Asked by: Steve Darling (Liberal Democrat - Torbay)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the impact of hospice funding on people's experiences of death and dying.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and hospices will have a big role to play in that shift.
Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.
Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life, as well as their loved ones.
No assessment has been made of the impact of hospice funding on people’s experiences of death and dying. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth and range of palliative and end of life care provision within their ICB footprint.
Asked by: Helen Grant (Conservative - Maidstone and Malling)
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 dementia care in England.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
The Dementia Training Standards Framework sets out the required essential knowledge and skills, as well as the expected learning outcomes applicable across the health and care spectrum. To support the quality of dementia care planning by primary care providers, the Dementia: Good Personalised Care and Support Planning guide promotes consistent personalised care and support planning. To further improve care, NHS England has refreshed the RightCare Dementia Scenario. This sets out best practice for supporting people with dementia, from diagnosis to dying well.
To enhance an integrated approach to hospital discharge, six national discharge frontrunner pilots are testing improved dementia care. This includes dementia hubs, which aim to improve care and support for dementia patients waiting for discharge, so that their needs are at the centre of every decision.
Asked by: John Hayes (Conservative - South Holland and The Deepings)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to improve the (a) diagnosis of and (b) age-appropriate support for young onset dementia.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
NHS England is committed to delivering high quality care and support for every person with dementia at every age, and central to this is the provision of personalised care.
The Well Pathway for Dementia includes diagnosing well, living well, supporting well, and dying well, and highlights that services need to be integrated, commissioned, monitored, and aligned with the National Institute for Health and Care Excellence’s standards for each component of the pathway. It makes it clear that the needs, wishes, and preferences of each individual, including those with young onset dementia, should be taken into account when planning and providing their care.
Asked by: Justin Madders (Labour - Ellesmere Port and Bromborough)
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 assessment of the adequacy of levels of age-appropriate support offered by Integrated Care Boards for people with young onset dementia.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
NHS England is committed to delivering high quality care and support for every person with dementia at every age, and central to this is the provision of personalised care.
The Dementia Well Pathway includes diagnosing well, living well, supporting well, and dying well, and highlights that services need to be integrated, commissioned, monitored, and aligned with the National Institute for Health and Care Excellence’s standards for each component of the pathway. It makes it clear that the needs, wishes, and preferences of each individual, including those with young onset dementia, should be taken into account when planning and providing their care.
Asked by: Justin Madders (Labour - Ellesmere Port and Bromborough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department plans to provide (a) guidance and (b) resources to support Integrated Care Systems in developing a designated care pathway for people with young onset dementia.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
NHS England is committed to delivering high quality care and support for every person with dementia at every age, and central to this is the provision of personalised care. The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s (NICE) guidelines.
The Dementia Well Pathway includes diagnosing well, living well, supporting well, and dying well, and highlights that services need to be integrated, commissioned, monitored, and aligned with the NICE’s standards for each component of the pathway. It makes it clear that the needs, wishes, and preferences of each individual should be taken into account in planning and providing their care.
Guidance on dementia care in hospital is referenced in The Dementia Care Pathway, and signals that commissioners should continue to actively engage in local system leadership. An improvement agenda should be developed jointly with key partners, including healthcare providers, social care, local government, and the voluntary and independent sectors. Additionally, on 24 January 2024, the Government announced that it will publish a Major Conditions Strategy covering six conditions, including dementia.
Asked by: Desmond Swayne (Conservative - New Forest West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make it her policy to end the funding of hospices through integrated care boards.
Answered by Victoria Atkins - Shadow Secretary of State for Environment, Food and Rural Affairs
I commend my Rt Hon. Friend’s tireless advocacy for high-quality end-of-life care, through his work on the APPG for Dying Well.
I understand his concerns about potential variation in provision. However, the Health and Care Act 2022 included a legal duty for integrated care boards to commission palliative and end of life care, in line with wider NHS devolution.
Integrated care boards are best positioned to understand and meet the needs of their local population, and commission appropriate end-of-life services, including from the NHS and voluntary sector organisations, such as hospices.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if her Department will take steps to require every Integrated Care Board to develop a young onset dementia pathway to (a) standardise and (b) improve dementia (i) care and (ii) support for people of working age.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
Provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence guidelines.
The Dementia Well Pathway includes diagnosing well, living/ supporting well and dying well, and highlights that services need to be integrated, commissioned, monitored, and aligned with NICE standards for each component of the pathway. It makes it clear that the needs, wishes and preferences of each individual, including those of working age, should be taken into account in planning and providing their care.
Asked by: Julian Sturdy (Conservative - York Outer)
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 help support people with early onset dementia.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
NHS England is committed to delivering high quality care and support for every person with dementia at every age, and central to this is the provision of personalised care. Provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs.
The Dementia Well Pathway includes diagnosing well, living well, supporting well, and dying well, and highlights that services need to be integrated, commissioned, monitored, and aligned with the National Institute for Health and Care Excellence’s (NICE) standards for each component of the pathway. It makes it clear that individual needs, wishes and preferences should be taken into account in planning and providing care.
In January 2023 the Government announced that it will publish a Major Conditions Strategy early 2024. By bringing dementia and other conditions strategies together, we will be able to focus on where there are similarities in approach and ensure care is better centred around the patient.
Asked by: Lord Hay of Ballyore (Democratic Unionist Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve treatment and care for patients with Alzheimer's.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We want a society where every person with dementia, their families and carers, receive high quality, compassionate care, from diagnosis through to end of life. To improve care for patients with dementia, including those with Alzheimer’s disease, NHS England's RightCare team is refreshing the RightCare Dementia Scenario. The scenario works through the dementia well pathway journey from diagnosing well through to dying well, detailing optimal and sub optimal approaches, with associated costings for each. The RightCare team is developing a dementia model pathway based on data for each component of the dementia well pathway to provide a high-level view of what dementia care activity looks like for local areas and will support targeted support where appropriate.
There are also several potential new disease modifying treatments for Alzheimer’s disease in development. The Medicines and Healthcare products Regulatory Agency, the National Institute for Health and Care Excellence (NICE), NHS England and the Department are working closely to ensure that arrangements are in place to support the adoption of any new licensed and NICE recommended treatment for dementia as soon as possible.
Asked by: Gregory Campbell (Democratic Unionist Party - East Londonderry)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what changes have been made to the provision of services for people with dementia in the period since the publication of the guidance by the NHS and the Alzheimer’s Society entitled The dementia guide: Living well after your diagnosis in November 2020.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
Since the publication of the guidance by the National Health Service and the Alzheimer’s Society in November 2020, NHS England is funding an evidence-based improvement project for two trusts in each region, encompassing 14 sites in total, to pilot the Diagnosing Advanced Dementia Mandate tool to improve diagnosis of dementia in care homes and to create an alternative pathway for diagnosing dementia. NHS England is also stepping up and accelerating preparation for the rollout of any potential new treatments, including the establishment of a dedicated programme team for early Alzheimer’s treatments.
NHS England's RightCare team is refreshing the RightCare Dementia Scenario which works through the dementia well pathway journey from diagnosing well through to dying well, detailing optimal and sub optimal approaches, with associated costings for each. The RightCare team is also developing a ‘dementia model pathway’.
Following publication of the Strategic Framework on 14 August 2023, we are continuing to develop the Major Conditions Strategy, informed by the Call for Evidence and ongoing engagement. This includes dementia as one of the six major conditions. Our intention is to publish the strategy in early 2024.