Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many learning disability nurse vacancies there are as of 30 April 2024.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department does not hold vacancy rates that are granular enough to identify rates for learning disability nurses. However, NHS England publishes quarterly vacancy statistics for registered nurses working in National Health Service trusts, which are available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-survey
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department takes to involve people with learning disabilities in the development and implementation of measures to reduce their health inequalities.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
We recognise the importance of involving people with a learning disability in policy development and implementation to support in reducing the health inequalities they experience. We aim to do this in a range of ways within the Department, some of which are set out below.
Experts by experience are members of governance structures, such as the Oliver McGowan Code of Practice Board. This Board has supported the development of the Oliver McGowan Code of Practice. The Code will guide registered health and care providers to meet their statutory requirement to ensure their staff receive learning disability and autism training appropriate to their role. The Code sets an expectation that training is co-produced and co-delivered by people with a learning disability and autistic people. The draft Code was publicly consulted on, including an easy read version to ensure accessibility.
In developing the Building the Right Support (BtRS) Action Plan, published in July 2022, we sought expertise, advice and challenge from experts by experience. The Plan brings together actions across government and public services to strengthen community support and reduce overall reliance on specialist mental health inpatient care for people with a learning disability and autistic people.
The BtRS Advisory Group was established to improve direct engagement with experts by experience. The Group developed an independent, co-produced report on ‘What Good Looks Like’ in terms of community services. The final report has a specific focus on actions that integrated care systems should take to ensure the best possible community support for people with a learning disability and autistic people.
Additionally, the Department jointly manages the Health and Wellbeing Alliance which is a partnership between representatives in the health and care system and sector. This enables the sector, including people with a learning disability, to share their expertise at a national level with the aim of improving services and policy development.
Integrated care boards are now expected to have an Executive Lead on learning disability and autism. As part of their role, the Executive Lead will support the Board in championing co-production of policies and service delivery and recognising the value of people’s lived experiences. NHS England has published guidance on this role, which is available at the following link:
https://www.england.nhs.uk/long-read/executive-lead-roles-within-integrated-care-boards/
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 30 April 2024 to Question 23729 on the National Learning Disability Board, for what reason the National Learning Disability Board was disbanded in 2016.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
In 2016, following a reorganisation and re-prioritisation exercise within the Department, the decision was made to disband the National Learning Disability Board and integrate its objectives into wider programmes and activities aimed at improving outcomes for this population. The Department keeps its governance structures under periodic review.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much her Department spent on autism assessments in each of the last five years; how much funding her Department has allocated to autism assessments in each of the next three years; and what recent assessment her Department has made of the adequacy of that funding in meeting the target waiting time for such an assessment.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Information on the total spend on autism assessments is not held centrally. NHS England is responsible for funding allocations to integrated care boards (ICBs), which are responsible for commissioning services using these core allocations to meet the needs of their local populations, including autism assessment services. The following table shows the total baseline expenditure in ICBs for learning disability and autism services over the last five years, disaggregated for autism services where possible:
| Learning disability | Autism services | Unseparated learning disability and autism services | Total |
2019/20 | N/A | N/A | £1,809,200,000 | £1,809,200,000 |
2020/21 | N/A | N/A | £2,285,600,000 | £2,285,600,000 |
2021/22 | £85,800,000 | £3,700,000 | £2,268,300,000 | £2,357,900,000 |
2022/23 | £625,800,000 | £27,100,000 | £1,928,800,000 | £2,581,700,000 |
2023/24 | £926,000,000 | £47,100,000 | £1,928,800,000 | £2,904,600,000 |
In addition, specific funding has been allocated to ICBs in 2023/4 and 2024/25 from the Service Development Funding, to improve autism assessment waiting lists and pathways. The following table shows information on the additional national funding allocated to ICBs by NHS England, over each of the last five years, to improve autism assessment waiting lists and pathways:
| Service Development Funding via the NHS Long Term Plan Transformation Funding | Spending Review 2021 via the COVID-19 Recovery Fund | Total funding for autism assessment pathways |
2019/20 | N/A | N/A | N/A |
2020/21 | N/A | N/A | N/A |
2021/22 | £2,500,000 | £14,500,000 | £17,000,000 |
2022/23 | £5,000,000 | N/A | £5,000,000 |
2023/24 | £4,200,000 | N/A | £4,200,000 |
2024/25 | £4,300,000 | N/A | £4,300,000 |
Notes:
The NHS Operational and Planning Guidance 2024/25 asks local systems to improve autism assessment pathways, through implementation of the NHS England autism assessment national framework. Allocations from 2025/26 onwards are subject to future decisions on spending. Further information on the operational and planning guidance and national framework is available respectively at the following links:
https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/
