Asked by: Danny Chambers (Liberal Democrat - Winchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many deaths have been recorded in inpatient mental health settings in each of the last five years.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The information requested is not held centrally. All deaths of children and young people under the care of Tier 4 inpatient children and young people’s mental health services are routinely reported to the Department via NHS England. Such deaths are also notified to the Care Quality Commission and the National Confidential Inquiry into Suicide and Safety in Mental Health.
Since 2019, there have been a total of 23 deaths of young people aged under 18 years old in contact with Tier 4 services, including those on home leave, or who had absconded. We are unable to provide the information broken down by year, as the annual data held by NHS England includes a small patient count of fewer than five cases which could lead to the identification of individuals.
All providers are required to notify the Care Quality Commission of the deaths of patients detained under the Mental Health Act 1983. The following table shows the number of deaths of patients detained under the Mental Health Act notified to the Care Quality Commission in the last five years:
Year | Total |
2020 | 474 |
2021 | 405 |
2022 | 410 |
2023 | 335 |
2024 | 343 |
2025 | 311 |
Total | 2278 |
Source: the Care Quality Commission
Notes:
This data is counts of notifications to the Care Quality Commission under Regulation 17 of the Care Quality Commission (Registration) Regulations 2009, Notification of death or unauthorised absence of a service user who is detained or liable to be detained under the Mental Health Act 1983.
Asked by: Andrew Gwynne (Independent - Gorton and Denton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will implement a national youth health strategy to reduce mortality in people under 39 that includes (a) mental health conditions and (b) sudden cardiac death.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is already taking action to improve the physical and mental health of young people. The Government is co-producing a National Youth Strategy which will set out a long-term vision for young people, aged 10 to 21 years old, and up to 25 years old for those with special educational needs and disabilities, and provide them with meaningful choices and chances.
The 10-Year Health Plan to reform the National Health Service will make it fit for the future and better support children, young people, and adults. The Government is committed to taking a cross-Government strategic approach to children and young people’s mental health, and will recruit 8,500 additional mental health staff by the end of the Parliament and will expand mental health support teams in schools in England.
NHS England is currently working with a range of stakeholders to review the national service specification for inherited cardiac conditions. This will support patients who often present as young adults with a previously undiagnosed cardiac disease, or families requiring follow up due to a death from this cause, including sudden cardiac death. The service specification can be accessed at the following link:
https://www.england.nhs.uk/wp-content/uploads/2017/11/cardiology-inherited-cardiac-conditions.pdf
There are no current plans to implement a national youth health strategy.
Asked by: Lord Bradley (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to change the way that deaths of patients detained in secure settings under the Mental Health Act 1983 are investigated.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are currently no such plans at this time to change the way that deaths of patients detained in secure settings under the Mental Health Act 1983 are investigated.
The Mental Health Bill will deliver our manifesto commitment to modernise the Mental Health Act 1983. It will give patients greater choice, autonomy, enhanced rights and support, and ensure everyone is treated with dignity and respect throughout treatment. The Bill will make the Act fit for the 21st century, redressing the balance of power from the system to the patient and ensuring people with the most severe mental health conditions get better, more personalised, care.
The Patient Safety Incident Response Framework sets out the NHS’s approach to developing and maintaining effective systems and processes for responding to patient safety incidents for the purpose of learning and improving patient safety. The Framework became a requirement in the NHS standard contract from April 2024. Under this framework a locally-led patient safety incident investigation is required for deaths of patients detained under the Mental Health Act (1983) or where the Mental Capacity Act (2005) applies, where there is reason to think that the death may be linked to problems in care (i.e., the incident meets the “learning from deaths” criteria, the investigation explores decisions or actions as they relate to the safety event).
In addition, all deaths among people detained under the Mental Health Act 1983 are reported to the Care Quality Commission and referred to the Coroners Office.
Asked by: Clive Lewis (Labour - Norwich South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to take steps to monitor the potential impact of the ban on puberty blockers on (a) the mental health and (b) suicide rates among trans patients under the age of 18.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The emergency banning order, restricting the sale or supply of puberty blockers, was introduced by the previous government. The Order enables those who were already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues, before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland-registered prescriber can legally switch to a UK based prescriber to continue their treatment.
We will continue to monitor the impact of the emergency order, including on mental health and suicide. All child deaths undergo a multi-agency review by a Child Death Overview Panel and that information is reported to the National Child Mortality Database. There is a monthly exercise by NHS officials to check the waiting list against NHS records to identify any deaths.
Professor Louis Appleby, Chair of the National Suicide Prevention Strategy Advisory Group, has examined evidence for a large rise in suicides claimed by campaigners. His paper, which was published on 19 July 2024, concluded that the data does not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock clinic.
