Conservatives reject Lib Dem plans to tackle planning delays in North Norfolk

Conservative councillors have voted down plans to cut delays in dealing with planning issues in North Norfolk.

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Norman Lamb urges NHS England to fund essential HIV treatment

Norman Lamb, MP for North Norfolk and the Liberal Democrat spokesperson for health, has urged NHS England to provide funding for the ground-breaking HIV prevention treatment Pre-Exposure Prophylaxis, or PrEP.

Despite huge improvements in the management of HIV in recent years, a total of 6,151 people in the UK were newly diagnosed with the virus in 2014. Studies have shown that PrEP is extremely effective at reducing the risk of infection in people who are at high risk of getting HIV, and the PROUD study last year suggested that the treatment can reduce infection by 86%.

However, NHS England said this week that it will not provide access to PrEP nationally, arguing that HIV prevention services are the responsibility of local authorities. Instead, it announced a further two-year study of PrEP at "test sites", restricting access to the treatment to around 500 men at high risk of infection.

Thousands of people are now set to miss out on the drug, which is why Norman Lamb has tabled a motion in Parliament calling on the Government to intervene and ensure that this essential treatment is made available on the NHS as soon as possible.  

The full text of the motion is as follows:

That this House raises serious concerns over the recent decision by NHS England to delay the national roll-out of Pre-Exposure Prophylaxis (PrEP) for HIV; notes that this decision was made despite overwhelming evidence of the effectiveness of PrEP in reducing infection with HIV in high-risk groups, including the PROUD study which showed that PrEP reduced the risk of infection by 86 per cent; further notes that HIV transmission rates are increasing not only in the men who have sex with men population but also among BME communities and heterosexual women; affirms that PrEP, which is already available in other countries such as France, the US, Canada, Kenya and Israel, is a crucial part of the armoury in the fight against HIV and could prevent 7,400 new cases of the infection by 2020; believes that NHS England's announcement of PrEP test sites over the next two years is unnecessary in light of the clinical evidence available, and is concerned that this may be intended to avoid acceptance of responsibility for commissioning HIV prevention treatments rather than local authorities; further believes that, as an essential treatment, responsibility for commissioning PrEP should lie with NHS England rather than local authorities; and urges the Government to intervene as a matter of urgency to ensure that NHS England takes the steps necessary for PrEP to be considered as part of the next annual CPAG prioritisation process so that all high-risk groups are able to access the treatment as soon as possible.


Norman Lamb criticises removal of Mental Health from NHS Quality Premium scheme

Norman Lamb, MP for North Norfolk and Liberal Democrat spokesperson for health, has spoken out after NHS England dropped a key financial incentive for NHS commissioners to improve mental health care.

The Quality Premium scheme is intended to reward clinical commissioning groups (CCGs) for improvements in the quality of health services they commission.  However, recent guidance published by NHS England has revealed that mental health has been dropped from the list of national measures in next year’s scheme.

In response to a written parliamentary question asked by Norman Lamb, the Government confirmed that mental health Quality Premium measures will only retained next year (2016/17) if selected by commissioners as “a local priority area”.

The new guidance published by NHS England includes a list of 80 local indicators, including 17 categorised as ‘mental health’.  However, commissioners are only able to select 3 of these, and mental health faces stiff competition from incentives to outcomes in cancer, circulatory conditions, maternity care, respiratory disease, trauma and other areas. 

Norman Lamb has written to the Health Secretary, Jeremy Hunt, and the Chief Executive of NHS England, Simon Stevens, to ask if they will guarantee that these changes will not result in mental health being disadvantaged.

Commenting, Norman Lamb said:

“This development further exposes the appalling gulf between rhetoric and practice when it comes to mental health in the NHS. 

“History tells us that mental health services are at the front of the queue for cuts when there are savings to be made, so NHS England should be doing everything in its power to incentivise commissioners to improve the quality of mental health care provided to patients.

