Asked by: Baroness Whitaker (Labour - 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 people with Primary Progressive Aphasia can access speech and language therapy through Specialised Cognitive Neurology Services in all specialised neurology centres.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence guidelines.
The Government is committed to improving care for everyone with dementia, including those with Primary Progressive Aphasia, which is why we have funded the work of the Dementia 100: Assessment Tool Pathway programme, which brings together multiple resources into a single, consolidated tool. This will help simplify best practice for busy system leaders and help create communities and services where the best possible care and support is available to those with dementia.
A number of experts, including those with expertise in speech and language therapy and dementia care, provided independent, desktop analysis of the tool and this invaluable feedback was integrated into the tool. The D100: Pathway Assessment Tool is available on the Royal College of Psychiatrists’ website.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 12 March (HL13897), what are the health disparities of Gypsy, Traveller and Roma ethnic groups in the areas in that Answer, in particular (1) maternal mortality outcomes, (2) mental health provision, (3) cancer outcomes, and (4) cardiovascular disease; and what action they are taking to reduce those disparities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is a priority for the Government to increase the amount of time people spend in good health and prevent premature deaths. Our 10-Year Health Plan for England sets out a reimagined service designed to tackle inequalities in both access and outcomes, including our ambitious commitment to halve the healthy life expectancy gap between the richest and poorest regions.
NHS England has launched a Maternity and Neonatal Equalities dashboard that brings together key information to address health inequalities in maternity and neonatal care services from a range of data sources, with breakdowns by ethnicity and deprivation to make health inequalities visible, measurable, and actionable in maternity and neonatal services.
NHS England is implementing a new anti-discrimination programme, which aims to ensure all service users and their families will receive care free from discrimination and racism, and all staff will experience a work environment free from discrimination and racism. All trusts are expected to have completed the programme by 2027.
We have legislated to modernise the Mental Health Act to strengthen choice, autonomy and rights, and ensure people are treated with dignity and respect. The Government is also committed to delivering the cross-sector Suicide Prevention Strategy for England (2023 to 2028), including its ambition to improve evidence and better understand national trends and suicide rates in particular groups, including people who are Gypsy, Roma or Travellers.
The Government and NHS England have announced a three-year Neighbourhood Early Diagnosis Fund as part of £200 million investment for Cancer Alliances to tackle inequalities in screening and early diagnosis in deprived and underserved areas. Core20PLUS5 also includes early cancer diagnosis as a priority area for accelerated improvement.
The Department recognises inequalities exist across the cardiovascular disease (CVD) pathway. The Department and NHS England are working together to develop a CVD Modern Service Framework which will support, evidence-led consistent, high quality and equitable care.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the research published by PSE Healthy Energy and Stanford University in Environmental Research Letters on 25 March on the harmfully high levels of benzene measured in UK homes emitted by gas cooktops.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK Health Security Agency (UKHSA) has noted the published research but has not made a full assessment of the study, which is based on a small number of stoves. Currently, there are limited studies that have investigated benzene concentrations in United Kingdom homes. Further research is needed to better understand exposure to indoor air pollutants and the effects on health.
Reducing emissions of pollutants and ensuring adequate ventilation within indoor environments are important. The UKHSA continues to consider and evaluate the evidence of exposure to indoor air pollutants and the potential health effects.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the number of people aged 18 and over who have speech, language and communication needs.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England does not hold a dataset that would support an estimate of the number of people aged 18 years old and over who have speech, language, and communication needs to this degree.
The Government recognises the important role that speech and language therapy services play in supporting people to overcome health and social barriers and enhancing overall quality of life.
All NHS services, including speech and language therapy, should operate in accordance with the best available evidence-based practices. Where sufficient evidence exists, the National Institute for Health and Care Excellence (NICE) publishes formal guidance. Frontline services, including those delivering speech and language therapy, are expected to adhere to NICE guidance wherever it is available and applicable.
The Department continues to work with NHS England and other partners to improve understanding of speech, language and communication needs for people of all ages.
It is the ambition of this Government that, through its commitment to deliver a single patient record, people who have speech, language and communication needs will receive more co-ordinated, personalised and predictive care across the system.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the finding set out in the joint report by the Roma Support Group and Friends, Families and Travellers Enablers of digital inclusion in primary care for Gypsy, Roma and Traveller Communities, published in June, that 46 per cent of Gypsy, Roma and Traveller people surveyed reported they had no access to digital primary care services due to a lack of confidence in using technology, language barriers and a preference for in-person services, what steps they plan to take to improve those communities’ access to digital primary healthcare services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We know that some patients will struggle to access digital services. We will ensure patients have multiple routes of access to primary care by guaranteeing a face-to-face general practice appointment to anyone who wants one, and by implementing a modern booking system to end the 8:00am rush. Digital tools used in primary care settings must meet required minimum standards of functionality set by NHS England, ensuring a consistent quality of service for patients, and all organisations providing National Health Services, including primary care providers, must follow the Accessible Information Standard.
