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Mr. Burstow: To ask the Secretary of State for Health what assessment he has made of the impact on professional body journals of the introduction of NHS e-recruitment of allied health professions. [186271]

Mr. Hutton: The Department has had regular meetings with representatives from the healthcare professions to discuss the national health service e-recruitment project and will continue to work with them. In addition, the Department of Health and the Department of Trade and Industry are working with members of the Periodical Publishers Association to share information about the development of the service, assess its impact and explore ways in which the service and the health journals can work together to support cost effective recruitment into the NHS.

Mr. Burstow: To ask the Secretary of State for Health what arrangements his Department has made to ensure that non-NHS employers will have access to e-recruitment for allied health professionals. [186272]

Mr. Hutton: The first phase of the e-recruitment service for the national health service is to extend the service to NHS employers. When the service has bedded in there will be an opportunity to consider extending the service to other employers and organisations.

Mr. Burstow: To ask the Secretary of State for Health what plans he has to monitor the implementation of NHS e-recruitment in respect of NHS trusts spending on hard copy advertisements. [186273]

Mr. Hutton: National health service employers joining the e-recruitment service are asked to report annually on their spend in hard copy advertisements and how savings are being reallocated to direct patient care.

Fall/Osteoporosis Services

Sandra Gidley: To ask the Secretary of State for Health what discussions (a) he and (b) his officials have had with primary care trusts with regard to the integration of falls and osteoporosis services. [181437]

Dr. Ladyman: In the development of support for local action on putting in place integrated falls services officials have had continued interaction with colleagues within primary care trusts and councils. This has included involvement in the development of the national service framework for older people, published in 2001, which contains a service model for an integrated falls
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service, including appropriate links to osteoporosis, and of supporting information on service development and good practice.

The national primary care development team's healthy communities collaborative on falls and the falls collaborative have also provided opportunities for primary care trusts and departmental officials to come together to consider these issues.

Mr. Burstow: To ask the Secretary of State for Health what osteoporosis-specific activities his Department is engaged with; and which relate particularly to osteoporosis sufferers who have not fallen. [182734]

Dr. Ladyman: Local health trusts are taking measures to reduce the risk of fracture by indentying individuals at risk and ensuring appropriate interventions. This is supported by the work of the National Institute for Clinical Excellence (NICE), which is currently undertaking a technology appraisal looking at five osteoporosis durgs. The Department has also asked NICE to produce a clinical guideline on the assessment of risk fracture and prevention of osteoporotic fractures in individuals at high risk. The guideline will refer to, update and extend the evidence base of previously published guidelines and technology appraisals and those currently under development. Work on the clinical guideline is underway and expected to be published in 2005.


Mr. Brady: To ask the Secretary of State for Health (1) what peer review has been undertaken of the Newcastle University report "Bioavailability of fluoride in drinking water—a human experimental study", funded by his Department; [185052]

(2) where he expects the Newcastle University report funded by his Department, "Bioavailability of fluoride in drinking water—a human experimental study", to be published. [185053]

Miss Melanie Johnson: A draft of the final report was submitted for peer review to five eminent academic experts in this field at universities in Sweden, the United States, London, Sheffield and Leicester. In addition, Professor Andy Renwick of the University of Southampton provided advice on the project and on the draft report as an independent member of the Department's steering group. All of these comments were provided to the Newcastle team to help with its preparation of the final report. The university has put the report on its website at

I understand that the researchers plan to submit an article about their findings to an academic journal.

Foundation Trusts

Kate Hoey: To ask the Secretary of State for Health what the average turnout of (a) public voters and (b) patient voters has been in elections for boards of foundation trust hospitals. [185640]

Mr. Hutton [holding answer 21 July 2004]: I am informed by the chairman of the independent regulator that, in respect of the first 20 national health service
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foundation trusts authorised to date, the average turnout in elections of public voters and patient voters was 52 per cent. and 27 per cent. respectively.

General Practitioners (Out-of-hours Service)

Alan Simpson: To ask the Secretary of State for Health what comparative assessment he has made of the impact on hospital emergency services of (a) out-of-hours service cover by general practitioners in (i) Sheffield and (ii) other areas which have chosen not to use an arm's length service provider and (b) the cover provided in (A) Nottingham and (B) other areas using arm's length providers. [184969]

Mr. Hutton: No central comparison has been made of the impact of out-of-hours services on emergency services of areas where general practitioners have not opted-out and areas where organised providers, such as GP co-ops, have been commissioned by primary care trusts (PCTs) to provide the service.

As recommended by the independent review of GP out-of-hours services, PCTs should be developing integrated networks of unscheduled care, which bring together accident and emergency, ambulance services, walk-in centres and in-hours services, to meet the full range of patient needs and to reduce unnecessary referrals to emergency services.

There is to be no change to the pattern of provision for 80 per cent. of Nottingham residents already served by the GP co-operative, Nottingham Emergency Medical Services (NEMS) and which have been so for six years. NEMS is an active participant of the local emergency care network and no adverse impact on emergency care has been identified locally.

Alan Simpson: To ask the Secretary of State for Health what steps he is taking to encourage general practitioners to ensure that out-of-hours cover services are supported by appropriate access to patient records and history. [184970]

Mr. Hutton: The national quality standards, which all providers of out-of-hours services must meet, include specific requirements that there is rapid and effective transmission of patient data between general practitioner practices and out-of-hours services, a system for transmitting information on patients with special needs from the practice to the provider, and all providers must be able to supply full clinical details of all consultations to the patient's GP practice by the next working day.

This will be further improved through the introduction of the electronic patient record. In Nottingham local providers and practices are establishing systems for sharing patient information. Nottingham Emergency Medical Services, in partnership with the local emergency care network and NHS Direct, has already established a database of important information provided by GPs on the most vulnerable members of their practice population. This is being extended and access to this is being enabled for other emergency care providers.

Alan Simpson: To ask the Secretary of State for Health what comparative assessment he has (a) made and (b) commissioned of patient safety under
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(i) National Emergency Medical Services cover and (ii) general practitioners running their own out-of-hours service. [184974]

Mr. Hutton: All organised out-of-hours providers must meet the national quality standards. The standards, which cover clinical governance, organisational and service standards, and access and clinical assessment, are designed to ensure that patients receive the highest-quality care, and were recommended by the independent review of general practitioner out-of-hours services in 2000.

The national quality standards are currently being reviewed by an expert group, to reflect the new contractual mechanisms in primary care. The new standards will come into effect on 1 January 2005 and from this date all providers of out-of-hours services, including GP practices which choose not to opt-out, will have to meet the quality standards as a contractual obligation.

Primary care trusts (PCTs) will monitor all providers in the delivery of their services to ensure they meet the standards and the strategic health authorities in turn will performance manage the PCTs in delivering these services.

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