Asked by: Lord Bradley (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 accessibility of mental health services to (1) children and young people, and (2) older adults, who have speech, language and communication needs.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the NHS Priorities and Operational Planning Guidance for 2024/25, NHS England is continuing to expand access to mental health services. This includes increasing the number of children and young people accessing comprehensive mental health support, as well as the number of adults and older adults completing a course of treatment for anxiety and depression via NHS Talking Therapies, some of whom having speech, language, and communication needs. Support may include provision of speech and language therapy as part of a local offer, however decisions about service provision are down to local determination by integrated care boards, to meet locally identified need.
As set out in the Equality Act 2010, all organisations, including those in health and social care, must take steps to remove the barriers individuals face because of disability. The National Health Service must make it as easy for disabled people to use health services as it is for people who are not disabled. NHS organisations and publicly funded social care providers must also comply with the Accessible Information Standard, to meet the communication needs of patients and carers with a disability, impairment, or sensory loss.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to change the way that deaths of patients detained in secure settings under the Mental Health Act 1983 are investigated.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are currently no such plans at this time to change the way that deaths of patients detained in secure settings under the Mental Health Act 1983 are investigated.
The Mental Health Bill will deliver our manifesto commitment to modernise the Mental Health Act 1983. It will give patients greater choice, autonomy, enhanced rights and support, and ensure everyone is treated with dignity and respect throughout treatment. The Bill will make the Act fit for the 21st century, redressing the balance of power from the system to the patient and ensuring people with the most severe mental health conditions get better, more personalised, care.
The Patient Safety Incident Response Framework sets out the NHS’s approach to developing and maintaining effective systems and processes for responding to patient safety incidents for the purpose of learning and improving patient safety. The Framework became a requirement in the NHS standard contract from April 2024. Under this framework a locally-led patient safety incident investigation is required for deaths of patients detained under the Mental Health Act (1983) or where the Mental Capacity Act (2005) applies, where there is reason to think that the death may be linked to problems in care (i.e., the incident meets the “learning from deaths” criteria, the investigation explores decisions or actions as they relate to the safety event).
In addition, all deaths among people detained under the Mental Health Act 1983 are reported to the Care Quality Commission and referred to the Coroners Office.
Asked by: Lord Bradley (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 speech and language therapy services in prisons.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England’s Regional Health and Justice teams directly commission the primary healthcare services within prisons, and oversee the healthcare delivery based on the primary care service specifications for prisons. In line with the specifications, healthcare providers should provide healthcare which includes supporting people’s mental health, as well as communication, speech, and language needs.
Healthcare services in the children and young people secure estate are commissioned locally by Regional Health and Justice commissioners using core outcome-based specifications, which are benchmarked by the Healthcare Standards for Children and Young People in Secure Settings. These include several individual standards that reference speech, language, and communication needs, as part of the overall complex needs that are common in children held in these settings.
NHS England recently held an event for regional Health and Justice neurodiversity leads and commissioners on neurodiversity specialist recruitment, to support with recruitment and training in specialist areas such as speech and language therapists. This included a presentation from the Royal College of Speech and Language Therapist’s prisons lead. In addition, NHS England has allocated additional funding to Health and Justice regions which has been ring-fenced for use on their adult prison custodial neurodiversity pathways.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to increase the capacity and geographical distribution of inpatient secure mental health beds.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has advised that work is currently underway with the 15 Adult Secure Provider Collaboratives across England to speed up the safe and timely transfer of appropriately assessed people from prison. This includes identifying existing capacity, including workforce estates and location, that can be reconfigured at pace; identifying where additional capacity, including workforce and estates, may be required; and, scoping at pace, the creation of alternative clinically safe service models.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to review the funding of hospices in England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We want a society where every person receives high-quality, compassionate care, including at end of life. We understand that, financially, times are difficult for many voluntary and charitable organisations, including hospices, due to the increased cost of living. We want a society where these costs are manageable for both voluntary organisations, like hospices, and the people whom they serve.
The Government is going to shift the focus of healthcare out of the hospital and into the community, and we recognise that hospices will play a vital role. We will consider next steps on palliative and end of life care more widely in the coming months.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what was the financial position of each integrated care board at the end of financial year 2023–24.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The financial year-end reports for integrated care boards are still in progress and not yet finalised. We anticipate that final, audited reports will be completed and available in July 2024.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 12 March (HL3021), what is the distribution of each category of commissioned mental health service bed into each integrated care board area.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England does not hold this data at an integrated care board level.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many (1) high secure, (2) medium secure, and (3) low secure, mental health service beds are in each integrated care board area of England.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The following table shows the amount of mental health service beds available, broken down by security level, as well as when the data was last validated:
Specialised Mental Health Inpatient Services | Commissioned Beds | Last Validated |
Adult High Secure | 715 | October 2022 |
Adult Medium Secure | 2965 | March 2021 |
Adult Low Secure | 3003 | March 2021 |
Total | 6683 | N/A |
Source: NHS England.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many people entering prison underwent reception screening for mental health issues; and how many of these were undertaken by a person with a recognised mental health qualification, in each of the last five years.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Everyone coming into prison either from courts or transfer from another prison or on remission from a psychiatric unit receives the first reception screening. This screening is based on National Institute for Health and Care Excellence guidelines and includes questions on a person’s mental health. The clinicians undertaking the initial reception screening could be either a general nurse or a mental health nurse. We do not have the breakdown of those that undertake reception screenings when seeing prisoners and their qualifications.
Any patient that requires further support or investigations for physical or mental health conditions is appropriately referred on to the relevant team. It is important to note that the initial health screen on reception is to keep people safe in the first few days. A more comprehensive second screening is undertaken within seven days of arrival.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what was the aggregate financial surplus or deficit for each integrated care board in England at the end of the first quarter of the 2023–24 financial year; and what was the percentage change from the surplus or deficit at the beginning of the 2023–24 financial year.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
At the beginning of each financial year, all integrated care boards (ICBs) will agree a plan for the year with NHS England that includes expected expenditure against budgets for each month. At the end of the first quarter, several ICBs have reported an overspend against the agreed plan for that quarter. A table of the full list of these ICBs is attached.