Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, in the light of the <i>Winterbourne View—Time for Change</i> report published in November 2014 and the <i>Transforming Care for People with Learning Disabilities—Next Steps</i> report published January 2015, what plans they have to introduce a national mandatory commissioning framework for community services for people with a learning disability or autism whose behaviour challenges.
Answered by Earl Howe - Deputy Leader of the House of Lords
NHS England has a core function to support local commissioning development by setting out clearer expectations about the services which need to be in place to meet standards. It is also able to support commissioners in putting such services in place, but it is not able to mandate a specific way of commissioning services.
The Department is currently consulting on whether to use powers under the Care Act 2014 to mandate pooled budgets between local government and the National Health Service for spending on appropriate community based care for people with learning disabilities. The consultation document was published on 6 March and can be found at:
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what progress has been made by NHS England in establishing a framework for workforce planning to increase the supply of British Sign Language interpreters within healthcare settings.
Answered by Earl Howe - Deputy Leader of the House of Lords
NHS England has no plans to establish a framework for workforce planning to increase the supply of British Sign Language interpreters within healthcare settings.
The provision of language support, including interpretation and translation, is driven by the requirement for all National Health Service organisations to comply with the public sector equality duty. As public sector organisations, NHS bodies have a duty to ensure that all people have equal access to the information and services that they provide.
The provision of interpretation and translation services by NHS bodies is a matter for local determination based on the composition of the communities they serve, and the needs and circumstances of their patients, service users and local populations.
As part of its commitment to improving the experience of patients using NHS services, empowering people to be equal partners in their own care and help reduce unacceptable variation in the quality of reasonable adjustments, NHS England is developing an Information Standard for the provision of accessible, personalised information.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the compliance with the principles of the Mental Capacity Act 2005 by Camphill Village Trust Limited with regard to the service provision changes being made at nine of its communities in which people with a learning disability currently live alongside volunteer co-workers.
Answered by Earl Howe - Deputy Leader of the House of Lords
The Department has not undertaken such an assessment.
The Department understands that Camphill Village Trust Limited (CVT) is making changes to service provision at its communities in England in order to ensure safe and high quality care and to ensure its compliance with all relevant legislation. These decisions are a matter for CVT.
The Care Quality Commission monitors providers’ compliance with the Mental Capacity Act 2005.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how they intend to conduct clinical trials for pronuclear transfer and maternal spindle transfer should Parliament approve the draft Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015.
Answered by Earl Howe - Deputy Leader of the House of Lords
If approved, the Draft Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015 will enable mitochondrial donation as a treatment. Safety and efficacy have been considered in depth throughout the consultation process on these techniques. It is recognised that for any new IVF technique there will need to be careful monitoring of the procedure and, subsequently, any pregnancies. Although treatments provided would not take the form of a clinical study, evidence produced from the treatments would form an important part of the ongoing assessment of the safety and efficacy of the techniques.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by the Parliamentary Under-Secretary of State for Business, Innovation and Skills, Mr George Freeman, on 14 January (HC220047), whether Nocodazole has been licensed by the Medicines and Healthcare Products Regulatory Agency; and if so, for what purpose and where the outcomes of the phase 1 clinical trial were published.
Answered by Earl Howe - Deputy Leader of the House of Lords
There are no marketing authorisations containing nocodazole approved in the United Kingdom. No clinical trial applications for investigation of nocodazole have been approved by the Medicines and Healthcare products Regulatory Agency.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what progress they have made in working with Health Education England, Skills for Health and partners to develop a national workforce academy to improve the knowledge and skills of health and social care professionals working with people with a learning disability or autism whose behaviour challenges.
Answered by Earl Howe - Deputy Leader of the House of Lords
Sir Stephen Bubb’s report, Winterbourne View – Time for Change, which was published in November recommended that a national workforce academy should be established. A cross-system response to the report is expected early in the new year and will be coordinated by NHS England.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the impact of Public Health England’s recommendation that children and adults with a learning disability should routinely be offered influenza vaccination on uptake among people with a learning disability.
