Asked by: Daisy Cooper (Liberal Democrat - St Albans)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of whether the NHS workforce plan should be updated by NHS England to reflect the staffing needs of the eight new children and young people's gender services regional centres.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
No specific formal assessment has been made. Gender medicine is a highly specialised field of medicine, and NHS England are actively working to recruit more staff for the new regional children and young people gender identity services. NHS England has also been working closely with other professional bodies to develop tailored training for these professionals. NHS England will commission the required professional training curriculum and competencies framework, not just for staff working in the new gender services, but also for clinicians working in secondary, primary, and community care. It is expected that this will also help to increase the support for children and young people, ensuring they receive a more holistic model of care.
Asked by: Bell Ribeiro-Addy (Labour - Streatham)
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 (a) hospice and (b) other end-of-life services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
As part of the Health and Care Act 2022, the Government added palliative care services 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.
The majority of palliative and end of life care is provided by National Health Service staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide, and consequently, the funding arrangements reflect this.
To support ICBs, NHS England has published statutory guidance and service specifications for both adults and children. NHS England has also commissioned the development of a palliative and end of life care dashboard, which brings together relevant, all age local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of both adults and children in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities.
NHS England has also funded seven strategic clinical networks for palliative and end of life care. These networks support commissioners in the delivery of outstanding clinical and personalised care for people in the last years of life, and reduce local variation.
At a national level, NHS England has confirmed it will renew the Children and Young People’s hospice funding for 2024/25, again allocating £25 million of grant funding for children’s hospices, using the same prevalence-based allocation approach as in 2022/23 and 2023/24. The Government has provided £60 million of additional funding to help deliver the one-off payments to over 27,000 eligible staff employed on dynamically linked Agenda for Change contracts by non-NHS organisations, including some hospices.
Asked by: Bell Ribeiro-Addy (Labour - Streatham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what funding support her Department is providing to Integrated Care Boards on the operation of (a) hospices, (b) palliative care and (c) end-of-life services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The majority of palliative and end of life care is provided by core National Health Service staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services.
The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the integrated care board (ICB) footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide, and consequently, the funding arrangements reflect this.
However, since 2020, NHS England has provided hospices with over £350 million to secure and increase NHS capacity, and to support hospital discharge, as part of the COVID-19 response. In addition, since 2021/22, nearly £63 million has been provided to children’s hospices as part of the Children and Young People’s Hospice Grant. Furthermore, additional investment in children and young people’s palliative and end of life care, including hospices, has also been made through the NHS Long Term Plan’s commitment to match-fund clinical commissioning groups, and subsequently ICBs, totalling over £23 million.
As set out in the Health and Care Act 2022, ICBs are responsible for determining the level of NHS-funded palliative and end of life care locally, including hospice care, and are responsible for ensuring that the services they commission meet the needs of their local population.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many nurses have worked in NHS community health services on average in each of the last 10 years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England publishes Hospital and Community Health Services workforce statistics for England. These include staff working for hospital trusts and integrated care boards, but excludes staff working for other providers such as in primary care, general practice or social care. This data is drawn from the Electronic Staff Record, the human resources system for the National Health Service.
The latest statistics on NHS nursing workforce by area of nursing and care setting can be found in the link below within the ‘Nurses by Setting’ worksheet:
Within this data there are nurses working in community settings within several staff groups including community health nurses, community learning disability nurses, community mental health nurses, and as health visitors.
Asked by: Mark Hendrick (Labour (Co-op) - Preston)
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 ensure (a) blind, (b) partially sighted, (c) deaf and (d) hearing impaired patients receive (i) care and (ii) communications related to their heath in an accessible format; and if she will make an estimate of the cost to the public purse of missed appointments due to (A) inaccessible and (B) missed communications.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Under the Equality Act (2010), health and social care organisations must make reasonable adjustments to ensure that disabled people, including blind, partially sighted, deaf, and hearing impaired patients, are not disadvantaged. Since 2016, all National Health Service organisations and publicly funded social care providers in England are required to comply with the Accessible Information Standard (AIS).
NHS England is responsible for the AIS, and have completed a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. The AIS review included input from individuals with lived experience and voluntary sector organisations for blind, partially sighted, deaf, and hearing impaired patients.
One of the aims of the review was to strengthen assurance of implementation of the AIS, and a self-assessment framework has been developed to support providers of NHS and social care services, to measure their performance against the AIS and develop improvement action plans to address gaps in implementation. The AIS self-assessment framework is designed to enable enhancements around assurance and allows organisations, commissioners, and the Care Quality Commission (CQC) to judge performance and compliance.
NHS England will publish a revised AIS in due course. Following publication, NHS England will continue work to support its implementation with awareness raising, communication and engagement, and updated e-learning modules on the AIS to ensure NHS staff are better aware of the standard, and their roles and responsibilities in implementing it.
NHS England collects data on the total costs of missed appointments, but that data is not broken down sufficiently to enable us to make an estimate of appointments missed due to inaccessible or missed communications.
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, what steps she is taking to help improve the knowledge of GPs on the symptoms of young onset dementia.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
We want all general practitioners to have received appropriate training, in order to provide high quality care to people with dementia, regardless of the person’s age or individual needs.
