To ask His Majesty's Government how they plan to ensure the sustainability of the stroke rehabilitation innovations developed through the Stroke Quality Improvement in Rehabilitation (SQuIRe) projects to ensure that every stroke survivor has the best chance of recovery.

To ask His Majesty's Government how they plan to ensure the sustainability of the stroke rehabilitation innovations developed through the Stroke Quality Improvement in Rehabilitation (SQuIRe) projects to ensure that every stroke survivor has the best chance of recovery.

My Lords, it is now two years since the UK Health Security Agency replaced Public Health England. As we await the Science and Technology Committee’s report on the threat caused by zoonotic diseases such as Covid, avian flu and Ebola, can the Minister update the House on the progress the agency is making in building resilience in these areas? It reported last year on global work on developing pandemic-fighting tools but not on the nitty-gritty needed to tackle underlying problems still hampering us, such as tackling widespread health inequalities, building systems for vaccine resistance and raising public awareness of the threats we all face.

My Lords, it is now two years since the UK Health Security Agency replaced Public Health England. As we await the Science and Technology Committee’s report on the threat caused by zoonotic diseases such as Covid, avian flu and Ebola, can the Minister update the House on the progress the agency is making in building resilience in these areas? It reported last year on global work on developing pandemic-fighting tools but not on the nitty-gritty needed to tackle underlying problems still hampering us, such as tackling widespread health inequalities, building systems for vaccine resistance and raising public awareness of the threats we all face.

To ask His Majesty’s Government what steps they are taking to improve treatment and care for those of working age who are affected by stroke.

To ask His Majesty’s Government what steps they are taking to improve treatment and care for those of working age who are affected by stroke.

I thank the Minister. We know that one in four strokes happen to working-age people, and that it is also a leading cause of disability. Speech and physiotherapy support after stroke is therefore vital, because it helps recover key skills such as motor functions and cognitive ability, and it can be the difference between returning to work and not returning, or giving up altogether. With serious delays across the country in getting people to hospital and scanned, and in providing the speech and physiotherapy that is needed, and with chronic staff shortages across the country in hospital and community settings, good care is just not the reality for thousands of stroke sufferers. Some 40,000 people missed out last year on essential six-month, post-stroke reviews. When will the up and coming major conditions strategy be published? How will it specifically support effective stroke rehabilitation and recovery, and what timescales will be set for that?

I thank the Minister. We know that one in four strokes happen to working-age people, and that it is also a leading cause of disability. Speech and physiotherapy support after stroke is therefore vital, because it helps recover key skills such as motor functions and cognitive ability, and it can be the difference between returning to work and not returning, or giving up altogether. With serious delays across the country in getting people to hospital and scanned, and in providing the speech and physiotherapy that is needed, and with chronic staff shortages across the country in hospital and community settings, good care is just not the reality for thousands of stroke sufferers. Some 40,000 people missed out last year on essential six-month, post-stroke reviews. When will the up and coming major conditions strategy be published? How will it specifically support effective stroke rehabilitation and recovery, and what timescales will be set for that?

My Lords, the Patient Safety Commissioner’s report is all the more valuable because it is drawn from patients’ experiences, including physical, psychological and emotional impacts and their daily struggle with accessing health and other key services such as social security benefits and special educational needs support for the valproate-harmed children they are raising. What is being done to support

mothers and families as they cope with the indecision and delay over the Government’s response to the commissioner and await the vital support they need?

My Lords, the Patient Safety Commissioner’s report is all the more valuable because it is drawn from patients’ experiences, including physical, psychological and emotional impacts and their daily struggle with accessing health and other key services such as social security benefits and special educational needs support for the valproate-harmed children they are raising. What is being done to support

mothers and families as they cope with the indecision and delay over the Government’s response to the commissioner and await the vital support they need?

