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 - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
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 - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
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 Wood Green)
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 - Parliamentary Under-Secretary (Department of Health and Social Care)
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 - Parliamentary Under-Secretary (Ministry of Justice)
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 - Parliamentary Under-Secretary (Ministry of Justice)
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 (Independent - 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
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
Asked by: Dan Carden (Labour - Liverpool, Walton)
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 help tackle health inequalities.
Answered by Neil O'Brien
The Government is committed to its levelling up mission to narrow the gap in Healthy Life Expectancy by 2030 and increase Healthy Life Expectancy by five years by 2035. Our approach will continue to focus on supporting people to live healthier lives, helping the National Health Service and social care to provide the best treatment and care for patients and tackling health disparities through national and system interventions such as the NHS’s Core20PLUS5 programme.
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 to improve healthy life expectancy, as well as reduce pressure on the NHS and reduce ill-health related labour market inactivity. 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.
We have published our initial report ‘Major Conditions Strategy: Case for change and our strategic framework’ which identifies the importance of tackling inequalities to improve health outcomes, and is available at the following link:
Our intention is to publish the Major Conditions Strategy in early 2024.
Asked by: Wes Streeting (Labour - Ilford North)
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 potential impact of ambulance delays in December 2022 on mortality rates for (a) heart attack and (b) stroke patients.
Answered by Will Quince
No specific assessment has been made. The Office for Health Improvement and Disparities updated their Excess Mortality report on 12 January 2023. This provides data to 30 December 2022 and includes information on the causes of death which contributed to excess deaths last month.
We recognise response times are an important factor for the outcomes of a range of conditions, and there are a number of significant measures in place to improve ambulance performance. The National Health Service winter resilience plan will increase NHS bed capacity by the equivalent of at least 7,000 general and acute beds, alongside significant investment to improve patient discharge from hospital, with an additional £200 million made available on top of the £500 million already invested last year. These measures help improve patient flow through hospital, reducing ambulance handover delays and enabling swifter responses to incoming 999 calls.
The Delivery plan for recovering urgent and emergency care services was published on 30 January and sets out plans to bring down Category 2 response times to 30 minutes in 2023/24, with further improvements towards pre-pandemic levels the following year, including through delivering 800 new ambulances (including 100 specialist mental health vehicles).
Asked by: Rosena Allin-Khan (Labour - Tooting)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many children have died while (a) detained under the Mental Health Act and (b) in a mental health setting as a voluntary patient who were (i) patients held in NHS settings and (ii) NHS patients held in settings run by private providers in each year from 2016 to 2022.
Answered by Gillian Keegan - Secretary of State for Education
We are unable to provide the information requested due to the low numbers involved in each year which could lead to the identification of individuals. However, information notified to the Department by NHS England and NHS Improvement shows that there were 21 deaths of children and young people in inpatient settings in National Health Service organisations between 2015/16 and 2021/22 and seven in independent healthcare organisations. This information does not record whether those individuals were detained under the Mental Health Act 1983 or in the care of a mental health setting as a voluntary patient.
When the Department is informed by NHS England of any such death, the Care Quality Commission is immediately notified, which reviews the information and determines its regulatory response. The National Confidential Inquiry into Suicide and Safety in Mental Health is also notified, which records all cases of inpatient deaths among adults and children and young people. These cases are routinely analysed and the Inquiry makes recommendations on preventative measures.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Cabinet Office:
To ask Her Majesty's Government how many recorded deaths were (1) residents of adult care homes, and (2) patients in NHS England hospitals, in each calendar month of 2020, up to and including August.
Answered by Lord True - Leader of the House of Lords and Lord Privy Seal
The information requested falls under the remit of the UK Statistics Authority. I have therefore asked the Authority to respond.
Dear Lord Warner,
As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Questions asking how many recorded deaths were (i) residents of adult care homes, and (ii) patients in NHS England hospitals, in each calendar month of 2020, up to and including August (HL7908).
The Office for National Statistics (ONS) is responsible for publishing mortality statistics for deaths registered in England and Wales. The most recent annual figures published are for deaths registered in 2019[1]. However, we do publish provisional weekly deaths registrations which are currently published for deaths registered up to 28 August 2020[2]. As part of this report, data is published by place of occurrence, which includes hospitals and places outside of hospitals, such as care homes.
Table 1 below provides the provisional number of deaths registered in care homes and hospitals by each calendar month of 2020, registered up to 28 August 2020, in England. The ‘Hospitals (acute or community, not psychiatric)’ figure includes deaths in NHS hospitals and private hospitals in England. Currently, the ONS does not publish age breakdowns of deaths registered in care homes. The figure includes children and adults, as some care homes may cater for adults as well as children. More detailed analysis on deaths, registered by place of occurrence, is available in our weekly report.
Table 1: Provisional number of deaths registered by place of occurrence, England, deaths registered between 1 January 2020 and 28 August 2020[3][4][5][6][7]
Month | Place of occurrence | |
Care home | Hospital (acute or community, not psychiatric) | |
January | 12,046 | 24,615 |
February | 9,231 | 18,229 |
March | 10,563 | 20,902 |
April | 26,835 | 34,520 |
May | 14,870 | 18,126 |
June | 8,579 | 15,191 |
July | 7,684 | 14,528 |
August | 7,151 | 13,362 |
Source: ONS
Yours sincerely,
Professor Sir Ian Diamond
[3]Based on date a death was registered rather than occurred.
[4]All figures for 2020 are provisional.
[5]Non-residents are excluded in the England totals.
[7]Care homes includes homes for the chronic sick; nursing homes; homes for people with mental health problems and non-NHS multi function sites.