Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they require to ensure the Care Quality Commission (CQC) updates its digital infrastructure so that statutory notifications of deaths can be automatically aggregated and analysed by a service user’s specific condition; and what assessment it has made of the CQC's response to a Freedom of Information request that it cannot extract data on the deaths of learning disabled or autistic individuals without a manual review of over 133,000 records.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Improving statutory notifications was in scope of the Care Quality Commission’s (CQC) transformation programme undertaken between 2021 and 2023. One of the improvements from the programme was an increase in the range of data fields collected as part of notifications for reporting.
Through recent upgrades, it is now possible for the CQC to aggregate and analyse death notifications, including for a person with a learning disability, or an autistic person.
The CQC’s response to the mentioned Freedom of Information request was given under section 12 of the Freedom of Information Act. The CQC is currently reviewing the response provided to the requester and will contact them directly regarding the information provided to them.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many prosecutions have been brought by the Care Quality Commission (CQC) since 2009 regarding the unsafe or inadequate care of people with a learning disability; and what assessment they have made of the effectiveness of the CQC’s enforcement strategy for learning disabilities in this regard.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Since 2009, the Care Quality Commission (CQC) has brought 124 criminal prosecutions to date. 111 of these prosecutions have been brought since April 2015, when the CQC was given statutory criminal enforcement powers under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Following a review of their data, the CQC can confirm that of these 111 criminal prosecutions, 12 cases have related to the care and treatment of people with a learning disability, and this could have been where the person receiving the care and treatment was a person with a learning disability or where the provider specialised in the care and treatment for people with a learning disability.
All 12 prosecutions relate to breaches of Regulations 12 and 22 of the 2014 Regulations for failure to provide safe care and treatment causing or exposing a service user to avoidable harm. The CQC also criminally enforced a further case regarding a Regulation 11 breach, for failure to obtain appropriate consent. The CQC issued two Fixed Penalty Notices, which is an alternative criminal sanction at the CQC’s disposal.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether a decision has been made on whether (1) the Department of Health and Social Care, (2) integrated care boards, (3) hospital trusts, or (4) individual GPs, will hold primary statutory data controllership for patient data processed in the single patient record; if not, what are the specific legal and operational models currently under consideration; and on what date they intend to publish the final legal framework establishing data controllership for that programme.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Single Patient Record (SPR) will improve outcomes for patients by giving professionals access to all the key information they need to deliver care, in one place, affording safer decision-making with fewer information gaps. No decision has been made on the arrangements for how the SPR will be delivered, and what the implications are for data controllership.
We will be consulting with general practitioners through a series of national engagement events starting in June 2026. This follows our programme of deliberative engagement with the public in 2024, which aimed to understand how a single patient record could be designed in a way that maximises benefits and is trusted by the public; the outcomes from this engagement are helping to shape our approach to the SPR.
It is in the best interest of all parties to have an agreed position on key issues such as data controllership. Data controllership is a specific legal term under UK General Data Protection Regulation that reflects the reality on the ground of who decides what data is collected and how it is used. In effect, a data controller is a decision-maker on the use of data and is accountable for its use.
The following points are our starting position, which we look forward to discussing with the profession.
Health and care organisations will remain data controllers for the data they hold in their practices, and what they share with SPR, to provide services to their patients.
Regulations made under the bill will require relevant health and care organisations, including general practices, to share relevant data with the SPR for the purpose of making it available to clinicians in different care settings, to improve the care of their patients.
Where, in accordance with the regulations, the SPR operator determines the means and purposes of processing data in the SPR, they will also become a data controller, with responsibilities to comply with the data protection legislation.
There is no date for publication of any legal or governance frameworks which will apply, although these will be published before any data is processed within the SPR.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether Integrated Care Boards will be required to include an executive director with specific, named responsibility for learning disabilities within the new NHS structure.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We are committed to improving outcomes for people with a learning disability and have set clear expectations of local systems to drive this forward. NHS England has published statutory guidance which makes clear that each integrated care board (ICB) is expected to have an executive lead for learning disability and autism who will support the board in meeting their duties in relation to people with a learning disability and autistic people. The guidance on executive lead roles within ICBs remains in place and there are no plans to change this.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to continue the LeDeR programme beyond the expiration of its current national contract; and, if they have no such plans, what alternative framework they will implement to ensure continued oversight, review and learning from the deaths of people with a learning disability and autistic people.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is clear that the stark health inequalities and poor life expectancy faced by people with a learning disability are unacceptable. This is recognised in the 10-Year Health Plan, with key objectives within the plan being to equip health and care services to narrow health inequalities, drive earlier intervention through a shift from treatment to prevention, and ensure more holistic support in the community.
