Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department for Education:
To ask His Majesty's Government whether the proposed report on a consistent child identifier (CCI) as provided under section 179 of the Health and Social Care Act 2022 will ensure that a CCI relates to both (1) children’s health and social care, and (2) the safeguarding and welfare of children; and if not, why not.
Answered by Baroness Barran
In response to the Health and Social Care Act 2015, the department commissioned Ivana La Valle to conduct a research report into extending the duties of the NHS number as a unique identifier from adult social care to children’s social care. The findings concluded that while there was general support for using the NHS number as a unique identifier, there was limited evidence on how this could be achieved or whether it would be possible. The government therefore supported the voluntary use of the NHS number where the local authority and health agencies decide that this is an effective way for them to share information. In 2021, as the Bill for the Health and Care Act 2022 progressed through Parliament, the debate on the need for and feasibility of introducing a consistent identifier was revisited, resulting in the government's commitment to explore the issue further in this report. Consequently, the government will report in July 2023 on government policy on the use of a consistent child identifier for children.
The department is leading a cross-government programme to meet the legislative commitment in the Health and Social Care Act 2022. A cross-government steering group, including officials from the Department for Education, the Department of Health and Social Care and the Home Office, have overseen the programme. The programme has also reported into the Child Protection Ministerial Group. The programme has undertaken targeted research with frontline practitioners across agencies, including health, police, schools and social care, and analysed current systems and good practice. The findings of the research and analysis will be included in a report laid before Parliament in July on the government policy on information sharing, including policy related to a consistent child identifier for children.
The focus of the research responding to the commitment in the Health and Social Care Act 2022 has been on how to improve information sharing between agencies for child safeguarding and promotion of welfare purposes. However, current and future policy recommendations may have wider reach across children’s health and social care. The government will report in July on its policy on information sharing, including policy related to a consistent child identifier for children.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department for Education:
To ask His Majesty's Government why the NHS number has been a mandatory consistent identifier for adults across health and adult social care since 2015 but no such identifier has been established across health and social care and protection services for children.
Answered by Baroness Barran
In response to the Health and Social Care Act 2015, the department commissioned Ivana La Valle to conduct a research report into extending the duties of the NHS number as a unique identifier from adult social care to children’s social care. The findings concluded that while there was general support for using the NHS number as a unique identifier, there was limited evidence on how this could be achieved or whether it would be possible. The government therefore supported the voluntary use of the NHS number where the local authority and health agencies decide that this is an effective way for them to share information. In 2021, as the Bill for the Health and Care Act 2022 progressed through Parliament, the debate on the need for and feasibility of introducing a consistent identifier was revisited, resulting in the government's commitment to explore the issue further in this report. Consequently, the government will report in July 2023 on government policy on the use of a consistent child identifier for children.
The department is leading a cross-government programme to meet the legislative commitment in the Health and Social Care Act 2022. A cross-government steering group, including officials from the Department for Education, the Department of Health and Social Care and the Home Office, have overseen the programme. The programme has also reported into the Child Protection Ministerial Group. The programme has undertaken targeted research with frontline practitioners across agencies, including health, police, schools and social care, and analysed current systems and good practice. The findings of the research and analysis will be included in a report laid before Parliament in July on the government policy on information sharing, including policy related to a consistent child identifier for children.
The focus of the research responding to the commitment in the Health and Social Care Act 2022 has been on how to improve information sharing between agencies for child safeguarding and promotion of welfare purposes. However, current and future policy recommendations may have wider reach across children’s health and social care. The government will report in July on its policy on information sharing, including policy related to a consistent child identifier for children.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of any adverse effects on children as a result of not establishing a consistent child identifier, especially those children with (1) complex needs and disabilities, (2) long-term conditions such as asthma, autism and epilepsy and (3) looked after children and those at risk; and whether they will publish such an assessment.
Answered by Lord Markham
No specific assessment has been made. Every child is assigned an National Health Service number at birth or the first time they have contact with NHS services. The NHS number acts as is a unique patient identifier and is used to share information within electronic healthcare records. This contributes to improved health outcomes for children, including looked after children and those with complex needs, disabilities and long-term conditions, by ensuring that health professionals identify patients correctly and have access to information to inform the delivery of appropriate care.
