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Written Question
Palliative Care: Integrated Care Boards
Thursday 7th March 2024

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 is taking steps to help support integrated care boards to develop palliative care strategies for (a) hospices, (b) care homes, (c) hospitals and (d) within the community in their areas.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

While the National Health Service has always been required to commission appropriate palliative and end of life care services to meet the reasonable needs of their population, in 2022 palliative care services were added to the list of services an integrated care board (ICB) must commission, promoting a more consistent national approach and supporting commissioners in prioritising palliative and end of life care in all settings. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.

From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. Additionally, NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities.


Written Question
Palliative Care
Monday 22nd January 2024

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, if she will make an assessment of the adequacy of NHS staffing levels for the delivery of palliative care services in (a) hospitals, (b) hospices and (c) homes in the community.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The Government recognises that access to high-quality, palliative and end of life care can make all the difference to individuals and their loved ones. As set out on the Health and Care Act 2022, integrated care boards (ICBs) are responsible for commissioning palliative and end of life services that meet the needs of their population. In July 2022, NHS England published statutory guidance for commissioners on palliative and end of life care, which sets out the considerations for ICBs to meet their legal duties.

In 2023, NHS England published the NHS Long Term Workforce Plan (LTWP). The LTWP sets out the steps the NHS and its partners need to take to deliver an NHS workforce that meets the changing needs of the population over the next 15 years. It will put the workforce on a sustainable footing for the long term. The LTWP aims to grow the number and proportion of NHS staff working in mental health, primary and community care to enable the service ambition to deliver more preventative and proactive care across the NHS. The LTWP sets out an ambition to grow these roles 73% by 2036/37, including plans to increase the community workforce specifically by 3.9% each year.

Most hospices are independent, charitable organisations, and are, therefore, responsible for determining their own staffing levels. While the LTWP did not explicitly model demand for health professionals from non-NHS settings, it does assume that the expansion of domestic education and training and improved retention would have a positive impact on healthcare numbers working elsewhere in the health and care system.


Written Question
Palliative Care
Tuesday 19th April 2022

Asked by: Martyn Day (Scottish National Party - Linlithgow and East Falkirk)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what plans he has to examine the (a) rise in deaths in private homes and (b) quality of end of life care that people have received since the start of the covid-19 pandemic.

Answered by Gillian Keegan - Secretary of State for Education

We continue to monitor the number of deaths in private homes and the quality of end of life care to understand the impact of the pandemic on palliative and end of life care provision.

NHS England and NHS Improvement review the quality of end of life care service provision through the National Audit of Care at the End of Life. Its most recent National Summary is expected to be published in summer 2022. The National Institute for Health Research has also commissioned research into the end-of-life care experiences of black people during the COVID-19 pandemic.


Written Question
Hospices: Pay
Tuesday 28th September 2021

Asked by: Andrew Rosindell (Conservative - Romford)

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 challenges facing hospices to (a) recruit and (b) train healthcare staff, in the event that care homes are unable to match the 3 per cent pay rise for NHS staff.

Answered by Gillian Keegan - Secretary of State for Education

We have made no specific assessment as most hospices are independent, charitable organisations and develop and adopt terms and conditions of employment to recruit the staff they need to deliver services.

The Department and NHS England and NHS Improvement, will continue to engage with the sector to understand the issues they face, including determining any funding arrangements and implications for non-National Health Service organisations providing NHS services as a result of the 3% pay uplift for NHS staff. Health Education England provides comprehensive training for all health and care staff involved in palliative and end of life care through the end of life care for all resources. These are regularly updated and publicised throughout the system including to the hospice community.


Written Question
Health Services: Coronavirus
Tuesday 16th February 2021

Asked by: Lord Hunt of Kings Heath (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what additional (1) clinical, and (2) palliative, care support, other than access to tele-medicine, has been available to carers providing end of life care (a) in residential care homes where there is no nursing presence, and (b) at home, during the COVID-19 pandemic.

Answered by Lord Bethell

NHS England and NHS Improvement have published a range of online only guidance and resources to support healthcare professionals, carers and those less accustomed to providing end of life care in a variety of settings including in-home care.

In addition, local areas provide access to medication and equipment, direct and specialist support, and education and training for care home staff. Supporting this, NHS England and NHS Improvement have also supplied pulse oximeters and iPads to care homes to enable them to connect better with general practice.


Written Question
Palliative Care
Thursday 28th January 2021

Asked by: Andrew Rosindell (Conservative - Romford)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if his Department will review the use of language and sentiments to describe the dying process in hospitals and care homes.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The importance of honest and open conversation is acknowledged as a key part in the delivery of high-quality, personalised palliative and end of life care. This is supported by extensive work on improving communications skills, increasing numbers of personalised care and support plans and supporting Dying Matters in their national campaigns to improve public conversation around death and dying. Dying Matters is a broad based, inclusive and rapidly growing national coalition which aims to change public knowledge, attitudes and behaviours towards dying, death and bereavement. The Department treats new research with interest and always works to ensure the care and support delivered is in accordance with evidence-based best practice.


Written Question
Care Homes: Palliative Care
Monday 25th January 2021

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 he will make an assessment of the accuracy of reports by the Queen’s Nursing Institute that one in ten care home staff were instructed to change resuscitation orders for patients without discussion with family members, nursing staff or patients; and if he will make a statement.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The Department is aware of the Queen’s Nursing Institute report. There were 163 responses to the survey with 16 reporting some changes to standard Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) practice. The responses are anonymous and the Department is unable to comment on individual cases.

The Department asked the Care Quality Commission (CQC) to review how DNACPR decisions were used during the COVID-19 pandemic, building on concerns reported earlier in the year. The review will take a national view of how these decisions were made in and across different types of services including hospitals, primary care and care homes. The CQC is working closely with stakeholders, users of services and providers. Interim findings were published on 3 December, with a final report due in early 2021.


Written Question
Palliative Care
Wednesday 20th January 2021

Asked by: Jim Shannon (Democratic Unionist Party - Strangford)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many NHS clinical commissioning group areas provide (a) admissions seven days a week to specialist palliative care beds and (b) specialist palliative care services seven days a week in patients' homes.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

This data is not held centrally.


Written Question
Care Homes: Palliative Care
Wednesday 30th September 2020

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, what steps he has taken to ensure that Do Not Resuscitate instructions are not imposed on care homes in winter 2020-21.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The Department remains clear that the blanket application of do not attempt cardiopulmonary resuscitation decisions (DNACPRs) is unacceptable and that standards and quality of care should be maintained even in pressurised circumstances. The Adult Social Care Winter Plan published on 18 September 2020 reiterates this.

Agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians or other legally recognised advocates. We have been working with NHS England and NHS Improvement to take national action across a number of fronts and continue to work with stakeholders to understand what more we can do nationally, to stop inappropriate DNACPR decisions being made for individuals.


Written Question
Care Homes: Palliative Care
Wednesday 9th September 2020

Asked by: David Davis (Conservative - Haltemprice and Howden)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many do not resuscitate orders were put in place in care homes where the person died (a) from any cause and (b) with covid-19 on the death certificate between 1 February 2020 to 1 August 2020.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The Department does not hold data on the numbers or assessment of Do Not Attempt Cardiopulmonary Resuscitation Decisions (DNACPR).

Agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians or other legally recognised advocates. There has not been a national instruction or directive issued for blanket DNACPR decisions to be put in place. We remain clear that the blanket application of DNACPRs is unacceptable and that standards and quality of care should be maintained even in pressurised circumstances.