Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the adequacy of the availability of NHS provision for the diagnosis of ADHD in (a) Oxfordshire and (b) England.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including access to attention deficit hyperactivity disorder (ADHD) assessment and treatment, in line with relevant National Institute for Health and Care Excellence (NICE) guidance. The NICE guideline on ADHD does not recommend a maximum waiting time from referral for an assessment of ADHD to the point of assessment or diagnosis. The Department has not made a specific assessment of the availability of National Health Service provision for the diagnosis of, or treatment of, ADHD in Oxfordshire.
In respect of the adequacy of ADHD service provision nationally, in December 2023, NHS England initiated a rapid piece of work to consider ADHD service provision within the NHS. The initial phase of work identified challenges, including with current service models and the ability to keep pace with demand. Following this initial review, NHS England is establishing a new ADHD taskforce alongside the Government, to look at ADHD service provision and its impact on patient experience. The new taskforce will bring together expertise from across a broad range of sectors, including the NHS, education, and justice, to better understand the challenges affecting people with ADHD, and to help provide a joined up approach in response to concerns around rising demand.
Alongside the work of the taskforce, NHS England has announced that it will continue to work with stakeholders to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems which are trialling innovative ways of delivering ADHD services, to ensure best practice is captured and shared across the system.
In respect of the availability of NHS provision for the treatment of ADHD nationally, the Department is aware of, and taking action to address, disruptions to the supply of medicine used for the management of ADHD. Disruptions to the supply of medicines have been primarily driven by issues which have resulted in capacity constraints at key manufacturing sites. Nationally, the Department has been working hard with industry to help resolve those issues as quickly as possible. As a result of our ongoing activity, some issues have been resolved. However, we know that there continue to be disruptions to the supply of some other medicines, including methylphenidate and guanfacine. The latest information we have received from manufacturers is that these should largely be resolved by May 2024 and October 2024, respectively.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the adequacy of the availability of NHS provision for the treatment of ADHD in (a) Oxfordshire and (b) England.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including access to attention deficit hyperactivity disorder (ADHD) assessment and treatment, in line with relevant National Institute for Health and Care Excellence (NICE) guidance. The NICE guideline on ADHD does not recommend a maximum waiting time from referral for an assessment of ADHD to the point of assessment or diagnosis. The Department has not made a specific assessment of the availability of National Health Service provision for the diagnosis of, or treatment of, ADHD in Oxfordshire.
In respect of the adequacy of ADHD service provision nationally, in December 2023, NHS England initiated a rapid piece of work to consider ADHD service provision within the NHS. The initial phase of work identified challenges, including with current service models and the ability to keep pace with demand. Following this initial review, NHS England is establishing a new ADHD taskforce alongside the Government, to look at ADHD service provision and its impact on patient experience. The new taskforce will bring together expertise from across a broad range of sectors, including the NHS, education, and justice, to better understand the challenges affecting people with ADHD, and to help provide a joined up approach in response to concerns around rising demand.
Alongside the work of the taskforce, NHS England has announced that it will continue to work with stakeholders to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems which are trialling innovative ways of delivering ADHD services, to ensure best practice is captured and shared across the system.
In respect of the availability of NHS provision for the treatment of ADHD nationally, the Department is aware of, and taking action to address, disruptions to the supply of medicine used for the management of ADHD. Disruptions to the supply of medicines have been primarily driven by issues which have resulted in capacity constraints at key manufacturing sites. Nationally, the Department has been working hard with industry to help resolve those issues as quickly as possible. As a result of our ongoing activity, some issues have been resolved. However, we know that there continue to be disruptions to the supply of some other medicines, including methylphenidate and guanfacine. The latest information we have received from manufacturers is that these should largely be resolved by May 2024 and October 2024, respectively.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department is taking steps to bring waiting times for mental health patients in-line with waiting times for physical health patients.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
We remain committed to achieving parity between mental and physical health services, as outlined in the parity of esteem definition set out in a letter to the Public Accounts Committee in February 2024.
Given funding is important for reaching parity of esteem, we are making good progress with investment in National Health Service mental health services. Between 2018/19 and 2023/24, NHS spending on mental health has increased by £4.7 billion in cash terms, as compared to the target of £3.4 billion in cash terms set out at the time of the Long-Term Plan. For 2024/25, mental health spend is forecast to continue to grow, and will make up 9.01% of all recurrent NHS spending.
In February 2022, NHS England published the outcomes of its consultation on the potential to introduce five new access and waiting time standards for mental health services, as part of its clinically led review of NHS Access Standards. These are: for an urgent referral to a community based mental health crisis service, a patient should be seen within 24 hours of referral, across all ages; for a very urgent referral to a community based mental health crisis service, a patient should be seen within four hours of referral, for all age groups; patients referred from accident and emergency should be seen face to face within one hour by a mental health liaison or children and young people’s equivalent service; children, young people and their families and carers presenting to community-based mental health services, should start to receive care within four weeks of referral; and adults and older adults presenting to community-based mental health services should start to receive help within four weeks of referral.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of trends in the level of average waiting times for receiving NHS mental health (a) treatment and (b) other support services on the (i) wellbeing and (ii) employment of patients requiring those services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
While no such assessments have been made, through the NHS Long Term Plan the Government is providing record levels of investment and increasing the mental health workforce, to expand and transform National Health Service mental health services in England, helping to reduce waiting times. The NHS is also working towards implementing new waiting time measures for people requiring mental healthcare in both accident and emergency and in the community, to increase transparency, drive improvements in the quality of data, promote timely access to the most appropriate and high-quality support, and drive accountability in local systems.
The 2023 Spring Budget contained a package of over £400 million to support the long-term sick and disabled in remaining in or entering employment. This included approximately £75 million for the expansion of the Individual Placement and Support scheme, to help people with severe mental illness into employment. At the 2023 Autumn Statement, we announced a further £795 million of funding to increase the number of sessions per course of Talking Therapies treatment and broaden access, leading to an expected additional 384,000 people completing a course of treatment by 2028/29. It will also fund an additional 100,000 Individual Placement and Support places over five years, which will help people with severe mental illness gain and retain paid employment.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made with Cabinet colleagues of the impact of trends in the number of patients waiting for mental health treatment on the economy.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
While no such assessments have been made, through the NHS Long Term Plan the Government is providing record levels of investment and increasing the mental health workforce, to expand and transform National Health Service mental health services in England, helping to reduce waiting times. The NHS is also working towards implementing new waiting time measures for people requiring mental healthcare in both accident and emergency and in the community, to increase transparency, drive improvements in the quality of data, promote timely access to the most appropriate and high-quality support, and drive accountability in local systems.
The 2023 Spring Budget contained a package of over £400 million to support the long-term sick and disabled in remaining in or entering employment. This included approximately £75 million for the expansion of the Individual Placement and Support scheme, to help people with severe mental illness into employment. At the 2023 Autumn Statement, we announced a further £795 million of funding to increase the number of sessions per course of Talking Therapies treatment and broaden access, leading to an expected additional 384,000 people completing a course of treatment by 2028/29. It will also fund an additional 100,000 Individual Placement and Support places over five years, which will help people with severe mental illness gain and retain paid employment.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the Sixth-Fifth Report of the Committee on Public Accounts of Session 2022-23 on Progress in improving NHS mental health services, HC 1000, if she will make an assessment of the reasons for the reported shortage of mental health professionals in the NHS workforce.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
We are committed to attracting, training, and recruiting the mental health workforce of the future, as well as retaining and developing our current workforce. Since 2016, we have expanded and diversified the types of roles that are available, as well as upskilling and transforming the workforce to deliver innovative models of care. However, while there have been significant increases, we acknowledge that the rise in demand for services means that more growth is needed to improve and expand services, to keep in line with this. The NHS Long Term Workforce Plan sets out the need to grow the overall mental health and learning disability workforce the fastest of all care settings, at 4.4% per year up to 2036/37.
To support this ambition, the plan sets out a number of targeted interventions for the mental health workforce, including increasing mental health training places by 13% by 2025/26 and 28% by 2028/29. These interventions will be delivered via partnerships working across the Department of Health and Social Care, integrated care systems and providers, as well as with wider partners such as the Department for Education and Office for Students.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure that staffing levels of mental health professionals in the NHS meet levels of demand for their services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
To deliver the NHS Long Term Plan’s mental health commitments and help reduce waiting times, our aim has been to grow the mental health workforce nationally by an additional 27,000 professionals by March 2024.
We are making positive progress, delivering three quarters of this, or approximately 20,800 new professionals, by December 2023, with further growth expected to have been achieved once the full year figures for 2023/24 are available. This growth is in addition to the commitment to grow the National Health Service’s mental health workforce by 19,000 between 2016/17 and 2020/21, as set out in Stepping Forward to 2020/21: the mental health workforce plan for England, which was achieved in September 2021.
At a national level, we are committed to attracting, training, and recruiting the mental health workforce of the future, as well as retaining and developing our current workforce. The NHS Long Term Workforce Plan’s modelling projections set out a need to grow the overall mental health and learning disability workforce the fastest of all care settings, at 4.4% per year up to 2036/37, to help improve access to services and quality of care.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help ensure the adequacy of short-term supplies of the diabetes medication Ozempic or semaglutide.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Following intensive work with industry, the broad supply position for glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the United Kingdom has improved. However, global supply issues remain with specific medicines, including ozempic (semaglutide). We issued updated guidance to healthcare professionals in the form of a National Patient Safety Alert on 3 January 2024, on how to manage patients requiring these medicines, with input from expert clinicians. We continue to work closely with manufacturers and others working in the supply chain to help ensure the continued supply of GLP-1 RAs for UK patients, and to resolve the remaining supply issues as quickly as possible, for example by asking suppliers to expedite deliveries.
We know how distressing and frustrating medicine supply issues can be, and the Department will continue to help ensure that these critical medicines reach diabetes patients. If any patient is concerned about their treatment, they should discuss this with their clinician at the earliest opportunity.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
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 7 December 2023 to Question 4738 on Health Services: Disability, what steps her Department is taking to ensure the updated Accessible Information Standard is published as soon as possible.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS England is responsible for the review of the Accessible Information Standard (AIS) and its publication and remains committed to publishing the updated AIS as soon as possible. NHS England is working to both progress the documentation through the publication approval process as well as ensuring that, when published, the AIS and supporting documentation are available in accessible formats.
The Department is working closely with NHS England to ensure joint implementation of the updated AIS and receives periodic updates on progress. Following extensive engagement, with a specific focus on those with lived experience and the voluntary sector organisations that support them, NHS England has completed the review of the AIS and its associated documents. The review considered the effectiveness of the current AIS, how the standard is implemented and enforced in practice, and identified recommendations for improvement.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help maintain the availability of (a) pharmacies and (b) medication.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is closely monitoring changes to the pharmacy network to ensure access to the services they provide on behalf of the National Health Service. Access to services remains good with 80% of people in England living within 20 minutes walking distance of a pharmacy and twice as many pharmacies in the most deprived areas of the country. Patients can also choose to access NHS pharmaceutical services remotely through any of the approximately 400 internet pharmacies, who are contractually required to deliver medicines to patient home free of charge. Every three years, local authorities in England undertake pharmaceutical needs assessments for their areas to ensure provision continues to meet their population’s needs.
We have well-established processes for managing and mitigating medicine supply issues, which involve working with the pharmaceutical industry, the Medicines and Healthcare products Regulatory Agency, NHS England, the devolved governments and others operating in the supply chain to help ensure patients have access to the treatments they need.