Tag: Baroness Hollins

The below Parliamentary question was asked by Baroness Hollins on 2015-12-21.

To ask Her Majesty’s Government whether the remit and funding of the National Learning Disabilities Mortality Review of premature deaths in people with learning disabilities includes a review of the investigations carried out by NHS Trusts into unexpected deaths for that patient group; and if not whether they intend to alter the remit.

Lord Prior of Brampton

The Learning Disabilities Mortality Review Programme is managed by the University of Bristol on behalf of NHS England. The contract with the University focusses on supporting local reviews of premature deaths of people with learning disabilities; the investigation processes and draws together learning from the reviews. The remit for this work does not include a review of the investigations undertaken by NHS trusts into unexpected deaths for this patient group. There is no current intention to alter this remit.

The current programme is piloting local reviews of premature deaths of people with learning disabilities, as the first stage of rolling these out across England by 2018. These reviews will be the key first step to ensure local processes are in place to inform the co-ordination of future investigations of premature deaths of people with learning disabilities by NHS trusts. There will be clear protocols put in place to ensure that any unexpected deaths are subject to a multidisciplinary review, covering the totality of the person’s care, to assess the causes of death and any actions which could have been taken to prevent that death.

The Mortality Review Programme will provide strategic support for the local review process, develop a core data set for use by local review teams and support both the development of action plans in response to a death and the identification of recurrent themes at local, regional and national levels. The case reviews will support health and social care professionals, and others, to identify, and take action on, the avoidable contributory factors leading to premature deaths by people with learning disabilities whilst the identification of regional and national themes will inform wider action.

The below Parliamentary question was asked by Baroness Hollins on 2015-12-21.

To ask Her Majesty’s Government whether, in the light of Mazars’ report investigating unexpected deaths at Southern Healthcare, they intend to establish a national review into premature deaths for people with mental illness, in addition to those with learning disabilities.

Lord Prior of Brampton

Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 requires registered mental health providers to notify the Care Quality Commission (CQC) about deaths of people detained or liable to be detained under the Mental Health Act 1983. In addition, the CQC monitors data provided by the Health and Social Care Information Centre through the Mental Health Minimum Data Set on deaths of mental health hospital patients.

The CQC will be undertaking a wider review into the investigation of deaths in a sample of all types of National Health Service trust (acute, mental health and community trusts) in different parts of the country. As part of this review, the CQC will assess whether opportunities for prevention of death have been missed, for example by late diagnosis of physical health problems.

There are currently no plans to establish a national review into premature deaths of people with mental illness.

The below Parliamentary question was asked by Baroness Hollins on 2016-01-20.

To ask Her Majesty’s Government whether they will link GP registers of people with learning disabilities and ONS mortality data to enable comparisons of age and cause of death between people with learning disabilities and the general population at a national level, and to measure change over time.

Lord Prior of Brampton

The Department of Health is currently working with Public Health England, NHS England, the Health and Social Care Information Centre and the Learning Disability Mortality Review Programme to consider the feasibility of linking different datasets in order to compare outcomes for people with learning disabilities with the general population. This aims to help reduce inequalities and poor outcomes, including premature mortality, in people with learning disabilities.

The below Parliamentary question was asked by Baroness Hollins on 2016-01-20.

To ask Her Majesty’s Government what assessment they have made of the case for requiring NHS Trusts to conduct reviews of deaths of people with learning disabilities as part of investigating all unexpected deaths, as suggested by the recent Mazars report, in addition to the National Learning Disabilities Mortality Review process.

Lord Prior of Brampton

The revised Serious Incident Framework published in March 2015 has sought to simplify the incident management process and ensure that serious incidents are identified correctly, investigated thoroughly and, most importantly, learned from to prevent the likelihood of similar incidents happening again. The NHS England Serious Incident Framework 2015 applies to NHS-commissioned services for those with learning disabilities. A copy is attached.

The below Parliamentary question was asked by Baroness Hollins on 2016-03-07.

To ask Her Majesty’s Government what preparations have been made to achieve the safe and effective transfer of responsibility for Tier 4 obesity services from NHS England to Clinical Commissioning Groups.

Lord Prior of Brampton

Specialised commissioning teams at NHS England are in contact with clinical commissioning groups (CCGs) and a formal process has been agreed to transfer the technical and service aspects of the commissioning responsibility.

