Asked by: Baroness Hodgson of Abinger (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 prospects of equitable access to hospice care for all children and young people who need palliative and end of life care in 2024.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises that access to high-quality, palliative and end of life care can make all the difference to individuals and their loved ones. Funding for children’s and young people’s palliative and end of life care is made available locally through integrated care boards (ICBs), which are responsible for commissioning services in response to the needs of their local population.
In addition, NHS England has confirmed that it will be renewing the Children and Young People’s hospice grant for 2024/25, once again allocating £25 million grant funding for children’s hospices. NHS England is reprioritising budgets for 2024/25, in light of the revised assessment of financial position and, whilst it is holding funding aside for the children and young people’s hospice sector, it cannot confirm further details, including the distribution mechanism, until 2024/25 financial planning is concluded.
Children and young people’s palliative and end of life care is provided by a range of services and providers from across the statutory and voluntary, community and social enterprise sectors. The majority of palliative and end of life care is provided by National Health Service staff and services, but we recognise that the voluntary sector organisations, including hospices, also play a very vital part in providing support to people at end of life and their loved ones.
The Government has not made a direct assessment of the prospects of equitable access to hospice care for all children and young people who need palliative and end of life care in 2024. However, NHS England’s palliative and end of life care team has recently engaged with 24 ICBs to understand how to better support commissioners and has also reviewed all 42 ICB Joint Forward Plans for their inclusion of palliative and end of life care, with 69% making a specific mention. Further analysis is ongoing, but the intention is to use this to help shape and focus support to ICBs.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they expect integrated care boards to be able to identify how many children and young people access children’s hospices; and what steps they will take if they cannot.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Children and young people’s palliative and end of life care is provided by a range of local services and providers from across the statutory and voluntary, community and social enterprise sectors, including hospices, with the experience and skills to meet those needs.
While there is no explicit requirement for integrated care boards (ICBs) to identify how many children and young people specifically access children's hospices, commissioning of children and young people’s palliative and end of life care services is the statutory duty of ICBs, which must commission these services in response to the needs of their population,
In July 2022, NHS England published statutory guidance for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties and makes clear reference to the importance of access to services. A copy of the guidance is attached.
NHS England has also published a service specification for children and young people which provide guidance on undertaking assessments to enable high-quality commissioning of services that meet both population need and preferences. A copy of the specification is attached.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how much money was spent per case on palliative and end of life care for children and young people in (1) 2022, and (2) 2023; and how much they anticipate spending in 2024.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government does not hold information on how much money was spent per case on palliative and end of life care for children and young people in 2022 and 2023. Patient-level spend is not collated at a national level, with spend based on need determined during the integrated care board (ICB) commissioning process.
At a national level, NHS England supports palliative and end of life care for children and young people through the Children and Young People’s hospice grant. The grant provided approximately £17 million in 2021/22, £21 million in 2022/23 and £25 million in 2023/24 directly to children and young people’s hospices. NHS England has confirmed that it will be renewing the grant for 2024/25, once again allocating £25 million grant funding for children’s hospices using the same prevalence-based allocation approach as in 2022/23 and 2023/24. NHS England is reprioritising budgets for 2024/25, in light of the revised assessment of financial position and, whilst it is holding funding aside for the children and young people’s hospice sector, it cannot confirm further details, including the distribution mechanism, until 2024/25 financial planning is concluded.
Additionally, in line with the NHS Long Term Plan commitment, NHS England has provided approximately £8.5 million match-funding to participating ICBs and formerly clinical commissioning groups between 2022/23 and 2023/24 that committed to invest in children and young people’s palliative and end of life care, including hospices, giving a total investment of £17 million for that period.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what directions and guidance the Department of Health and Social Care will provide to integrated care boards on commissioning palliative and end of life care for children and young people.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Children and young people’s palliative and end of life care is provided by a range of services and providers from across the statutory and voluntary, community and social enterprise sectors. Commissioning of these services is the statutory duty of integrated care boards (ICBs), which must commission palliative and end of life care services in response to the needs of their local population and ensure that they are provided by a range of local organisations with the experience and skills to meet those needs.
In July 2022, NHS England published statutory guidance for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties. A copy of this guidance is attached.
NHS England has also published a service specification for children and young people, which provides guidance on undertaking assessments to enable high-quality commissioning of services that meet both population need and preferences. A copy of this specification is attached.
