Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many locked mental health rehabilitation facilities there are in England.
Answered by Nadine Dorries
Information obtained by the Care Quality Commission from mental health inpatient providers indicates that providers who responded reported 96 locked inpatient mental health rehabilitation wards in England in 2019.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to improve care for people in segregation in locked mental health rehabilitation facilities.
Answered by Nadine Dorries
The mental health rehabilitation workstream of the Getting It Right First Time programme has considered locked mental health rehabilitation facilities to help improve care for people in those facilities. The workstream’s report is expected to be published in early 2021.
The Government is clear that restrictive interventions and restraint should only ever be used as a last resort, when all attempts to de-escalate a situation have been employed. We are working to finalise the draft statutory guidance for the Mental Health Units (Use of Force) Act 2018 and accompanying public consultation and will set out a timetable for publishing the guidance and commencing the Act at the earliest opportunity.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps the Government is taking to improve training for health, care and education employees in locked mental health rehabilitation facilities to ensure that those employees have the necessary training and skills to work with people in those facilities with (a) learning disabilities and (b) autism who also have complex needs and challenging behaviour.
Answered by Nadine Dorries
Health and social care staff working in locked mental health rehabilitation facilities must have the skills and knowledge to make a positive difference to the lives of people with learning disabilities and autistic people. This is a priority for the Government and we are developing plans to introduce the Oliver McGowan mandatory training in learning disability and autism to make sure that this happens.
We are working with Health Education England and Skills for Care to develop and test a standardised training package, backed by £1.4 million investment. Work is already underway to develop the training and testing will take place in a variety of health and social care settings to help shape how it will be rolled out and delivered in future.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what proportion of patients have been in their current psychiatric unit in a locked mental health rehabilitation facility in England for more than (a) one year, (b) two years, (c) three years and (d) four years.
Answered by Nadine Dorries
This information requested could only be obtained at disproportionate cost.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps the Government is taking to reduce the number of people experiencing delayed discharge from locked mental health rehabilitation facilities.
Answered by Nadine Dorries
The NHS Long Term Plan sets out that all health systems in England will deliver new and integrated models of primary and community mental health care for adults and older adults with severe mental illnesses backed by almost £1 billion of new investment per year by 2023/24. These new models will include transformed and improved care for people with community mental health rehabilitation needs, building services in local communities both to prevent people from going into hospital unnecessarily and to support timely discharge for those people who are in need of inpatient care. All health systems in England are expected to be delivering these new models from 2021/22.
The mental health rehabilitation workstream of the Getting It Right First Time programme has considered discharge from acute mental health inpatient care. The workstream’s report is expected to be published in early 2021.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps the Government is taking to reduce the number of out of area placements in locked mental health rehabilitation facilities to ensure that patients are not geographically distant from their homes and support networks.
Answered by Nadine Dorries
The Care Quality Commission report into the state of care in mental health services from 2014-2017 highlighted concerns about the high number of people in out of area locked rehabilitation wards. Following this, the mental health rehabilitation workstream of the Getting It Right First Time programme has considered locked mental health rehabilitation facilities alongside its consideration of out of area placements. The workstream’s report is expected to be published in early 2021.
NHS England and NHS Improvement expect this report to recommend that all trusts and clinical commissioning groups should develop robust systems to bring patients treated out of area back to their local area. It also expects the report to recommend that clear monitoring arrangements are in place where out-of-area placements are considered necessary.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps the Government is taking to tackle the use of (a) seclusion and (b) restraint when applied inappropriately in locked mental health rehabilitation facilities.
Answered by Nadine Dorries
The Government is clear that, where needed, inpatient care should be high quality, therapeutic and for the shortest time possible. The use of seclusion and any kind of restraint should only be used as a last resort and in line with strict protocols.
We are improving practice and minimising all types of force used on patients in accordance with the aims of the Mental Health Units (Use of Force) Act 2018. We are working to finalise the draft statutory guidance for this Act and accompanying public consultation.
Work is also ongoing with the Care Quality Commission, NHS Digital and NHS England and NHS Improvement to prepare for the implementation and commencement of the Act’s requirements. We will set out a timetable for publishing the statutory guidance and commencing the Act at the earliest opportunity.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
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 (a) people with learning disabilities and/or autism and (b) other people were held in locked mental health rehabilitation facilities in England in (i) 2018, (ii) 2019 and (iii) 2020.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The latest information available on the number of inpatients in England with a learning disability or autistic people by ward type is set out in the following table.
Inpatient setting | March 2018 | % of patients | March 2019 | % of patients | March 2020 | % of patients |
Secure forensic | 1,155 | 49% | 1,085 | 48% | 985 | 47% |
Acute learning disability | 375 | 16% | 345 | 15% | 315 | 15% |
Acute generic mental illness | 230 | 10% | 285 | 13% | 285 | 14% |
Forensic rehabilitation | 115 | 5% | 105 | 5% | 110 | 5% |
Complex care/rehabilitation | 315 | 13% | 280 | 12% | 245 | 12% |
Other specialist | 60 | 2% | 50 | 2% | 45 | 2% |
Other | 115 | 5% | 105 | 5% | 115 | 5% |
Source: Assuring Transformation Data, NHS Digital.
The data excludes revisions made by providers after the data was initially collated and the data between years is therefore not directly comparable.
The information relating to the proportion of other people in locked mental health rehabilitation facilities in England is not available in the format requested and could only be obtained at disproportionate cost.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress his Department has made on ensuring that each person who is in segregation on a ward for people with a learning disability and/or autism in a locked mental health rehabilitation unit has a discharge plan.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
In 2019, the Secretary of State for Health and Social Care committed to conducting independent case reviews for people with a learning disability or autistic people who were identified as being in long term segregation. The reviews of people identified as being in long term segregation in November 2019 have now been completed and recommendations were made in each case to improve individual circumstances and support moving individuals to less restrictive settings.
Asked by: Jeremy Hunt (Conservative - South West Surrey)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many (a) mental health and (b) learning disability nurses were employed in the NHS in each year from 2010 to 2020.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
NHS Digital publishes Hospital and Community Health Services (HCHS) workforce statistics. These include staff working in hospital trusts and clinical commissioning groups but not staff working in primary care, local authorities or other providers.
The following table shows the number of mental health and learning disability nurses, full time equivalent (FTE) employed in the National Health Service as at September each year along with the latest figure as of July 2020.
| Mental health nurses (FTE) | Learning disabilities nurses (FTE) |
September 2010 | 40,247 | 5,137 |
September 2011 | 39,024 | 4,667 |
September 2012 | 38,135 | 4,311 |
September 2013 | 37,397 | 4,035 |
September 2014 | 36,581 | 3,776 |
September 2015 | 35,671 | 3,577 |
September 2016 | 35,488 | 3,442 |
September 2017 | 35,390 | 3,305 |
September 2018 | 35,835 | 3,234 |
September 2019 | 36,696 | 3,186 |
July 2020 | 37,421 | 3,217 |
Source: NHS HCHS monthly workforce statistics, NHS Digital - July 2020
Notes:
Mental health and learning disability service provision is also commissioned by the NHS from private sector providers. The figures do not reflect staffing in the private sector.
Further information, including on different methodologies for counting the mental health workforce, is published by NHS Digital at the following link: