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To ask Her Majesty's Government what plans they have, if any, to ensure quicker access for children to child and adolescent mental health services.
To ask Her Majesty's Government what plans they have, if any, to ensure quicker access for children to child and adolescent mental health services.
We have committed to at least an additional 345,000 children and young people aged 0-25 being able to access mental health support by 2023/24.
Our Green Paper Transforming children and young people’s mental health provision: a green paper aims to improve the provision of services for children. One of the key proposals of the Green Paper is to create new Mental Health Support Teams in and near groups of schools and colleges, to enable children to get timely support for mild to moderate conditions.
In December 2018, we announced 25 Trailblazer sites to run the first wave of 59 Mental Health Support Teams. In 12 of these areas we are also testing a four-week wait standard, exploring how Mental Health Support Teams and specialist services can work together to achieve more timely access to appropriate treatment.
To ask Her Majesty's Government what statistics they have about the prevalence of e-cigarette use, particularly among young people; what evidence they are collecting to determine whether e-cigarettes and vaping devices are an effective way to stop smoking; and what action they are taking to ensure that there is full awareness of...
To ask Her Majesty's Government what statistics they have about the prevalence of e-cigarette use, particularly among young people; what evidence they are collecting to determine whether e-cigarettes and vaping devices are an effective way to stop smoking; and what action they are taking to ensure that there is full awareness of...
Data from nationally representative surveys indicate that, in England, current vaping among young people remains low and concentrated among those who have already smoked. Among adults, vaping prevalence is 6.3%, with almost all vapers being smokers or ex-smokers. This data can be found in the attached Office for National Statistics statistical bulletin, Adult smoking habits in the United Kingdom: 2018.
Smoking rates continue to decline among both adults and youth. Public Health England (PHE) monitors the developing evidence on effectiveness of e-cigarettes for quitting smoking. A major UK randomised control trial has found e-cigarettes to be twice as effective as nicotine replacement therapy products when combined with behavioural support.
Data from English stop smoking services indicate that people who use an e-cigarette in their attempt to quit have the highest success rates. UK regulation of e-cigarettes includes measures to protect young people, including a ban on most forms of advertising, a minimum age of sale of 18 years and a ban on proxy purchasing.
PHE provides evidence-based information to healthcare professionals, teachers and the public about the relative harmfulness of e-cigarettes, vaping devices and smoked tobacco.
To ask Her Majesty's Government what assessment they have made of research by Imperial College London, published on 13 January, which links global warming with an increase in the violent deaths of young people.
To ask Her Majesty's Government what assessment they have made of research by Imperial College London, published on 13 January, which links global warming with an increase in the violent deaths of young people.
Public Health England has not made an assessment of the research by Imperial College London, published on 13 January 2020.
To ask Her Majesty's Government what plans they have to address the ‘treatment gap’ for young people who are referred to mental health services but rejected for not meeting eligibility criteria.
To ask Her Majesty's Government what plans they have to address the ‘treatment gap’ for young people who are referred to mental health services but rejected for not meeting eligibility criteria.
Under the NHS Long Term Plan, mental health services will continue to receive a growing share of the National Health Service budget, with funding to grow by at least £2.3 billion a year in real terms by 2023/24. Spending for children and young people’s mental health services will grow faster than the overall spend on mental health, which will itself be growing faster than the overall NHS budget.
The new investment announced in the Long Term Plan will mean that by 2023/24, an extra 345,000 children and young people aged 0-25 will receive mental health support via NHS-funded mental health services and school or college-based mental health support teams.
To ask Her Majesty's Government what assessment they have made of reports that clinicians at the Tavistock Centre have been too quick to give children and young people gender reassignment treatment; and what action they intend to take as a result.
To ask Her Majesty's Government what assessment they have made of reports that clinicians at the Tavistock Centre have been too quick to give children and young people gender reassignment treatment; and what action they intend to take as a result.
The matter is subject to an ongoing legal process and therefore the Department is unable to comment pending judicial ruling.
To ask Her Majesty's Government whether the Care Quality Commission has published a specific inspection framework for Child and Adolescent Mental Health (CAMHS) Tier 4 inpatient services; what is the maximum time allowed between inspections of CAMHS inpatient services; and in what ways the views and experiences of child patients...
To ask Her Majesty's Government whether the Care Quality Commission has published a specific inspection framework for Child and Adolescent Mental Health (CAMHS) Tier 4 inpatient services; what is the maximum time allowed between inspections of CAMHS inpatient services; and in what ways the views and experiences of child patients...
Tier 4 inspections are covered as part of the child and adolescent mental health wards core service. The definition for this core service is as follows:
Child and adolescent mental health services may assess and treat children and young people as an inpatient in hospital. This may be when community-based services cannot meet their needs safely and effectively because of their level of risk and/or complexity and where they need 24-hour nursing and medical care.
If providers are registering with the CQC as a new provider, the CQC will normally aim to inspect within 12 months of registration. For services that are rated, providers will receive their initial rating at this inspection. The CQC use this initial rating to determine when next to inspect the service.
For both National Health Service trusts and independent providers, the following principles apply regarding re-inspection (for NHS trusts since June 2017 and for independent providers since April 2018):
- Inadequate – Normally within 12 months of publishing the last comprehensive inspection report;
- Requires improvement - Normally within two years of publishing the last comprehensive inspection report;
- Good - Normally within three and a half years of publishing the last comprehensive inspection report; and
- Outstanding - Normally within five years of publishing the last comprehensive inspection report.
These are maximum inspection intervals, therefore the CQC may inspect more frequently, particularly if there is a risk.
The CQC encourages people to share their experience to ensure it is acted upon, including through the national Tell Us About Your Care partner charities.
The CQC aim to speak to children and young people and their families/carers during the inspection (depending on their availability) and have specific inspection tools to enable this.
This information is published as part of the inspection framework for NHS acute hospitals.
To ask Her Majesty's Government on what dates each of the registered Child and Adolescent Mental Health Tier 4 inpatient services were last inspected; and what is the schedule for future inspections for each service.
To ask Her Majesty's Government on what dates each of the registered Child and Adolescent Mental Health Tier 4 inpatient services were last inspected; and what is the schedule for future inspections for each service.
The Care Quality Commission (CQC) has provided the following response.
The dates each of the registered Child and Adolescent Mental Health Tier 4 inpatient services were last inspected are attached, due to the size of the data.
The CQC carry out either comprehensive or focused inspections. For National Health Service trusts, these inspections will usually be unannounced.
In a few instances, where there are very good reasons, the CQC may let a service know it is coming. For example, the CQC may contact a trust to make sure senior management are present to answer its questions.
To enable the CQC to observe normal practice in a service, it has introduced more unannounced inspections as part of its comprehensive inspection methodology.
Because the CQC requests information from providers beforehand, it will carry out the inspection within three months of the provider submitting its provider information request. However, the CQC will not announce the day on which it intends to inspect.
To ask Her Majesty's Government what assessment they have made of the European Monitoring Centre for Drugs and Drug Addiction's European Drug Report 2019: Trends and Developments, published in June 2019, and in particular the findings that the UK has the highest rate of cocaine use among young adults in...
To ask Her Majesty's Government what assessment they have made of the European Monitoring Centre for Drugs and Drug Addiction's European Drug Report 2019: Trends and Developments, published in June 2019, and in particular the findings that the UK has the highest rate of cocaine use among young adults in...
We are concerned by the findings of the European Monitoring Centre for Drugs and Drug Addiction’s European Drug Report 2019 on the prevalence of cocaine use in the United Kingdom, especially among younger people. The Home Secretary has appointed Professor Dame Carol Black to lead a major review which will build on existing Government strategies to combat drugs and will examine the harms that drugs cause and the best ways to prevent drug-taking. The report will also examine the drivers behind recent trends such as the increased recreational use of Class A drugs by young adults. The plan is for Dame Carol to present the Home Secretary with a report detailing her key findings and proposals by the end of the summer. The outcome of this meeting will shape phase 2 of the review. The Government will respond to recommendations made in the report once it is finalised and published.
To ask Her Majesty's Government what is their assessment of the paper Impact of a ban on the open display of tobacco products in retail outlets on never smoking youth in the UK: findings from a repeat cross-sectional survey before, during and after implementation, published in the British Medical Journal in...
To ask Her Majesty's Government what is their assessment of the paper Impact of a ban on the open display of tobacco products in retail outlets on never smoking youth in the UK: findings from a repeat cross-sectional survey before, during and after implementation, published in the British Medical Journal in...
The Government keeps all such evidence on the impact of its policies under review, including the possible wider application of individual policies to other areas. The Government intends to conduct a formal post-implementation review of this legislation with a report due in spring 2020 and evidence of this nature will be looked at to assess the overall impact of legislation. There are no plans to extend the current ban on open display of tobacco products in retail outlets to other products.
Lords motion to take note of the mental health of children and young adults in the United Kingdom. Agreed to on question.
Lords motion to take note of the mental health of children and young adults in the United Kingdom. Agreed to on question.
To ask Her Majesty’s Government what action they are taking to improve children’s and young people’s access to mental health care.
To ask Her Majesty’s Government what action they are taking to improve children’s and young people’s access to mental health care.
