Written questions by Slaughter.

What steps he is taking to tackle the (a) palliative, (b) end of life care and (c) other medical needs of older prisoners.

As a signatory to the National Partnership Agreement for Health and Social Care for people in contact with the criminal justice system, the Department is committed to working with the Ministry of Justice, HM Prison and Probation Service, NHS England, and the UK Health Security Agency to ensure that safe, legal, decent, and effective care that improves health outcomes and reduces health inequalities is provided for all prisoners, including those who are elderly. NHS England is responsible for providing a full range of healthcare services to meet the needs of the prison population. Every prison will have a health needs assessment undertaken on a regular basis which is then used to locally determine the health needs and requirements of that prison’s population. This includes supporting elderly prisoners in their palliative care, end of life care, and other health needs such as dementia care. Local authorities also have a duty to support elderly prisoners with their social care needs. The Dying Well in Custody Charter and supporting self-assessment framework describes a set of national standards for local adoption and provides a tool for a local multi-disciplinary approach to providing agreed standards of palliative and end of life care to people in prison. The charter is available at the following link: https://www.england.nhs.uk/long-read/dying-well-in-custody-charter/#:~:text=It%20is%20the%20last%20thing,of%20their%20place%20of%20death

If he will consider the merits of implementing safety recommendation R/2025/055 in the report by the Health Service Safety Investigations Body entitled Mental health inpatient settings: Creating conditions for the delivery of safe and therapeutic care to adults, published on 30 January 2025.

We are grateful to the Health Services Safety Investigations Body for their report on creating conditions for learning from deaths in mental health inpatient settings. The report highlights important concerns and safety recommendations that can help us to improve inpatient mental health services.We will formally respond to all the recommendations for the Department made within this report in due course.

What role he plans integrated care systems will play in addressing malnutrition across their localities.

Malnutrition is a clinical condition affecting all ages, across all communities, and in all health and care settings. Most cases of malnutrition will be secondary to another health condition, which may impact on nutritional needs or a person’s ability to eat and drink. All National Health Services are recommended to adhere to the National Institute for Health and Care Excellence’s (NICE) clinical guideline, Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition, which is available at the following link:https://www.nice.org.uk/guidance/cg32This sets out the recommendations, based on best available evidence, of the organisation, screening, and delivery of nutritional support in hospitals and communities. This includes screening for malnutrition and the risk of malnutrition. The NICE guidelines recommend that all hospital inpatients should be screened for malnutrition on admission, as well as all outpatients at their first clinic appointment. Screening should be repeated weekly for inpatients, and when there is clinical concern for outpatients. People in care homes should be screened on admission, and when there is clinical concern.All people who are identified as being malnourished or at risk of malnutrition should be assessed by an appropriately qualified health professional, such as a dietitian, to receive an individualised care plan in line with their individual circumstances, dietary preferences, and medical needs.NHS England’s Nursing Directorate is leading on a review and refresh of the National Nutrition and Hydration guidance, which builds on NHS England’s previous Commissioning Excellent Nutrition and Hydration guidance 2015-2018. This previous guidance is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2015/10/nut-hyd-guid.pdfA National Hydration and Nutrition Advisory Board was established in June 2023, providing strategic advice, direction, and oversight across the review, codesign, and development of the policy.There is no current estimate on the savings that could be made as a result of increasing the screening and treatment of malnutrition. However, efforts to prevent malnutrition and to treat it early could potentially reduce both the clinical and economic burden to the healthcare system. Malnourished patients spend on average 30% longer in hospital than patients who are not malnourished.Integrated care systems, made up of local partners including the NHS, councils, the voluntary sector, and others, are responsible for planning and commissioning health services for their local population. Integrated care systems and providers will be responsible for implementation and delivery of the refreshed National Nutrition and Hydration policy.

If his Department will make an estimate of the potential savings to the public purse from increased levels of malnutrition (a) screening and (b) treatment.

