Further letter from the Parliamentary
Clerk to the Clerk of the Committee (PE 2)
HEALTH SELECT COMMITTEE PUBLIC EXPENDITURE
INQUIRY 2002 FOLLOW-UP INFORMATION
I promised you further information relating
to items 6 and 13, where we had originally said that the information,
although not available now, would be available shortly.
Attached is a response to both these points:
Item 6: An assessment of the cost of agency
nurses to the hospital sector as a whole—to be drawn from
annual accounts when ready.
The information requested is contained in the
table below.
Non-NHS Nursing, Midwifery and Health
Visiting Staff: England 1997/98 to 2001/02
| Year | NHS Trust
Expenditure
| Health Authority
Expenditure
| Primary Care Trust
Expenditure
| Total Expenditure |
| | £
| £ | £
| £ |
| 1997/98 | 216,260,884
| 77,683 | n/a
| 216,338,567 |
| 1998/99 | 272,024,211
| 200,951 | n/a
| 272,225,162 |
| 1999/00 | 360,459,424
| 1,197,259 | n/a
| 361,656,683 |
| 2000/01 | 432,914,315
| 1,631,700 | 885,867
| 435,431,882 |
| 2001/02 | 521,020,359
| 880,295 | 23,930,773
| 545,831,427 |
| Source: | 1. Annual financial returns of NHS trusts, 1997/98 to 2001/02
|
| 2. Annual financial returns of health authorities, 1997/98 to 2001/02
|
| 3. Annual financial returns of primary care trusts, 2000/01 and 2001102
|
| Note: | 1. There is one financial return for an NHS trust outstanding for 2000/01
|
| 2. All data for 2001/02 are provisional
|
Item 13: Check on whether information is centrally held
on mothers-to-be choosing to have caesarean sections.
We do not hold that information. The Maternity Hospital Episode
System (HES) collects the recorded delivery method of women. For
caesareans can be either "elective caesarean" or "emergency
caesarean". "Elective" is recorded if the caesarean
was planned in advance whether it was at the woman's request or
on the advice of her consultant.
However, the Department commissioned the biggest ever National
Sentinel Caesarean Section Audit. The Audit was undertaken by
the RCOG, in collaboration with the RCM; Royal College of Anaesthetists
and National Childbirth Trust (NCT). A Report of the findings
from the Audit was published by the RCOG on 26 October 2001.
The aim of this multi-disciplinary audit was to relate CS
rates to specific underlying patient characteristics, in order
to help develop standardised CS rates for particular patient groups.
This will eventually lead to a more informed approach to determine
what an appropriate CS rate might be for any particular maternity
unit. The results of the audit have been referred to the National
Institute for Clinical Excellence to develop clinical guidelines
on the use of caesarean sections. In addition the Department will
use the findings in the audit to develop the Children's National
Service Framework which include maternity services.
Table 4.10.2
I have also been asked to pass on a point of clarification
in respect of the written evidence that relates to table 4.10.2
in our written evidence. You might wish to add this:
"Table 4.10.2 shows the number of clients aged 18 and
over receiving community based services as part of a care package
following assessment by a Council with Social Services responsibilities
(CSSR). The components of a care package can vary, and may include
any combination of services provided at a client's home or long
and short term residential and nursing care of various kinds,
including LA and independent sector residential care and nursing
home provision. In table 4.10.2 the figure of 1,567,000 relates
to the grand total of clients receiving any service at all in
2000-01, following assessment.
"An alternative definition is the number of people who
receive community based services—that is, services provided
to support people living in the community, or support their carers,
including short term residential care. On this latter basis, the
number of clients receiving community based services whether or
not in combination with long term residential or nursing care
provision is 1,330,000.
"The two figures of 1,567,000 and 1,300,000 are shown
explicitly in Table Pl.1 (page 70) of the Referrals, Assessments
and Packages of Care for Adults Report, December 2001 (in respect
of 2000-01)."
21 November 2002
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