Asked by: Seema Malhotra (Labour (Co-op) - Feltham and Heston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 11 March 2024 to Question 16630 on Chronic Fatigue Syndrome, when she plans to publish the final myalgic encephalomyelitis delivery plan.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence’s (NICE) guideline, Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management, published in October 2021, outlines the expectations for inpatient care for patients with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The guidance states that where possible, patients with ME should be provided with a single room, and that factors such as the level of lighting and sound should be taken into consideration, and necessary adjustments made.
It is the duty of clinicians to keep themselves appraised of best practice, in particular guidance issued by the NICE. Whilst guidelines are not mandatory, clinicians and commissioners are expected to take them fully into account when designing services that meet the needs of their local population. The NICE promotes its guidance via its website, newsletters, and other media.
The Department is working with NHS England to develop an e-learning course on ME for healthcare professionals, with the aim of supporting staff in providing better care and improving patient outcomes. The Medical Schools Council will promote the NHS England e-learning package on ME to all United Kingdom medical schools, and encourage medical schools to provide undergraduates with direct patient experience of ME.
We have finished consulting on My Full Reality, the cross-Government interim delivery plan on ME, which seeks to improve the experiences and outcomes of people living with this condition. We are in the process of analysing the results of the consultation. The views and experiences gathered through this consultation will be used to build a picture of how well the interim delivery plan identifies and meets the needs of the ME community, and to highlight any significant gaps where further action may be necessary. We will publish a summary of the consultation responses, which will inform the final delivery plan being published later this year, in due course.
Asked by: Seema Malhotra (Labour (Co-op) - Feltham and Heston)
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 increase inpatient provision for patients with myalgic encephalomyelitis.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence’s (NICE) guideline, Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management, published in October 2021, outlines the expectations for inpatient care for patients with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The guidance states that where possible, patients with ME should be provided with a single room, and that factors such as the level of lighting and sound should be taken into consideration, and necessary adjustments made.
It is the duty of clinicians to keep themselves appraised of best practice, in particular guidance issued by the NICE. Whilst guidelines are not mandatory, clinicians and commissioners are expected to take them fully into account when designing services that meet the needs of their local population. The NICE promotes its guidance via its website, newsletters, and other media.
The Department is working with NHS England to develop an e-learning course on ME for healthcare professionals, with the aim of supporting staff in providing better care and improving patient outcomes. The Medical Schools Council will promote the NHS England e-learning package on ME to all United Kingdom medical schools, and encourage medical schools to provide undergraduates with direct patient experience of ME.
We have finished consulting on My Full Reality, the cross-Government interim delivery plan on ME, which seeks to improve the experiences and outcomes of people living with this condition. We are in the process of analysing the results of the consultation. The views and experiences gathered through this consultation will be used to build a picture of how well the interim delivery plan identifies and meets the needs of the ME community, and to highlight any significant gaps where further action may be necessary. We will publish a summary of the consultation responses, which will inform the final delivery plan being published later this year, in due course.
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, what discussions she has had with (a) clinicians, (b) hospice leaders and (c) academics on future funding requirements for hospice and end of life care.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.
The majority of palliative and end of life care is provided by NHS 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. Consequently, the funding arrangements reflect this.
In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.
The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.
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. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.
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. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.
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, what steps she is taking to ensure that integrated care boards have clear accountability over their funding decisions for (a) hospices and (b) palliative and end of life care services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.
The majority of palliative and end of life care is provided by NHS 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. Consequently, the funding arrangements reflect this.
In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.
The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.
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. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.
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. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.
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 provide financial support to integrated care boards to tackle regional inequalities in (a) hospice, (b) palliative and (c) end of life care services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.
The majority of palliative and end of life care is provided by NHS 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. Consequently, the funding arrangements reflect this.
In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.
The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.
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. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.
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. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.
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: 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: 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.