Learning from lives and deaths – people with a learning disability and autistic people (LeDeR) reviews are a crucial part of tackling the health inequalities faced by people with a learning disability and autistic people and aim to drive key service improvements to improve health outcomes and prevent avoidable deaths at a local level. We remain committed to reviewing every death that is notified to LeDeR, learning from both good and poor practice, and ensuring that learning from reviews is shared and used to drive tangible service improvements.
NHS England’s national LeDeR policy sets out a clear governance framework and expectation that integrated care boards (ICBs) should prioritise LeDeR reviews within their delivery plans and ensure that actions are implemented to improve services and reduce premature mortality for their local populations. We have recognised that more can be done to ensure consistent delivery across ICBs and will continue to work with NHS England to strengthen oversight, assurance, and support where needed.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how they intend to ensure that the health and care needs of people with learning disabilities are addressed through a dedicated strategic framework; and what mechanisms for national accountability will be included in such a framework.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The 10-Year Health Plan recognises the need to reduce health inequalities for people with a learning disability and sets out our aims to support a shift to empowering patients and preventing sickness, rather than just treating it, and offering more holistic, on-going support in the community.
The Government is committed to improving care for people with a learning disability. Whilst there are no plans to develop a dedicated strategic framework, there is significant work already underway and clear expectations in place for health and care services to take actions which should improve health outcomes for this group. This includes the roll out of mandatory training on learning disability and autism for health and care staff, implementation of a Reasonable Adjustment Digital Flag, continued uptake of annual health checks and health action plans, and the Mental Health Act reforms. Progress continues to be made on these initiatives.
Integrated care boards (ICBs) are expected to drive service improvements and governance through existing frameworks. ICBs have an Executive Lead on learning disability and autism and an Executive Lead on learning from lives and deaths, or LeDeR. Each ICB is required to consider and demonstrate how they will reduce the health inequalities faced by people with a learning disability and autistic people within their local populations within the five-year strategic plans mandated as part of the Medium-Term Planning Framework, which is available on the NHS.UK website.
The Government recognises that more could be done to ensure consistent delivery and will continue to work with NHS England to strengthen oversight and support where needed.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in light of research by Dr George Julian showing that the Care Quality Commission has secured only one prosecution for a death involving a person with a learning disability in over a decade, what assessment they have made of the effectiveness of the CQC's enforcement strategy in this area.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Care Quality Commission (CQC) is an independent regulator, and decisions on enforcement action are a matter for the CQC, exercised in line with its statutory remit and published enforcement policy.
Prosecution is one of a range of regulatory tools available to the CQC and is used where breaches are serious, there is sufficient evidence to provide a realistic prospect of conviction, and prosecution is in the public interest, particularly where other regulatory action would not be proportionate or sufficient.
In making these decisions, the CQC is guided by The Code for Crown Prosecutors, and all criminal investigations are conducted in accordance with the Police and Criminal Evidence Act 1984 and its codes of practice.
Asked by: Lord Scriven (Liberal Democrat - 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 30 March (HL15724), whether the post of the previous chief executive of the South Yorkshire Integrated Care Board was identified for the redundancy pool as a direct result of a legal merger or abolition of that ICB as part of the reduction of ICBs from 42 to 26; and if no such merger or abolition was formally proposed for South Yorkshire ICB, on what basis that post was identified for redundancy under that framework.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether (1) NHS England, or (2) the Department of Health and Social Care, were contacted by the South Yorkshire Integrated Care Board regarding the redundancy of its previous Chief Executive prior to the redundancy payment being issued in October 2025; if so, on what date that contact occurred; and for what purpose that contact was made.
Answered by Lord Ahmad of Wimbledon
It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.
Asked by: Lord Scriven (Liberal Democrat - 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 30 March (HL15723), whether the interim leadership cover for the South Yorkshire Integrated Care Board carries out the same statutory duties as the redundant Chief Executive role; and if so, what assessment they have made of the compliance of this redundancy with the HM Treasury guidance on Public Sector Exit Payments and value for money protocols.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.