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NHS National Programme

Chris Grayling: To ask the Secretary of State for Health what cost-benefit analyses have been carried out as part of the initial work of the NHS National Programme projects. [127634]

Mr. Hutton: Each major project within the national programme for information technology in the national health service (NPfIT) is subject to business case approval

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process. The business cases include what conventionally can be termed cost-benefit considerations, developed with increasing detail through the life of the project and subject to review and approval at key stages.

The business cases completed and approved to date are as follows:

NHS E-mail and Directory Service—Full business case approval received 13 September 2002, contract awarded to EDS on 26 September 2002.


Electronic appointment booking—Full business case approval received 26 September 2003, contract awarded to SchlumbergerSema on 8 October 2003.

The procurement process is continuing for the remaining key elements of NPfIT and relevant business case approval will be received before proceeding through to final award of contract for the following:

Integrated care records service (includes local service providers for the geographic clusters and national application service provider for NHS Data Spine)


N3 (The New NHS Network).

National Institute for Clinical Excellence

Mr. Edwards: To ask the Secretary of State for Health what criteria the National Institute for Clinical Excellence uses to decide when to look at new treatments in between their particular class appraisals. [137575]

Ms Rosie Winterton: The work programme for the National Institute for Clinical Excellence is determined by Ministers having regard to national health service priorities and published selection criteria. These criteria are set out on the Department's website at www.doh.gov.uk/nice/consultation2002/overviewdec02. pdf

Mr. Edwards: To ask the Secretary of State for Health if he will provide the National Institute for Clinical Excellence with extra funds (a) to carry out more appraisals and (b) to issue interim guidance on new technologies during 2004. [137576]

Ms Rosie Winterton: The National Institute for Clinical Excellence has been notified of its funding for the three financial years 2003–04 to 2005–06. The funding includes provision for an additional appraisal committee to be established.

Mr. Edwards: To ask the Secretary of State for Health what guidance is being given to funders to ensure that new medical treatments that are class compatible with the National Institute for Clinical Excellence appraised treatments are not denied funding because they have become licensed in between NICE's appraisal. [137577]

Ms Rosie Winterton: In August 1999, the Department issued Health Service Circular 1999/176, which asks national health service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from the National Institute for Clinical Excellence is not available at the time the technology first became available. These arrangements should involve an assessment of all the available evidence.

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Nurses

Tim Loughton: To ask the Secretary of State for Health (1) how many learning disability specialist nurses are employed in each primary care trust; [138041]

(2) what the ratio is of specialist learning disability nurses to (a) population and (b) patients receiving such specialist care in each primary care trust area. [138042]

Mr. Hutton [holding answer 11 November 2003]: Information is not collected centrally on the number of patients receiving specialist learning disabilities care. Employment arrangements of learning disabilities nurses vary from place to place; they are employed by organisations other than primary care trusts (PCTs), which often cover several PCT areas. It is therefore not possible to show the ratio of qualified learning disability nurses to PCT populations. Information on the number of qualified learning disabilities nurses by strategic health authority and per 100,000 population has been placed in the Library.

Older People (Services)

Mr. Burstow: To ask the Secretary of State for Health if he will publish the definition of a stroke unit in relation to the milestones within the National Service Framework for Older People. [138180]

Dr. Ladyman: The formal definition of a stroke unit is still being developed. We would expect, however, that there would be a consultant physician with specialist knowledge of stroke formally recognised as having principal responsibility for stroke services. This consultant would be supported by a multi-disciplinary team who are specialists in stroke care.

Overseas Treatment Scheme

Mr. Brazier: To ask the Secretary of State for Health pursuant to his answer of 9 June 2003, Official Report, column 692W, on overseas treatment, how many further operations have been carried out abroad under the NHS overseas treatment scheme; whether he is now in possession of information on the clinical outcomes of these operations; and what proportion of them resulted in medical complications. [136944]

Mr. Hutton: Since 9 June 2003, no patients have been treated in France as part of the overseas treatment programme. The total number of patients treated in France is 275. The total number of patients treated abroad, including the pilot project, is 588.

The Department does not routinely collect information about the post-operative complication rates arising after surgery for patients treated abroad.

National health service organisations may collect and analyse this kind of information, among other indicators of quality, as part of their local clinical governance arrangements designed to assure and continuously improve the quality of care for all NHS patients. The NHS is responsible for ensuring that NHS patients receive high clinical standards of care wherever they are treated. From November 2003, where orthopaedic patients are treated abroad, there is support and agreement to register these patients on the United Kingdom National Joint Registry.

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East Kent Hospitals NHS Trust local audit committee, commissioned by the overseas commissioners, is undertaking a comparative audit of outcomes against patients treated by local consultants. When completed, East Kent Hospitals NHS Trust will hold this information.

Patient Forums

Mr. Colman: To ask the Secretary of State for Health how many of the proposed statutory patient and public involvement forums in England are served by local network providers who are insolvent. [137199]

Ms Rosie Winterton: No local network provider contracted to support patients' forums is insolvent.

One organisation involved in a joint contract, The College of Health, has recently become insolvent. However, the Council of Ethnic Minority Voluntary Organisations, which was a joint contractor with the College of Health to provide staff support, is now contracted solely to provide the support to the patients' forums previously covered under the joint contract.

Bob Russell: To ask the Secretary of State for Health who will determine which applicants will be selected to serve on each patient and public involvement forum. [137484]

Ms Rosie Winterton: The Commission for Patient and Public Involvement in Health is responsible for appointing members of patients' forums. Regional managers or delegated members of staff lead the selection decision for each potential patients' forum member. The decision is made against nationally uniform selection criteria, supported by an appeals procedure.

Bob Russell: To ask the Secretary of State for Health how many applications have been received for each patient and public involvement forum. [137485]

Ms Rosie Winterton: Information for individual patients' forums is not available. The national figure for applications for membership of patients' forums is 3,793 at 11 November 2003, which represents over 90 per cent. of the target for the first tranche of recruitment.

Mr. Austin Mitchell: To ask the Secretary of State for Health what steps he has taken to ensure that (a) organisations given contracts to organise patients' forums and (b) the members of patients' forums (i) have experience in patient advocacy, (ii) have knowledge of the working practices of the NHS and (iii) live in the local community. [135632]

Ms Rosie Winterton: People from all walks of life are encouraged to join patients' forums, bringing with them a diversity of experience and views. The majority of members of a forum must be people for whom services are being or have been provided by the relevant national health service trust or relevant primary care trust (PCT) and, in the case of PCTs' patients' forums, are living in the area where the service is provided. A general understanding of the NHS by members is desirable. More important is to find individuals who have a real interest in improving services and a commitment to represent the views of the community served by the trust or PCT.

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Local network providers were identified using a competitive tendering programme and were awarded contracts on the basis of their ability to provide effective support at a community level, not where they were located.

It is not the role of patients' forums or local network providers to provide patient advocacy. Under the new system this is given by patient advice and liaison services and independent complaints advocacy services.

Mr. Austin Mitchell: To ask the Secretary of State for Health how many patient forums are in place; and how many members have been appointed. [135633]

Ms Rosie Winterton: The programme of recruitment to the patients' forums is still under way. We understand the national and local advertising campaigns have elicited a large number of applications, which are currently being processed by the Commission for Patient and Public Involvement in Health (CPPIH). The CPPIH is on track for achieving full forum coverage by 1 December.

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