My Lords, on International Women’s Day last week, Carers UK stressed that older women aged 75 to 79 are providing the most unpaid care—50 hours per week—and that there has been an alarming increase since 2011 in women aged over 85 providing unpaid care. These are not the women who come under the Government’s award of one week’s unpaid carer’s leave from work, and neither will they be first in line for the small amounts of respite care funding that GPs have been allocated. How are the Government addressing this situation, and what specific actions will be taken to help to alleviate the terrible burden of care these women face?

My Lords, on International Women’s Day last week, Carers UK stressed that older women aged 75 to 79 are providing the most unpaid care—50 hours per week—and that there has been an alarming increase since 2011 in women aged over 85 providing unpaid care. These are not the women who come under the Government’s award of one week’s unpaid carer’s leave from work, and neither will they be first in line for the small amounts of respite care funding that GPs have been allocated. How are the Government addressing this situation, and what specific actions will be taken to help to alleviate the terrible burden of care these women face?

My Lords, the commission’s wide-ranging and comprehensive report is very welcome, but it heavily reinforces the urgent need for radical change in the way we diagnose, treat and care for dementia patients and support their families and carers. To ensure timely, speeded-up diagnosis, the training of primary care practitioners in dementia-specific symptoms and diagnostic methods is crucial. What steps are the Government taking to strengthen general practice and

community pharmacy in this regard so that individuals with dementia can receive appropriate care and support as early as possible?

My Lords, the commission’s wide-ranging and comprehensive report is very welcome, but it heavily reinforces the urgent need for radical change in the way we diagnose, treat and care for dementia patients and support their families and carers. To ensure timely, speeded-up diagnosis, the training of primary care practitioners in dementia-specific symptoms and diagnostic methods is crucial. What steps are the Government taking to strengthen general practice and

community pharmacy in this regard so that individuals with dementia can receive appropriate care and support as early as possible?

To ask His Majesty’s Government what actions they are taking in response to the NHS Innovation and Life Sciences Commission’s Dementia Commission: 2023 Report.

To ask His Majesty’s Government what actions they are taking in response to the NHS Innovation and Life Sciences Commission’s Dementia Commission: 2023 Report.

My Lords, I emphasise that the task force recommended by Nuffield to oversee its key recommendations needs to get to work urgently. The family-focused research work with parents, including parent carers, about their experiences of shared decision-making with healthcare professionals on care and treatment, is vital, as is the comprehensive information and guidance for parents and staff that is called for across the 16 Nuffield recommendations. What timescales are the Government envisaging for this crucial work to commence and become operational, including guidance to clinical and ethical committees?

My Lords, I emphasise that the task force recommended by Nuffield to oversee its key recommendations needs to get to work urgently. The family-focused research work with parents, including parent carers, about their experiences of shared decision-making with healthcare professionals on care and treatment, is vital, as is the comprehensive information and guidance for parents and staff that is called for across the 16 Nuffield recommendations. What timescales are the Government envisaging for this crucial work to commence and become operational, including guidance to clinical and ethical committees?

My Lords, the Minister told the House on Tuesday that hospital discharges have recently been reduced by 10%. However, he knows that this figure goes up and down as some people leave hospital while more come in at the other end, and it depends on which period of time is measured. From July to November last year there was in fact a steady rise, so we need to be specific about dates when we talk about making progress. On the care settings that patients are being discharged to—care homes—how are the Government keeping track of how the extra funding allocated to deal with chronic local staff shortages has supported the discharge process? Will it continue in the longer term?

My Lords, the Minister told the House on Tuesday that hospital discharges have recently been reduced by 10%. However, he knows that this figure goes up and down as some people leave hospital while more come in at the other end, and it depends on which period of time is measured. From July to November last year there was in fact a steady rise, so we need to be specific about dates when we talk about making progress. On the care settings that patients are being discharged to—care homes—how are the Government keeping track of how the extra funding allocated to deal with chronic local staff shortages has supported the discharge process? Will it continue in the longer term?

The Nuffield Trust has called the NAO findings a

“damning indictment of the Government’s progress towards delivering social care change”.

