Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many young people with autism placed in secure accommodation in England in 2018-2019 were held in seclusion.
Answered by Caroline Dinenage
The data is not held centrally in the format requested.
The NHS Long Term Plan commits to achieving at least a 50% reduction in the number of people with a learning disability or autism who are inpatients in mental health hospitals by 2023/24. The NHS Planning Guidance requires a 35% reduction as soon as possible in 2019/20.
In May 2019, the Care Quality Commission published their thematic review interim report regarding the use of restrictive interventions in settings that provide inpatient and residential care for people with, or who might have, mental health problems, learning disabilities and/or autism. We accepted all the recommendations and will undertake independent reviews of the care of everyone with a learning disability or autism detained in long-term segregation.
The Mental Health Units (Use of Force) Act 2018 applies in relation to the use of force (restraint) in mental health units which provide National Health Service-funded treatment.
The aim of the Act is to bring more rigour and accountability around the recording, reporting and training of staff in the use of force in mental health units, with a view to reducing the use of restrictive practices.
The Act applies to all patients, children, young people and adults, who are being assessed or receiving treatment in a mental health unit.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of young people with autism placed in secure beds in hospitals since October 2015.
Answered by Caroline Dinenage
The Assuring Transformation (AT) dataset provides data on the numbers of people with a learning disability and/or autism receiving inpatient care commissioned by the National Health Service in England. The AT dataset does not cover other secure settings such as young offender institutions or secure children’s homes.
According to the AT dataset, the number of inpatients under the age of 18 with autism in a secure hospital ward between 1 April 2018 and 31 March 2019 was 70.
The following table shows the number of inpatients under the age of 18 with autism in a secure hospital ward by year, from 1 October 2015 to 30 September 2019, according to the AT dataset.
Date | Number of inpatients* |
1 October 2015 – 30 September 2016 | 60 |
1 October 2016 – 30 September 2017 | 45 |
1 October 2017 – 30 September 2018 | 70 |
1 October 2018 – 30 September 2019 | 70 |
|
|
Note:
The Assuring Transformation collection covers England, but includes patients whose care is commissioned in England and provided elsewhere in the UK. These figures represent the number of patients who are receiving inpatient care at the end of each month. Figures have not been revised with more recent information, but show the position at the end of each month as extracted from the system at that time.
Values have been rounded to the nearest five to minimise disclosure risks associated with small numbers.
Some patients have not been formally diagnosed with either a learning disability or autism but remain in the collection as they are understood to fall under one of these categories and as such were returned by data submitters.
The above table includes patients who are under 18 at the start of the reporting year but may have turned 18 during the year.
Inpatients may appear across more than one year.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many young people with autism placed in secure accommodation in England in 2015 were held in seclusion.
Answered by Caroline Dinenage
The data is not held centrally in the format requested.
The NHS Long Term Plan commits to achieving at least a 50% reduction in the number of people with a learning disability or autism who are inpatients in mental health hospitals by 2023/24. The NHS Planning Guidance requires a 35% reduction as soon as possible in 2019/20.
In May 2019, the Care Quality Commission published their thematic review interim report regarding the use of restrictive interventions in settings that provide inpatient and residential care for people with, or who might have, mental health problems, learning disabilities and/or autism. We accepted all the recommendations and will undertake independent reviews of the care of everyone with a learning disability or autism detained in long-term segregation.
The Mental Health Units (Use of Force) Act 2018 applies in relation to the use of force (restraint) in mental health units which provide National Health Service-funded treatment.
The aim of the Act is to bring more rigour and accountability around the recording, reporting and training of staff in the use of force in mental health units, with a view to reducing the use of restrictive practices.
The Act applies to all patients, children, young people and adults, who are being assessed or receiving treatment in a mental health unit.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many young people with autism were placed in secure accommodation in 2018-19.
Answered by Caroline Dinenage
The Assuring Transformation (AT) dataset provides data on the numbers of people with a learning disability and/or autism receiving inpatient care commissioned by the National Health Service in England. The AT dataset does not cover other secure settings such as young offender institutions or secure children’s homes.
According to the AT dataset, the number of inpatients under the age of 18 with autism in a secure hospital ward between 1 April 2018 and 31 March 2019 was 70.
The following table shows the number of inpatients under the age of 18 with autism in a secure hospital ward by year, from 1 October 2015 to 30 September 2019, according to the AT dataset.
Date | Number of inpatients* |
1 October 2015 – 30 September 2016 | 60 |
1 October 2016 – 30 September 2017 | 45 |
1 October 2017 – 30 September 2018 | 70 |
1 October 2018 – 30 September 2019 | 70 |
|
|
Note:
The Assuring Transformation collection covers England, but includes patients whose care is commissioned in England and provided elsewhere in the UK. These figures represent the number of patients who are receiving inpatient care at the end of each month. Figures have not been revised with more recent information, but show the position at the end of each month as extracted from the system at that time.
Values have been rounded to the nearest five to minimise disclosure risks associated with small numbers.
Some patients have not been formally diagnosed with either a learning disability or autism but remain in the collection as they are understood to fall under one of these categories and as such were returned by data submitters.
