Asked by: Baroness Browning (Conservative - Life peer)
Question to the Ministry of Justice:
To ask His Majesty's Government to whom the Official Solicitor reports concerning (1) fee setting and (2) decisions to represent.
Answered by Lord Ponsonby of Shulbrede - Lord in Waiting (HM Household) (Whip)
In most cases, the decision to instruct the Official Solicitor is made by the Courts where no other suitable person has been identified. The Official Solicitor, Sarah Castle, can act as her own solicitor or instruct a private firm of solicitors to represent her.
The Official Solicitor does not charge for acting as a litigation friend, only for her Court of Protection and Trust work, with authority to do this provided via individual Court Orders.
Where the Official Solicitor instructs an external legal firm to represent, costs can be recovered from the client and/or legal aid when the eligibility criteria is met. In house Court of Protection work is charged based on hourly charge out rates which are set by Senior Courts Costs Office.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Ministry of Justice:
To ask His Majesty's Government what assessment they have made of the current requirement for cases before the Court of Protection to receive representation from the Official Solicitor.
Answered by Lord Ponsonby of Shulbrede - Lord in Waiting (HM Household) (Whip)
There is no requirement for cases before the Court of Protection to receive representation from the Official Solicitor. Representation may be provided by a litigation friend other than the Official Solicitor, or by the appointment of another form of legal representative. In appropriate cases the Official Solicitor may agree to act as a representative of last resort.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Ministry of Justice:
To ask His Majesty's Government what assessment they have made of the need for proceedings of the Court of Protection to continue to be conducted in private.
Answered by Lord Ponsonby of Shulbrede - Lord in Waiting (HM Household) (Whip)
Attended hearings in the Court of Protection have ordinarily been held in public since 2016 with a ‘Transparency Order’ being made by the court to prohibit the publication of information that identifies, or is likely to identify, the vulnerable person concerned, their family, or any other person specified in the order. This allows the public and the media to attend hearings to observe how decisions are made whilst maintaining the privacy of the vulnerable person, their family, and any others involved.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government how many assessors trained and qualified in autism will work in each of the five regions under the Department for Work and Pension's Health Assessment Advisory Service.
Answered by Baroness Sherlock - Parliamentary Under-Secretary (Department for Work and Pensions)
The department and the Health Assessment Advisory Service (HAAS) are fully committed to supporting those with mental health conditions.
All health professionals (HPs) within the five regions of HAAS are fully qualified in their health discipline and have passed strict recruitment and experience criteria. They must also be registered with a relevant regulatory body such as the General Medical Council, the Nursing and Midwifery Council, Health and Care Professions Council or European Economic Area equivalent. The department has not specified that HAAS employ HPs who are specialists in specific conditions or impairments. Instead, the focus is on ensuring they are experts in disability analysis, focusing on the effects of health conditions and impairments on the claimant’s daily life.
All HPs receive comprehensive training in the functional assessment of mental health conditions and disabilities, including Autism. From 09 September 2024 the educational material for all HAAS HPs was provided by DWP. As part of our review, we identified best practice in the NHS and have implemented the Oliver McGowan training as part of the mandatory training requirements for every HP. This training is recognised to be of significant value to HPs in ensuring they have the skills and knowledge to provide safe, informed, and compassionate assessments to claimants with autism and learning disabilities. This is in addition to our comprehensive education programme for HPs.
Following the completion of core training to undertake the role, HPs will engage in an annual training programme, and HAAS has been provided with materials (such as Continual Professional Development modules) to support the development of their HPs where learning needs are identified. This approach ensures that both service wide and individual training needs are met and will be of benefit to those with neurodiversity where applicable.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government what qualifications are stipulated for assessors of people on the autism spectrum by the Health Assessment Advisory Service.
Answered by Baroness Sherlock - Parliamentary Under-Secretary (Department for Work and Pensions)
The department and the Health Assessment Advisory Service (HAAS) are fully committed to supporting those with mental health conditions.
All health professionals (HPs) within the five regions of HAAS are fully qualified in their health discipline and have passed strict recruitment and experience criteria. They must also be registered with a relevant regulatory body such as the General Medical Council, the Nursing and Midwifery Council, Health and Care Professions Council or European Economic Area equivalent. The department has not specified that HAAS employ HPs who are specialists in specific conditions or impairments. Instead, the focus is on ensuring they are experts in disability analysis, focusing on the effects of health conditions and impairments on the claimant’s daily life.
