Mr Jim Cunningham: To ask the Secretary of State for Health how many people were readmitted to hospital due to malnutrition in each of the last five years for which data are available; and how many such patients resided at a care home or residential home. [175170]
Norman Lamb: Information on whether a patient was readmitted to hospital due to malnutrition is not held centrally.
Mr Jim Cunningham: To ask the Secretary of State for Health how many patients were discharged from hospital with a nutritional care plan in each of the last five years for which data are available. [175171]
Norman Lamb: The information requested is not collected centrally.
National health service hospitals have their own discharge policies. Hospitals' discharge policies should follow government guidance on discharge of patients. If a patient is assessed as requiring nutritional support, they will receive a care plan to help them to ensure optimal nutrition and weight maintenance.
In line with the National Institute for Care Excellence Quality Standard for nutrition support in adults, published in November 2012, service providers should ensure that people who are malnourished or at risk of malnutrition have a management care plan that aims to meet their complete nutritional requirements.
Mr Jim Cunningham: To ask the Secretary of State for Health what steps he is taking to reduce the incidence of malnutrition in (a) hospitals and (b) care homes; and if he will make a statement. [175172]
Norman Lamb: All providers of regulated activities, including hospitals and care homes, are required by law to have policies in place that protect people from the risk of inadequate nutrition and hydration. We expect the Care Quality Commission to take swift action should it find this not to be the case.
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The importance of good-quality food for patients is recognised both in terms of improving their health and in relation to their overall experience of services. Poor diet can cause serious illness and even increase the risk of early death.
It is for health and social care providers to develop local nutrition and hydration policies and there are a number of best practice resources and guidelines available to help providers do this. These include the National Institute for Health and Care Excellence clinical guidelines to help the national health service identify patients who are malnourished or at risk of malnutrition, and the essence of care benchmarking system which includes food and drink.
Providers may also use the ‘red tray’ scheme wherein patients are identified for special attention.
As part of our continued work to improve hospital food, Age UK chair Dianne Jeffrey has agreed to chair a panel to look at standards of food in hospitals. The work will focus particularly on nutritional quality, mealtime experience and the help given to patients to eat.
Mental Health
Chris Ruane:
To ask the Secretary of State for Health (1) what his Department has spent on the promotion of
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five a day for mental health in each year for which data are available; [174987]
(2) what estimate he has made of the number of visits to GPs per year by people who have (a) undergone and (b) not undergone mindfulness interventions; [175038]
(3) how many people reported poor (a) mental and (b) physical health in (i) May 2010 and (ii) the most recent period for which data are available; [175060]
(4) how many people have been diagnosed with anxiety disorder in each year for which data are available; [175062]
(5) what assessment he has made of the age of onset of depression over the longest period for which data are available; [175063]
(6) what assessment he has made of the effect of materialism on levels of mental health; [175064]
(7) if he will give the annual results for the (a) depression register for adults number 18 plus or (b) depression prevalence for adults 18 plus (percentage) for each year in which data are available. [175125]
Norman Lamb: The number of adults aged 18 or over on the quality and outcomes framework (QOF) depression register and the raw prevalence rates for all available years are given in the following table.
| Number of adult patients aged 18 or over1 on the QOF depression register and the raw prevalence rate in England | ||
| Sum of register count | Prevalence | |
| 1 2008-09 prevalence is presented on the basis of registers as a percentage of whole practice list size. 2 There was a change in the QOF business rules for the depression register in 2012-13. Previously, all patients with a record of unresolved depression at any point in their general practitioner (GP) patient record were included on the register. As of April 2013, the register rules were changed to only include patients with a record of unresolved depression since April 2006. As a result, fewer patients are included on the register, thus reducing the reported prevalence. Note: Raw prevalence = sum of registers for all practices/sum of list sizes for all practices (expressed as a percentage). | ||
The Department has not invested funds in this promotion of five a day for mental health.
The Department does not collect data on estimates of the number of visits to GPs per year of people who have undergone or not undergone mindfulness interventions.
The Department is aware of the numbers of people who have common mental health problems that include depression and anxiety disorders, however there is no breakdown of the data into individual disorders. Mindfulness cognitive behavioural therapy is a National Institute for Health and Care Excellence (NICE) approved treatment designed to prevent relapse for those with recurrent depression and is not recommended for the treatment of anxiety disorders. The recent NICE social anxiety guidelines specifically states that mindfulness approaches are not recommended for the treatment of people with social anxiety disorders.
The Health Survey for England (HSE) provides estimates of people with poor mental and physical health, most recently in 2011. The proportion who reported long- term mental health problems in HSE in 2010 was 4.18% and in 2011 the figure was 3.76%.
In 2010, 66.04% of people with long standing mental health problems also had a longstanding physical health problem, representing 2.24% of the total population. In 2011, the equivalent figure was 55.53%, representing 1.77% of the total population.
The Department does not collect data for the age of onset of depression centrally.
The Department has not commissioned any research on the effect of materialism on levels of mental health.
Mental Health Services: Young People
Alan Johnson: To ask the Secretary of State for Health how many days (a) under-16 year-olds-and (b) under-18-year-olds spent on adult mental health wards in each region in each of the last five years. [174601]
Norman Lamb: I refer the right hon. Member to the answer I gave the hon. Member for East Worthing and Shoreham (Tim Loughton) on 5 November 2013, Official Report, columns 166-68W.
I look forward to meeting the right hon. Member next month to discuss the outstanding issues from his adjournment debate on 23 October about in-patient mental health services for children and adolescents.
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Mental Illness
Jeremy Corbyn: To ask the Secretary of State for Health what advice he gives to police forces on dealing with people who are suffering from mental health difficulties. [175268]
Norman Lamb: Police forces should work closely with local mental health professionals to ensure that people they deal with who have mental health difficulties receive a supportive response from the most appropriate agency.
The Department has been working closely with the Home Office, national policing leads, NHS England and other key partners to produce an agreed statement and set of principles to guide responses in cases where people in mental health crisis come to the attention of the police. We aim to publish this joint concordat before the end of the year.
If a person experiencing mental health problems is arrested and taken to police custody, they will often have access to liaison and diversion services. These schemes for adults and young people who come into contact with the criminal justice system, in police custody and courts, identify and assess health needs. They aim to link offenders to appropriate treatment and to inform charging and sentencing decisions as people progress through the criminal justice system.
The Home Office, Department of Health and Ministry of Justice are undertaking work to roll out liaison and diversion schemes in police custody suites nationally from 2014.
The Department is also funding mental health “street triage” in nine police force areas. The forces involved are the Metropolitan police service, British Transport police, West Yorkshire police, West Midlands police, Thames Valley police, North Yorkshire police, Sussex police, Derbyshire constabulary, and Devon and Cornwall police. In these schemes, already operational in some parts of the country, mental health professionals advise and support police officers directly when they deal with people who may have a mental health need.
NHS: Training
Kate Green: To ask the Secretary of State for Health (1) what steps Health Education England takes with its counterparts in Scotland, Wales and Northern Ireland to ensure that assessment of need in the commissioning of student places for the education and training of health care workers takes place on a UK-wide basis; [174571]
(2) what steps Health Education England plans to take to ensure that determination of the number of student commissions for health care workers by local education and training boards takes full account of the number of health care workers employed outside the NHS; [174757]
(3) what steps Health Education England plans to take to ensure that an England-wide assessment of need is made to inform the commissioning of student places for the education and training of health care workers; [174758]
(4) what steps Health Education England plans to take to ensure that reductions in student places commissioned by local education and training boards do not threaten the viability of education and training courses for health care workers; [174759]
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(5) what data (a) his Department and (b) Health Education England gather and use to inform the number of student commissions for health care workers by local education and training boards; [174760]
(6) what steps he plans to take to ensure that the determination of the number of student commissions for health care workers by local education and training boards is based on consistent and accurate data. [174761]
Dr Poulter: The information in this response has been supplied by Health Education England (HEE).
In June, HEE produced the first ever work force guidance for England. The aim of this work force planning guide is to secure future work force to maintain safe staffing levels while supporting transformation of services. The guide provides clarity around roles, responsibilities, milestones and timelines, and creates the opportunity to consider priorities between professional groups, between current and future work force, and between numbers and skills, values and behaviours. The guide is available at:
www.hee.nhs.uk/work-programmes/workforce-planning/new-workforce-planning-guide-for-the-nhs/
HEE's approach to open, robust, evidence-based decision making has included a call for evidence, active engagement with stakeholders, professional engagement through the HEE advisory groups and work with our local education and training boards (LETBs) and their local audiences.
In 2013 this means that HEE has collected and assessed the future forecast work force requirements of virtually every national health service provider and also assessed the future supply of staff in each LETB area. These data are then triangulated against information received through the ‘call for evidence’ from organisations such as royal colleges, staff organisations, and patient bodies. These processes will, within current data limitations, attempt to assess the impact on the NHS work force of the requirements of the devolved nations, and the independent sector. HEE is working with other stakeholders to ensure that robust work force information continues to be available to inform the work force planning process in future years.
HEE has primary responsibility for health care education and training in England, but where possible will endeavour to work with the devolved Administrations and health services of Scotland, Wales and Northern Ireland to deliver objectives that impact and improve health services across the United Kingdom.
HEE continues to engage with the devolved nations including through a regular four-nation work force planners forum. LETBs include non-NHS employers as members, including a number of cases where independent sector providers are full board members.
HEE is also working closely with its education providers and higher education funding council for England to ensure that the impact of any decisions on education programmes are carefully implemented with regard to the impact on these partners.
They have also carried out due diligence on the picture inherited from the former strategic health authorities and have shared information widely in the interest of openness and transparency.
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Mr Sanders: To ask the Secretary of State for Health (1) if he will take steps to ensure that the determination of the number of student commissions for health care workers by local education and training boards takes full account of the many health care workers now employed outside the NHS; [174896]
(2) if he will take steps to ensure that an England-wide assessment of need is made in the commissioning of student places for the education and training of health care workers; [174902]
(3) what steps he is taking to ensure that the determination of the number of student commissions for health care workers by local education and training boards is based on consistent and accurate data; [174903]
(4) what steps Health Education England is taking to ensure that reductions in commissioned student places by local education and training boards do not affect the viability of education and training courses for health care workers; [174904]
(5) what data (a) his Department and (b) Health Education England (i) commission and (ii) use to calculate the number of student commissions for health care workers by local education and training boards; [174905]
(6) what steps Health Education England is taking with its counterparts in Scotland, Wales and Northern Ireland to ensure UK-wide assessment of need in the commissioning of student places for the education and training of health care workers. [174907]
Dr Poulter: The information in this response has been supplied by Health Education England (HEE).
In June, HEE produced the first ever work force guidance for England. The aim of this work force planning guide is to secure future work force to maintain safe staffing levels while supporting transformation of services. The guide provides clarity around roles, responsibilities, milestones and timelines, and creates the opportunity to consider priorities between professional groups, between current and future work force and between numbers and skills, values and behaviours. The guide is available at:
hee.nhs.uk/work-programmes/workforce-planning/new-workforce-planning-guide-for-the-nhs/
HEE's approach to open, robust, evidence-based decision making has included a call for evidence, active engagement with stakeholders, professional engagement through the HEE advisory groups and work with our local education and training boards (LETBs) and their local audiences.
In 2013 this means that HEE has collected and assessed the future forecast work force requirements of virtually every NHS provider and also assessed the future supply of staff in each LETB area. These data are then triangulated against information received through the 'call for evidence' from organisations such as royal colleges, staff organisations, and patient bodies. These processes will, within current data limitations, attempt to assess the impact on the NHS work force of the requirements of the devolved nations, and the independent sector. HEE is working with other stakeholders to ensure that robust work force information continues to be available to inform the work force planning process in future years.
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HEE has primary responsibility for health care education and training in England but where possible will endeavour to work with the devolved Administrations and health services of Scotland, Wales and Northern Ireland to deliver objectives that impact and improve health services across the United Kingdom.
HEE continues to engage with the devolved nations including through a regular four-nation work force planners forum. LETBs include non-NHS employers as members, including a number of cases where independent sector providers are full board members.
HEE is also working closely with its education providers and Higher Education Funding Council for England to ensure the impact of any decisions on education programmes are carefully implemented with regard to the impact on these partners.
They have also carried out due diligence on the picture inherited from the former strategic health authorities and have shared information widely in the interest of openness and transparency.
Older People: Greater London
Jeremy Corbyn: To ask the Secretary of State for Health what estimate he has made of (a) the number of dependent elderly in each London borough and (b) the number of such elderly people that have no family living in their borough. [175269]
Norman Lamb: The numbers of older people in London receiving residential and community based support from their local authority in 2012-13 are detailed in the following table:
| 2012-13 | ||
| Residential | Community | |
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| Source: Health and Social Care Information Centre, Community Care Statistics, Social Services Activity, England—2012-13, Provisional release. | ||
In addition, a number of older people in each borough fund their own care and support without help from their local authority. The Department does not collect data on this group of people.
The Department does not collect data on the number of elderly people who have family living in their borough.