Malnutrition is a clinical condition affecting all ages, across all communities, and in all health and care settings. Most cases of malnutrition will be secondary to another health condition, which may impact on nutritional needs or a person’s ability to eat and drink. All National Health Services are recommended to adhere to the National Institute for Health and Care Excellence’s (NICE) clinical guideline, Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition, which is available at the following link:https://www.nice.org.uk/guidance/cg32This sets out the recommendations, based on best available evidence, of the organisation, screening, and delivery of nutritional support in hospitals and communities. This includes screening for malnutrition and the risk of malnutrition. The NICE guidelines recommend that all hospital inpatients should be screened for malnutrition on admission, as well as all outpatients at their first clinic appointment. Screening should be repeated weekly for inpatients, and when there is clinical concern for outpatients. People in care homes should be screened on admission, and when there is clinical concern.All people who are identified as being malnourished or at risk of malnutrition should be assessed by an appropriately qualified health professional, such as a dietitian, to receive an individualised care plan in line with their individual circumstances, dietary preferences, and medical needs.NHS England’s Nursing Directorate is leading on a review and refresh of the National Nutrition and Hydration guidance, which builds on NHS England’s previous Commissioning Excellent Nutrition and Hydration guidance 2015-2018. This previous guidance is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2015/10/nut-hyd-guid.pdfA National Hydration and Nutrition Advisory Board was established in June 2023, providing strategic advice, direction, and oversight across the review, codesign, and development of the policy.There is no current estimate on the savings that could be made as a result of increasing the screening and treatment of malnutrition. However, efforts to prevent malnutrition and to treat it early could potentially reduce both the clinical and economic burden to the healthcare system. Malnourished patients spend on average 30% longer in hospital than patients who are not malnourished.Integrated care systems, made up of local partners including the NHS, councils, the voluntary sector, and others, are responsible for planning and commissioning health services for their local population. Integrated care systems and providers will be responsible for implementation and delivery of the refreshed National Nutrition and Hydration policy.

What steps his Department is taking to ensure that NHS patients receive appropriate (a) screening and (b) treatment for malnutrition.

Malnutrition is a clinical condition affecting all ages, across all communities, and in all health and care settings. Most cases of malnutrition will be secondary to another health condition, which may impact on nutritional needs or a person’s ability to eat and drink. All National Health Services are recommended to adhere to the National Institute for Health and Care Excellence’s (NICE) clinical guideline, Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition, which is available at the following link:https://www.nice.org.uk/guidance/cg32This sets out the recommendations, based on best available evidence, of the organisation, screening, and delivery of nutritional support in hospitals and communities. This includes screening for malnutrition and the risk of malnutrition. The NICE guidelines recommend that all hospital inpatients should be screened for malnutrition on admission, as well as all outpatients at their first clinic appointment. Screening should be repeated weekly for inpatients, and when there is clinical concern for outpatients. People in care homes should be screened on admission, and when there is clinical concern.All people who are identified as being malnourished or at risk of malnutrition should be assessed by an appropriately qualified health professional, such as a dietitian, to receive an individualised care plan in line with their individual circumstances, dietary preferences, and medical needs.NHS England’s Nursing Directorate is leading on a review and refresh of the National Nutrition and Hydration guidance, which builds on NHS England’s previous Commissioning Excellent Nutrition and Hydration guidance 2015-2018. This previous guidance is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2015/10/nut-hyd-guid.pdfA National Hydration and Nutrition Advisory Board was established in June 2023, providing strategic advice, direction, and oversight across the review, codesign, and development of the policy.There is no current estimate on the savings that could be made as a result of increasing the screening and treatment of malnutrition. However, efforts to prevent malnutrition and to treat it early could potentially reduce both the clinical and economic burden to the healthcare system. Malnourished patients spend on average 30% longer in hospital than patients who are not malnourished.Integrated care systems, made up of local partners including the NHS, councils, the voluntary sector, and others, are responsible for planning and commissioning health services for their local population. Integrated care systems and providers will be responsible for implementation and delivery of the refreshed National Nutrition and Hydration policy.