Through the Health and Care Act 2022, the Government has committed to report on Government’s policy on information sharing in relation to the safeguarding of children, including looked after children and those at risk, by summer 2023. The report will include an explanation of whether it is the Government’s policy that a consistent child identifier should be used across agencies.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the adverse (1) costs, and (2) effectiveness, of NHS services for children as a result of the absence of a consistent child identifier.
Answered by Lord Markham
No specific assessment has been made. Every child is assigned a National Health Service number at birth or the first time they have contact with NHS services. The NHS number acts as a unique patient identifier and is used to share information within electronic healthcare records. This contributes to improved health outcomes for children by ensuring that health professionals identify patients correctly and have access to information to inform the delivery of appropriate care.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the British Medical Association report Building the Future: Getting IT Right, published on 5 December 2022; in particular, the finding that "nearly 76 per cent of doctors ranked 'interoperability of systems' as a 'significant barrier' to digital transformation"; and what assessment they have made of whether the absence of a consistent child identifier prevents the interoperability of IT systems for protecting children's health and care.
Answered by Lord Markham
An assessment on interoperability has been made across several areas through the Digital Maturity Assessment, providing greater understanding of individual organisational-level capability and enabling focus on national efforts to support levelling up those organisations at a lower level of maturity.
Every child born in England is issued a National Health Service number at birth which stays with them throughout their life. The NHS number acts as a unique patient identifier and is used to share information within electronic healthcare records. This contributes to improved health outcomes for children by ensuring that health professionals identify patients correctly and have access to information to inform the delivery of appropriate care.
Asked by: Lord Warner (Crossbench - 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 of 14 February (HL5163), whether they will undertake a comparison of the impact of the UK's rebate rates in the voluntary scheme for branded medicines with the more favourable rebates in other European countries, given their declared ambitions for the UK life sciences sector.
Answered by Lord Markham
We have no plans to undertake such a comparison. Differences in the structure of medicine pricing policies and systems make direct comparisons of payment percentages or rebates with other countries difficult and potentially misleading.
The Government is open to ideas about how a successor to the voluntary scheme for branded medicines pricing and access should operate from 2024 onwards. We will be considering a range of factors and will work with industry to consider learning from approaches in the United Kingdom and internationally, to agree a mutually beneficial successor that supports better patient outcomes; ensures the sustainability of National Health Service spend on branded medicines; and enables a strong UK life sciences industry.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to measure the effectiveness of (1) NHS England's plan to fund art, music or gardening classes instead of prescribing antidepressants, announced on 2 March, and (2) the National Institute of Health and Care Excellence's draft guidance, issued on 1 March, approving the use of digitally enabled therapies for patients with depression, anxiety, post-traumatic stress disorder and body dysmorphia disorders.
Answered by Lord Markham
The Department is committed to the roll out of social prescribing and associated activities, including arts, music and gardening across the National Health Service in England. Social Prescribing Link Workers (SPLWs) work with people to understand ‘what matters to them’ then to connect them to agencies for practical, emotional and social support and to community groups and activities. Where individuals consent, SPLWs capture wellbeing outcomes before and after engagement with the social prescribing service as routine practice, using standardised outcomes measures such as Office for National Statistics Four. There is growing evidence on the role that activities, whether they be creative, activity- or nature-based, improve people’s health and wellbeing. The role of SPLW is also being evaluated by the National Institute for Health and Care Research to determine how access, engagement and outcomes vary by delivery model, geography and population characteristics over time.
The National Institute for Health and Care Excellence (NICE) Guidance has been released for guided Digital Cognitive Behavioural Therapy tools for children and young people with symptoms of low mood and anxiety. The technologies in these categories are being evaluated by NICE as part of their Early Value Assessment, which covers both clinical and cost effectiveness.