“It speaks volumes that a scheme designed to deliver the ‘major priorities’ of the NHS, by the Government’s own admission, no longer includes national targets in mental health. Mental health should be a national priority, and it’s deeply disappointing the Government didn’t even see fit to discuss these plans with charities before a decision was made.

“The timing of this announcement, only a month after the Mental Health Taskforce published its landmark vision for revolutionising mental health services, is just extraordinary. But on top of Simon Stevens’ recent comments that there is unlikely to be any extra money for mental health next year, it’s clear that there are very difficult times ahead for people with mental illness.

“The Government and NHS England have offered enough warm words on mental health – it’s time these are backed up with action to end the continuing discrimination at the heart of our NHS.  This has to start with a clear plan for implementing the recommendations of the Mental Health Taskforce.”

 

Parliamentary Question

The questions tabled by Norman Lamb MP, and the Government’s joint response, are as follows:

To ask the Secretary of State for Health what assessment he has made of the likely impact of the removal of mental health Quality Premium measures in NHS England’s ‘Quality Premium Guidance for 2016/17’ on mental health outcomes.

To ask the Secretary of State for Health what discussions he has had with mental health charities regarding the removal of mental health Quality Premium measures in ‘NHS England’s Quality Premium Guidance for 2016/17’.

Answer:

The 2016/17 Quality Premium (QP) scheme has been designed to support the delivery of the major priorities for the National Health Service, as set out in the Five Year Forward View and in the NHS Mandate. The QP scheme is reviewed annually, with the intention of having a range of high impact measures addressing a range of priorities across the Five Year Forward View.

However, there is scope for clinical commissioning groups (CCGs) to focus on mental health, if this is a local priority area in 2016/17. Each CCG is expected to select three local indicators from a menu of suitable measures aligned to the Right Care programme, which sets out a clinically led methodology for improvement and reducing variation in care. This menu includes 17 mental health indicators.

The QP scheme is a part of NHS England’s wider incentive system, including the Commissioning for Quality and Innovation scheme, which includes an incentive focussing on improving the physical health for patients with severe mental illness.

As the QP will be retaining mental health as an indicator there has been no new assessment of the effect of removing.

While there have not yet been any formal meetings with mental health charities about this, following the Mental Health Taskforce report, NHS England are keen to work with stakeholders-including mental health charities- to develop a new and robust mental health indicator for potential inclusion in the 2017/18 QP. This will align with the additional funding to drive improvements in ‘Improved Access to Psychological Therapies’ access from April 2017.


Norman Lamb asks for assurance on new Norfolk mental health helpline

Norman Lamb, the Liberal Democrat MP for North Norfolk, has asked for assurance that the region’s new combined mental health helpline will be able to meet the needs of everyone who needs it.

It was announced last week that the Wellbeing Service mental health helpline will be extended to support people using the Norwich and Central Norfolk Mind Mental Health Helpline, which is set to close. The announcement was made following a long campaign by patients and the Eastern Daily Press.

Norman Lamb has written to the Chief Officer of South Norfolk CCG, Antek Lejk, asking what hours the merged helpline will be open, and whether it will have the capacity to cope with calls currently dealt with by the Mind helpline and the Wellbeing Service.

Commenting, Norman Lamb said:

“It’s completely essential that everybody suffering from a mental health crisis or a moment of anxiety is able to speak to someone for advice and support.

“I was really relieved at the announcement that the Wellbeing Service will be extended so that people using the Mind helpline won’t be left without any kind of help.

“But we need a guarantee that the merged helpline will have enough capacity and will be open for sufficient hours to make sure that nobody falls through the gaps.”


Norman Lamb: The Government must set out its plan for mental health

Norman Lamb MP has challenged the Government to provide a clear plan for implementing the recommendations of the Mental Health Five Year Forward View.

The long-awaited report of the independent Mental Health Taskforce, published last week, highlighted the desperate state of mental health care in England. It contained 58 recommendations to improve services – including the introduction of comprehensive waiting time standards in mental health, 24-hour access to care for everyone suffering a mental health crisis, and an end to the practice of people with mental illness being shunted across the country to receive care.

However, the Government has so far failed to outline a clear strategy for implementing these recommendations. Speaking in the House of Commons on Tuesday (23rd February), Health Minister Alistair Burt could only offer the vague promise of a series of “rolling responses” to the Taskforce’s report, without laying out any steps for achieving its vision.

People with mental illness still do not enjoy the same right to access treatment on time as people with physical health conditions; and because these access rights determine where the money goes in the NHS, mental health has always been under-funded. Norman Lamb and Nick Clegg began to rectify this in government by securing the first ever NHS waiting time standards in mental health, as a starting point in an ambitious programme that by 2020 would aim to provide a comprehensive set of access rights.  The Taskforce report endorsed this ambition, but the Government is yet to clarify how and when this ambition will become a reality.

The Minister was also unable to put forward a strategy or timetable for ending the scandal of out of area mental health placements. During a House of Commons debate led by Norman Lamb in December, Alistair Burt pledged to develop a plan to reduce long-distance inpatient admissions after considering the findings of the Taskforce report and Lord Crisp’s Commission on Acute Adult Psychiatric Care.

Both reports have now concluded that the practice is unacceptable and should be eliminated nationally. However, when pressed for a timetable by Alistair Carmichael, Lib Dem MP for Orkney and Shetland, Alistair Burt could only say that he’d “like to see it done as fast as reasonably practicable”.

As well as calling for a clear action plan, the Liberal Democrats are holding the Government to account to ensure that the Taskforce’s recommendations are properly funded. The report said that its recommended changes will require an extra £1 billion by 2020; but while the Government claims to have accepted this demand, it is believed that much of this money will be recycled from previous announcements, or taken from other parts of the health system that are already at breaking point and do not have resources to spare. The Minister’s response to questions from MPs did not shed any light on exactly how much additional investment mental health will receive over the next five years, or where this funding would come from.

Commenting after the questions in the House of Commons, Norman Lamb said:

“This report sets out a once-in-a-generation opportunity to deliver real and lasting change to mental health services. But there has been a disappointing lack of detail in the Government’s response so far, even though ministers have had many months to prepare.

“Mental health has always been the Cinderella service of the NHS, and change can only be delivered if there is a drive, ambition and clear vision at the heart of government. The ‘Future in Mind’ blueprint for transforming mental health services for children and young people, the Crisis Care Concordat, the first ever waiting time standards in mental health – these were all secured by the Liberal Democrats in government as part of a wider mission to achieve equality for mental health.

“Paul Farmer’s Taskforce report endorses and builds on these important steps, but it is simply no good for the minister to stand at the despatch box and offer vague promises of a rolling programme of reform. With no detailed plan for delivering the change that’s needed, there is a real risk that nothing will happen. Crucial proposals will be kicked into the long grass, and we will find ourselves in 2019 with the mental health system brought to its knees, and realise that the Government has left it too late.

“I am calling on the Government to develop, without delay, a clear and timetabled strategy for implementing the Taskforce’s recommendations in full. We cannot afford to waste any time - and with NHS commissioners already planning next year’s services, the Government has to act immediately.”


Norman Lamb welcomes Mental Health Five Year Forward View

Norman Lamb MP has welcomed the launch of a landmark report setting out a five-year strategy for transforming mental health care in England.

One in four people will experience a mental health problem at some point in their lifetime. However, this area has historically been neglected in the NHS, and people with mental illness often do not enjoy the same access to effective treatment as those with physical conditions.

The Mental Health Taskforce, chaired by Paul Farmer (Chief Executive of Mind), was set up to bring an end to this discrimination, and its report makes a wide range of recommendations on how to provide better support for people suffering from mental ill health.

The key recommendations are:

  • 24 hour access to mental health crisis care, 7 days a week. This includes better funding for Crisis Resolution and Home Treatment Teams, which offer intensive home treatment for people in a mental health crisis as an alternative to hospital admission.
  • Comprehensive access and waiting time standards in mental health, giving people the right to treatment on a timely basis.
  • Access to psychological therapies expanded to help over 600,000 more people.
  • Better support for the physical health of people with severe mental health problems.
  • More personalised and effective support to help twice as many people with mental illness to find / stay in work
  • The practice of sending acutely ill patients long-distances for treatment should be eliminated as quickly as possible.
  • Urgent action to help people from Black and Minority Ethnic communities to access good quality mental health care

Many of these recommendations build on the crucial work done by Norman Lamb and the Liberal Democrats in government and in opposition.