To follow on from my noble friend’s question, the NAO points out that only 7.5% of the much vaunted £265 million allocated by the Government to addressing social care staff shortages and recruitment for 2023-35 has actually been spent, heavily impacted by the DHSC’s staff recruitment freeze. What specific actions are the Government taking to address this and ensure that the money they say is there is actually paid out?

The Nuffield Trust has called the NAO findings a

“damning indictment of the Government’s progress towards delivering social care change”.

To follow on from my noble friend’s question, the NAO points out that only 7.5% of the much vaunted £265 million allocated by the Government to addressing social care staff shortages and recruitment for 2023-35 has actually been spent, heavily impacted by the DHSC’s staff recruitment freeze. What specific actions are the Government taking to address this and ensure that the money they say is there is actually paid out?

My Lords, the NAO’s recent figures show that so far, only 7.5% of the much-vaunted £265 million allocated by government to addressing social care staffing shortages and recruitment for 2023-25 has been spent due to the DHSC staff recruitment freeze; and the training workforce development programme has also stalled because the department has not managed to set up the necessary systems to administer provider payments. What is the Minister’s response to this and the ADASS survey finding that government investment in social care so far has just stopped the ship sinking and has not moved local authorities out of the storm they are trying to navigate?

My Lords, the NAO’s recent figures show that so far, only 7.5% of the much-vaunted £265 million allocated by government to addressing social care staffing shortages and recruitment for 2023-25 has been spent due to the DHSC staff recruitment freeze; and the training workforce development programme has also stalled because the department has not managed to set up the necessary systems to administer provider payments. What is the Minister’s response to this and the ADASS survey finding that government investment in social care so far has just stopped the ship sinking and has not moved local authorities out of the storm they are trying to navigate?

My Lords, most of us will have the amazing work of our own local children’s hospice in mind today in response to this Question. Ours in Surrey is the care and support that the Shooting Star Children’s Hospices provide for babies, children and young people with life-limiting conditions, and their families. We fully support the children’s hospice grant going directly to a hospice. It is the most cost-effective way; it overcomes the patchy performance of many ICBs and their CCG predecessors on hospice funding, and it avoids hospices having to engage with multiple ICSs when their services go across areas. What actions are the Government taking to ensure that ICBs meet the NICE standards in supporting children’s hospice care and against ICBs that have made no attempt to access the current grant arrangements?

My Lords, most of us will have the amazing work of our own local children’s hospice in mind today in response to this Question. Ours in Surrey is the care and support that the Shooting Star Children’s Hospices provide for babies, children and young people with life-limiting conditions, and their families. We fully support the children’s hospice grant going directly to a hospice. It is the most cost-effective way; it overcomes the patchy performance of many ICBs and their CCG predecessors on hospice funding, and it avoids hospices having to engage with multiple ICSs when their services go across areas. What actions are the Government taking to ensure that ICBs meet the NICE standards in supporting children’s hospice care and against ICBs that have made no attempt to access the current grant arrangements?

Thankfully, my Lords, understanding of and support for autism have changed substantially since the now 40 year-old Mental Health Act, especially about being clear on what an autism-friendly environment looks like and should be, although sadly that is not often found in mental health settings and ATUs. Did the Government’s decision to abandon the new mental health Bill this Session include an assessment of the impact this would have on patients? This is particularly urgent now that changes to the code of practice, recommended by the excellent report on long-term segregation by the noble Baroness, Lady Hollins, will not be considered until we deal with the Bill. How and when will the Government deliver the significant changes needed?

Thankfully, my Lords, understanding of and support for autism have changed substantially since the now 40 year-old Mental Health Act, especially about being clear on what an autism-friendly environment looks like and should be, although sadly that is not often found in mental health settings and ATUs. Did the Government’s decision to abandon the new mental health Bill this Session include an assessment of the impact this would have on patients? This is particularly urgent now that changes to the code of practice, recommended by the excellent report on long-term segregation by the noble Baroness, Lady Hollins, will not be considered until we deal with the Bill. How and when will the Government deliver the significant changes needed?