This government has committed to implementing the expert recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institue of Health and Care Research – the research arm of the department – are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.
Children and young people who are unable to access puberty blockers when they have previously done so are strongly advised to meet with their clinician. We expect clinicians to be working with impacted patients to consider what the best care for them is going forward. We understand some children and young people may be concerned or distressed by the changes. If they are already under the care of a Children and Young People’s mental health provider or Child and Adolescent Mental Health Services, they can contact their team for advice. If they are not, their general practice team will be able to assess whether further referrals for mental health support are required.
Professor Appleby’s paper is available at the following link:
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department collates data on patients that die while under the care of a mental health provider.
Answered by Maria Caulfield
The Department doesn't collect data on deaths in this group directly, but relies on data from several other sources. Under the Care Quality Commission (Registration) Regulations 2009: Regulation 17, providers have a legal duty to notify the Care Quality Commission (CQC) of the deaths of people detained, or liable to be detained, under the Mental Health Act. This data is routinely published in the CQC’s Monitoring the Mental Health Act annual report.
However, this only covers people liable to be detained under the Mental Health Act, not voluntary inpatients, and not those under other secondary mental health services. There is no national notification system for the Department, for deaths within this group.
All deaths must be registered, and deaths that appear to be sudden or violent, or deaths that occur in state custody, for instance where someone is detained under the Mental Health Act, must be referred to a coroner for an inquest to determine the cause of death. In a case where the coroner concludes that action can be taken to prevent future deaths, they can choose to issue a Section 28 report addressed to the individual or organisation they believe can take that action. All deaths of patients under Tier 4 care of the Child and Adolescent Mental Health Services, are reported to ministers.
The National Confidential Inquiry into Suicide and Safety in Mental Health uses death registrations and engagement with clinicians to identify deaths by suicide, by people in contact with mental health services, including both inpatients and people being cared for in the community.
Asked by: Navendu Mishra (Labour - Stockport)
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 improve the provision of (a) mental health support and (b) other care for patients who have experienced early pregnancy loss.
Answered by Maria Caulfield
The Department’s response to the Pregnancy Loss Review sets out what actions the Government intends to take to improve the care and support women and families receive when experiencing a pre-24-week gestation baby loss. We are committed to expanding and transforming mental health services in England so that people, including those affected by the loss of a baby or traumatic birth, can get the help and support that they need, when they need it.
As of February 2023, there were 35 Maternal Mental Health Services, which combine maternity, reproductive health and psychological therapy for women experiencing mental health difficulties related to their maternity experience. Services in each integrated care system area are due to be operational by March 2024.
The Government funded the Stillbirths and Neonatal Death charity to work with other baby loss charities and Royal Colleges to produce and support the roll-out of a National Bereavement Care Pathway. The pathway covers a range of circumstances of a baby loss including miscarriage, stillbirth, termination of pregnancy for medical reasons, neonatal death and sudden infant death syndrome.
As of 1 January 2023, 108 National Health Service trusts or 84% in England have committed to adopting the nine National Bereavement Care Pathway standards. 21 trusts and NHS England continue to push for their inclusion.
Asked by: Catherine West (Labour - Hornsey and Friern Barnet)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to her Department's publication entitled Major conditions strategy: case for change and our strategic framework published on 21 August 2023, what steps she is taking to ensure NHS non-clinical staff employed through the Additional Roles Reimbursement Scheme have awareness of the six major health conditions in the strategy.
Answered by Andrea Leadsom
The Major Conditions Strategy will focus on tackling the six major conditions groups – cancers, mental ill-health, cardiovascular disease (including stroke and diabetes), dementia, chronic respiratory diseases, and musculoskeletal disorders – that account for around 60% of ill-health and early death in England.
General practices are self-employed contractors to the National Health Service and it is largely up to employers to determine how best to staff their Primary Care Networks or GPs to best meet the needs of their population. The demands each patient places on their GPs are different and can be affected by many different factors, including rurality and patient demographics.
Individual employers are responsible for ensuring their staff are trained and competent to carry out their role, and for investing in the future of their staff through providing continuing professional development funding.
As part of the Delivery plan for recovering access to primary care, published in May 2023, we will invest in care navigation training to help teams direct patients to the right person.
Asked by: Lord Blunkett (Labour - Life peer)
Question to the Ministry of Justice:
To ask His Majesty's Government whether the deaths of prisoners serving an imprisonment for public protection (IPP) sentence in secure mental health facilities are included in overall figures of deaths of IPP prisoners, published by the HM Prison and Probation Service.
Answered by Lord Bellamy
On 16 October 2023, the Lord Chancellor announced he would be looking at options to curtail the licence period to restore greater proportionality to IPP sentences in line with recommendation 8 of the report by the Justice Select Committee (JSC), published on 28 September 2022.
