with the National Institute for Health and Care Excellence’s guideline on ADHD. The National Institute for Health and Care Research has commissioned a research project to provide initial insights into local ADHD assessment waiting time data collection.
With respect to autism, NHS England publishes data on how many people are waiting for an autism diagnosis and for how long, which provides useful information nationally and locally to support local areas in improving their performance and reducing assessment and diagnosis waiting times. Data is not available publicly for the Borough of Halton, but is available publicly for the Cheshire and Merseyside ICB, and therefore the ICB has provided data on numbers of children waiting for autism assessments in Halton. As of the end of January 2024, they state there were 848 children awaiting autism assessment in Halton. The longest wait time for an autism assessment panel and outcome or diagnosis in Halton is 107 weeks.
The NHS Cheshire and Merseyside ICB advises that it is working with providers to increase capacity, and has put waiting list initiatives in place to help reduce waiting times for autism assessments. The ICB also commissions pre and post diagnosis support for children and young people on autism and ADHD waiting lists, and is planning on commissioning a coordinator role to support families whilst they are waiting for neurodevelopmental assessments.
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 has had discussions with pediatricians on trends in the number of young children diagnosed with (a) autism and (b) ADHD.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Secretary of State for Health and Social Care has regular discussions on a wide range of matters with a wide range of people, including clinical staff.
Data on numbers of diagnoses for autism is not held centrally. However, data on referrals for assessment shows that the number of patients aged between zero and 17 years old with an open suspected autism referral in September 2023 was 91,729, which is an increase of 56% since September 2022, and an increase of almost 700% since April 2019, when data collection began. Data on children and young people in this dataset is expected to be an underestimate. Caution should be used when interpreting these statistics since they are experimental statistics.
In respect of attention deficit hyperactivity disorder (ADHD), there is currently no single, established dataset that can be used to monitor waiting times for assessment and numbers of diagnoses nationally. Although data is not held centrally, it may be held locally by individual National Health Service trusts or commissioners. We are exploring options to improve data collection and reporting on ADHD assessment waiting times to help improve access to ADHD assessments in a timely way and in line with the National Institute for Health and Care Excellence (NICE) guidelines. The National Institute for Health and Care Research has commissioned a research project to provide initial insights into local ADHD assessment waiting times data collection. NHS England is also currently scoping a national programme of work on ADHD.
Asked by: Lord Touhig (Labour - Life peer)
Question to the Department for Education:
To ask His Majesty's Government what assessment they have made of the current level of training on autism that teachers receive; and what consideration they have given to introducing whole school staff training on autism.
Answered by Baroness Barran - Parliamentary Under-Secretary (Department for Education)
I refer the noble Lord to the answer of 22 February 2024 to Question 14564.
Asked by: Lord Touhig (Labour - Life peer)
Question to the Department for Education:
To ask His Majesty's Government what consideration they have given to introducing national guidance on how to adapt school environments to support the needs of autistic pupils.
Answered by Baroness Barran - Parliamentary Under-Secretary (Department for Education)
I refer the noble Lord to the answer of 12 February 2024 to Question 11638.
Asked by: Lord Touhig (Labour - Life peer)
Question to the Department for Education:
To ask His Majesty's Government what assessment they have made of the National Autistic Society's Cullum Centres; and what consideration they have given to rolling out the Cullum model in mainstream schools across the country.
Answered by Baroness Barran - Parliamentary Under-Secretary (Department for Education)
The department works closely with the National Autistic Society (NAS) and is aware of the Cullum Centres and the evaluation currently being undertaken by Goldsmiths, University of London, but has made no assessments of the Centres to date. The department engages regularly with NAS and other autism stakeholders to understand the issues faced by autistic children and young people and to understand possible solutions.
The department supports local authorities to provide sufficient school places for all children, including autistic children, through capital funding. The department has published over £1.5 billion of High Needs Provision Capital Allocations for the 2022/23 and 2023/24 financial years. This funding is allocated to local authorities to support them to deliver new places and improve existing provision for children and young people with special educational needs and disabilities (SEND), including those with autism, or who require alternative provision (AP). This funding forms part of the department's transformational investment of £2.6 billion in new high needs provision between 2022 and 2025 and is on top of the department’s ongoing delivery of new special and AP free schools.
Reaching over 70% of schools and further education (FE) colleges, the Universal Services programme helps the school and FE workforce to identify and meet the needs of children and young people with SEND earlier and more effectively. The programme will also help the schools to successfully prepare children and young people for adulthood, including employment. Universal offers online training, professional development groups, bespoke school and college improvement projects, sector-led research, autism awareness training and an embedded focus on preparation for adulthood, including employer-led webinars for college staff. The programme commenced in May 2022 and runs until Spring 2025, with a budget of nearly £12 million.
The department has begun collecting data from local authorities on available capacity in special schools, SEND units and resourced provision, along with corresponding forecasts of demand for these places. This data will help the department to effectively support local authorities to fulfil their statutory duty to provide sufficient specialist places.
Asked by: Munira Wilson (Liberal Democrat - Twickenham)
Question to the Department for Education:
To ask the Secretary of State for Education, if she will make an assessment of the potential (a) merits of implementing a mental health support team plus model in schools and (b) impact of such an approach on the mental wellbeing of children and young people.
Answered by David Johnston - Parliamentary Under-Secretary (Department for Education)
In December 2017, the government published a consultation to gather views on the proposals set out in its publication, ‘Transforming Children and Young People’s Mental Health Provision’. The green paper is available at: https://assets.publishing.service.gov.uk/media/5a823518e5274a2e87dc1b56/Transforming_children_and_young_people_s_mental_health_provision.pdf.
