Asked by: Paula Barker (Labour - Liverpool Wavertree)
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 ensure that mental health patients who could pose a risk to the wider public have their cases managed appropriately.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
The Mental Health Act 1983, now and when reformed, has the necessary powers to enable clinicians to manage high risk mental health patients. The planned reforms will not change the fundamental powers and purpose of the Act, which is to detain and treat people when they are so unwell they become a risk to themselves or others. However, when the very serious decision is taken to detain someone, the reforms will ensure there is a modern framework for the use of these powers, to ensure patients are treated with dignity and respect and that they receive care and treatment which supports recovery.
The Mental Health Bill will seek to improve the management of risk within the Act. This Government has made additional changes to the bill published in draft in 2022 to achieve this, including the introduction of a new requirement for the patient’s responsible clinician to consult another person who has been professionally concerned with the patient’s care when they are deciding about whether to discharge a patient.
NHS England included a requirement in the 2024/25 NHS Priorities and Operational Planning Guidance that all integrated care boards (ICBs) “review their community services by Q2 2024/25 to ensure that they have clear policies and practice in place for patients with serious mental illness, who require intensive community treatment and follow-up but where engagement is a challenge”.
The outcome of these reviews and local action plans will be presented at ICB’s public boards to ensure the outcome of the review is transparent and locally led.
Asked by: Paula Barker (Labour - Liverpool Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what he is taking to ensure effective intelligence sharing between mental health services and (a) the police and (b) other relevant services when a patient is deemed to pose a risk to the wider public.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Mental health services work and engage with a range of services to manage patients identified as a potential risk. The nature of this engagement will vary depending on the nature and level of the risk. For example, this may be through formal processes such as multi-agency public protection arrangements.
In matters of national security, health services work with Counter Terrorism policing and the wider security sector to ensure that information is shared appropriately, to provide a complete picture of any risk, and to provide the right interventions and care for patients.
Local level arrangements will also be in place, as police forces are operationally independent. Whilst the roll out of the Right Care, Right Person approach has reduced the involvement of police in mental health incidents, they will continue to engage where there is a serious risk of harm, and local level arrangements have been put in place to support safe roll out between police, and health and social care services.
We intend to use the Code of Practice following the Mental Health Bill to further underline good practice for how mental health services should work with other services, including the police, to keep people safe, particularly regarding consideration of discharge.
Asked by: Paula Barker (Labour - Liverpool Wavertree)
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 ensure that (a) NHS England and (b) Berkshire Healthcare NHS Trust respond to Sir Adrian Fulford's prevention of future deaths report following the Forbury Garden terrorist incident in June 2020.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
It is the responsibility of the individual organisations named within a Report to Prevent Future Deaths to take action to address any identified failures. Following Sir Adrian Fulford's report, each organisation, including NHS England and the trusts, has written to the Judge Coroner, setting out what action they have taken to address the points he has made.
As a first step, NHS England included a requirement in the National Health Services’ 2024/25 priorities and operational planning guidance that all integrated care boards (ICBs) ‘review their community services by Q2 2024/25 to ensure that they have clear policies and practice in place for patients with serious mental illness, who require intensive community treatment and follow-up but where engagement is a challenge’. Further information on the 2024/25 priorities and operational planning guidance is available at the following link:
https://www.england.nhs.uk/operational-planning-and-contracting/
The outcome of these reviews and local action plans will be presented at the ICBs’ Public Boards, to ensure the outcome of the review is transparent and locally led.
Asked by: Paula Barker (Labour - Liverpool Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the guidance by the National Institute for Health and Care Excellence entitled Integrated health and social care for people experiencing homelessness, published on 16 March 2022, what steps his Department is taking to implement these guidelines in health and social care settings.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department recognises the importance of the National Institute for Health and Care Excellence’s guidelines, and is working across the Government and the health system, and with local government, commissioners, and the voluntary sector, to continue to review and support implementation of the guidance Integrated health and social care for people experience homelessness (NG214), both nationally and locally. With the aim to include setting priority areas of focus and identifying and sharing best practice for implementation.
Asked by: Paula Barker (Labour - Liverpool Wavertree)
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 ensure that home care workers are paid correctly for their travel time.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
All workers, including social care workers, must be paid at least the National Minimum Wage or National Living Wage for the work that they do. Time spent travelling between appointments counts as working time for minimum wage purposes. If anyone thinks they are not receiving at least the minimum wage, they can contact the Advisory, Conciliation and Arbitration Service or submit a query directly to HM Revenue and Customs.
On 10 October 2024, recognising the central role of our amazing care workforce, we took a critical step, introducing the legislation that will establish the first ever Fair Pay Agreement for care professionals. Fair Pay Agreements will empower worker, employer, and other sector representatives to negotiate pay and terms and conditions in a regulated and responsible manner and will help to address the recruitment and retention crisis in the sector, in turn supporting the continued delivery of high-quality care.