My Lords, the NHS is on track to meet the Five Year Forward View for Mental Health commitment that 70,000 more children and young people will access treatment each year by 2020-21. Under the NHS Long Term Plan, a further 345,000 children and young people will receive support by 2023-24. Our recent Green Paper sets out our plans to pilot a four-week waiting time for specialist NHS mental health services for children and young people.
My Lords, the NHS is on track to meet the Five Year Forward View for Mental Health commitment that 70,000 more children and young people will access treatment each year by 2020-21. Under the NHS Long Term Plan, a further 345,000 children and young people will receive support by 2023-24. Our recent Green Paper sets out our plans to pilot a four-week waiting time for specialist NHS mental health services for children and young people.
My Lords, the NHS is on track to meet the Five Year Forward View for Mental Health commitment that 70,000 more children and young people will access treatment each year by 2020-21. Under the NHS Long Term Plan, a further 345,000 children and young people will receive support by 2023-24. Our recent Green Paper sets out our plans to pilot a four-week waiting time for specialist NHS mental health services for children and young people.
To ask Her Majesty’s Government what action they are taking to improve children’s and young people’s access to mental health care.
I thank the right reverend Prelate for her very important question. We are coming from a low base in children’s and young people’s mental health services, and successive Governments have failed to prioritise these services as they should have. That is exactly why the long-term plan sets out our determination to address this—to ensure that all children get the care they need. With more money, more staff and more beds, there will be £2.3 billion a year more for this area by 2023-24, a figure that is growing faster than the rest of the NHS budget. It is why the NHS and HEE are targeting to recruit 8,000 more children’s and young people’s mental health staff, and why we are bringing in the first ever access and waiting services. I accept, however, that the pace at which this is going is frustrating, but it is important to understand the base from which we are coming.
I thank the right reverend Prelate for her very important question. We are coming from a low base in children’s and young people’s mental health services, and successive Governments have failed to prioritise these services as they should have. That is exactly why the long-term plan sets out our determination to address this—to ensure that all children get the care they need. With more money, more staff and more beds, there will be £2.3 billion a year more for this area by 2023-24, a figure that is growing faster than the rest of the NHS budget. It is why the NHS and HEE are targeting to recruit 8,000 more children’s and young people’s mental health staff, and why we are bringing in the first ever access and waiting services. I accept, however, that the pace at which this is going is frustrating, but it is important to understand the base from which we are coming.
My Lords, I thank the Minister for her remarks and welcome the commitment to prioritising investment in mental health care for children and young people. However, data published by the NHS in November showed that only one in four young people with a mental health disorder accessed specialist mental health services in the previous year. I welcome plans from the Government to increase this figure to 100% within the decade, but given that three-quarters of children with a diagnosable mental health condition do not currently get access to the support they need, how will the Government act to help this generation of children who will have moved on to adult services before this rollout is complete?
The noble Lord, Lord Hunt, is very experienced in this area and has been involved with local clinical commissioning groups. The NHS has already opened 117 additional new mental health beds, and we have introduced new waiting standards for psychosis and eating disorders among children. Progress is already being made, but we should not dismiss the frustrations of those trying to access services. That is why we have put in place ambitious new targets with the long-term plan: we want to see 100% of children able to access the care they need.
The noble Lord, Lord Hunt, is very experienced in this area and has been involved with local clinical commissioning groups. The NHS has already opened 117 additional new mental health beds, and we have introduced new waiting standards for psychosis and eating disorders among children. Progress is already being made, but we should not dismiss the frustrations of those trying to access services. That is why we have put in place ambitious new targets with the long-term plan: we want to see 100% of children able to access the care they need.
My Lords, on pace, will the Minister acknowledge that this Government and their predecessor, the coalition Government, have made any number of promises about investment in and prioritisation of mental health services, particularly for children and young adults, but that when it comes to the decisions made by clinical commissioning groups, the reality is that they have not brought them to fruition? What guarantees do we have that this time clinical commissioning groups will do what they have been asked?
The noble Baroness is right: those with particular needs, where autism or learning disabilities cross over into mental illness, must be taken into account. Some distressing figures show that those with learning disabilities do not get the physical health assessments that they need either. This must be taken into account and is in part why the children and young people’s Green Paper puts in place designated senior leads for mental health in schools and mental health support teams in and around schools, so that those needs can be identified as early as possible, and we can prioritise prevention and early identification of mental health needs when they arise.
The noble Baroness is right: those with particular needs, where autism or learning disabilities cross over into mental illness, must be taken into account. Some distressing figures show that those with learning disabilities do not get the physical health assessments that they need either. This must be taken into account and is in part why the children and young people’s Green Paper puts in place designated senior leads for mental health in schools and mental health support teams in and around schools, so that those needs can be identified as early as possible, and we can prioritise prevention and early identification of mental health needs when they arise.