Answered by Earl Howe - Deputy Leader of the House of Lords
The measures that have been introduced to promote the offer of influenza vaccination to people with a learning disability should result in increased uptake among this group. It is not possible accurately to predict or quantify the scale of the change.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what steps they are taking to address variations in uptake and quality of annual health checks for people with a learning disability.
Answered by Earl Howe - Deputy Leader of the House of Lords
General Practitioners are supported to deliver annual health checks for people with learning disabilities from the age of 14 through the Designated Enhanced Service payment scheme. The promotion of and increased access to annual health checks is a priority for NHS England.
NHS England is working in partnership with the Improving Health and Lives team in Public Health England to deliver workshops for stakeholders, and to improve information to people with learning disabilities and their families and carers to support them to access the services.
NHS England’s work in 2014-15 has focused on analysing the variation in uptake at the level of its Area Teams, including engaging with a range of stakeholders to assess the barriers and obstacles to improving uptake. This early engagement and analysis has highlighted the importance that local clinical leadership has had in driving up uptake in areas where there is higher uptake.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what steps they are taking to ensure that every acute hospital employs a learning disability liaison nurse.
Answered by Earl Howe - Deputy Leader of the House of Lords
The Equality Act 2010 exists to protect people with disabilities from discrimination. All National Health Service providers including acute hospitals have a duty to promote disability equality.
The requirement for acute hospitals to make ‘reasonable adjustments’ for people with learning disabilities is normally included in commissioner contracts and compliance measured as part of the contract management role/process. Trusts are held to account through this mechanism.
Learning Disability Liaison Nurses are proven to improve the quality of services for people with learning disabilities in acute hospitals, and are an important way of demonstrating compliance with the requirement.
The Care Quality Commission’s (CQC) approach to inspecting trusts ensures that the trust has made appropriate adjustments to meet the needs of service users, as outlined in the Key Line Of Enquiry for ‘Responsive’ in the appendix to the acute hospital handbook, available on the CQC’s website. Appropriate adjustments specifically include provision for the care of patients with learning disabilities.
The Government’s Mandate to NHS England sets out our ambitions for the health service, which include an objective that NHS England ensures clinical commissioning groups work with local authorities to ensure that vulnerable people, particularly those with learning disabilities and autism, receive safe, appropriate, high quality care. NHS England sets out how it will achieve the objectives in the Mandate in its 2014-15 – 2016-17 business plan. The Government will hold NHS England to account for its achievement.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what progress has been made to eliminate the use of police cells as a place of safety for children and adults experiencing a mental health crisis.
Answered by Earl Howe - Deputy Leader of the House of Lords
The Government is taking action to prevent the inappropriate use of police cells as a place of safety under the Mental Health Act 1983.
The Government has an ambition to reduce this practice by 50% this year – and to see how police and health colleagues can work together so that it does not happen at all to children and young people.
Last year the number of people taken to police cells as places of safety fell significantly, from 8,667 in 2011-12 to 6,028 in 2013-14. The police have told us that between the six months of April and September this year there have been 2,282 such cases – which, if maintained over the rest of the year, would result in a further 24% decrease in use of cells over last year. At the same time the use of health-based places of safety increased by 3,019 uses between 2012-13 and 2013-14.
This puts us well on track to achieve our aim of reducing the 2011-12 figure of 8,667 uses of police cells by half in 2014-15.
There was a small reduction of 10% in the numbers of children who were taken to a police cell as a place of safety – for 2013-14 this happened in 236 cases, and for 2012-13 this happened in 263 cases.
In February, we published a Crisis Care Concordat to make sure people in crisis get the help they need. All localities are working together to complete local crisis declarations agreed by all the local relevant agencies, by the end of the year.
The concordat states a clear expectation that “police custody is never used as a place of safety” for under-18s, except in very exceptional circumstances where a police officer makes the decision that immediate safety of a child or young person requires it.
In conjunction with the Home Office, the Department of Health has conducted a review of Section 135 and Section 136 of the Mental Health Act 1983. This was published on 18 December 2014.
The new Children and Young People's Mental Health and Well-Being Taskforce will also be looking at the issue of under 18s being detained in police custody as part of its Access and Prevention work.