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Antipsychotic Medication
Mr. Burstow: To ask the Secretary of State for Health what research his Department has commissioned in the last four years into prescribing of (a) traditional and (b) atypical antipsychotic medication to older people (i) in general, (ii) in care homes and (iii) in hospitals. [7393]
Jacqui Smith: The Department, through the health technology assessment (HTA) programme, has funded research to the value of over £1.4 million on antipsychotic medication in general. This includes a multi-centre randomised controlled trial on the cost utility of antipsychotics in severe schizophrenia, a systematic evaluation of the clinical and cost-effectiveness of "atypical" antipsychotics in the treatment of schizophrenia and systematic reviews of (i) comparative studies of depot neuroleptic agents and (ii) studies of oral versus depot neuroleptic agents for patients with schizophrenia.
The HTA programme has also undertaken a review for the National Institute for Clinical Excellence (NICE) on the clinical effectiveness and cost-effectiveness of the newer (atypical) antipsychotic drugs in the treatment of schizophrenia. This includes some reference to older people. NICE has started its appraisal and the appraisal committee will produce the provisional appraisal determination this month and final guidance is expected in March 2002.
Through such measures as the National Service Framework for Older People and the Care Standards Act 2000, the Department has set out clear requirements for the proper management of medicines for older people.
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This includes specific reference to existing guidance on the appropriate prescribing of antipsychotic drugs and other medication for mental health problems.
Continuing Care
Mr. Burstow: To ask the Secretary of State for Health (a) how many appeals were lodged against decisions under continuing care criteria, (b) how many appeals resulted in the NHS assuming funding responsibility in full and (c) what the mean and median number of weeks was an appellant waited from the date the appeal was lodged to the appeal decision for each (i) NHS region and (ii) health authority, in (A) 1998–99, (B) 1999–2000 and (C) 2000–01. [7411]
Jacqui Smith: The information requested is not available centrally.
Delayed Discharge (Elderly Patients)
Mr. Burstow: To ask the Secretary of State for Health how many people aged 75 years and over (a) experienced delayed discharge, (b) experienced delayed discharge due to awaiting residential placement and (c) required emergency readmission within 28 days of hospital discharge in Q3 and Q4 2000–01 and Q1 2001–02 in each (i) NHS region and (ii) health authority . [7392]
Jacqui Smith: Copies of the information requested have been placed in the Library. This does not include information requested on Quarter 1 2001–02 figures for each national health service region and health authority for the total number of elderly people aged 75 and over who experienced delayed discharge due to awaiting residential placement. From April this year figures on reasons for delay were only collected on the basis of patients of all ages.
Mr. Burstow: To ask the Secretary of State for Health if he will list for (a) NHS regions and (b) health authorities, the number of elderly people aged 75 years and over for each quarter from Q1 1999–2000 to Q1 2001–02 experiencing delayed discharge because they were awaiting a domiciliary care package. [7387]
Jacqui Smith: The information requested has been placed in the Library.
Free Nursing Care
Mr. Burstow: To ask the Secretary of State for Health (1) what arrangements he has made to deal with appeals against assessment decisions under his Department's free nursing care guidance; how nursing home residents will be informed of their appeal rights; and if residents will have access to advocacy services in such cases; [7389]
- (2) what steps his Department has taken to inform (a) nursing home managers and owners and (b) self- funding and part-funding nursing home residents of free nursing care schemes; and when such information was sent. [7390]
Jacqui Smith: Guidance on free nursing care in nursing homes was issued to the national health service and councils with social service responsibilities on 25 September. On the same day, organisations representing care homes were advised that the guidance had been issued. A Department of Health leaflet, "NHS
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Funded Nursing Care in Nursing Homes—What it means for you", has been issued to health authorities and councils to pass on copies to nursing home residents, their families and carers, nursing homes and general practitioner practices. A copy is also available on the Department's website at www.doh.gov.uk/jointunit/ freenursingcare. Information abut the free nursing care scheme, including some frequently asked questions, was placed on the website when draft guidance was issued for consultation in July.
Both documents refer to the opportunities for individuals to have determinations reviewed and, if necessary, that decision reviewed by a local continuing care panel on appeal. Residents will have equal access to local advocacy services and, in respect of health services, from April 2002, to the patient advocacy and liaison service. These issues can be raised by and with the national health service nurse at the time that the registered nursing care contribution is carried out.
Care Homes
Tim Loughton: To ask the Secretary of State for Health how many licensed residential homes and nursing homes in England and Wales are operated (a) privately, (b) by local authorities and (c) by voluntary organisations. [7608]
Jacqui Smith: The table shows the number of registered private, local authority staffed and voluntary residential and nursing care homes in England. Information on the number of homes in Wales is a matter for the Welsh Assembly.
| Homes registered for the provision of: | (a) Operated privately | (b) Operated by local authority | (c) Operated by voluntary organisations | Total(85) |
|---|---|---|---|---|
| Residential care | 16,530 | 2,030 | 3,950 | 22,500 |
| Nursing homes(83) | 3,550 | (86)— | (86)— | 3,550 |
| Dual registered(84) | 2,330 | (86)— | (86)— | 2,330 |
(82) Includes small homes (less than four places)
(83) General and mental nursing homes, and private hospitals and clinics. Excludes dual registered homes.
(84) Homes providing residential and nursing care.
(85) Rounded numbers.
(86) Not applicable.
Note:
Figures may not add to totals because of rounding.
Source:
Department of Health annual returns
Tim Loughton: To ask the Secretary of State for Health if he will list those local authorities which operate residential care homes in England and Wales. [7607]
Jacqui Smith: All local social services authorities in England, with the exception of the City of London, operate residential care homes. Further details on numbers of homes operated by each authority are given in the statistical bulletin entitled 'Community Care Statistics 2000, Residential Personal Social Services for Adults, England', copies of which are available in the Library and on the internet at http://www.doh.gov.uk/public/ sb0028.htm. Information on the number of homes in Wales is a matter for the Welsh Assembly.
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Health Authorities (Deficits)
Tim Loughton: To ask the Secretary of State for Health what the deficit for the 2001–02 year was as at 30 September for each health authority in England and Wales; and what deficits have been carried over from 2000–01 in each case. [7623]
Mr. Hutton: Information on the financial position of health authorities in England at 30 September will be included in returns received in late November. However, all health authorities plan to achieve financial balance in 2001–02.
Health authorities now produce their accounts on a resource basis rather than income and expenditure. The provisional annual summarised accounts for 2000–01 show only one health authority, Bexley and Greenwich, failed to achieve financial balance. The health authority merged on 1 April 2001.
Matters for Wales are the responsibility of the devolved Administration.
Out-patient Appointments
Tim Loughton: To ask the Secretary of State for Health what percentage of patients fail to keep out-patient appointments in each of the five years. [7617]
Mr. Hutton: In 2000–01, 11.4 per cent. of patients failed to keep their first out-patient appointments in England. We are tackling this by introducing booking systems throughout the national health service. By the end of 2005 all out-patient appointments and elective hospital admissions will be pre-booked, with patients agreeing the date (and time) for out-patient appointments in advance. Booking systems have been proved to reduce missed appointments significantly.
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