My Lords, about two-thirds of children with autism and two-fifths of children with special educational needs experience mental health problems. But the provision of specialist clinical community child learning disabilities services is sparse. What are Her Majesty’s Government doing to ensure that the needs of those vulnerable young people are planned for in the new funding allocation?
The outcomes will be monitored by NHS England, but also by the CCGs. Of course, they will be taken into account by local authorities as well.
The outcomes will be monitored by NHS England, but also by the CCGs. Of course, they will be taken into account by local authorities as well.
My Lords, the first mental health support teams will be set up in 25 trailblazer areas, of which 12 will also trial a four-week waiting time. Will those teams be in partnership with local authorities and the relevant CCGs, and who will monitor and evaluate the outcomes?
The noble Baroness is very expert in this area, and I thank her for that interesting proposal. I should like to take it back to the teams in the department and write to her on that point, if that would be okay.
The noble Baroness is very expert in this area, and I thank her for that interesting proposal. I should like to take it back to the teams in the department and write to her on that point, if that would be okay.
My Lords, given the fragmentation and lack of co-ordination on the ground between local mental health services, what assessment have the Government made of the potential benefits of establishing local offers for mental health, mirroring the approach to local offers for special educational needs introduced by the Children and Families Act, to improve access?
The noble Lord raises an extremely important and difficult area of service. This is exactly why the Government have just launched a review of autism services, which is currently open for consultation. We are trying to improve these services as we speak.
The noble Lord raises an extremely important and difficult area of service. This is exactly why the Government have just launched a review of autism services, which is currently open for consultation. We are trying to improve these services as we speak.
My Lords, I have been told that the Government expect every health body to provide a seven-day specialist multidisciplinary service to prevent people with autism needing in-patient care. That has been government policy since 2015. In the last four years, there has been a 24% increase in autistic people without a learning disability being placed in mental health hospitals. What are the Government doing about this policy failure?
I thank the noble Earl for his question. Obviously, recruitment aims in the mental health service are essential, and the workforce plan sets out an aim for 600 full-time posts in mental health. We have already discussed the Government’s plan in the Green Paper to set up 8,000 new children’s and young people’s posts in mental health. But that is no good if we are not also retaining those staff. NHS Improvement and NHS Employers are now working to ensure that all mental health trusts are given the tools to drive improvements in retention. This is a programme that has seen improved turnover, and we shall keep monitoring it to ensure that we retain the staff we work so hard to recruit.
I thank the noble Earl for his question. Obviously, recruitment aims in the mental health service are essential, and the workforce plan sets out an aim for 600 full-time posts in mental health. We have already discussed the Government’s plan in the Green Paper to set up 8,000 new children’s and young people’s posts in mental health. But that is no good if we are not also retaining those staff. NHS Improvement and NHS Employers are now working to ensure that all mental health trusts are given the tools to drive improvements in retention. This is a programme that has seen improved turnover, and we shall keep monitoring it to ensure that we retain the staff we work so hard to recruit.
My Lords, as a trustee of a mental health service for adolescents—the Brent Centre for Young People—I welcome the additional funding the Government are bringing forward. Is the Minister aware, however, that one of the most effective ways of preventing children having to access mental health care is supporting, for instance, groups of adoptive parents, foster carers or head teachers, with a senior clinician? However, there is concern that many senior experienced clinicians have been lost because of the shortage of funding. Will the Minister look at what she can do to stem that loss, find out what the issue is, and do what she can to invest in that area as well?
To ask Her Majesty's Government, further to the Written Answer by Baroness Manzoor on 29 January (HL12882), in what format the information requested, or similar information, is available.
To ask Her Majesty's Government, further to the Written Answer by Baroness Manzoor on 29 January (HL12882), in what format the information requested, or similar information, is available.
National data on the number of mental health inpatient beds for children and young people is available from 2013/14 onwards is shown in the following table.
Year | Number of mental health inpatient beds for children and young people |
2013/14 | 1,343 |
2014/15 | 1,386 |
2015/16 | 1,442 |
2016/17 | 1,449 |
2017/18 | 1,465 |
As of 1 April 2018 | 1,503 |
Source: NHS England management information.
Data on mental health inpatient beds for children and young people is available by region from 2016/17 onwards, and is shown for the North West and East Midlands areas in the following table.
Year | Number of mental health inpatient beds for children and young people | |
| North West1 | East Midlands2 |
2016/17 | 210 | 131 |
2017/18 | 210 | 131 |
2018/19 (April) | 210 | 131 |
2018/19 (December) | 210 | 151 |
Source: NHS England management information
1 Includes Greater Manchester, Lancashire and Cheshire.
2 Includes Derbyshire.
Information for December 2018/19 has been included in order to reflect changes in the area covered by the East Midlands category.