All HPs receive comprehensive training in the functional assessment of mental health conditions and disabilities, including Autism. From 09 September 2024 the educational material for all HAAS HPs was provided by DWP. As part of our review, we identified best practice in the NHS and have implemented the Oliver McGowan training as part of the mandatory training requirements for every HP. This training is recognised to be of significant value to HPs in ensuring they have the skills and knowledge to provide safe, informed, and compassionate assessments to claimants with autism and learning disabilities. This is in addition to our comprehensive education programme for HPs.
Following the completion of core training to undertake the role, HPs will engage in an annual training programme, and HAAS has been provided with materials (such as Continual Professional Development modules) to support the development of their HPs where learning needs are identified. This approach ensures that both service wide and individual training needs are met and will be of benefit to those with neurodiversity where applicable.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what criteria apply to NHS hospitals when requesting patients to sign a 'do not resuscitate' form.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
There are no set criteria applied to National Health Service hospitals when requesting patients sign do not resuscitate forms. Doctors are required to make do not attempt cardiopulmonary resuscitation (DNACPR) decisions based on the individual circumstances of a patient, and with the involvement of the person concerned or, where the person lacks capacity, their family, or any other legally recognised advocate.
Patient facing guidance setting out how DNACPR decisions should be made, and how individuals or their families can get support about a DNACPR, is provided on the NHS website, in an online only format.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many 'do not resuscitate' forms have been signed in each of the past five years.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Department does not hold this data.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to address barriers to discharge from mental health inpatient units for autistic people and people with learning disabilities related to the provision of (1) suitable housing, and (2) social care support.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
On 26 January 2024, we published statutory guidance on discharge from mental health inpatient settings. This guidance sets out key principles for how National Health Service bodies and local authorities across adult and children’s services should work together to support people to be discharged from mental health inpatient services, including mental health inpatient services for people with a learning disability and for autistic people. This guidance states that strong links should be made with relevant community services prior to, and during, the person’s stay in hospital, and that this should include links in relation to meeting the person’s needs related to health, social care, education, housing, and any other individual needs.
In 2023/24, we are investing an additional £121 million to improve community support, as part of the NHS Long Term Plan. This includes funding for children and young people’s keyworkers. We continue to support the delivery of new supported housing by providing capital subsidies to providers, through the Care and Support Specialised Housing Fund and the Affordable Homes Programme in England. We have also made available up to £8.6 billion over this and next financial year, to support adult social care and discharge.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the effectiveness of the dynamic support register and Care (Education) and Treatment Review policy for autistic people without a learning difficulty in (1) preventing hospital admissions, and (2) speeding up hospital discharges.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England published updated policy and guidance on both Care (Education) and Treatment Reviews (C(E)TRs) and Dynamic Support Registers (DSRs) on 25 January 2023, for implementation from 1 May 2023, to help ensure people get the support they need to stay well in their communities. This includes guidance on the timescales for C(E)TRs and on ensuring that actions are taken forward.
NHS England produced the updated policy and guidance following a process of reviewing the learning since the inception of C(E)TRs and DSRs, including consultation and engagement with people with lived experience. This process included drawing on the findings of the Norfolk Safeguarding Adults Board’s review of the deaths of Joanna, Jon and Ben at Cawston Park in Norfolk, and the subsequent safe and wellbeing reviews for all people with a learning disability and autistic people in mental health hospitals.
Asked by: Baroness Browning (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that Care (Education) and Treatment Reviews are taking place within recommended timeframes, and that recommendations arising from those reviews are being acted on.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England published updated policy and guidance on both Care (Education) and Treatment Reviews (C(E)TRs) and Dynamic Support Registers (DSRs) on 25 January 2023, for implementation from 1 May 2023, to help ensure people get the support they need to stay well in their communities. This includes guidance on the timescales for C(E)TRs and on ensuring that actions are taken forward.
NHS England produced the updated policy and guidance following a process of reviewing the learning since the inception of C(E)TRs and DSRs, including consultation and engagement with people with lived experience. This process included drawing on the findings of the Norfolk Safeguarding Adults Board’s review of the deaths of Joanna, Jon and Ben at Cawston Park in Norfolk, and the subsequent safe and wellbeing reviews for all people with a learning disability and autistic people in mental health hospitals.