NHS England’s palliative and end of life care team has recently engaged with 24 ICBs to understand how to better support commissioners, and has also reviewed all 42 ICB Joint Forward Plans for their inclusion of palliative and end of life care, with 69% of those plans making a specific mention. Further analysis is ongoing, but the intention is to use this information to help shape and focus support to ICBs.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many infants admitted to the Somerset NHS Foundation Trust in each of the past five years were subject to investigation under its guidelines regarding suspected abuse in children; of those, how many were identified as having been subjected to abuse; and whether this figure is similarly reflected in other trusts across the country.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Somerset NHS Foundation Trust guidelines define abuse and neglect as forms of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm. All staff have a responsibility to safeguard children at risk of abuse or neglect in the National Health Service. This involves protecting children from maltreatment and preventing impairment of children’s health and development. Somerset NHS Foundation Trust does not hold data on the number of infants admitted in the past five years subject to investigation regarding suspected abuse or the number of infants identified as subjected to abuse. NHS England also does not collect the data requested.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are funding research into finding a cure for mesothelioma.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Research is crucial in the fight against cancer. That is why the Department invests £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was over £101 million for 2021/22.
NIHR funded the following research programmes, totalling approximately £3 million, since 2018:
- A double blind, placebo-controlled, randomized phase II study of Pemetrexed and Cisplatin with and without Ruxolitinib in Malignant Pleural Mesothelioma;
- Mesothelioma and Radical Surgery 2: a multicentre randomised trial comparing (extended) pleurectomy decortication versus no (extended) pleurectomy decortication for patients with malignant pleural mesothelioma (MARS 2);
- Nivolumab with ipilimumab for untreated unresectable malignant pleural mesothelioma [ID1609];
- Treating mesothelioma with Intra-pleural Lipoteichoic acid (the TILT Trial): A feasibility study using the ‘Trial within a Cohort’ methodology;
- Developing a short-term integrated rehabilitation service for people with newly diagnosed thoracic cancer;
- Randomised controlled trial to compare the diagnostic yield of Positron Emission Tomography Computerised Tomography (PET-CT) guided pleural biopsy versus CT-guided pleural biopsy in suspected pleural malignancy (PET-biopsy trial);
- Zoledronic acid in the management of malignant pleural mesothelioma - a feasibility study (Zol-A Study); and
- MesoTRAP: A feasibility study comparing video-assisted thoracoscopic partial pleurectomy/decortication with indwelling pleural catheter in patients with trapped lung and pleural effusion due to malignant pleural mesothelioma designed to address recruitment and randomisation uncertainties and sample size requirements for a phase III trial.
The NIHR is also supporting delivery in the health and care system of over 50 mesothelioma research studies funded by research funding partners in the charity and public sectors since 2018.
The NIHR welcomes funding applications for research into any aspect of human health, including research into mesothelioma. As with other Government funders of health research, the NIHR does not allocate funding for specific disease areas. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money and scientific quality.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what were the survival rates for people diagnosed of mesothelioma in each of the five years up to December 2022.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The latest mesothelioma cancer survival statistics available are for those adults diagnosed between 2016-2020, followed up to 2021.
The table below provides the year of cancer diagnosis, the years since diagnosis (from 1 to 5), and the respective survival rates, with associated 95% upper and lower confidence intervals (CIs). Where estimates are not possible due to low reliability, a [u] is shown.