It is for each area's health and wellbeing board to prepare joint strategic needs assessments (JSNAs) to assess the health and social care needs of the whole local community, including older people who need care and support. Based on the JSNAs, the local authority must work with local communities to agree local priorities for action to improve both health and care services.
Paediatrics
Jeremy Lefroy: To ask the Secretary of State for Health (1) what steps he plans to take to reconfigure general, non-specialist, paediatric services in (a) Stafford and (b) England; [174720]
(2) which NHS organisation has overall responsibility for regional and national critical care infrastructure. [174721]
Jane Ellison: The policy of this Government is that the configuration of health services across England, including critical care and non-specialist paediatric services, is driven by the local national health service. Local commissioners and clinicians are best placed to ensure that services meet the needs of their local population, and to consider where changes might be necessary in order to best meet those needs now and in the future.
All proposals for change are subject to proper and public scrutiny by local authorities, whose health and overview scrutiny committees should work closely with the local NHS throughout the process. These scrutiny committees also have the ability to refer an NHS proposal for change to the Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), for a final decision.
In Stafford, trust special administrators have been appointed to Mid Staffordshire NHS Foundation Trust to develop a plan for the continued provision of services. It is expected that the administrators' final report will recommend changes to the way services are provided. The special administration regime is intended to provide a time-limited framework for resolving problems at a significantly challenged trust. However the process also ensures that there is appropriate input from local stakeholders and the public as service proposals are developed.
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Radiotherapy
Tessa Munt: To ask the Secretary of State for Health (1) with reference to section 1.4.1 of the 2011 National Radiotherapy Implementation Group's report on stereotactic radiotherapy, whether commissioners have approved treatment with stereotactic ablative radiotherapy for (a) prostate, (b) spinal, (c) renal, (d) head and neck, (e) hepatic and (f) oligometastases form of cancer since December 2010; [174754]
(2) whether clinical trials with stereotactic ablative radiotherapy have taken place for (a) prostate, (b) spinal, (c) renal, (d) head and neck, (e) hepatic and (f) oligometastases form of cancer since December 2010. [174755]
Dr Poulter: Information regarding commissioners who have approved stereotactic ablative radiotherapy (SABR) for prostate, spinal, renal, head and neck, hepatic and oligometastases forms of cancer since December 2010 is not available.
The National Radiotherapy Implementation Group's report on SABR, published in July 2011, concluded that the evidence only supported the routine use of SABR in the treatment of early stage non-small cell lung cancer for patients who are unsuitable for surgery. For the cancers mentioned in section 1.4.1 of the report, it stated that treatment should only be commissioned within a clinical trial or on an individualised basis.
Since 1 April, NHS England has been responsible for commissioning radiotherapy services, including SABR. Following consultation, on 4 April 2013 NHS England published a SABR commissioning policy that supported the conclusions of the NRIG report, recommending that routine commissioning of SABR treatment was only suitable for early stage non-small cell lung cancer for patients who are unsuitable for surgery.
The Department's National Institute for Health Research has not funded any clinical trials of SABR for prostate, spinal, renal, head and neck, hepatic or oligometastatic cancer since December 2010.
There are completed and ongoing international clinical trials examining the use of SABR in a range of cancer sites. Details of these are available on the clinicaltrials.gov registry at:
www.clinicaltrials.gov/
Social Services
Catherine McKinnell: To ask the Secretary of State for Health how the forthcoming regulations and national eligibility criteria for social care will account for individuals of working age with moderate care needs. [175058]
Norman Lamb: The Government published a draft of the national eligibility criteria regulations in June for discussion. The eligibility criteria are intended to be equivalent to the level operated by the vast majority of local authorities in the current system. Local authorities will remain able to meet needs which are not deemed eligible, if they choose to do so. The threshold is about establishing a minimum standard, not taking away councils' discretion to go further.
The new care and support system will introduce a new focus on prevention, and people whose needs do not meet the national eligibility criteria will be able to receive information and advice to help delay or even prevent their need for local authority arranged care or
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support. In addition, the integration transformation fund will support the delivery of integrated services, including intervening early so that older and disabled people can stay healthy and independent at home.
Catherine McKinnell: To ask the Secretary of State for Health how the forthcoming regulations governing the eligibility criteria for social care will incorporate and adequately account for fluctuating conditions. [175117]
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Norman Lamb: The Government published a draft of the national eligibility criteria regulations in June for discussion. The draft regulations take account of people with fluctuating needs by requiring the local authority to consider the person's needs over a period of time. Where a person has fluctuating needs, the draft regulations will allow the local authority to consider the person's history when determining whether the person has eligible needs.