Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, in the light of reports that drug-related deaths are increasing in the areas of England where cuts to drug treatment budgets have been among the greatest, whether they intend to establish a national inquiry and action plan to tackle this issue in order to reduce the number of deaths.
Answered by Lord O'Shaughnessy
Public Health England (PHE) led an inquiry last year into the rises in drug-related deaths. The inquiry report, Understanding and preventing drug-related deaths: The report of a national expert working group to investigate drug-related death in England, was published on 9 September 2016 and a copy is attached.
The Government is investing over £16 billion over the current five-year spending review period for local authorities (LAs) to spend on public health. LAs are responsible for making decisions on how to spend their local allocation, but the public health grant conditions make it clear that they must have regard for the need to improve the take up of and outcomes from their drug and alcohol misuse treatment services. Whilst there is considerable variation across the country, with some regions showing large increases in recent years, PHE will continue to support LAs in delivering tailored, accessible and effective services where people stand the best chance of recovery.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, in the light of the increases in the number of opioid-related deaths, what consideration they have given to the advice of the Advisory Council on the Misuse of Drugs supporting the use of opioid substitution treatment.
Answered by Lord O'Shaughnessy
The Government has considered the Advisory Council on the Misuse of Drugs’ (ACMD’s) advice carefully and set out a range of work it is taking forward to address it in its response published in July.
For people to achieve and sustain freedom from drug dependence, the Government recognises the need for high quality treatment interventions as well as wider recovery support, including stable employment and housing, to enable people to build and maintain their recovery and live a life free from drugs. The ACMD’s recommendations and the findings of its published evidence review have informed the current and future work programme of Public Health England (PHE) in relation to supporting the quality of Opioid Substitution Therapy. PHE is also developing guidance, in partnership with NHS England, to support local areas to effectively meet the needs of people with co-existing mental health and substance misuse problems, which it is planning to publish this year.
As we continue with the implementation of the Drug Strategy published this summer, the advice of the ACMD will be fundamental to informing our approach and the Government will continue to seek its valuable input and advice.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department for International Development:
To ask Her Majesty’s Government when the decision was made to stop the Department for International Development funding for the charity Planet Aid; what formal evaluation or audits were made of the work of Planet Aid and when were those carried out; and on what evidence the recommendation to stop Planet Aid funding was made.
Answered by Lord Bates
DFID has no record of directly funding Planet Aid and therefore no record of stopping funding to the organisation.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Ministry of Justice:
To ask Her Majesty’s Government whether Community Rehabilitation Companies are required to collect data on mental health, physical health or substance misuse; and if so, whether that data will be published, when, and in what format.
Answered by Lord Henley
Community Rehabilitation Companies gather information on an individual offenders’ mental health, health and substance misuse as part of establishing their rehabilitation and resettlement needs and risk assessment. This information is not collated by the Ministry of Justice centrally. We are carrying out a comprehensive review of the probation service to improve outcomes for offenders and communities and will publish the outcome of this in due course.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Ministry of Housing, Communities and Local Government:
To ask Her Majesty’s Government, in implementing the proposed voluntary agreement with housing associations regarding the extended right to buy, how they will safeguard the land interests of charities that have been acquired by charitable donation.
Answered by Baroness Williams of Trafford - Shadow Chief Whip (Lords)
Under the voluntary agreement with the National Housing Federation, there will be a presumption that housing association tenants will have the right to purchase their home at Right to Buy level discounts, but associations will not be obliged to sell particular properties where there are reasons why this would not be in the interests of their operations.
This includes housing associations exercising discretion over the sale of properties provided through charitable or public-benefit resources or bequeathed for charitable or public-benefit purposes, and in the possession of the housing association before it became registered under the Housing Act 1974 (or later equivalent legislation).
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, in the light of the research published in July 2015 in <i>Addiction</i> on the payment by results drug recovery pilots, what advice they plan to issue to public health directorates on the commissioning of drug treatment services.
Answered by Lord Prior of Brampton
The Department of Health-funded independent evaluation of the drugs and alcohol recovery payment by results pilots programme has yielded several interim reports to date and is currently drawing to a conclusion. We will wait for this report to ensure that any advice is based upon the fullest and best available evidence.
The article published in Addiction is an early output from the evaluation, based on data collected during the first year of the drugs and alcohol recovery payment by results pilots programme. The final evaluation report, which is due in late August 2015, is expected to be published in late Autumn 2015 following an independent peer review process.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of changes in the number of deaths from heroin and morphine abuse over the first full year since they placed a financial incentive on the successful completion of drug treatment; and whether they have any plans to discontinue that policy on the grounds of patient safety.
