Question to the Ministry of Housing, Communities and Local Government:

To ask His Majesty's Government what steps they will take to ensure that the planning and funding of supported housing models are fully integrated across the Ministry of Housing, Communities and Local Government and the Department of Health and Social Care.

Answered by Baroness Taylor of Stevenage - Baroness in Waiting (HM Household) (Whip)

The government recognises that supported housing is an important part of the delivery of social homes for people with care and support needs, including for older people and disabled working-age adults with personal care needs. My Department and the Department for Heath and Social Care coordinate closely on supported housing.

At the Spending Review, the government announced £39 billion for a new Social and Affordable Homes Programme over 10 years from 2026-27 to 2035-36. We want to see new supply of supported housing in England through the new programme, in greater numbers and also across a diverse range of cohorts and housing types. This includes older people’s housing, specialist housing for those with complex needs, such as long-term housing for people with learning disabilities, autism or mental health issues, and transitional housing for those experiencing or at risk of rough sleeping and homelessness or from domestic abuse. Many of the Established Mayoral Strategic Authorities have also indicated supported housing amongst their local priorities in relation to the programme.

We know that supported housing can often cost more to deliver. In the new programme, while we will maintain the principle that all bids will be assessed for value for money based on their particular circumstances, flexibility on grant rates has been built in for accommodation where the level of design and adaptation results in higher costs. We would encourage providers to come forward with ambitious bids.

The commissioning of local housing-related support services is for local authorities to determine. Local authorities are best placed to plan and decide on local spending priorities that meet the needs of their local population. Through the Supported Housing (Regulatory Oversight) Act, local authorities will be required to produce supported housing strategies to assess current and future need for supported housing in their area. The strategies will assist local authorities and housing providers with long-term planning and delivery to meet demand.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what specific policy and funding steps they will take to mandate the full implementation of the learning disabilities mortality review programme recommendations.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Learning from lives and deaths reviews (LeDeR) play a vital role in identifying learning from the notified deaths of people with a learning disability and autistic people, and the recommendations made in individual reviews, as well as the annual report, are key drivers for national and local service improvement. LeDeR reviews incorporate more than just the last episode of care before a person’s death, as they also include the key health and social care experiences the person had. The Government remains committed to reviewing every death notified to LeDeR and sharing the learning from these reviews widely to inform change.

There are no plans to mandate aspects of the LeDeR programme. Integrated care boards (ICBs) are held accountable for the care of people with a learning disability through existing governance processes, such as the NHS Operating Framework and annual assessment of ICB delivery. ICBs are expected to have an Executive Lead on LeDeR and NHS England’s national LeDeR policy sets out the clear expectation that ICBs prioritise LeDeR in their delivery plans and produce an annual report on their findings and actions taken.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what specific policy changes they will make to ensure that integrated care boards and healthcare providers are held accountable for systemic failures in providing equitable care for people with learning disabilities.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government is committed to improving care for people with a learning disability and has recognised within our new 10-Year Health Plan the unacceptable inequalities and poor life expectancy this group of people faces.

Integrated care boards (ICBs) are held accountable for the care of people with a learning disability through existing governance processes, such as the NHS Operating Framework and annual assessment of ICB delivery. ICBs are expected to have an Executive Lead for learning disability and autism to support the board in planning to meet the needs of its local population of people with a learning disability and autistic people and to have effective oversight of, and support improvements in, the quality of care.

Findings from learning from lives and deaths reviews (LeDeR) are a crucial tool for identifying systemic failures in the care of people with a learning disability and autistic people, as well as driving local service improvements. This is why ICBs are expected to have an Executive Lead on LeDeR and NHS England’s national LeDeR policy sets out the clear expectation that ICBs prioritise LeDeR reviews in their delivery plans and ensure that actions are implemented to improve services and reduce premature mortality.

In the recently published Medium-Term Planning Framework, published 24 October 2025, the Government reaffirmed its commitment to reducing the health inequalities faced by people with a learning disability and autistic people, setting up ambitious targets for ICBs and health care providers. This includes reducing admission rates to mental health hospitals for people with a learning disability and autistic people, and optimising existing resources to reduce long waits for autism and attention deficit hyperactivity disorder assessments.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what formal mechanism is in place to monitor and audit how local authorities and integrated care boards use resources designated for people with a learning disability, particularly where delegated agreements under section 75 of the National Health Service Act 2006 or equivalent arrangements are in effect, to ensure that funding intended for statutory duties is not being used to offset general budgetary deficits.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Integrated care boards (ICBs), as set out in NHS England statutory guidance published 9 May 2023, are expected to assign an executive lead role for learning disability and autism to a suitable board member. The named lead is expected to support the board in planning to meet the needs of its local people with a learning disability and its local autistic people and to have effective oversight of, and support improvements in, the quality of care for people in a mental health, learning disability and autism.

There are clear expectations of ICBs in relation to care and support provision for people with a learning disability and autistic people, and they are held accountable through existing governance processes. The Medium-Term Planning Framework, published 24 October, sets out priorities for ICBs and providers on learning disability and autism, including reducing health inequalities and reliance on mental health inpatient care. ICBs report their spend on Learning Disability and Autism Services as part of routine financial reporting, monitored by NHS England. The Model ICB Blueprint sets out the direction of travel for the role and functions of ICBs in relation to commissioning services for the needs of their local population. There is a range of best practice guidance available and published to support ICBs to commission services for people with a learning disability.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 10 November (HL11512), how many separate formal meetings involving a minister and either a senior manager or the clinical lead at NHS England with specific responsibility for the learning from lives and deaths (LeDeR) programme there have been with the LeDeR programme and its findings as the principal or only item on the agenda since July 2024; and on which specific dates those focused meetings took place.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

As set out in the Written Answer on 10 November, there are regular conversations between the relevant minister, Department officials, and senior clinical and managerial leads at NHS England in relation to improving overall health outcomes for people with a learning disability and autistic people.

Several meetings have taken place since July 2024 and the publication of the recent annual Learning from Lives and deaths, people with a learning disability and autistic people report was discussed. The Parliamentary Under Secretary of State for Health Innovation and Safety, who recently assumed responsibility for this, has met senior managers and discussed key findings from the report and the wider work underway to tackle health inequalities and improve access to, and the quality of, services for people with a learning disability.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will introduce an NHS activity-based payment scheme for mental health and community services; and if so, what measures they will introduce to ensure stable and fair payment for those services through that scheme.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Neither the Department or NHS England have any plans to introduce an activity-based payment scheme for all community and mental health services. However, it may be appropriate to introduce activity-based payment for some community and mental health services in the future.

NHS England is developing standard currencies for community and mental health services that can be used as the basis for future payment models. The development of community and mental health tariffs will be dependent on the availability of good quality costing and activity data.