Mental Health and NHS Performance Update — House of Lords, 2017-01-09
Topic: Health
James O’Shaughnessy (Conservative, Centre-right): My Lords, with permission, I will repeat a Statement made by my right honourable friend the Secretary of State in the other place. The Statement is as follows "This Government are committed to a shared society in which public services work to the highest standards for everyone. This includes plans announced by the Prime Minister this morning on mental health. I am proud that, under this Government, 1,400 more people are accessing mental health services every day compared to 2010 and we are investing more in mental health than ever before, with plans for 1 million more people with mental health conditions to access services by 2020. But we recognise that there is more to do, and will proceed with plans to further improve mental health provision, including: formally accepting the recommendations of the independent Mental Health Taskforce, which will see mental health spend increase by £1 billion a year by the end of the Parliament; a Green Paper on children and young people’s mental health to be published before the end of the year; enabling every secondary school to train someone in mental health first aid; a new partnership with employers to support mental health in the workplace; up to £15 million extra invested in places of safety for those in crisis following the highly successful start to this programme in the last Parliament; an ambitious expansion of digital mental health provision; and an updated and more comprehensive suicide prevention strategy. Further details of these plans are contained in the Written Ministerial Statement laid in the House this morning However, turning to winter, as our most precious public service, the NHS has been under sustained pressure for a number of years. In just six years, the number of people over 80 has risen by 340,000, and life expectancy has risen by 12 months. As a result, demand is unprecedented: the Tuesday after Christmas was the busiest day in the history of the NHS, and some hospitals are reporting that A&E attendances are up to 30% higher compared to last year. I therefore want to set out how we intend to protect the service through an extremely challenging period and sustain it for the future First, I would like to pay tribute to staff on the front line: 1.3 million NHS staff, alongside 1.4 million in the social care system, do an incredible job which is frankly humbling for all of us in this House. An estimated 150,000 medical staff, and many more non-medical staff, worked on Christmas Day and New Year’s Day. They have never worked harder to keep patients safe, and the whole country is in their debt With respect to this winter, the NHS has made more extensive preparations than ever before. We started the run-up to the winter period with over 1,600 more doctors and 3,000 more nurses than just a year ago, bringing the total increase since 2010 to 11,400 more doctors and 11,200 more hospital nurses. The NHS allocated £400 million to local health systems for winter preparedness; it nationally assured the winter plans of every trust; it launched the largest ever flu vaccination scheme, with over 13 million people already vaccinated; and it also bolstered support outside A&Es, with 12,000 additional GP sessions offered over the festive period The result has been that this winter has already seen days where A&E departments have treated a record number of people within four hours, and there have been fewer serious incidents declared than many expected. As Chris Hopson, head of NHS Providers, said, although there have been serious problems at some trusts, the system as a whole is doing slightly better than last year. However, there are indeed a number of trusts when the situation has been extremely fragile. All of last week’s A & E diverts happened at 19 trusts, of which four are in special measures. The most recent statistics showed that nearly three-quarters of trolley waits occurred in just two trusts. In Worcestershire in particular there has been a number of unacceptably long trolley waits and two deaths reported in the media while patients were in A&E. We are also aware of ongoing problems in the North Midlands, with extremely high numbers of 12-hour trolley waits Nationally, the NHS has taken urgent action to support these trusts, including working intensively with leadership and brokering conversations with social care partners to generate a joined-up approach across systems of concern. As of this weekend, there are some signs that pressure is easing both in the most distressed trusts and across the system. However, with further cold weather on the way this weekend, a spike in respiratory infections and a rise in flu, there will be further challenges ahead NHS England and NHS Improvement will also consider a series of further measures which may be taken in particularly distressed systems on a temporary basis at the discretion of the local clinical leaders. These may include: temporarily releasing time for GPs to support urgent care work; clinically triaging non-urgent calls to the ambulance service for residents of nursing and residential homes before they are taken to hospital; continuing to suspend elective care, including, where appropriate, suspension of non-urgent out-patient appointments; working with the CQC on rapid reinspection where this has the potential to reopen community health and social care bed capacity; and working with community trusts and community nursing teams to speed up discharge. Taken together, these actions will give the NHS the flexibility to take further measures as and when appropriate at local level However, looking to the future, it is clear we need to have an honest discussion with the public about the purpose of A&E departments. There is nowhere outside the UK that commits to all patients that it will sort out any urgent health need within four hours. Only four other countries—New Zealand, Sweden, Australia and Canada—have similar national standards, which are generally less stringent than ours. This Government are committed to maintaining and delivering that vital four-hour commitment to patients. But since it was announced in 2000, there have been nearly 9 million more people visiting our A&E departments, up to 30% of whom NHS England estimates do not need to be there, and the tide is continuing to rise. If we are going to protect the four-hour standard, we need to be clear it is a promise to sort out all urgent health problems within four hours, but not all health problems, however minor. As Professor Keith Willett, NHS England’s medical director for acute care, has said, no country in the world has a four-hour standard for all health problems, however small, and if we are to protect services for the most vulnerable nor can we. So NHS England and NHS Improvement will continue to explore ways to ensure that at least some of the patients who do not need to be in A&E can be given good alternative options, building on progress under way with the streaming policy in the NHS England’s A&E plan. This way, we will be able to improve the patient experience for those with more minor conditions who are currently not seen within four hours as well as protect the four-hour promise for those who actually need it Taken together, what I have announced today are plans to support the NHS in a difficult period but also plans for a Government who are ambitious for our NHS, quite simply, to offer the safest, highest-quality care available anywhere for both mental and physical health. But they will take time to come to fruition, and in the meantime all of our thoughts are with NHS and social care staff who are working extremely hard over the winter, and throughout the year, both inside and outside our hospitals I commend this Statement to the House".