Asked by: Paul Farrelly (Labour - Newcastle-under-Lyme)
Question to the Department for Environment, Food and Rural Affairs:
To ask the Secretary of State for Environment, Food and Rural Affairs, if she will take steps to ban the (a) production and (b) use of polystyrene plastic packaging in the UK.
Answered by Rebecca Pow - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)
Packaging materials, including polystyrene, are already covered by the Producer Responsibility Obligations (Packaging Waste) Regulations which place a legal obligation on businesses that make or use packaging to ensure that a proportion of the packaging they sell is recovered and recycled. This creates an incentive for companies to use less packaging and to ensure that their packaging can be recycled at end of life as it will reduce their costs in complying with the Regulations.
In general, we prefer to help people and companies make the right choice, rather than banning items outright. We have, however, recently consulted on changes to the packaging producer responsibility scheme, looking at all aspects of the regime including mechanisms to encourage increased recyclability.
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, what plans he has to improve access to bereavement care and support; and if he will make a statement.
Answered by Nadine Dorries
The Government’s response to the independent review of choice in end of life care (July 2016) made clear that high quality bereavement care is a key component of good end of life care, supporting families and loved ones at this very difficult time in their lives. For this reason, a number of resources have been developed to help improve bereavement support and end of life care.
The funding and delivery of National Health Service bereavement services is a matter for local commissioners.
Providing better information and support to people bereaved by suicide is a key area for action in the National Suicide Prevention Strategy.
Under the NHS Long Term Plan, all areas in England will have suicide bereavement services providing timely and appropriate support to families and staff by 2023/24.
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, what steps his Department takes to share good practice in bereavement care across the health system; what progress his Department has made to end variation in bereavement care by 2020, as committed to in 2016 in response to the Review of Choice in End of Life Care; and if he will make a statement.
Answered by Caroline Dinenage
The Government’s response to the independent review of choice in end of life care (July 2016) made clear that high quality bereavement care is a key component of good end of life care, supporting families and loved ones at this very difficult time in their lives. For this reason, a number of resources have been developed to help improve bereavement support and end of life care.
Health Education England, in partnership with Skills for Care and Skills for Health, published a refreshed End of Life Care Core Skills Education and Training Framework in March 2017 which aims to standardise end of life care training and education, including around bereavement care. It is available at the following link:
www.skillsforhealth.org.uk/services/item/536-end-of-life-care-cstf-download
The national bereavement care pathway for pregnancy and baby loss was launched in 2017 and seeks to increase the quality of, and reduce the inequity in, the bereavement care provided by healthcare professionals after the loss of a baby or pregnancy at any gestation. It is available at the following link:
Guidance for NHS trusts on working with bereaved families and carers was published by NHS England in July 2018 and provides advice to trusts on how they should support, communicate and engage with families following a death of someone in their care. The guidance is available at the following link:
In December 2018, NHS England published ‘When a child dies - a guide for parents and carers’ to support parents through the child death review process and help them understand the support that is available. This is available at the following link:
www.lullabytrust.org.uk/wp-content/uploads/parent-leaflet-child-death-review.pdf
‘Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020’, published by the National Palliative and End of Life Care Partnership, sets out the ambitions for palliative and end of life care and presents a framework for local action. This is available at the following link:
The importance of bereavement care is also reflected in the National Institute for Health and Care Excellence quality standard on end of life care and other end of life care guidance, which commissioners should take into account when planning services for local populations. The quality standard is available at the following link:
www.nice.org.uk/guidance/qs13/resources/end-of-life-care-for-adults-pdf-2098483631557
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, which exemplar bereavement care pathways have been identified as models of good practice by his Department and NHS England; what effect they have had on improving bereavement support; and if he will make a statement.
Answered by Caroline Dinenage
The Government’s response to the independent review of choice in end of life care (July 2016) made clear that high quality bereavement care is a key component of good end of life care, supporting families and loved ones at this very difficult time in their lives. For this reason, a number of resources have been developed to help improve bereavement support and end of life care.
Health Education England, in partnership with Skills for Care and Skills for Health, published a refreshed End of Life Care Core Skills Education and Training Framework in March 2017 which aims to standardise end of life care training and education, including around bereavement care. It is available at the following link:
www.skillsforhealth.org.uk/services/item/536-end-of-life-care-cstf-download
The national bereavement care pathway for pregnancy and baby loss was launched in 2017 and seeks to increase the quality of, and reduce the inequity in, the bereavement care provided by healthcare professionals after the loss of a baby or pregnancy at any gestation. It is available at the following link:
Guidance for NHS trusts on working with bereaved families and carers was published by NHS England in July 2018 and provides advice to trusts on how they should support, communicate and engage with families following a death of someone in their care. The guidance is available at the following link:
In December 2018, NHS England published ‘When a child dies - a guide for parents and carers’ to support parents through the child death review process and help them understand the support that is available. This is available at the following link:
www.lullabytrust.org.uk/wp-content/uploads/parent-leaflet-child-death-review.pdf
‘Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020’, published by the National Palliative and End of Life Care Partnership, sets out the ambitions for palliative and end of life care and presents a framework for local action. This is available at the following link:
The importance of bereavement care is also reflected in the National Institute for Health and Care Excellence quality standard on end of life care and other end of life care guidance, which commissioners should take into account when planning services for local populations. The quality standard is available at the following link:
www.nice.org.uk/guidance/qs13/resources/end-of-life-care-for-adults-pdf-2098483631557
Asked by: Angela Crawley (Scottish National Party - Lanark and Hamilton East)
Question to the Department for Environment, Food and Rural Affairs:
To ask the Secretary of State for Environment, Food and Rural Affairs, what steps the Government is taking to promote alternatives to plastic packaging.