My Lords, the JCVI endorses the RSV vaccination programme for 75 year-olds and ages above, but its 11 September statement underlines that the cost-effectiveness of vaccinating over 65s should also be kept under review, particularly as evidence of the protection offered to over 75s emerges. Does the Minister have any further information on how this review has been taken forward, and on timescales for possible conclusions and recommendations? Obviously, extending the vaccination to over 65s would be a major advance.

My Lords, the JCVI endorses the RSV vaccination programme for 75 year-olds and ages above, but its 11 September statement underlines that the cost-effectiveness of vaccinating over 65s should also be kept under review, particularly as evidence of the protection offered to over 75s emerges. Does the Minister have any further information on how this review has been taken forward, and on timescales for possible conclusions and recommendations? Obviously, extending the vaccination to over 65s would be a major advance.

To ask His Majesty’s Government what recent assessment they have made of the impact of the length of waiting times for paediatric care on children’s developmental outcomes.

To ask His Majesty’s Government what recent assessment they have made of the impact of the length of waiting times for paediatric care on children’s developmental outcomes.

My Lords, the Academy of Medical Royal Colleges has described sick children as the

“forgotten casualties of the NHS’s waiting list crisis”

across hospital and community health. NHS data shows that over 220,000 are waiting for children’s and young people’s services, including paediatrics, autism spectrum disorder diagnosis, health visiting, and speech and language therapy. Even worse, almost 20,000 have been waiting over a year—that is 8% up on the previous month. What action are the Government taking specifically to address this appalling situation, and what cross-government measures are in place to try to mitigate the huge knock-on impact on children’s education, health and well-being, and on their families?

My Lords, the Academy of Medical Royal Colleges has described sick children as the

“forgotten casualties of the NHS’s waiting list crisis”

across hospital and community health. NHS data shows that over 220,000 are waiting for children’s and young people’s services, including paediatrics, autism spectrum disorder diagnosis, health visiting, and speech and language therapy. Even worse, almost 20,000 have been waiting over a year—that is 8% up on the previous month. What action are the Government taking specifically to address this appalling situation, and what cross-government measures are in place to try to mitigate the huge knock-on impact on children’s education, health and well-being, and on their families?

My Lords, the figures on overall declining numbers are concerning, particularly since this is the second successive steep fall, with, as the Minister said, the Department of Health relying on the UCAS clearing system and future nurse apprenticeships to try to make up the numbers. What changes does the Minister consider need to be made to the NHS workforce plan in the light of escalating problems with both the recruitment and retention of key staff?

My Lords, the figures on overall declining numbers are concerning, particularly since this is the second successive steep fall, with, as the Minister said, the Department of Health relying on the UCAS clearing system and future nurse apprenticeships to try to make up the numbers. What changes does the Minister consider need to be made to the NHS workforce plan in the light of escalating problems with both the recruitment and retention of key staff?

To ask His Majesty’s Government what additional funding is being made available for the implementation of the Department for Health and Social Care’s Major Conditions Strategy.

To ask His Majesty’s Government what additional funding is being made available for the implementation of the Department for Health and Social Care’s Major Conditions Strategy.

My Lords, the major conditions strategy has been well received in both approach and content, particularly the focus on primary and secondary prevention as part of a life-course approach, and bringing together a strategic framework for the six major conditions that drive over 60% of morbidity in England, including cancer, heart disease and stroke. However, key stakeholders have warned that, without adequate resources, NHS trusts and other bodies will struggle to deliver, especially given their current and future focus on trying to cope with ever-escalating waiting lists. Do the Government acknowledge this and how will January’s future strategy address it?

My Lords, the major conditions strategy has been well received in both approach and content, particularly the focus on primary and secondary prevention as part of a life-course approach, and bringing together a strategic framework for the six major conditions that drive over 60% of morbidity in England, including cancer, heart disease and stroke. However, key stakeholders have warned that, without adequate resources, NHS trusts and other bodies will struggle to deliver, especially given their current and future focus on trying to cope with ever-escalating waiting lists. Do the Government acknowledge this and how will January’s future strategy address it?