NHS: Healthcare Data

Lord Stone of Blackheath Excerpts

Thursday 6th September 2018 Lords Chamber

[Lord Stone of Blackheath (Lab)]

My Lords, when speaking of data in research, scientists and medics refer only to quantitative research, as has been done in this debate so far. But qualitative research also produces immensely beneficial data.

I declare an interest as former chair of the UK ground-breaking healthtalk organisation. It has created a platform presenting thousands of free-to-access video and audio clips, drawn from rigorous qualitative research, to help people learn about their condition, manage their own health and make decisions about their treatment.

Helping patients to find out what it has been like for others who have faced the same health conditions as them has been one of the most transformative aspects of the internet. But people worry whether the information they find online is reliable and need healthcare professionals to guide them to reliable sources of peer information online. This qualitative data is used to teach medical students and nurses about what matters to patients and to help design services that meet the needs of all concerned. In line with the Department of Health’s expanded focus into social care, a new platform, socialcaretalk.org, is currently being developed, which will include hundreds of interviews with people who have experienced social care first hand.

Healthtalk.org is run by a charity, DIPEx, in partnership with the Health Experiences Research Group at the University of Oxford’s Nuffield Department of Primary Care Health Sciences. Rigorous qualitative research methods are used to collect interviews with patients on film, which are then analysed for themes and turned into a multimedia resource that is widely used by the general public and health professionals. Evaluations have found that users of the platform report better understanding of their own health and greater confidence in talking to others about their health, and feel more inclined to take an active role in their own healthcare. Site users say that they find information on the website that they have not found elsewhere and answers to questions that they would otherwise have asked their healthcare professional. A third of respondents stated that the information on the website had reduced their need to make an appointment with a health professional. More than half the UK population uses the internet to seek information about their health. Healthtalk.org was used almost 6 million times in 2017, and the website covers more than 100 health topics.

The work of the team in the UK is being replicated around the world by 13 other member countries across Europe, North America, the Middle East, East Asia and Oceania, which have joined the DIPEx international collaboration. These sister international group websites are creating and developing together, and the qualitative data produced spans 11 languages and 42 health conditions. Including the UK’s healthtalk.org website, 140 conditions are covered, with well over 120 publications in peer-reviewed international journals. These publications are based on thousands of hours of audio and video records of interviews, and are a valuable qualitative data resource.

These outstanding results depend on funding from charities, philanthropic donations and government bodies. I ask the Minister and his team to recognise the power of patients’ stories and experiences and how they can be used to provide not only information and support for people with health conditions, their families and carers but reliable resources of knowledge and understanding for those institutions that will train our healthcare professionals in the future. They must be well funded, and qualitative data must be valued alongside quantitative data in the health service.

Talking about data, as I have used only four minutes, could the clerk add two minutes to the debate that I am speaking in later this afternoon?

Childhood Obesity: Yoga

Lord Stone of Blackheath Excerpts

Thursday 21st June 2018 Lords Chamber

[Lord O’Shaughnessy]

I am wondering how my noble friend has made such an accurate assessment. He did not see my weight on the scales this morning. He is quite right. Of course, it is a combination of exercise and healthy eating, which is why there has been a push for both those things in our schools. There are great risks to pregnant women from being obese, not only to themselves with diabetes in pregnancy, which tends to reappear in later life, but in the impact on their children. That is why it is so important that pregnant women get good advice about healthy eating.

[Lord Stone of Blackheath (Lab)]

My Lords, today is International Yoga Day, on which we are about to launch the All-Party Parliamentary Group on Yoga in Society. As with mindfulness, we will be offering staff here on the Estate, MPs and Peers courses in seated yoga and breathing techniques, which have other benefits besides tackling obesity. I ask the Minister and other noble Lords to sign up to such courses.

[Lord O’Shaughnessy]

I will bring my mat.

Health: Parity of Esteem

Lord Stone of Blackheath Excerpts

Tuesday 20th October 2015 Lords Chamber

Asked by

[Lord Stone of Blackheath]

To ask Her Majesty’s Government what progress has been made in establishing parity of esteem between mental and physical well-being.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, we are committed to improving mental health services, putting them on a par with physical health services. We have already expanded our world-leading psychological therapy services. This approach is now being emulated internationally. For example, Sweden is now running a pilot project in Stockholm based on IAPT principles. We have also introduced the first ever access and waiting times for mental health and changed people’s attitudes towards mental health.

[Lord Stone of Blackheath (Lab)]

Thank you. Will the Minister study the Mindful Nation UK report, published today by the Mindfulness Initiative and the All-Party Group on Mindfulness? It shows that mindfulness-based cognitive therapy—MBCT—recommended by NICE 10 years ago for recurrent depression, can provide cost-effective interventions for a range of mental and physical health conditions. In fact, almost four in five GPs want to recommend MBCT, but only one in five has courses available in their area. Expanding mindfulness provision in the NHS could save £15 for every £1 spent. Also, I ask the Minister, mindfully, to look at the evidence in the report suggesting that mindfulness-based interventions could provide powerful support and engender compassion to help those thousands of health workers who are fraught by some of the stresses of working in the National Health Service today.