Answered by Thérèse Coffey
Plastic food packaging serves important purposes such as protecting food, providing important storage information, extending the shelf life and decreasing food waste.
The Government is working with retailers and the Waste and Resources Action Programme (WRAP) to encourage their efforts to reduce waste and to explore the introduction of plastic-free supermarket initiatives in which fresh food is sold loose, giving consumers the choice. WRAP has published a technical report on the evidence for providing fresh produce loose and we are working with Morrisons to evaluate its current trial of selling produce loose, to assess the impact on food waste.
The WRAP Evidence Review: Plastic Packaging and Fresh Produce, pulled together evidence on a variety of fresh produce and summarised the current evidence available on whether it is suitable to be sold loose. Some items, for example cucumbers, have a significantly longer shelf life when shrink wrapped.
Our priority is to prevent or reduce waste in the first place. The Packaging (Essential Requirements) Regulations already require all retailers to ensure that all their packaging does not exceed what is needed to make sure that the products are safe, hygienic and acceptable for both the packed product and for the consumer. As part of the Resources and Waste Strategy, we have committed to review the effectiveness of these Regulations by the end of next year.
We have also consulted on reforms to the way we manage packaging waste. The reforms to the Producer Responsibility Obligations (Packaging Waste) Regulations will require producers to fund the full net-cost of managing the packaging they place on the market, once it becomes waste. This creates an incentive for companies to use less packaging and to ensure that their packaging can be recycled at end of life as it will reduce their costs in complying with the Regulations.
In our consultation we have set out options for how we want to enhance the incentive for producers to make better packaging design choices. The options are for a modulated fee system or a deposit fee system. These options provide a financial incentive for producers, in addition to the full-net cost fees, to move towards using more easily recycled packaging materials and formats.
In April last year, WRAP and the Ellen MacArthur Foundation launched their world leading UK Plastics Pact, with support from the Government, and all the major supermarkets have signed up to it. The Pact brings these organisations together with four key targets for 2025 that aim to reduce the amount of plastic waste generated, which includes actions to eliminate problematic or unnecessary single-use plastic packaging items. Our proposed reforms will support supermarkets in achieving those targets.
Asked by: Rosie Cooper (Labour - West Lancashire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the effectiveness of the NHS Long Term Plan in achieving the Government’s commitment to end variation in end-of-life care by 2020.
Answered by Caroline Dinenage
‘Our Commitment to you for end of life care’, published in July 2016, set out what everyone should expect from their care at the end of life and the actions we are taking to make high quality care a reality for all. Since its publication, NHS England has been working to deliver the Choice Commitment, as set out in the Government’s Mandate to the National Health Service. Through its National Programme Board for End of life Care, a range of activity has been coordinated and undertaken with all key system partners care and stakeholders to improve equity of access to, and experience of, palliative and end of life care. A progress report was published the following year on 21 September 2017.
Key to reducing variation and delivering personalised care is ensuring that patients are identified as likely to be in their last year of life. This means their end of life care can be improved by personalising it according to their needs and preferences at an earlier stage. However, it is also vital that services are available to provide the care to people in the community and in their homes in a timely way. The Long Term Plan published on 7 January 2019, set out significant investment and activity to drive further improvement in both these areas in support of the Government’s Choice Commitment.
Asked by: Stephen Timms (Labour - East Ham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has to include meeting the end of life care choice commitment for babies, children and young people in the new NHS long-term plan; and if he will make a statement.
Answered by Caroline Dinenage
‘Our Commitment to you for end of life care’, published in July 2016, set out what everyone should expect from their care at the end of life and the actions we are taking to make high quality, personalised care a reality for all, both adults and children. Through the Mandate to NHS England, we have asked NHS England to deliver the Choice Commitment, and through its National Programme Board for End of life Care, NHS England is working with all key system partners and stakeholders, including the children’s end of life care charity Together for Short Lives, to achieve this. A copy of the Choice Commitment and the One Year On progress report can be found at the following link:
www.gov.uk/government/publications/choice-in-end-of-life-care-government-response
End of life care, including for babies, children and young people, is an important part of the proposals which are helping to shape the long-term plan for the National Health Service. The plan is expected for publication later this year.
