Asked by: Bambos Charalambous (Labour - Enfield, Southgate)
Question to the Department for Education:
To ask the Secretary of State for Education, what steps he is taking to ensure provision for pupils with cerebral palsy in schools.
Answered by Nadhim Zahawi
It is important that children with medical conditions, such as cerebral palsy, are supported to receive a full education. Under Section 100 of the Children and Families Act (2014), governing boards are required to make arrangements to support pupils with medical conditions and to have regard to statutory guidance.
The guidance is available at: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3, and covers a range of areas including the preparation and implementation of school policies for supporting pupils with medical conditions, the use of individual healthcare plans, staff training, medicines administration, roles and responsibilities, consulting with parents and collaborative working with healthcare professionals. It was developed with a range of stakeholders including the Health Conditions in Schools Alliance (HCSA), school leaders, academy organisations, unions, young people and their parents, and Department of Health and Social Care officials and is based on good practice in schools.
We continue to work with organisations such as the HCSA to help raise further awareness of the duty on schools.
To be awarded qualified teacher status, trainees must meet the teachers’ standards, which include a requirement that they adapt teaching to meet the strengths and needs of all pupils. The performance of all existing teachers in maintained schools must be assessed every year against the teachers’ standards. It is the responsibility of school leaders to determine the training needs of their staff within their approach to school improvement, professional development and performance management.
Staff training is critical in enabling school staff to provide the support needed to pupils with medical conditions. The statutory guidance is clear that governing boards should ensure that any member of school staff providing support to a pupil with medical needs has received suitable training. It also states that training should be sufficient as to ensure that staff are competent and have confidence in their ability to support pupils with medical conditions, and to fulfil the requirements as set out in individual healthcare plans.
Asked by: Bambos Charalambous (Labour - Enfield, Southgate)
Question to the Department for Education:
To ask the Secretary of State for Education, if his Department will include guidance on education provision for children with cerebral palsy to teacher training courses.
Answered by Nadhim Zahawi
It is important that children with medical conditions, such as cerebral palsy, are supported to receive a full education. Under Section 100 of the Children and Families Act (2014), governing boards are required to make arrangements to support pupils with medical conditions and to have regard to statutory guidance.
The guidance is available at: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3, and covers a range of areas including the preparation and implementation of school policies for supporting pupils with medical conditions, the use of individual healthcare plans, staff training, medicines administration, roles and responsibilities, consulting with parents and collaborative working with healthcare professionals. It was developed with a range of stakeholders including the Health Conditions in Schools Alliance (HCSA), school leaders, academy organisations, unions, young people and their parents, and Department of Health and Social Care officials and is based on good practice in schools.
We continue to work with organisations such as the HCSA to help raise further awareness of the duty on schools.
To be awarded qualified teacher status, trainees must meet the teachers’ standards, which include a requirement that they adapt teaching to meet the strengths and needs of all pupils. The performance of all existing teachers in maintained schools must be assessed every year against the teachers’ standards. It is the responsibility of school leaders to determine the training needs of their staff within their approach to school improvement, professional development and performance management.
Staff training is critical in enabling school staff to provide the support needed to pupils with medical conditions. The statutory guidance is clear that governing boards should ensure that any member of school staff providing support to a pupil with medical needs has received suitable training. It also states that training should be sufficient as to ensure that staff are competent and have confidence in their ability to support pupils with medical conditions, and to fulfil the requirements as set out in individual healthcare plans.
Asked by: Bambos Charalambous (Labour - Enfield, Southgate)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will introduce a national cerebral palsy register.
Answered by Caroline Dinenage
NHS England is responsible for securing high quality outcomes for people with cerebral palsy, and it has advised that there are currently no plans to establish a national register of children with the condition.
PACE, the charity which supports children and families affected by motor disorders such as cerebral palsy indicates that the current United Kingdom incidence rate of cerebral palsy is around one in 400 births and that approximately 1,800 children are diagnosed with cerebral palsy every year.
In October 2017, the National Institute for Health and Care Excellence (NICE) published the Quality Standard ‘Cerebral palsy in children and young people’. This standard covers the diagnosis, assessment and management of cerebral palsy and comprises four Quality Statements which describe high quality cerebral palsy care that can be used for the measurement and improvement of services locally. This is available at the following link:
Furthermore, on 16 July 2018, NICE published a draft guideline on the care and support adults with cerebral palsy should receive. It outlines the steps needed to address the variation in the provision of specific services for adults with cerebral palsy and aims to help local and regional services to provide consistent clear pathways of clinical and social care.