For NHS Talking Therapies for anxiety and depression services, a key characteristic is the routing collection of clinical outcome measures and monitoring activity. NHS England’s Digitally Enabled Therapies (DETs) Assessment Criteria enables DETs to be reviewed for suitability for use in NHS Talking Therapies Services.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department for Education:
To ask His Majesty's Government, further to the Written Answer of Baroness Barran on 9 March (HL5961), what estimates they have made of the number of children not regularly in school; whether there has been an increase in the number of children absent from school since the COVID-19 pandemic; and whether they will fund local education authorities to maintain registers of children not in school until they can legislate to make such registers a statutory requirement.
Answered by Baroness Barran
School attendance has improved since 2010, but COVID-19 and its aftermath significantly damaged attendance levels. COVID-19 caused higher levels of sickness absence, and exacerbated existing problems with persistent absence, with vulnerable children particularly affected. Attendance is now improving, and the government is committed to returning to pre-pandemic levels and better.
In autumn/spring 2018/19 overall attendance was 96.7%. The current academic year to date attendance is 4.3 percentage points lower at 92.4%.
Local authorities have a statutory duty to make arrangements that enable them to establish, the identities of children in their area who are not receiving a suitable education. To assist with fulfilling this duty, the department expects all local authorities in England to maintain some form of register to help identify these children, in line with our guidance to local authorities on elective home education. This function is funded through existing budgets and resources.
When the suitable legislative opportunity arises to take forward the Children Not in School measures, the department will review and undertake a further new burdens assessment to assess the level of funding required to support implementation of the registers, as well as for the proposed local authority duty to support home educating families.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department for Education:
To ask His Majesty's Government, further to the written answer by Baroness Barran on 9 March (HL5960), what further checks they have made to the 81 settings that claimed to have changed their operations; what steps they have taken to ensure that the 21 settings that have closed their operations have not reopened in another location; what powers local authorities have to close settings that are not compliant with safeguarding requirements; and whether, in the consultation to be launched later this year, they will seek to define "school" so as to enable Ofsted to close unsatisfactory settings more speedily.
Answered by Baroness Barran
It is a criminal offence under Section 96 of the Education and Skills Act 2008 to conduct an independent school which is not registered with the Department. Her Majesty’s Chief Inspector of Schools (HMCI) may, under Section 97 of that Act, inspect without notice any setting which they have 'reasonable cause to believe' is the site of an unregistered independent school. Settings that have previously been inspected under Section 97 and where the proprietor has been issued with a warning notice are likely to be inspected again under Section 97 to check compliance. This includes settings where the second inspection confirms closure or a change to compliant operation. A setting may not be inspected again under Section 97 where HMCI no longer has reasonable cause to believe that an unregistered school is being conducted. This may occur, for example, if the setting has registered as a school and is then subject to inspection as such. Ofsted considers all intelligence it receives about unregistered independent schools and will undertake a Section 97 inspection where it has reasonable cause to believe that an unregistered independent school is operating. This includes where new intelligence is received about previously closed sites or where proprietors that have received warning notices may be operating on alternative sites.
The department has consulted on expanding the categories of full-time institutions that will be regulated in the same way as independent schools, as well as defining what is ’full-time’ for these purposes. Following this consultation, the government intends to legislate in this area at the next available opportunity.
Local authorities have overarching responsibility for safeguarding children and young people in their area, whether these children attend a school (either registered or unregistered), or an out-of-school setting (a setting not offering full-time education). They have a range of legal powers already in place to support them in this responsibility. The department will continue to work with authorities to ensure they are utilising the existing legal powers available to them. The department will also be reviewing and strengthening our existing guidance for local authorities on unregistered schools and out-of-school settings to support them to do this.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to ensure that staff in the adult social care sector (1) are all paid at above the legal minimum wage, and (2) have their pay brought in line with staff undertaking similar roles in the NHS.
Answered by Lord Markham
All businesses irrespective of their size or business sector are responsible for paying the correct National Living Wage and National Minimum Wage to their staff.
If any care worker is concerned that they are being underpaid, we strongly urge them to call the the Advisory, Conciliation and Arbitration Service (Acas) helpline for free, impartial and confidential advice about their rights and entitlements. Acas officers will pass on cases to HM Revenue & Customs for further consideration where appropriate.
The Department has no plans to align the pay progression of adult social care workers to National Health Service pay scales.