Asked by: Kevan Jones (Labour - North Durham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that children with life-limiting conditions and their families have access to children's palliative care in the community out-of-hours and at weekends.
Answered by Caroline Dinenage
High quality community care is crucial to the delivery of end of life care services and our Choice Commitment, this includes out-of-hours and weekend services. Work undertaken by NHS England and system partners at a national level includes supporting sustainability and transformation partnership planning to address end of life care in all settings and providing key data on services; providing guidance on cost effective commissioning in end of life care; and providing practical examples of how out-of-hours access to palliative care, seven days a week, can be achieved.
Going forward, we will have new measures in place to assess progress and hold commissioners to account, including a new indicator to measure deaths in hospital after three or more emergency admissions in the final 90 days of life, which will help us assess quality and provision of out of hospital care.
NHS England is currently working with experts to develop new commissioning models for children and young people’s palliative care as it can be difficult for some clinical commissioning groups to meet the needs of this vulnerable group given the relatively small number of children concerned and their geographical spread.
Asked by: Alex Sobel (Labour (Co-op) - Leeds North West)
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 ensure that end of life patients are able to die at home.
Answered by Caroline Dinenage
Our Commitment to you for end of life care’, published in 2016, set out what everyone should expect from their care at the end of life and the actions we are taking to make high quality, personalised care a reality for everyone. This includes measures to enable personalisation; improve care quality; enhance education and training in end of life care; and encourage the spread of innovative models of care. The Commitment also sets out that by 2020 we want to significantly improve patient choice, including ensuring an increase in the number of people able to die in the place of their choice, including at home.
Through the Mandate to NHS England, we have asked NHS England to deliver the Choice Commitment, and for 2018-19, we have set NHS England the objective of increasing the percentage of people identified as likely to be in their last year of life. Earlier identification should mean that a person’s end of life care can be improved by personalising it according to their needs and preferences at an earlier stage and to enable the right care planning can take place which is key to supporting someone to die in a place of choice. NHS England will use the Quality and Outcomes Framework to demonstrate such an increase by looking at the percentage of people who are on the general practitioner register for supportive and palliative care, and consider expected levels based on local populations. Currently the national English average is 0.37%, it is anticipated this figure will increase in the 2018/19 period.
NHS England has launched an ‘Identification Project’ with four integrated care systems/sustainability and transformation partnership areas to demonstrate how the number of people identified in the last year of life can be increased in practice, to train staff and share learning.
Asked by: Roger Godsiff (Labour - Birmingham, Hall Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will include end of life care in the long-term plan for the NHS; and what steps are being taken to improve end of life care.
Answered by Caroline Dinenage
Delivering improvements to end of care is a key priority for this Government and end of life care is an important part of the proposals which are helping to shape the long-term plan for National Health Service.
NHS England is now considering the many responses and submissions it has received, including those from end of life care charities, as part of the listening exercise it held to help develop and refine policy proposals for inclusion in the plan. NHS England will continue working with key stakeholders to test the plan before its publication in November 2018.
In ‘Our Commitment to you for end of life care’, published in July 2016, the Government set out what everyone should expect from their care at the end of life and the actions being taking to make high quality and personalisation a reality for all and to reduce variation in end of life care. NHS England is responsible for delivering the commitment, in partnership with system partners and key stakeholders, through its National End of Life Care Programme Board. Key steps over the first two years include:
- Working with Public Health England and the Care Quality Commission to provide bespoke end of life care data and support packs to Sustainability and Transformation Partnerships to plan for, and improve, end of life care services;
- Testing Personal Health Budgets for people approaching the end of life;
- Working with Health Education England to ensure that all staff involved in the delivery of end of life care have appropriate education and training choice and quality of care at the end of life and strengthening medical curricula to support choice and quality and the of life;
- Inspecting and rating NHS hospital and community services for end of life care. This new inspection approach has a clear focus on end of life care and applies in all services where end of life care is delivered;
- Developing a new indicator for the Clinical Commissioning Group Improvement and Assessment Framework (CCG IAF) to measure deaths in hospital after three or more emergency admissions in the final 90 days of life to help assess choice and quality in end of life care; and
- Supporting to trusts rated as ’inadequate or ‘needs improvement’ to improve end of life care services. At the start of 2017/18, 66 trusts were in these categories (four were inadequate). This is now down to 56.
For 2018-19, the Government’s Mandate asks NHS England to increase the percentage of people identified as likely to be in their last year of life, so that their end of life care can be improved by personalising it according to their needs and preferences at an earlier stage. NHS England will use the Quality and Outcomes Framework to demonstrate such an increase by looking at the percentage of people who are on the general practitioner register for supportive and palliative care, and consider expected levels based on local populations. Currently the national English average is 0.37%, it is anticipated this figure will increase in the 2018/19 period.