Mental and Physical Health: Parity of Esteem

Lord Stone of Blackheath Excerpts

Thursday 10th October 2013 Lords Chamber

[Lord Stone of Blackheath (Lab)]

My Lords, there is a great deal of expertise here today on this subject. I am no expert, but I have two perspectives based on my particular experiences. The first is as chair of the award -winning health charity DIPEx. We have spent 10 years researching, in depth and on camera through the Health Experiences Research Group at Oxford University, patients’ experiences of illness. We publish them on the internet for free as www.healthtalkonline.org and www.youthhealthtalk.org. We have completed 75 separate modules of different illnesses, each with more than a year’s interviewing.

We have covered a wide range of physical illnesses, including most of the cancers, heart conditions, diabetes and osteoporosis. We have also researched mental conditions such as depression, experiences of psychosis, dementia and life on the autism spectrum, and we are about to launch a recently completed module on the use of antidepressants.

I want to relate here some of the observations from patients’ perspectives. First, patients living with physical, mental and social needs must be seen as actor-agents in their own recovery. The Centre for Mental Health has said that we should ensure that people using mental health services are equal partners in their care and support, with full respect for their needs, wishes and human rights.

Secondly, our senior researcher Susan Kirkpatrick, conducting interviews with the www.healthtalkonline.org patients from the recent antidepressant module to be launched in November, says that while people feel that an antidepressant may be helpful, most say that they benefit most from a combination of medication and therapeutic help. However, the effectiveness of therapeutic treatments seems not to be proven to the satisfaction of those prescribing these medications. The new charity, MQ, has said that to achieve parity of care, we must also have parity of research. MQ is one of the few organisations in the field that does not take sides. It believes that medication and therapies deserve equal research, and says that there is a huge gap between the cost of mental illness and its research funding, as has been mentioned. The UK should capitalise on its role as a leader in research and become one in developing better treatments for mental illness.

Thirdly, as my noble friend has mentioned, for some patients a long waiting time for therapeutic help proves frustrating and even debilitating, and in some mental health cases can be fatal. Here is a disparity. It seems that the system can understand the urgencies in a case of physical illness but with mental illness it feels that the patient can wait. The Centre for Mental Health has observed, as have many people whom we have interviewed, that appropriate waiting times must be established so that people with mental health problems know the maximum waiting time for a treatment, just as people with physical health problems know the longest that they can expect to wait for a treatment.

The NHS constitution has no requirements on waiting times for people with mental health problems, and in particular many psychological therapies are NICE approved and recommended in NICE clinical guidelines. However, due to the NHS constitution, people are not entitled to them in the same way as one is entitled to drugs approved by the NICE technology appraisals. That means that commissioners are not obliged to commission psychological therapies. Even when they do, as has been said, often a maximum number of treatments are prescribed. Can noble Lords imagine, for drugs for a physical illness or chemotherapy, being told, “When you’ve had a maximum of 20 of these injections or radiotherapy sessions, you’re on your own, mate”? Why should that be so for treatment for mental illnesses?

To return to medicines versus therapies, my second viewpoint is from my involvement in mindfulness practice. For centuries we have understood that there are practices we can adopt at an early age for our physical well-being that can be preventive and stop us getting ill, so that even if we contract an illness our physical fitness helps us to recover faster or at least helps us live more comfortably with the condition that we have. We have only recently become aware that the same is true for our mental health. With mindfulness-based practices, one can have a healthier, more enjoyable and productive way of life, and mindfulness can prevent depression and anxiety. It has been proven to NICE that to prevent people slipping back into depression, mindfulness practice can be more effective than drugs or talking methods.

Again, the Centre for Mental Health has said that we need to narrow the gap in the way people’s needs are met in physical and mental health, not only in health and social care but in education, employment and the criminal justice system. A mindfulness strategy for the UK is being designed and developed by my honourable friend Chris Ruane MP and my noble friend Lord Layard and others. It builds upon the work currently being done in this field by universities such as Bangor, Oxford and Exeter. They are working on mindfulness in the education system, for students and teachers in schools and universities, so that it exists in the same way as we have physical training, and are also working in the criminal justice system where, as has been said, we have systemic issues with mental health. Mindfulness practice could be enormously helpful for offenders and police.

Noble Lords may wish to know that in addition to the gymnasium for one’s physical health on the Parliamentary Estate, a mindfulness course operates in this building, including Members of the other place from all parties and a number of Peers. The course is conducted by Professor Mark Williams and Chris Cullen, using their scientifically proven method of training. We have a new series starting here next week, which noble Lords may wish to join. Mindfulness will allow people to understand that mind and body are one and that we should care for each for the development of the other. Thank you.