The standard of training for health care professionals is the responsibility of the health care independent statutory regulatory bodies who set the outcome standards expected at undergraduate level and approve courses and Higher Education Institutions to write and teach the curricula content that enables their students to meet the regulators outcome standards.
Whilst not all curricula may necessarily highlight a specific condition, they all nevertheless emphasize the skills and approaches a Health Care Practitioner must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients, including for dementia.
The NHS Long Term Workforce Plan, published on 30 June 2023, sets out NHS England’s commitment to improving training for workers caring for people with dementia.
The Long Term plan also sets out the plan for there to be more healthcare staff working in and with GP practices, which will mean people will be able to get an appointment with the right professional depending on their needs. This means that those with dementia will be able to access the most appropriate support more quickly.
The plan will include more GPs, nurses and 20,000 additional pharmacists, physiotherapists, paramedics, physician associates and social prescribing link. These bigger teams of staff will work with other local services to make sure people, including those with dementia, get better access to a wider range of support for their needs.
We are seeing more people from younger cohorts with multimorbidity. Multimorbidity challenges the specialised approach to medicine, which has improved our ability to successfully treat single diseases. The Long Term Plan also addresses the increased need for medical and other clinical professionals with generalist and core skills to manage and support patients with seemingly unrelated diseases.
There are also a variety of resources available on the NHS England E-learning for Health platform, including a programme on dementia care, designed to enhance the training and education of the health and social care workforce.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment her Department has made of the impact of the Strikes (Minimum Service Levels) Act 2023 on the ability of healthcare professionals to participate in industrial action.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Strikes (Minimum Service Levels) Act 2023 allows for regulations to be laid in Parliament in the health sector. The Strikes (Minimum Service Levels: NHS Ambulance Services and the NHS Patient Transport Service) Regulations 2023 came into force on 8 December 2023.
As we set out in in our consultation response on minimum service levels in the ambulance sector, in our engagement with representatives from ambulance trusts, they indicated that establishing a minimum service level at the level specified in the regulations would require approximately 80% of an ambulance service’s resources on a typical shift. Therefore, if an employer chose to issue work notices during a strike, it is likely that a high proportion of all levels of paramedics, emergency care assistants, and other staff in the ambulance teams rostered to work on a strike would be named, and this would have a significant impact on the ability of employees to participate in strike action. The Department has consulted on whether to implement similar regulations for hospital services, and will set out its response in due course.
Asked by: Andrew Selous (Conservative - South West Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate she has made of the (a) cost to the NHS of lack of specialist bowel care for patients with neurogenic bowel disorders and (b) additional costs incurred by (i) diagnosis and treatment of pressure sores resulting from inadequate care and (ii) other secondary complications.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has no plans at present to establish a national policy on neurogenic bowel disorder. To help ensure that patients with neurogenic bowel receive timely and appropriate care, NHS England has developed a range of guidance, including its Excellence in Continence Care guidance. NHS England has also published a service specification for spinal cord injury services, which makes specific reference to bowel care. It outlines that patients with spinal injury should be provided with advice and care by specialist nursing staff in specialist fields, including in the field of bladder and bowel management. In addition, National Institute for Health and Care Excellence guidelines on faecal incontinence set out the care that patients with neurogenic bowel should receive, including a neurological bowel management programme.
No estimate has been made of the cost to the National Health Service of a lack of specialist bowel care for patients with neurogenic bowel disorders. Nor has an estimate been made of the costs incurred by the diagnosis and treatment of pressure sores, resulting from inadequate care and other secondary complications.
Asked by: Andrew Selous (Conservative - South West Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what her policy is on establishing a national policy for neurogenic bowel cancer; and what steps her Department is taking to ensure adequate care is available for people who need it.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has no plans at present to establish a national policy on neurogenic bowel disorder. To help ensure that patients with neurogenic bowel receive timely and appropriate care, NHS England has developed a range of guidance, including its Excellence in Continence Care guidance. NHS England has also published a service specification for spinal cord injury services, which makes specific reference to bowel care. It outlines that patients with spinal injury should be provided with advice and care by specialist nursing staff in specialist fields, including in the field of bladder and bowel management. In addition, National Institute for Health and Care Excellence guidelines on faecal incontinence set out the care that patients with neurogenic bowel should receive, including a neurological bowel management programme.
No estimate has been made of the cost to the National Health Service of a lack of specialist bowel care for patients with neurogenic bowel disorders. Nor has an estimate been made of the costs incurred by the diagnosis and treatment of pressure sores, resulting from inadequate care and other secondary complications.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an assessment of the potential benefits of introducing more flexible working arrangements for maternity staff in NHS services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Flexible working arrangements, or We work flexibly, is one of the elements contained in the NHS People Promise, with a commitment to deliver for staff, including midwives, by 2024/25. NHS England has created and shared flexible working arrangement resources, and delivered bespoke webinars and workshops on the issue. They have also brought together midwifery leaders from across the system to share good practice, foster collaboration, and support the implementation of flexible working across maternity services.
In September 2021, contractual changes took effect for employees covered by the NHS Terms and Conditions of Service Handbook, which includes the right to request flexible working from day one, without the need to provide a justification.
Flexible working is one of the key pillars of improving staff experience and retention, as set out in the Long Term Workforce Plan. It will contribute to the aim of retaining up to 130,000 more staff over the course of the plan. However, no assessment of the benefits of introducing more flexible working arrangements specifically for maternity staff has been made.