NHS Staffing: Long-term Plan
Debate between Baroness Tyler of Enfield and Baroness Manzoor
Baroness Manzoor
I am delighted that a new medical school is being opened in Lincoln, which is very welcome. On community nursing, we are trying to attract more nurses and medical practitioners to areas where there is greatest need, which are community nursing, psychiatry, mental health and learning disabilities. Last year, the Secretary of State announced golden hellos. We are also looking at further, more flexible training to enable a greater number of people to enter the profession.
Baroness Tyler of Enfield (LD)
My Lords, with concern being voiced about current vacancy levels among mental health professionals, let alone the additional 21,000 mental health practitioners the Government have said will be needed to treat a million more people by 2021, will the Government agree to fund a collaborative mental health careers campaign aimed at secondary school, college and university students, particularly psychology graduates, to help plug this gaping hole?
Baroness Manzoor
My Lords, we are looking at allied professionals and more creative ways of bringing a wide range of people into the profession. I cannot comment precisely on the question that the noble Baroness has asked. However, as she is aware, HEE has published the mental health workforce plan, which has the stretching ambition of delivering 21,000 new posts and employing 19,000 additional staff. As well as increasing recruitment and retention in mental health training, the NHS is creating new roles such as physician associates, nursing associates and allied health professional associates as well as looking at advanced clinical practitioners. On the specific question asked by the noble Baroness, I shall write to her.
NHS Long-term Plan
Debate between Baroness Tyler of Enfield and Baroness Manzoor
Baroness Tyler of Enfield (LD)
My Lords, I associate these Benches with the very warm wishes sent in the direction of the noble Lord, Lord O’Shaughnessy, in his future endeavours.
We welcome the publication of the long-term plan today. It is a very important document. It will take time to absorb all its contents and we on these Benches would welcome an opportunity to debate it in more detail. Yes, there is a lot to welcome in the plan, particularly the focus on prevention. We welcome the focus on children and young people’s services and particularly the inclusion of issues relating to people with learning disabilities. But there are many concerns about how this plan will be put into effect. The workforce plan will have to work a lot better than any of the existing workforce plans, particularly if we are to be successful in retaining existing NHS staff as well as recruiting new staff and getting NHS staff to return, feeling that it is possible to work in more flexible ways. It will require a much more creative staff plan than we have at the moment.
Of course it is good news that we will focus on prevention rather than cure, but will the Minister clarify the precise funding mechanisms that would allow that to happen, particularly the role of NHS England, Public Health England, and local authorities in this new world? Will she also confirm the role that pharmacies will play in the public health agenda and the funding mechanism for that? Also, when will the Green Paper on social care be published? It is critical to the agenda that is being set out. I particularly welcome the £2.3 billion set aside for mental health services as part of the long-term plan. What is vital now is that everyone in the NHS, local authorities, schools and employers work together to deliver these plans and ensure that that money gets to the front line. Will that money be ring-fenced?
I take a particular interest in children and young people’s mental health. We are told, and it is welcome, that there will be a new emphasis on crisis care and a new single point of access or crisis hotline delivered through NHS 111 and with that, we are told, all children and young people experiencing mental health crises will be able to access age-appropriate crisis care 24 hours a day, seven days a week. That is to be welcomed. But will the Minister say whether that new crisis care service, which I wholeheartedly support, will be part of or separate from the adult 24/7 community-based mental health crisis response service, which is also contained in the plan? Will it also include 24/7 availability of CAMHS assessment in all A&E departments in hospitals up and down the country?
Baroness Manzoor
My Lords, I thank both noble Baronesses for their contributions to this Statement. I am very grateful for some of the positive comments that were made from both Benches. I am very proud that this Government are putting £20.5 billion into the NHS. That is an amazing achievement. We must recognise that this is a great achievement for the NHS. The NHS is working closely within itself and with the Government to ensure that we can deliver the outcomes we all want, which are improved care for those who use the NHS and to prevent people from getting ill in the first place. I welcome this. As someone who worked in the NHS in my early days I recognise the importance of this money. We are not being disingenuous in what we are trying to achieve—far from it. It is because we passionately care about the NHS that we are doing this.
A number of points were raised by both noble Baronesses. I hope that they will appreciate that I have only just got this brief, but I will endeavour to do my best to answer all the questions. However, if there are any that I have not responded to, I will of course write to the noble Baronesses and place a copy in the Library. The noble Baroness, Lady Thornton, quite rightly raised the issue of staff. We need staff in the NHS if we are to carry out any plans. They are very important to us. She asked what we were doing. There are record numbers of dedicated NHS staff and they work tirelessly to make sure that patients get excellent care. We support them by training 25% more doctors, nurses and midwives, giving a significant pay rise to over 1 million staff and listening to the issues that matter to them. We know that this is a complex area and we are listening and talking to staff to see how we can bring about greater improvements in workforce planning.
To put this into context, there are currently record numbers of doctors, paramedics and ambulance staff, and all HCHS staff. The monthly workforce statistics for September 2018 show that since May 2010, there are over 45,900 more professionally qualified clinical staff working in NHS trusts and CCGs, including 16,500 or 17.4% more doctors, over 6,500 or 2.2% more nurses, midwives and health visitors, and 13,400 or 8.3% more nurses on our wards. We recognise that it is a complicated issue and that there are staff shortages in some areas, and we are actively engaging with staff and looking at solutions as we move forward.
Other issues raised by the noble Baroness, Lady Thornton, related to Brexit and to scrapping the 2012 Act as part of the long-term plan. That was about legislation and I shall deal with legislation first. I think the basis of the noble Baroness’s question was whether we are going to scrap the Lansley reforms. In June the Government asked the NHS to come forward with proposals for legislative reform to support the ambitions of the long-term plan, which have now been set out clearly. NHS England will continue to engage nationally and locally to refine the proposals over coming months. The Government will consider updating legalisation where there is clear evidence that doing so would improve services for patients.
The noble Baroness, Lady Thornton, mentioned performance and the noble Baroness, Lady Tyler, also touched upon it. The Government have been clear that through the long-term plan the NHS must get back on the path of recovering performance. The plan is clear on proposals for updating urgent and emergency care and on expectations to reduce waits for planned operations. We must ensure that we have a health system which focusses on clinically appropriate targets. The ongoing clinical review of standards, which will report in the spring, will be followed by a period of testing and evaluating any new or refined standards. The review is considering standards for physical and mental health.
The public health grant was touched upon by the noble Baronesses. We are already giving local government more than £16 billion for public health services over the current spending review period. The Government recognise the important role played by local authorities in supporting people to live longer, happier lives and managing demand for health services. We have a clear commitment to ensure that public health services continue to do that. Future budgets for PHE and the public health plan, which is part of the financial settlement for local authorities, will be finalised at the upcoming spending review.
NHS Workforce: Mental Health
Debate between Baroness Tyler of Enfield and Baroness Manzoor
Baroness Tyler of Enfield (LD)
My Lords, will the Minister say how the Government intend to respond to the report from the Royal College of Physicians on work and well-being in the NHS, which recommended that financial incentives should be included in NHS contracts to promote staff mental health and well-being?
Baroness Manzoor
That is an interesting question. As I have alluded to, NHS Improvement already has a programme to incentivise employers to ensure that they have good workplace strategies in place for well-being and mental health. It is looking to roll that out even further.