Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to enable GPs to prescribe antivirals, including Paxlovid, for the treatment of Covid in accordance with NICE evaluations.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Decisions on whether licensed medicines, including antivirals for COVID-19, should be recommended for routine National Health Service funding are made independently by the National Institute for Health and Care Excellence (NICE), on the basis of the evidence of costs and benefits.
The NICE recommends the antiviral Paxlovid, a combination of nirmatrelvir plus ritonavir, as an option for treating COVID-19 in adults, only if they do not need supplemental oxygen for COVID-19, and they have any of the following:
A phased implementation of the NICE’s recommendations on Paxlovid has been agreed, to allow more time for the NHS to put in place the capacity and infrastructure needed for the full rollout to all eligible patients. Prescribers, including general practitioners, are currently able to prescribe Paxlovid to NHS patients at the highest risk of severe COVID-19, in line with the approach to rollout set out in the NICE’s guidance.
Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether perinatal mental health training is incorporated into the undergraduate and postgraduate syllabuses for all general practitioners, health visitors, midwives, nurses and obstetricians and mental health professionals.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Government has mandated Health Education England (HEE) to provide national leadership on education, training and workforce development in the National Health Service in England.
It is the responsibility of the professional regulators to set the standards and content for education and training and ensure newly qualified doctors, nurses, midwives, obstetricians and mental health professionals are equipped with the knowledge, skills and attitudes to provide high quality patient care. The General Medical Council and Nursing and Midwifery Council set standards for the education of doctors, nurses, midwives and health visitors respectively. The royal colleges also have responsibility for developing curricula for doctors, nurses and midwives.
The Mandate between the Government and NHS England includes a specific objective to reduce the incidence and impact of postnatal depression through earlier diagnosis, and better intervention and support.
Maternity services feature prominently in the key objectives set out in the Mandate between the Government and the NHS England. The Mandate states that women should receive better care during pregnancy and have a named midwife responsible for ensuring personalised, one-to-one care throughout pregnancy, childbirth and during the postnatal period.
Health Education England will ensure that training in perinatal mental health is available so that specialist staff will be available to every birthing unit by 2017.
In addition, by March 2015 HEE, working with the Royal College of Midwives, will develop a continuing professional education framework for the existing maternity and early years workforce so that all healthcare professionals who come into contact with women using maternity and postnatal services have access to training to optimise the care and treatment of women with perinatal mental health illness.
Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what action they are taking to address any shortfall of beds in specialist inpatient mother and baby units.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
NHS England is responsible for commissioning specialised inpatient perinatal mental health services that provide a safe and secure environment for the care of women with severe mental illness and their infants. Assessments should be made by clinical commissioning groups based on local needs.
The number of inpatient mother and baby units specialising in psychiatric care during the perinatal period increased from 10 units in 2010 to 17 in 2014.
NHS England has committed in its business plan to develop and deliver a pathway to support women with postnatal mental health problems by March 2015. It is also working with local partners to support the continued development of maternity and perinatal mental health networks through its Maternity and Children Strategic Clinical Networks to promote seamless integrated comprehensive care across the whole clinical pathway.
To raise awareness of good maternal mental health during pregnancy and the first year after birth the Mandate between the Government and NHS England includes a specific objective to reduce the incidence and impact of postnatal depression through earlier diagnosis, and better intervention and support.
To support this, Health Education England will ensure that training in perinatal mental health is available so that specialist staff will be available to every birthing unit by 2017.
We have trained 400 perinatal mental health visitor champions who are supporting health visitors with the identification and management of anxiety, mild to moderate depression and other perinatal mental disorders and knowing when to refer on.
The Department has also commissioned the National Perinatal Epidemiology Unit at Oxford University to develop a perinatal mental health indicator, which will help us to better identify and address gaps in our services. NHS England is developing a plan to support women with postnatal mental health problems by March 2015 which will share best practice and learning with the National Health Service.
Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many clinical commissioning groups have a perinatal mental health strategy.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Details of which clinical commissioning groups have a perinatal mental health strategy are not collected centrally.
A National Childbirth Trust survey published in 2014 found that out of 194 CCGs questioned, 5 CCGs (3%) said they have a strategy for providing perinatal mental health services. A further 34 (18%) said they are developing or planning to develop a strategy.
However, NHS England will, through its Maternity and Children Strategic Clinical Networks, support the continued development of maternity and perinatal mental health networks to drive improvements to access, quality of care and inter-service communication. This will enhance the experience of women and families generally, and more specifically for the large numbers of women who are at risk of poor mental health during pregnancy and following childbirth.
Specialised Perinatal Mental Health Services (mother and baby units) are part of a wider network of Perinatal Mental Health services and the commissioning of the ‘specialist’ (local) and ‘specialised’ (national) pathway is a responsibility shared between NHS England, clinical commissioning groups and local authorities.
Health Education England is working with partners to ensure that pre and post registration training in perinatal mental health is available to enable specialist staff to be available to every birthing unit by 2017.
Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many of the proposed 375 perinatal mental health visitor champions have been trained.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Department has already funded the successful training of 573* perinatal mental health champions and this total is likely to increase further. The champions’ training was commissioned from the Institute of Health Visiting. It covers the fundamental requirements necessary for health visitors to manage anxiety, mild to moderate depression and other perinatal mental disorders, including knowing how to assess for the presence of these conditions and if identified, the variety of ways they can support mothers - either by intervening themselves or through referral on to a general practitioner or specialist.
The training model enables participants to become local perinatal mental health champions and to disseminate their skills and knowledge to health visitor and other professional colleagues locally. All health visitors also have access to supportive interactive e-learning modules to help them in the detection and management of perinatal depression and other maternal mental health conditions.
*Source: latest available data from the Institute of Health Visiting
Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether the report by the National Perinatal Epidemiology Unit at Oxford University commissioned by the Department of Health will be published; and if so, when.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The report has been completed and its publication is planned for the end of February 2015.
Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what proportion of midwives are trained to provide mothers with mental health support.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Government is committed to giving mothers the support and care they need throughout their pregnancy, birth and after birth. Safety and high quality care for mothers are at the heart of maternity services.
Health Education England’s (HEE) Mandate requires it to build knowledge and competence in perinatal mental health. HEE has developed a proposed set of learning objectives on perinatal mental health for student midwives, and has engaged with the Royal College of Midwives to discuss this proposal and ensure that the curriculum provides midwives with the appropriate level of knowledge and competence in perinatal mental health.
To ensure that qualified midwives keep their skills up-to-date with the latest evidence, HEE has developed three e-learning modules in partnership with the Institute of Health Visiting on perinatal mental health, intended for use by midwives, nurses and health visitors. The modules specifically cover perinatal depression and other maternal mental health disorders. HEE plans to develop further e-learning modules for the existing workforce in 2015, to reduce the incidence and impact of postnatal depression through earlier diagnosis, and better intervention and support.
HEE is working with partners to ensure that pre and post registration training in perinatal mental health is provided consistently. This will facilitate staff with specialist skills being available to every birthing unit by 2017.
HEE are sustaining the record number of midwives entering training this year, and has commissioned 2,563 new Midwifery training places for 2014/15. Between May 2010 and October 2014, the numbers of full-time equivalent midwives have increased by nearly 2,000 and over 6,000 are in training.
Asked by: Baroness Nye (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they have achieved their target of 4,200 extra health visitors by 2015.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Government is committed to growing the health visitor workforce by 4,200 full-time equivalents (FTEs) by April 2015, and transforming health visiting services to improve health outcomes and contribute to reducing health inequalities. The most recent management information (December 2014) published by NHS England estimates an indicative count of 11,310 FTE health visitors: some 3,218 more than the May 2010 baseline, representing an increase of 40% so far. In addition, there are approximately 1,036 health visitors who are due to complete training by the end of March 2015.