This process includes NHS England leading on the contract negotiation for 2016/17 on behalf of CCGs based on the current service provision. Although the transfer is effective from April 2016 in terms of the contract values, the timing of the handover will be agreed between local specialised commissioning teams and CCGs, in line with their preparedness.

NHS England will continue to work with CCGs to provide support as appropriate.

NHS England does not expect the services patients receive to be affected following the transfer of obesity surgery commissioning responsibilities to CCGs from April 2016, as the change is primarily to commissioning responsibilities.

No service changes are included as part of the transfer process. The transfer process will include providing information to CCGs on pathways, provider performance and any quality issues relating to this service.

The transfer should support better integration between Tier 3 and Tier 4 services (which include obesity services) which in turn should improve access for eligible patient and streamline pathways. Clinical teams remain responsible for the quality of their services.

NHS England through its clinical reference group has finalised clinical guidance to support commissioners and clinical teams. We would also look to leadership from royal colleges and professional groups to promote best practice in this area. CCGs already have mechanisms in place to monitor provider performance and quality through the existing quality assurance processes.

The below Parliamentary question was asked by Baroness Hollins on 2016-03-07.

To ask Her Majesty’s Government what safeguards are in place to ensure that the transfer of commissioning responsibility for Tier 4 obesity services from NHS England to Clinical Commissioning Groups does not have a negative impact on patient services or clinical standards, and how they will ensure that patients receive high quality, safe and effective care should that transfer proceed in April 2016.

Lord Prior of Brampton

Specialised commissioning teams at NHS England are in contact with clinical commissioning groups (CCGs) and a formal process has been agreed to transfer the technical and service aspects of the commissioning responsibility.

This process includes NHS England leading on the contract negotiation for 2016/17 on behalf of CCGs based on the current service provision. Although the transfer is effective from April 2016 in terms of the contract values, the timing of the handover will be agreed between local specialised commissioning teams and CCGs, in line with their preparedness.

NHS England will continue to work with CCGs to provide support as appropriate.

NHS England does not expect the services patients receive to be affected following the transfer of obesity surgery commissioning responsibilities to CCGs from April 2016, as the change is primarily to commissioning responsibilities.

No service changes are included as part of the transfer process. The transfer process will include providing information to CCGs on pathways, provider performance and any quality issues relating to this service.

The transfer should support better integration between Tier 3 and Tier 4 services (which include obesity services) which in turn should improve access for eligible patient and streamline pathways. Clinical teams remain responsible for the quality of their services.

NHS England through its clinical reference group has finalised clinical guidance to support commissioners and clinical teams. We would also look to leadership from royal colleges and professional groups to promote best practice in this area. CCGs already have mechanisms in place to monitor provider performance and quality through the existing quality assurance processes.

The below Parliamentary question was asked by Baroness Hollins on 2014-06-12.

To ask Her Majesty’s Government what plans they have to ensure that people with learning disabilities are not excluded from NHS England’s five-year strategic plan for National Health Service commissioners to improve quality of and access to health care, outlined in Everyone Counts: Planning for Patients 2014/15–2018/19.

Earl Howe

The Government’s Mandate to NHS England, sets out our ambitions for the health service, which include an objective that NHS England ensures clinical commissioning groups work with local authorities to ensure that vulnerable people, particularly those with learning disabilities and autism, receive safe, appropriate, high quality care. NHS England sets out how it will achieve the objectives in the Mandate in its 2014-15 – 2016-17 business plan. The Government will hold NHS England to account for its achievement.

Everyone Counts: Planning for Patients 2014/15 to 2018/19sets out a framework within which commissioners will need to work with providers and partners in local government to develop five year plans to secure the continuity of sustainable high quality care for all. Building on Everyone Counts, NHS England is beginning a programme of work to consider how to improve quality of and access to health care for people with learning disabilities. Within the framework there is specific reference to Transforming Care: A national response to Winterbourne View Hospital. This is a non-negotiable item that NHS England expects to be part of every relationship between commissioners and providers. As part of this, clinical commissioning groups, local authorities and specialised commissioners should work together to implement the core specification which describes the core principles that must be present in all education, health and social care services for children, young people, adults and older people with learning disabilities and/or autism who either display, or are at risk of displaying, behaviour that challenges.

NHS England is committed to work to reduce premature mortality amongst people with learning disability, including actions in response to the Confidential Inquiry into Premature Deaths of People with Learning Disabilities.