Asked by: Laurence Robertson (Conservative - Tewkesbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make available on the NHS, Selective Dorsal Rhizotomy procedures to reduce spasticity in lower limbs; and if he will make a statement.
Answered by Steve Brine
NHS England does not currently routinely commission Selective Dorsal Rhizotomy surgery and published a policy in 2014 based on the clinical evidence available at that time, which did not demonstrate the benefits of surgery over and above other non-surgical treatment options (such as intensive physiotherapy).
However, given the continued clinical and patient interest in the procedure, NHS England invested in a Commissioning through Evaluation (CtE) scheme which has gathered new ‘real world’ evidence from 140 children undergoing surgery in selected centres in England. The interim results of this scheme, independently evaluated by the National Institute for Health and Care Excellence, together with an updated review of the published evidence of clinical effectiveness, have been used to support the drafting of an updated policy proposition which will be considered as part of NHS England’s relative prioritisation process for investments in specialised care in May 2018.
If appropriate, there may also be an opportunity to further review the policy once the full evaluation is available from the CtE scheme in autumn 2018.
Asked by: John McNally (Scottish National Party - Falkirk)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential financial savings to (a) health, (b) social care services and (c) education services of the early identification of cerebral palsy.
Answered by Steve Brine
No assessment has been made.
However, the National Institute for Health and Care Excellence (NICE) published guidelines in January 2017 on the assessment and management of cerebral palsy. This provides authoritative, evidence-based guidance for healthcare professionals in identifying the early signs of cerebral palsy. Further information can be found via the following link:
Further to this, as part of the mandated reviews, health visitors (specialised nurses or midwives) assess the development of children between 0-5 years. They are skilled in early identification of delays, or concerns, in development. In such circumstances they will make a referral to a community paediatrician who will be able to diagnose any conditions, including cerebral palsy.
Asked by: John McNally (Scottish National Party - Falkirk)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential merits of introducing a national cerebral palsy register to record incidences of the condition and improve the provision of treatment for people affected.
Answered by Steve Brine
No assessment has been made. NHS England is responsible for securing high quality outcomes for people with cerebral palsy, and it has advised that there are currently no plans to establish a national register of children with the condition.
PACE, the charity which supports children and families affected by motor disorders such as cerebral palsy indicates that the current United Kingdom incidence rate of cerebral palsy is around one in 400 births and that approximately 1,800 children are diagnosed with cerebral palsy every year.
Asked by: John McNally (Scottish National Party - Falkirk)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to support the implementation of the NICE Quality Standard on cerebral palsy in children and young people.
Answered by Steve Brine
Quality standards (QS) are important in setting out to patients, the public, commissioners and providers what a high quality service should look like in a particular area of care. Whilst providers and commissioners must have regard to the National Institute for Health and Care Excellence (NICE) QS in planning and delivering services, they do not provide a comprehensive service specification and are not mandatory.
The NICE QS: Cerebral palsy in children and young people was published on 10 October 2017. This standard covers the diagnosis, assessment and management of cerebral palsy and comprises four Quality Statements which describe high quality cerebral palsy care that can be used for the measurement and improvement of services locally. These statements are drawn from existing, evidence based guidance; in this case NICE’s cerebral palsy clinical guideline, published in January 2017. Both the QS and guideline can be found at the following links:
Asked by: Gavin Robinson (Democratic Unionist Party - Belfast East)
Question to the Department for Education:
To ask the Secretary of State for Education, what information his Department holds on the number of children and young people with special educational needs who have cerebral palsy.
Answered by Nadhim Zahawi
The department does not collect data in this level of detail for the child or young person’s type of need.
We collect annual data from schools and colleges on special educational needs (SEN) as part of the School Census. This data is published annually each January.
Primary type of need is collected for those pupils with a statement of SEN or Education, Health and Care (EHC) plan. There are 12 categories of need, including physical disability. This is the highest level of detail that is collected.
The latest figures are available in Table 8 of the National Tables on the department’s website at: https://www.gov.uk/government/statistics/special-educational-needs-in-england-january-2017.
Under the Children and Families Act 2014, local authorities are required to conduct statutory EHC needs assessments to determine whether children and young people in their area have special educational needs which require additional support or provision. Where a local authority deems that a statutory EHC plan should be issued, it is responsible for securing the special educational provision specified in the plan.