A specific assessment of the adequacy of funding in meeting the National Institute for Health and Care Excellence’s waiting time standard for autism assessments has not been made. However, autism waiting times statistics are published on a quarterly basis. The total number of people with an open referral, where the diagnosis not yet completed, for suspected autism has increased by 47%, from 117,032 in December 2022 to 172,022 in December 2023. In December 2023, it was estimated that only 5.9% of patients whose referrals have been open in the system for at least 13 weeks received their first contact appointment within 13 weeks.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many learning disability nurses there (a) are and (b) were in each of the last five years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England publishes monthly Hospital and Community Health Services workforce statistics for England. These include staff working for hospital trusts and core organisations, but excludes staff working for other providers such as in primary care, general practice, or social care. This data is drawn from the Electronic Staff Record, the human resources system for the National Health Service. The statistics are available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics
A large proportion of learning disability nurses work outside NHS trusts, and we do not hold data on where they work. However, the Nursing and Midwifery Council publishes data on the number of nurses on the register across the United Kingdom, which will include nurses employed in other settings, such as education. Data is available in the Fields of Practice sheet in the permanent register data tables, at the following link:
https://www.nmc.org.uk/about-us/reports-and-accounts/registration-statistics/
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many and what proportion of learning disability nurses are in senior leadership roles.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England publishes monthly Hospital and Community Health Services workforce statistics for England. These include staff working for hospital trusts and core organisations, but excludes staff working for other providers such as in primary care, general practice, or social care. This data is drawn from the Electronic Staff Record, the human resources system for the National Health Service. The statistics are available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics
A large proportion of learning disability nurses work outside NHS trusts, and we do not hold data on where they work. However, the Nursing and Midwifery Council publishes data on the number of nurses on the register across the United Kingdom, which will include nurses employed in other settings, such as education. Data is available in the Fields of Practice sheet in the permanent register data tables, at the following link:
https://www.nmc.org.uk/about-us/reports-and-accounts/registration-statistics/
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an estimate of the number of health and adult social care staff that will undertake the second part of tier (a) one and (b) two of the Oliver McGowan Mandatory Training on Learning Disability and Autism in the next three years.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
We have provided estimates of the number of health and adult social care staff that would undertake Tier 1 and Tier 2 of the Oliver McGowan Mandatory Training in our consultation stage impact assessment. This assessment was published as part of the public consultation on the Oliver McGowan Code of Practice. The impact assessment and wider public consultation are available, respectively, at the following two links:
For healthcare, we estimated that over the first three years of training roll-out, 1,036,000 staff would be trained at Tier 1 level, and 1,186,000 staff would be trained at Tier 2 level. For adult social care, over the same period, we estimated that 840,000 staff would be trained at Tier 1 level, and 492,000 staff would be trained at Tier 2 level. In addition, over 1.7 million people have already completed the first part of Oliver McGowan Mandatory Training on Learning Disability and Autism, an e-learning package.
The final stage impact assessment incorporates additional evidence on the number of staff expected to undertake training, which was provided by organisations through the public consultation. The final assessment will be published in due course.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when the National Learning Disability Board last met.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The final meeting of the National Learning Disability Board took place on 19 July 2016. More information is available at the following link:
https://www.gov.uk/government/groups/learning-disability-programme-board#minutes
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to Appendix 1 of the guidance by NHS England entitled Improving identification of people with a learning disability: guidance for general practice, published on 11 October 2019, what recent estimate she has made of the number of people that have a learning disability; and how many and what proportion of those people are (a) on the learning disability register and (b) not on the register despite having conditions that would automatically entitle them to be on the register.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
There are approximately 1.3 million people in England with a learning disability, according to Mencap figures. NHS England data shows that, as of March 2023, there were 347,840 people of all ages with a learning disability on the learning disability register in England. However, this learning disability register is voluntary, and not everyone chooses to register.
It is a statutory requirement under the Equality Act 2010 that public sector agencies make reasonable adjustments to their practice that will make them as accessible and effective as they would be for people without disabilities. NHS England has published guidance aimed at improving the identification of people with a learning disability, which is available at the following link:
General practices should review this guidance and update their registers at least annually, to ensure that they are accurate.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many women with autism were in mental health inpatient care settings in each of the last five years.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The following table shows the number of female patients with either autism or autism and a learning disability in mental health care inpatient settings in England, in each of the last five years:
Year | Autism | Learning disability and autism | Total |
March 2020 | 270 | 115 | 390 |
March 2021 | 325 | 110 | 430 |
March 2022 | 375 | 110 | 485 |
March 2023 | 430 | 115 | 545 |
February 2024 | 395 | 90 | 490 |
Source: the data is taken from NHS England’s Assuring Transformation dataset, as of 28 February 2024.
Notes: