Asked by: Marsha De Cordova (Labour - Battersea)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the potential merits of ending the use of community treatment orders.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Independent Review of the Mental Health Act (2018) noted that whilst there is limited evidence that Community Treatment Orders (CTOs) prevent readmission, they do benefit some individuals, and thus the Review recommended reform rather than abolition.
The Government’s proposals, as set out in the draft Mental Health Bill, include reforming CTOs so that they can only be used where there is a strong justification and genuine therapeutic benefit for the patient. The aim of this was to strike a balance between the risks and benefits to patients, whilst mitigating against any potential unintended consequences related to the ending of CTOs.
The draft Mental Health Bill has concluded the pre-legislative scrutiny process, and the Joint Committee on the Draft Mental Health Bill published its report in January 2023. The Department continues to work through the recommendations, including those on CTOs, in the report. The Government will respond in due course.
Asked by: Marsha De Cordova (Labour - Battersea)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will include the quality of inpatient environments and the range of people’s experiences of inpatient treatment in the forthcoming Healthcare Safety Investigation Branch investigation into mental health inpatient care settings.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Department continues to work with the Healthcare Safety Investigation Branch (HSIB) to refine the scope of the upcoming Health Services Safety Investigations Body (HSSIB) investigation.
Discussions include the following four areas for the investigation: how providers learn from deaths in their care and use that learning to improve their services, including post-discharge; how young people with mental health needs are cared for in inpatient services and how their care could be improved; how out-of-area placements are handled; and how to develop a safe, therapeutic staffing model for all mental health inpatient services.
During the course of a HSIB investigation, HSIB investigators work collaboratively with patients, families and teams within the trusts, as well as spending time observing practice in provider organisations. HSSIB will take the same approach to ensure that there is family and patient involvement, including taking into account people’s experiences, and that they continue to be transparent in the investigation to support learning and achieve system level change.
Asked by: Marsha De Cordova (Labour - Battersea)
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 help ensure children and young people with complex mental health needs are cared for in safe and therapeutic environments.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
We have conducted a rapid review into mental health inpatient settings, including for children and young people with complex mental health needs, with a specific focus on how we use data and evidence to identify risks to safety and bring about improvements to outcome-based, therapeutic care. The findings were published on 28 June 2023, and the Government will publish a response in due course.
We are working with the Healthcare Safety Investigation Branch to prepare for the launch of a national investigation into mental health inpatient services in England once the new statutory investigatory body, the Health Services Safety Investigations Body (HSSIB), has been established in October. The scope is being refined but is likely to include issues such as how young people with mental health needs can be better cared for, how providers can learn from tragic deaths that take place in their care, how out-of-area placements are handled, and how staffing models can be improved. Across all these themes, the HSSIB will also be looking at how data is used by providers.
NHS England has established a three-year Mental Health, Learning Disability and Autism Inpatient Quality Transformation Programme which seeks to tackle the root causes of unsafe, poor-quality inpatient care in mental health, learning disability and autism settings. The programme is undertaking a review of children and young people’s inpatient services to support development of a new model of inpatient care for specialist services that can support localised treatment in the least restrictive environment but also ensure inpatient care is part of a seamless pathway that delivers quality care.
Asked by: Marsha De Cordova (Labour - Battersea)
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 reduce racial disparities in (a) mental health services and (b) experiences of the Mental Health Act 1983.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Department is aware that there are racial disparities in mental health services and in people’s experiences of the Mental Health Act 1983. Black people are over four times more likely to be detained than white people and eleven times more likely to put on a Community Treatment Order.
Under the Public Sector Equality Duty, National Health Service organisations have a responsibility to eliminate discrimination and to advance equality, including in relation to race. The Department expects all NHS organisations - including those delivering mental health services - to comply with the Duty, and to go further where appropriate.
The Advancing Mental Health Equalities (AMHE) strategy published by NHS England in 2020 helps set expectations for providers and commissioners to identify opportunities and drive forwards improvements to address inequalities in access to and experience of mental health services. As part of this, NHS England is also rolling out the Patient and Carer Race Equalities Framework, an organisational competency framework for all NHS mental health trusts which will help tackle inequalities in access, experience and outcomes for people from ethnic minority groups.