These changes are being taken forward in the Victims and Prisoners Bill. The measure will make it quicker and easier to terminate the IPP licence (and therefore the IPP sentence as a whole) whilst balancing public protection considerations.
The new measure will:
The Lord Chancellor was persuaded by the Committee’s recommendation to reduce the qualifying licence period from 10 years to 5 years and is going further: reducing the period to 3 years. These amendments will restore greater proportionality to IPP sentences and provide a clear pathway to a definitive end to the licence and, therefore, the sentence, while balancing public protection considerations.
There were 18 deaths of those serving IPP sentences in secure hospitals, up to 31 December 2022.
Please Note:
(1) Data is only available from 2009 onwards.
(2) Figures have been taken from a subset of published data in the Restricted Patients Statistical Bulletin, which has been published up to 31 December 2022.
(3) The data relates to all deaths, including natural causes and self-inflicted.
(4) Some cases may have ongoing investigations to determine the cause of death.
HMPPS publishes quarterly Safety in Custody statistics which cover deaths, self-harm and assaults in prison custody, in England and Wales. These published statistics do not include the death of those in secure mental health facilities.
Asked by: Lord Blunkett (Labour - Life peer)
Question to the Ministry of Justice:
To ask His Majesty's Government how many people serving an imprisonment for public protection sentence have died in secure mental health facilities.
Answered by Lord Bellamy
On 16 October 2023, the Lord Chancellor announced he would be looking at options to curtail the licence period to restore greater proportionality to IPP sentences in line with recommendation 8 of the report by the Justice Select Committee (JSC), published on 28 September 2022.
These changes are being taken forward in the Victims and Prisoners Bill. The measure will make it quicker and easier to terminate the IPP licence (and therefore the IPP sentence as a whole) whilst balancing public protection considerations.
The new measure will:
The Lord Chancellor was persuaded by the Committee’s recommendation to reduce the qualifying licence period from 10 years to 5 years and is going further: reducing the period to 3 years. These amendments will restore greater proportionality to IPP sentences and provide a clear pathway to a definitive end to the licence and, therefore, the sentence, while balancing public protection considerations.
There were 18 deaths of those serving IPP sentences in secure hospitals, up to 31 December 2022.
Please Note:
(1) Data is only available from 2009 onwards.
(2) Figures have been taken from a subset of published data in the Restricted Patients Statistical Bulletin, which has been published up to 31 December 2022.
(3) The data relates to all deaths, including natural causes and self-inflicted.
(4) Some cases may have ongoing investigations to determine the cause of death.
HMPPS publishes quarterly Safety in Custody statistics which cover deaths, self-harm and assaults in prison custody, in England and Wales. These published statistics do not include the death of those in secure mental health facilities.
Asked by: Matt Hancock (Conservative - West Suffolk)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what data his Department holds on the effectiveness of preventive healthcare (a) programs and (b) interventions at (i) increasing average life expectancy and (b) reducing the incidence of preventable diseases in the last 10 years; and whether his Department has conducted research on the effectiveness of individual preventive healthcare (A) programs and (B) interventions.
Answered by Neil O'Brien - Shadow Minister (Policy Renewal and Development)
The Department is taking action to improve healthy life expectancy (HLE), improve average life expectancy (LE) and reduce incidence of preventable disease. We monitor the impact of our programmes and interventions on their target metrics, and we are working towards understanding their impact on HLE as part of our work to drive progress on our Levelling Up health mission.
On 24 January 2023, we announced our plan to publish the Major Conditions Strategy. This strategy will explore how we can tackle the key drivers of ill-health in England. The strategy will focus on six major groups of conditions, namely cancers, mental health, cardiovascular disease (including stroke and diabetes), dementia, chronic respiratory diseases, and musculoskeletal disorders, that account for approximately 60% of ill-health and early death in England.
There is a wide range of published research and evidence on preventative healthcare interventions, which informs both the development of policy and advice issues to health services including by the National Institute for Health and Clinical Excellence. In 2017, PHE published the Health Economics Evidence Resource, available at the following link: https://www.gov.uk/government/publications/health-economics-evidence-resource
This summarised the evidence on the cost-effectiveness of various prevention interventions used by local authorities.
Through the National Institute for Health and Care Research (NIHR), the Department has funded research on preventative healthcare interventions. For example, the NIHR Health and Social Care Delivery Research Programme funded study ‘What happens after an NHS Health Check? A survey and realist review’ has recently reported. The NIHR welcomes funding applications for research into any aspect of human health, including preventative healthcare interventions. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality. NIHR funded research is published in its journals library which is available at the following link:
https://www.journalslibrary.nihr.ac.uk