Answered by Earl Howe
Whilst no conclusions can be drawn from one year’s data, Public Health England is analysing the drug misuse and treatment datasets to identify possible reasons for the change in drug misuse deaths reported in 2013. This analysis is due to be published in a statistical bulletin in 2015 and will help inform any possible future actions.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, in the light of the findings in the <i>Evaluation of the Drugs and Alcohol Recovery Payment by Results Pilot Programme </i>(Interim Summary Report June 2014, National Drug Evidence Centre, University of Manchester) in respect of the impact of payment by results on practitioners and service users (1) what is their policy on reducing the number of service users prescribed opioid substitution medication; (2) what advice they give to local authority public health directorates on the use of the payment-by-result target for successful completions of drug treatment; (3) what regulatory framework covers local authority public health directorates' drug and alcohol commissioning and service delivery; and (4) who is responsible for regulation of the local authority commissioning of drug and alcohol provision.
Answered by Earl Howe
The Drug and Alcohol Recovery Payment by Results (PbR) pilots ran from April 2012 to March 2014. Their purpose was to develop and test the PbR approach to contracting for drug and alcohol services.
As with services in other parts of the country, providers in the eight PbR pilot sites were expected to take account of the United Kingdom guidelines on the Clinical Management of Drug Misuse and Dependence and the relevant guidance from the National Institute for Health and Care Excellence. Services that prescribe opioid substitute treatment must be registered with the regulator, the Care Quality Commission.
The Government’s 2010 Drug Strategy is ambitious to support more people to recover from dependence on drugs and alcohol, acknowledging that all treatments with a sound evidence base, including opioid substitution medication, have a role to play depending on the clinical circumstances of individual cases.
Pending the publication in 2015 of the independent evaluation of the pilot programme, in August 2014 the Department published a note on lessons learnt. This document was intended for commissioners and providers who are considering using a PbR method and highlights the key areas where additional attention may need to be focussed to optimise the PbR approach.
Local Authority Circular LAC(DH)(2014)2, Public Health Ring-fenced Grant Conditions – 2015-16, dated 17 December 2014, stipulates at paragraph 20 that “in commissioning services using funds from this grant, local authorities should also ensure that appropriate clinical governance arrangements are put in place.” The circular contains a link to a public health commissioning template which emphasises the importance of good clinical practice.
The structures for coordinating local Joint Strategic Needs Assessments and the provision of services are set out in the Health and Social Care Act 2012. Should there be a complaint which cannot be resolved locally about a local authority’s discharge of its functions, an individual can refer the matter to the Local Government Ombudsman.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the reasons for the 32 per cent rise in the number of deaths from heroin or morphine abuse between 2012 and 2013; and how many of the 765 people who died as a result of heroin or morphine abuse in 2013 had left drug treatment in the month that preceded their death.
Answered by Earl Howe
At this stage it is not possible to draw any definitive conclusions about a longer-term trend in deaths from one year’s data. Public Health England is currently analysing the data to better understand the reasons for the increase.
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Ministry of Justice:
To ask Her Majesty’s Government how many people committed suicide in prison in England in 2014; and of those (1) how many received mental health assessments prior to their deaths, and (2) how many were diagnosed with a mental health illness.
Answered by Lord Faulks
The number of self-inflicted deaths in prison custody in 2014 is due to be released on the 29th January 2015 at https://www.gov.uk/government/collections/safety-in-custody-statistics
The most recent Safety in Custody statistics bulletin covers deaths in prison custody up to the end of September 2014. In the first 9 months of 2014 there had been 58 self-inflicted deaths in prison custody in England. As it can be difficult to determine a person’s intent to take their own life, the National Offender Management Service (NOMS) classifies any death where a person has apparently taken their own life, irrespective of intent, as a self-inflicted death.
Information on mental health assessments and diagnoses are not collected centrally.
Prisoners receive a detailed medical examination on reception and those identified as having mental health needs are referred for a further mental health assessment. The reception healthcare screen also includes an assessment of the risk of self harm or suicide. Prisoners identified as being at risk of self harm or suicide (on reception, or at any point during their time in custody) are subject to Assessment, Care in Custody and Teamwork (ACCT), a flexible, prisoner-centred care planning process. The ACCT process includes a detailed psychosocial assessment by a trained assessor within 24 hours, and this is followed immediately by the first multi-disciplinary case review, at which a decision is reached about whether or not a further mental health assessment is necessary.
We are applying strenuous efforts to learn from each death and are providing further resources and support to prisons to help support their safer custody work. Reducing the number of self-inflicted deaths in prisons is a top priority, and our dedicated resources are providing support to many vulnerable prisoners every single day.