We are clear that all online tools must be provided as an additional option, not as a replacement for more accessible channels like telephone or reception services. This ensures that individuals without access to digital technology, including those from disadvantaged groups, are not excluded and can choose the method of communication that works best for them. All patients should be treated equitably no matter what route they access general practice with.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what progress they have made since the 2021 Friends, Families and Travellers mystery shopping exercise in ensuring that nomadic Gypsy and Traveller patients are not wrongfully refused access to GP services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We are very clear that a general practice (GP) cannot refuse registering a patient based on the race or ethnicity, gender, social class, age, religion, sexual orientation, appearance, disability, or medical conditions of the patient. This encompasses patients from gypsy, Roma, and traveller communities.
GPs have a responsibility to register people who are homeless, have no fixed abode, or are legitimately unable to provide documentation as proof of living within the catchment area. An individual should not be refused registration or appointments because they do not have a proof of address or personal identification. It is not considered a reasonable ground to refuse registration.
The General Medical Services Regulations were updated to require practices to use a standardised registration system that doesn't require identification or an address. Additionally, the regulations now require GPs to provide an online consultation tool, allowing patients to manage appointments, and view and request repeat prescriptions digitally. This service also simplifies electronic registration with GP surgeries. Digital registration is designed to accommodate diverse patient needs, enhancing accessibility, and making it easier for patients to register without visiting the practice in person.
However, to ensure that patients aren’t digitally excluded, the GP contract is clear that patients should always have the option of visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. Practice receptions should be open so that patients without access to telephone or online services are in no way disadvantaged.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to improve access to digital primary healthcare services among Gypsy, Roma and Traveller people.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We know that patients are struggling to access general practice (GP), and that these struggles can be particularly acute in inclusion health groups such as gypsy, Roma, and traveller communities.
We want to ensure that digital healthcare services are available to those who need them. The GP contract requires GPs to provide an online consultation tool, allowing patients to manage appointments, and view and request repeat prescriptions digitally. This service also simplifies electronic registration with GP surgeries. Digital registration is designed to accommodate diverse patient needs, enhancing accessibility, and making it easier for patients to register without visiting the practice in person.
However, to ensure that patients aren’t digitally excluded, the GP contract is clear that patients should always have the option of visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing GPs. Practice receptions should be open so that patients without access to a telephone or online services are in no way disadvantaged.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 25 October (HL1693), what assessment they have made of the June report, Enablers of digital inclusion in primary care for Gypsy, Roma and Traveller Communities, published by the Roma Support Group, and Friends, Families and Travellers, on access for Roma and Traveller people to digital services in primary care contexts such as GPs, opticians, pharmacies, and dentists.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Enablers of digital inclusion in primary care for Gypsy, Roma and Traveller Communities recommends that primary care services offer flexibility and choice, including non-digital access routes, and that accessibility should be prioritised when designing digital services.
We will ensure patients have multiple routes of access to primary care by guaranteeing a face-to-face general practice appointment to anyone who wants one, and by implementing a modern booking system to end the 8:00am rush. Digital tools used in primary care settings must meet required minimum standards of functionality set by NHS England, ensuring a consistent quality of service for patients, and all organisations providing National Health Services, including primary care providers, must follow the Accessible Information Standard.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 25 October (HL1778 and HL1779), how the Suicide Prevention Strategy envisages improving the suicide rate of Gypsy, Roma and Traveller communities over its five-year period.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The purpose of the strategy was to set a direction for suicide prevention for all organisations to consider (national and local government, researchers and VCSE sectors). The ambitions outlined in the Suicide Prevention Strategy of September 2023 cover five years and include research on and better understanding of national trends and suicide rates in particular groups, including Gypsy, Roma and Traveller people.
A qualitative research project exploring the lived experiences of Roma people in England and Wales, including priorities, needs and access to services, will shortly be starting. This project is led by the Qualitative Research Team, within the Centre for Equalities and Inclusion at the Office for National Statistics, delivered in partnership with Migration Yorkshire, Roma Support Group and the University of Sheffield, and in collaboration with the Department of Health and Social Care, Department for Education and Cabinet Office.
This project will provide insights into how Roma communities’ needs change over their lifetime and identify barriers to accessing services, including for maternal and mental health. Depending on the findings, this research may give us insight into the factors contributing to suicide risk within Roma communities and enable us to develop more targeted prevention strategies that resonate with the Roma community’s unique experiences and challenges, address the unique needs of the young Roma population in England and anticipate how migration and settlement patterns may influence their future healthcare requirements.
More broadly, our Inclusion Health initiative aims to support the Gypsy, Roma, and Traveller communities and other inclusion health groups. This program is specifically designed to address the unique needs of socially excluded groups.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken to ensure that nomadic Gypsy and Traveller patients are not wrongfully refused access to GP services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We are very clear that a general practice (GP) cannot refuse registering a patient based on the race or ethnicity, gender, social class, age, religion, sexual orientation, appearance, disability, or medical conditions of the patient. This encompasses patients from gypsy, Roma, and traveller communities.
Additionally, GPs have a responsibility to register people who are homeless, have no fixed abode, or are legitimately unable to provide documentation as proof of living within the catchment area. An individual should not be refused registration or appointments because they do not have a proof of address or personal identification. It is not considered a reasonable ground to refuse registration.
Practices also have a contractual duty to provide emergency treatment and immediately necessary treatment free of charge for up to 14 days to anyone within their practice area who isn’t registered with another provider of essential services.