Following on from the Independent Review of the MHA (published in 2018), Government published a draft Mental Health Bill in June 2022 and has signalled its intention to legislate when Parliamentary time allows. The draft Bill contains provisions to give individuals much more of a say in their care and treatment, will increase the support available from independent advocates, and allow people subject to the Act to choose the person they want to represent their interests.
We are also taking forward non-legislative work to address disparities, and have piloted new forms of more tailored, culturally appropriate advocacy.
Asked by: Marsha De Cordova (Labour - Battersea)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when the Government’s Maternity Disparities Task Force is next scheduled to meet.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Maternity Disparities Taskforce, which last met on 18 April 2023, brings together experts from across the health system, Government Departments and the voluntary sector to explore and consider evidence-based interventions to tackle maternal disparities. The next meeting will be scheduled in summer.
Outside of taskforce meetings, the Government continues to address maternal disparities through NHS England’s Equity and Equality guidance for Local Maternity Systems, supported by a £6.8 million investment, which focuses on actions to reduce disparities for women and babies from ethnic minorities and those living in the most deprived areas.
Asked by: Marsha De Cordova (Labour - Battersea)
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 tackle the shortage of ophthalmologists in the NHS.
Answered by Neil O'Brien
The Government recognises that there are workforce capacity challenges facing ophthalmology services, which is why we have increased training places in 2022, with further places planned for 2023. This sits alongside action being taken to train existing ophthalmology staff so they are able to work to the top of their clinical license.
The NHS Long Term Workforce Plan, backed by over £2.4 billion to fund additional education and training places over the next five years, sets out the steps the National Health Service and its partners need to take to deliver an NHS workforce that meets the changing needs of the population over the next 15 years. This is a high-level plan to support the NHS workforce as a whole, covering doctors, nurses, and other key health professions. The plan sets out how the primary eye care workforce could deliver more eye care services in the community to help build capacity.
Asked by: Marsha De Cordova (Labour - Battersea)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the NHS Workforce Plan, what steps his Department is taking to increase the number of ophthalmologists in the NHS.
Answered by Will Quince
The Government recognises that there are workforce capacity challenges facing ophthalmology services, which is why we increased training places in 2022, with further places planned for 2023. This sits alongside action being taken to train existing ophthalmology staff, so they are able to work to the top of their clinical license.
The NHS Long Term Workforce Plan, backed by over £2.4 billion to fund additional education and training places over the next five years, sets out the steps the National Health Service and its partners need to take to deliver an NHS workforce that meets the changing needs of the population over the next 15 years. This is a high-level plan to support the NHS workforce as a whole, covering doctors, nurses, and other key health professions. Therefore, it focuses on NHS-delivered services, such as primary care, community pharmacy and dentistry. While ophthalmologists are not explicitly covered in the plan, it does set out how the primary eye care workforce could deliver more eye care services in the community to help build capacity.
Asked by: Marsha De Cordova (Labour - Battersea)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what (a) financial and (b) human resources support is allocated to each NHS National Clinical Director.
Answered by Will Quince
National Clinical Directors do not receive individual financial or HR support. They are supported by the programme teams in which they are embedded and have access to the organisation’s HR resources in line with all employees. Programme teams are allocated budgets to support delivery of their priorities, but National Clinical Directors are not direct budget holders.
Asked by: Marsha De Cordova (Labour - Battersea)
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 (a) gather data at population level on hearing and sight loss and (b) improve delivery of services for people with hearing and sight loss.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Data is already collected showing the number of adults and children registered as being blind or partially sighted with local authorities in England. The Department do not have any plans to collect data on hearing loss. Where sight or hearing loss leads to a social care need, local authorities are responsible for assessing individual’s eligibility for care and support. The Action Plan on Hearing Loss (2015) sets out key objectives on hearing loss including, prevention, early diagnosis, maximising independence, and enabling people to take part in every-day activities.
‘Commissioning Services for People with Hearing Loss: A Framework for Clinical Commissioning Groups’ was published in July 2016. This framework supports the newly established integrated care boards in England to make informed decisions on maximising value for local populations and provide consistent, high quality, integrated care. It also addresses inequalities in access and outcomes between hearing services.
Asked by: Marsha De Cordova (Labour - Battersea)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the impact of unaddressed sensory health, vision and hearing conditions on (a) mental health and (b) cognitive decline.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
No specific assessment has been made.