Asked by: Paula Barker (Labour - Liverpool Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department taking to use NHS dietitians to help reduce health inequalities.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
Dietitians have an important contribution to reducing health inequalities. The Department published Addressing health inequalities across allied health professional (AHP) services: a guide for AHP system leaders in May 2024. The guide focuses on what AHP leaders need to know and what actions they can take at a system level to address health inequalities. This includes the utility of dietitians to reduce health inequalities. The guide is available at the following link:
We continue to promote the framework, My role in tackling health inequalities: a framework for allied health professionals, published in 2021. This work describes how allied health professionals (AHPs), including dietitians, can raise awareness, take action, and optimise advocacy through six lenses: self; patients; clinical teams, pathway and service groups; communities and networks; systems; and nurturing the future. The framework is designed to support AHPs to do whatever they can, large or small, to tackle health inequalities. Each section of the framework is accompanied by examples of AHP-led work already under way across England. The framework is available at the following link:
Asked by: Paula Barker (Labour - Liverpool Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will include health outcomes of those who experience homelessness in the NHS ten year plan.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS 10-Year Plan will consider the change needed to meet the three health mission goals: a fairer system where everyone lives well for longer; a National Health Service that is there when people need it; and fewer lives lost to the biggest killers. Officials within the Department will work closely with partners across the health service and NHS England as the plan is developed to consider better health outcomes for socially excluded groups, including those experiencing homelessness.
Asked by: Paula Barker (Labour - Liverpool Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to improve (a) access to and (b) engagement with health and social care services for those who experience homelessness.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department recognises the importance of reducing barriers to services for those experiencing homelessness and rough sleeping. This is why we supported the development and implementation of the National Institute for Health and Care Excellence’s (NICE) guidance, which provides recommendations on ways to improve access to, and engagement with, health and social care services for people experiencing homelessness. This guidance is available at the following link:
https://www.nice.org.uk/guidance/ng214
NHS England has also delivered the Inclusion Health Framework, which includes focus on the homeless population. Inclusion health is an umbrella term which includes homeless people and is used to describe people who are socially excluded, and who typically experience multiple interacting risk factors for poor health, such as stigma, discrimination, poverty, violence, and complex trauma.
https://www.nice.org.uk/guidance/NG214
Asked by: Paula Barker (Labour - Liverpool Wavertree)
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 utilise the expertise of (a) dietitians and (b) other allied health professionals to tackle long-term healthcare challenges.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
Dietitians are essential to a range of pathways detailed within the NHS Long Term Plan, including diabetes, cancer, cardiovascular disease, stroke as part of the multi-disciplinary team which includes the other allied health professions (AHPs).
AHPs are critical to the delivery of the NHS Long Term Plan, and plans to recover core services including, urgent and emergency care, urgent community services, primary care and community care, elective care, cancer, and diagnostics pathways. This is underpinned by the Allied Health Profession (AHPs) Strategy for England 2022 to 2027 AHPS Deliver, which is available at the following link:
Asked by: Paula Barker (Labour - Liverpool Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to improve the integration of (a) dietitians and (b) allied health professionals in the delivery of (i) public health and (ii) primary care.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is leading a collaboration between the nations of the United Kingdom, as well as 14 Allied Health Professional (AHP) bodies, including the British Dietetic Association, to refresh the UK Allied Health Professions Public Health Strategic Framework, which is available at the following link:
https://www.ahpf.org.uk/files/UK%20AHP%20Public%20Health%20Strategic%20Framework%202019-2024.pdf
Publication of the new strategic framework is planned for early 2025. It will include goals to increase the profile, capability, and leadership of AHPs, including dietitians, in public health, including how they integrate into the wider public health workforce.
The Department has also worked with the Council of Deans of Health to publish Public Health Curricula Guidance for Pre-Registration Education of AHPs, including dietitians, and with the Health and Care Professions Council to promote their revised standards of proficiency for public health.
The Network Contract Directed Enhanced Service (DES) was developed to support the establishment of primary care networks which would provide greater resilience for practices, and is available at the following link:
The Network Contract DES details that primary care networks are entitled to funding to support the recruitment of additional staff to deliver health services, which is referred to as the Additional Roles Reimbursement Scheme (ARRS). The ARRS includes first contact physiotherapists and paramedics and also dietitians, podiatrists, and occupational therapists. The inclusion of these AHP roles within primary care creates capacity within the system for the timely assessment and management of patients within the community, reducing the need for general practice (GP) intervention.
Together with existing GP staff, the new roles can help form a multidisciplinary team who can provide new services, better care for patients, and improve integration. GPs can refer to other AHPs not included in the ARRS as clinically indicated within the community.