The department has provided local authorities with £252 million between 2014-15 and 2017-18 to support local authorities to embed the special education needs and disabilities reforms as set out in the Children and Families Act 2014. In addition, we are allocating £6 billion in high needs funding in 2018-19 which local authorities can use to secure special educational provision.
Asked by: Gavin Robinson (Democratic Unionist Party - Belfast East)
Question to the Department for Education:
To ask the Secretary of State for Education, how many children and young people have cerebral palsy listed as a condition in their Education, Health and Care plan.
Answered by Nadhim Zahawi
The department does not collect data in this level of detail for the child or young person’s type of need.
We collect annual data from schools and colleges on special educational needs (SEN) as part of the School Census. This data is published annually each January.
Primary type of need is collected for those pupils with a statement of SEN or Education, Health and Care (EHC) plan. There are 12 categories of need, including physical disability. This is the highest level of detail that is collected.
The latest figures are available in Table 8 of the National Tables on the department’s website at: https://www.gov.uk/government/statistics/special-educational-needs-in-england-january-2017.
Under the Children and Families Act 2014, local authorities are required to conduct statutory EHC needs assessments to determine whether children and young people in their area have special educational needs which require additional support or provision. Where a local authority deems that a statutory EHC plan should be issued, it is responsible for securing the special educational provision specified in the plan.
The department has provided local authorities with £252 million between 2014-15 and 2017-18 to support local authorities to embed the special education needs and disabilities reforms as set out in the Children and Families Act 2014. In addition, we are allocating £6 billion in high needs funding in 2018-19 which local authorities can use to secure special educational provision.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of recent rises in NHS Resolution's provision against claims for clinical negligence; what provision against claims for clinical negligence will be needed in each of the next three financial years; and what action they are taking to reduce the level of such provision.
Answered by Lord O'Shaughnessy
NHS Resolution’s provision for clinical negligence claims at 31 March 2017 was £64.7 billion. Recent rises in the provision are due to a number of factors including increases in the number of claims received, the amount of damages awarded, particularly in maternity claims and legal costs. This is also influenced by two discount rates:
- The long term Public Expenditure System, set by HM Treasury, enabling a present value to be placed on future liabilities for accounting purposes but not affecting the costs of settling claims, changed from +2.2% to -0.8% from 31 March 2016, and increased the provision by £25.5 billion in 2015/16.
- The personal injury discount rate (PIDR), set by the Lord Chancellor, places current value on future losses for settlement through lump sum payments, affecting the cost of settling claims. PIDR changed from +2.5% to -0.75% from 20 March 2017 and contributed £4.7 billion to the increase in the provision in 2016/17.
The Government published draft legislation in September to reform the legal framework governing how the PIDR is set. The proposals will help ensure that claimants continue to receive full compensation but should significantly reduce overpayment by more reliably reflecting how awards are invested. Subject to its consideration of the Justice Select Committee’s pre-legislative scrutiny report and comments received from stakeholders on the draft legislation, the Government plans to introduce legislation to reform the law as soon as possible.
The provision is calculated annually taking into account latest developments in the claims environment to inform assumptions about claims volumes, inflation in settlements and legal costs and time to settle claims. It is, therefore, not possible to provide an accurate provision for the next three years although it will continue to increase for some years to come for inflationary and other reasons.
NHS Resolution manages the costs of claims appropriately, challenging claims without merit, excessive claims for damages and claimant legal costs. It works with trusts to help them understand their claims data to better assess where local interventions would have the greatest impact in reducing high volume or high cost claims, and shares learning and best practice from its analysis of claims. Its new strategy, Delivering fair resolution and learning from harm: Our strategy to 2022 gives it an enhanced focus on mediation, learning and prevention, as well as litigation, and it will deliver increased insight into what drives the costs of harm and work with others to develop interventions that improve safety and save money for the NHS, as demonstrated by its recent report Five years of cerebral palsy claims: A thematic review of NHS Resolution data. A copy of both documents is attached.
Following recent reports by the National Audit Office and the Public Accounts Committee on clinical negligence costs, the Department is working with the Ministry of Justice, HM Treasury and NHS Resolution and others to develop a cross government strategy to reduce them. This work is supported by our pursuit of improved safety standards and a transparent, learning culture across the NHS.