The above table includes patients who are under 18 at the start of the reporting year but may have turned 18 during the year.
Inpatients may appear across more than one year.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has to improve response times to recommendations for endovascular thrombectomy treatment for severe strokes which can be administered only within 24 hours.
Answered by Seema Kennedy
In March 2018, NHS England published their policy document ‘Clinical Commissioning Policy Proposition: Mechanical thrombectomy for acute ischaemic stroke’ which outlines key recommendations for diagnosis, referral, and patient pathways for intervention, and treatment.
The document can be accessed at the following link:
Stroke treatment outcomes are monitored by the Sentinel Stroke National Audit Programme against outcome measures for services which include:
- Time from onset to thrombectomy;
- Time from onset to arrival at thrombectomy centre;
- Time from arrival to arterial puncture; and
- Time from arterial puncture to thrombectomy.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, for what reason not all health trusts provide endovascular thrombectomy treatment.
Answered by Seema Kennedy
NHS England is responsible for commissioning endovascular thrombectomy treatment in designated specialised neuroscience centres.
Endovascular thrombectomy treatment requires specialist skills to maintain standards of safety and effectiveness. As the number of trained specialist doctors and staff who deliver the service is very small, not all health trusts provide these services.
Services are being developed nationally in 24 neuroscience centres, with 22 centres currently providing a thrombectomy service. These centres are extending their service hours in a phased and safe way while they recruit and train the required specialists.
Currently there are two centres providing a full 24/7 service, a further six centres will provide 24/7 services by the end of 2019/20. Other centres are developing their services and teams to extend their services over the coming years.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, for what reason endovascular thrombectomy treatment is provided 24/7 only at Stoke-on-Trent hospital and St George's hospital in London; and what steps he plans to take to widen the provision of that service.
Answered by Seema Kennedy
NHS England is responsible for commissioning endovascular thrombectomy treatment in designated specialised neuroscience centres.
Endovascular thrombectomy treatment requires specialist skills to maintain standards of safety and effectiveness. As the number of trained specialist doctors and staff who deliver the service is very small, not all health trusts provide these services.
Services are being developed nationally in 24 neuroscience centres, with 22 centres currently providing a thrombectomy service. These centres are extending their service hours in a phased and safe way while they recruit and train the required specialists.
Currently there are two centres providing a full 24/7 service, a further six centres will provide 24/7 services by the end of 2019/20. Other centres are developing their services and teams to extend their services over the coming years.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has in place to increase the number of specialists trained in endovascular thrombectomy treatment.
Answered by Seema Kennedy
In England, Health Education England (HEE) is supporting NHS England’s National Stroke Programme to support the education and training of the healthcare workforce in England to deliver stroke care, and this includes increasing the number of medical professionals able to carry out mechanical thrombectomy procedures. The interim NHS People Plan committed to the development of a credential for mechanical thrombectomy, to support the delivery of the NHS Long Term Plan. HEE will work with the Royal College of Radiologists who are developing a medical credential, and work is expected to be completed later in 2019. The Royal College of Radiologists’ remit is throughout the United Kingdom.
Staff numbers, education and training in Wales, Northern Ireland and Scotland is a matter for each of the devolved administrations in that country.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the recommendation of the Royal College of Surgeons in its report entitled, Recommendations for assuring standards in the independent sector, whether his Department has plans to require all new surgical procedures used in (a) the NHS and (b) private health providers to be registered before being offered to patients.
Answered by Stephen Hammond
There are currently no plans to require all new surgical procedures used in either National Health Service or private health circles to be registered before being offered to patients.
The National Institute for Health and Care Excellence provides technology appraisals that indicate which devices are suitable for routine use and which require more supervised evaluation. This applies to NHS care commissioned from NHS or independent sector providers.
Asked by: Ann Clwyd (Labour - Cynon Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans his Department has to improve the regulation of medical devices following recent public concern about patient safety.
Answered by Jackie Doyle-Price
The Government is committed to the safe and effective regulation of medical devices in the United Kingdom; we continue to strengthen safety while ensuring patients and the public have fast access to new, innovative devices.
While the Government considers the existing regulatory framework to be fundamentally sound, it has been instrumental in securing tougher regulations for medical devices across the European Union. The new EU Medical Devices Regulation (MDR), which fully applies from May 2020, maintain the strengths of the existing regulatory system, of which rapid access to market for new devices is a key aspect, whilst addressing the acknowledged weaknesses in the system. These include improving the standard and consistency of Notified Bodies, enhancing vigilance and post-market safety surveillance systems and improving the consistency of implementation of medical device legislation across the EU.
In the interim, steps have been taken to place more stringent requirements upon manufacturers. In 2016, a new guidance document was published on clinical evaluation. This sets out clearly the need to strengthen the clinical evidence on which a device is CE-marked. The information is available at the following link:
http://ec.europa.eu/DocsRoom/documents/17522/attachments/1/translations/
The MDR has further built on these expectations by introducing a higher threshold for clinical evidence before devices are allowed to be used in patients.
This will result in a significant strengthening of the regulatory framework and addresses a number of the concerns raised by the public around patient safety.