  • The Liberal Democrats introduced the first ever maximum waiting times in mental health, for common mental health conditions (e.g. depression and anxiety) and psychosis. This was announced as part of a vision for comprehensive waiting time standards, to give more people with mental illness the right to access treatment on a timely basis.
  • The ‘Future in Mind’ report was a blueprint for modernising children and young people’s mental health, backed by £1.25bn in funding secured by Nick Clegg. The Taskforce endorses the recommendations of the report, and calls for the funding to be invested in full over the next five years to help more than 70,000 children and young people.  
  • The Crisis Care Concordat was a historic agreement setting out how organisations can work together more effectively to provide better support for people experiencing a mental health crisis. The Taskforce recommends building on this work to improve access to crisis care.
  • Norman Lamb has repeatedly called for an end to out of area mental health placements, and urged the Government to commit to eliminating the practice in a House of Commons debate last December. Nobody suffering from mental illness should be shunted across the country to receive the care they need.

The Mental Health Taskforce identified the need to invest an additional £1 billion a year by 2020, in order to deliver these rapid improvements in mental health services and help over 1 million more people with mental health problems to access high quality care.

The NHS has pledged to provide the extra £1bn – but rather than investing new money into mental health, the Government is instead redirecting funds from other parts of the NHS which are already overstretched.

Commenting on the report, Norman Lamb said:

“This report sets an excellent ambition to revolutionise our mental health services and bring an end to the discrimination suffered by those with mental ill health at the heart of the NHS.

“Critically, it endorses the plan to introduce comprehensive maximum waiting time standards in mental health. Mental health was left out of maximum waiting time standards when they were introduced by Labour over a decade ago. This drives where the money goes in the NHS and outrageously disadvantages those with mental ill health. The Liberal Democrats introduced the first ever waiting time standards in mental health – but until there are comprehensive rights to get treatment on time, discrimination against those with mental illness will continue.”


Backlog of DBS applications poses risk to health and care sector

North Norfolk MP Norman Lamb has pressed the Government over reports that the recruitment of vital healthcare staff is being hindered by administrative delays.

 

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Norman Lamb calls for investment in young people's mental health after A&E admissions double

Norman Lamb, MP for North Norfolk and the Liberal Democrat spokesperson for health, has called for the Government to stick to its commitment of extra investment in children and young people’s mental health services after it was revealed that the number of young people admitted to A&E as a result of a psychiatric condition more than doubled over the last five years.

In response to a parliamentary question tabled by Norman, the Government confirmed that a total of 14,917 people aged 18 and under who were admitted to A&E with a recorded first diagnosis of a psychiatric condition in 2014/15, compared to only 6,950 in 2010/11 – an increase of 115% over the period. Meanwhile, the number of young people admitted for intentional self-harm also increased from 13,504 to more than 17,000.

During the Coalition Government, the Liberal Democrats secured £1.25bn of new funding to transform children and young people’s mental health services. This amounts to around £250 million in every year of the current parliament – but the Government has allocated only £143 million in this financial year (2015/16). 

Norman is currently leading a commission, set up by the think tank CentreForum, looking at how to improve the mental health services available to children and young people.

“These are deeply shocking figures which expose the true scale of the mental health challenge facing young people in this country,” said Norman Lamb.

“The Government is failing to support children and young people by not delivering the investment that was agreed before the General Election. In March 2015, Nick Clegg and I announced £1.25 billion to be spent over five years on improving young people’s mental health services, but the Government has already underspent by £107 million in the first year. 

“This is unacceptable, and these latest figures show the need for urgent investment in preventative services and community care to stop young people from reaching crisis point. It also shows the absolute need to introduce the same right to get treatment on a timely basis for children and young people suffering mental ill health as others enjoy.  I am calling on the Government to make up the shortfall immediately, and to deliver on its promise to provide the full £1.25bn over the next five years.”

 

Norman's parliamentary question and the Government's response is copied in full below.

Norman Lamb: To ask the Secretary of State for Health, how many people aged 18 and under were admitted to A&E for (a) deliberate self-harm and (b) psychiatric conditions in England in each of the last five years.

Alistair Burt (Minister for Communities and Social Care): While data on the number of people attending accident and emergency (A&E) departments is not collected centrally, the table does provide a number of A&E attendances for patients aged under 18 with a recorded first diagnosis of psychiatric conditions, those where the recorded patient group is 'intentional self-harm' and those where both criteria appear from 2010-11 to 2014-15.

Criteria

Year

2010-11

2011-12

2012-13

2013-14

2014-15

Diagnosis - Psychiatric Conditions

6,950

8,930

10,853

13,989

14,917

Patient Group - Intentional Self Harm

13,504

13,730

13,859

17,486

17,019

Attendances where both the above codes were recorded

1,098

1,340

1,687

2,205

2,313


Expert commission backs Norman Lamb's call to abolish out of area mental health placements

Norman Lamb’s call to end the scandal of mental health patients being shunted across the country has received the backing of a landmark report on acute psychiatric care.

The Commission on Acute Adult Psychiatric Care, led by Lord Crisp, was set up by the Royal College of Psychiatrists in response to concerns about the provision of services for people with severe mental illness.  Its report found that there are “major problems both in admissions to psychiatric wards and in providing alternative care and treatment in the community”.

One of the Commission’s key recommendations is that the practice of sending acutely ill patients long distances for non-specialist mental health treatment is phased out by October 2017, following months of campaigning by the Liberal Democrats.

Norman Lamb, the Liberal Democrat spokesperson for Health, led a House of Commons debate in November to highlight the scandal of out-of-area placements, and challenged the Government to commit to ending the practice completely within 12 months. The Government pledged at the time to make a recommendation based on the findings of Lord Crisp’s Commission, which reported today.

Official figures suggest that each month around 500 mental ill patients have to travel over 50km away from their home to a hospital bed. The report concluded that these long distances “are mainly due to difficulties in finding acute inpatient beds or suitable alternative services in their home area, and are a symptom of far more widespread problems in the functioning of the whole mental health system.”

Commenting on the new report, Norman Lamb said: “I am delighted with the recommendation of ending the scandal of out of area placements. The Government has already committed to taking a view based on the findings of this Commission, and I now urge the minister to commit to ending this outrageous practice.

“Being sent out-of-area during a mental health crisis – sometimes hundreds of miles away from family and friends – can cause unimaginable distress. We also know that being treated out-of-area raises the risk of suicide after being discharged from hospital. There is simply no excuse for allowing this to continue.

“This practice would never be tolerated in physical health services. It is an example of the total discrimination at the heart of our NHS, and one of the many examples of how people who suffer from acute mental ill health are disadvantaged by the system.”

Other recommendations in the report include:

  • A new waiting time pledge is included in the NHS Constitution from October 2017 of a maximum four-hour wait for admission to an acute psychiatric ward or acceptance for home-based treatment, in line with existing targets in physical health;
  • Commissioners and providers should undertake a service capacity assessment and improvement programme to ensure that they have an appropriate number of beds and Crisis Resolution and Home Treatment teams;
  • Better access to accommodation for those suffering mental illness;
  • Pilots to improve the experience of care for people from Black and Minority Ethnic communities
  • The collection, quality and use of data is radically improved to improve service quality, evidence-based care, and accountability.  


The full report can be accessed here


Lab-Con alliance opposes Norman Lamb's NHS Commission

Labour and Conservative united in Parliament last week to oppose plans for a Commission to examine the future of the NHS and Social Care. The Commission was proposed by Norman Lamb who has previously warned of an impending funding crisis faced by the NHS.

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