Year of diagnosis | Years since diagnosis | Net survival (%) | Net survival, lower 95% CI | Net survival, upper 95% CI |
2016-2020 | 1 | 46.0 | 44.7 | 47.4 |
2015-2019 | 1 | 46.0 | 44.8 | 47.3 |
2014-2018 | 1 | 45.3 | 44.0 | 46.7 |
2013-2017 | 1 | 44.7 | 43.5 | 46.0 |
2012-2016 | 1 | 44.5 | 43.2 | 45.7 |
2016-2020 | 2 | 24.1 | 23.0 | 25.2 |
2015-2019 | 2 | 23.6 | 22.5 | 24.7 |
2014-2018 | 2 | 23.1 | 22.0 | 24.1 |
2013-2017 | 2 | 21.7 | 20.7 | 22.8 |
2012-2016 | 2 | 21.4 | 20.4 | 22.4 |
2016-2020 | 3 | 14.7 | 13.8 | 15.7 |
2015-2019 | 3 | 14.3 | 13.4 | 15.2 |
2014-2018 | 3 | 13.8 | 12.9 | 14.7 |
2013-2017 | 3 | 12.8 | 12.0 | 13.7 |
2012-2016 | 3 | 12.2 | 11.4 | 13.1 |
2016-2020 | 4 | 10.0 | 9.1 | 10.9 |
2015-2019 | 4 | 9.6 | 8.7 | 10.5 |
2014-2018 | 4 | 9.4 | 8.6 | 10.3 |
2013-2017 | 4 | 8.3 | 7.4 | 9.2 |
2012-2016 | 4 | 7.6 | 6.8 | 8.5 |
2016-2020 | 5 | [u] | [u] | [u] |
2015-2019 | 5 | 7.1 | 6.2 | 8 |
2014-2018 | 5 | 7.1 | 6.3 | 8.1 |
2013-2017 | 5 | 6.6 | 5.8 | 7.6 |
2012-2016 | 5 | [u] | [u] | [u] |
This information is provided as survival estimates in rolling five-year periods because there are insufficient diagnoses of mesothelioma to provide estimates by a single year of diagnosis. This is because of the statistical frameworks used in the estimation of survival analysis which require minimum numbers of patients to be alive at each estimation point and for a minimum number to have died around the same time to reliably estimate the mortality rates of the cancer cohort. For cancers like mesothelioma, the number of patients remaining alive quickly falls to a number that no longer permits the estimation of survival beyond 5-years after diagnosis, shown as [u] in the table to detonate low reliability.
Furthermore, all estimates of survival vary with time from diagnosis. We have provided estimates at one, two, three, four and five years after diagnosis for five periods of diagnosis: 2012-2016 to 2016-2020, which is the most recent available.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of current NHS wait times for neurodiversity assessments for children; and what steps they are taking to reduce them.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
No specific assessment has been made. NHS England publish quarterly experimental data on how many people, including children, are waiting for an autism assessment. Whilst we recognise that a significant percentage of autism assessments for children are reported through the Community Services Data Set, which is currently not reported on within this publication, the reported data provides useful information to support local areas to assess local demand and adequacy of services.
Additionally, in a Westminster Hall debate, on 1 February 2023, the Parliamentary Under Secretary of State for Mental Health and Women's Health Strategy at the Department of Health and Social Care committed to look at how we can improve data on attention deficit hyperactivity disorder (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. On 5 April 2023, NHS England published a national framework and operational guidance for autism assessment services. This guidance, published in an online only format, will help the NHS improve their autism assessment pathways and improve the experience for children and young people referred to an autism assessment service.
This year, 2023/2024, £4.2 million is available to improve services for autistic children and young people, including autism assessment services and pre- and post-diagnostic support, and the continuation of the Autism in Schools programme. We are committed to increasing investment into mental health services by at least £2.3 billion a year by March 2024 and have set out our aim in the NHS Long Term Plan for an additional 345,000 children and young people to be able to get the mental health support they need.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to (1) prevent ill health, and (2) promote staying healthy, among older people.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We work to support the health needs of, and prevent ill health in, older people through a variety of action. This includes the NHS Health Check, which detects people at risk of developing cardiovascular disease in later life, and an ambitious prevention agenda to tackle the most common preventable diseases among older people. For example, encouraging people in mid-life to stop smoking, reduce their alcohol consumption and improve their diet to help reduce the risk of developing dementia, disability and frailty in later life.
The Government will also publish a Major Conditions Strategy which will set out a strong and coherent policy agenda that sets out a shift to integrated, whole-person care. The Strategy will tackle conditions that contribute most to morbidity and mortality across the population in England including cancers, cardiovascular disease, including stroke and diabetes, chronic respiratory diseases, dementia, mental ill health and musculoskeletal conditions. An interim report will be published in the summer.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether patients' mobility is monitored as part of the NHS Health Check.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The proportion of people taking up the offer of an NHS Health Check between April 2017 and March 2018 was 47.9%, April 2018 and March 2019 was 45.9%, April 2019 and March 2020 was 43.7%%, April 2020 and March 2021 was 39% and April 2021 to March 2022 was 40.5%.
Individuals aged between 40 to 74 are eligible for an NHS Health Check every five years however the Department does not collect data on individual patients. Patients' mobility is not monitored as part of the NHS Health Check.