The government response to the consultation was published in July 2018: https://assets.publishing.service.gov.uk/media/5b583d30ed915d0b6985cc21/government-response-to-consultation-on-transforming-children-and-young-peoples-mental-health.pdf. It outlined a commitment to implement three core proposals that the Department of Health and Social Care (DHSC), NHS England, the Department for Education and Health Education England would jointly take forward, one of which was to establish new Mental Health Support Teams (MHSTs), working in or near schools and colleges. MHSTs add value to support that settings already have in place, and more broadly are part of a wider programme of mental health transformation set out in the NHS Long Term Plan.
As of 31 March 2023, MHSTs covered 35% of pupils in schools and learners in further education settings in England. We are extending coverage of MHSTs to an estimated 44% of pupils and learners by the end of this financial year, and at least 50% by the end of March 2025.
The Early Evaluation of the Children and Young People’s Mental Health Trailblazer programme, published by the National Institute for Health Research in February 2023, revealed substantial progress in MHST implementation, despite challenges presented by the COVID-19 pandemic. Although this was a process evaluation, early impacts include improved school and college staff knowledge and confidence in dealing with mental health issues, improved access to support for some groups, and improvements in partnership working. The study also found that the experiences of the majority of children and young people who had contact with an MHST were positive. The early evaluation is available here: https://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/BRACE/trailblazer.pdf.
Work is already underway with partners to ensure that learnings are used to inform current and future practice. Since the MHST Trailblazers became operational in 2018/19, the Education Mental Health Practitioner curriculum has been strengthened in response to feedback on needs such as learning disabilities and autism, challenging behaviour and support for parents. In addition, a new Senior Wellbeing Practitioner role was launched in 2023 to support widening the MHST skillset and career progression opportunities.
The department, together with partners, will continue to listen to feedback and a planned phase 2 longer-term outcome evaluation, to inform MHST roll out and drive improvements in evidence-based mental health and emotional wellbeing support for children and young people.
Asked by: Barbara Keeley (Labour - Worsley and Eccles South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the findings in the Red Quadrant report entitled, Building the Right Support: An analysis of funding flows, published by her Department, in July 2022, whether she is taking steps to improve financial oversight of expenditure for the Building the Right Support programme.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
In our response to the Health and Social Care Committee’s report, The Treatment of Autistic People and People with Learning Disabilities published 27 July 2022, we noted the wide range of capital and revenue funding sources, as well as the range of support that a person who is, or is at risk of being, admitted to a mental health hospital may draw on. This makes assessing the costs and expenditure associated with the Building the Right Support (BtRS) programme practically challenging. The response, which referenced RedQuadrant’s report, set out that we are clear that there must be credible alternatives to inpatient care, so that people can live independent, fulfilled lives in their community, without financial incentives or disincentives which prevent this from happening.
We recognise the case for improving how data is collected, in order to better understand the specific costs related to BtRS. That is why the BtRS Delivery Board set up a Funding Flows task and finish group to look at improving national oversight of the National Health Service and local authority spend on services, and support for this group of people.
Asked by: Barbara Keeley (Labour - Worsley and Eccles South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many times the Funding Flows Task and Finish Group has met since 20 January 2023.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Funding Flows task and finish group has met five times since its inception in September 2022. Two of those meetings took place after 20 January 2023.
Asked by: Barbara Keeley (Labour - Worsley and Eccles South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many (a) autistic people and (b) people with learning disabilities were placed in an inpatient unit rated as inadequate by the Care Quality Commission in the last 12 months.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Assuring Transformation data shows that there are 130 people with learning disabilities or autism reported in a mental health inpatient setting which the Care Quality Commission (CQC) rates as inadequate. This is based on inpatients at the end of November 2023, and CQC inspection ratings on 17 January 2024. These units may not have been rated as inadequate at the point of the person’s admission.
Asked by: Anneliese Dodds (Labour (Co-op) - Oxford East)
Question to the Department for Education:
To ask the Secretary of State for Education, what steps her Department has taken to help ensure that new school buildings are designed so as to enable students with (a) physical disabilities, (b) mental disabilities and (c) autism spectrum conditions to be included in the (i) curriculum and (ii) life of the school; and what steps her Department has taken to assist schools to adapt existing buildings.
Answered by David Johnston - Parliamentary Under-Secretary (Department for Education)
The department’s ambition is for all children and young people, no matter what their special educational needs and disabilities are, to receive the right support to succeed in their education and as they move into adult life.
All school building projects that are delivered by the department must meet the requirements set out in the department’s school building specification. The department publishes a range of guidance specifically for the construction of special schools, which support the provision of inclusive learning environments including access, acoustics and specialist Special Educational Needs provision. These are available here: https://www.gov.uk/government/collections/school-design-and-construction.
More generally, all new school buildings must meet the requirements of the Building Regulation’s Approved Document: M, which sets out the details on access to and use of buildings. This can be found here: https://www.gov.uk/government/publications/access-to-and-use-of-buildings-approved-document-m.
The department does not publish specific guidance on how to adapt existing schools. Under the Equality Act 2010, schools must make reasonable adjustments to prevent pupils with special educational needs and disabilities being put at a substantial disadvantage. Additionally, under the Children and Families Act 2014, mainstream schools must use their best endeavours to make sure a child or young person who has special educational needs and disabilities, including those who are autistic, get the special educational provision they need.
To support the adaptation of existing buildings, the department has allocated over £1.5 billion of High Needs Provision Capital for the 2022/23 and 2023/24 financial years. This funding forms part of the department’s transformational investment of £2.6 billion in new high needs provision between 2022 and 2025. Local authorities can use this funding to deliver new places in mainstream and special schools, as well as other specialist settings, and to improve the suitability and accessibility of existing buildings.