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David Taylor: To ask the Secretary of State for Health (1) when the outcome of the review of the quality and outcomes framework of the General Medical Services contract will be announced; and if she will make a statement; 
Mr. Byrne [holding answer 17 November 2005]: NHS Employers, working on behalf of United Kingdom health Ministers, and the British Medical Association's general practitioners committee have finalised an agreement on the general medical services contract for 200607 which includes the review of the quality and outcomes framework and an announcement will be made shortly. It would be inappropriate to pre-empt the announcement.
Mr. Burstow: To ask the Secretary of State for Health how many and what proportion of general practitoner practices in (a) England, (b) each primary care trust and (c) each strategic health authority achieved Med 5 and Med 9 of the Quality and Outcomes Framework on medicines management in 200405. 
Mr. Lansley: To ask the Secretary of State for Health (1) how many interventional radiologists have been employed by the NHS in each year since 1997; and what plans she has to expand this number; 
(2) what assessment she has made of the optimum number of interventional radiologists needed by the NHS, with specific reference to the numbers needed to fully utilise minimally invasive technologies of proven clinical and cost-effectiveness. 
Mr. Byrne: Information is not collected centrally on the number of interventional radiologists employed in the national health service. The table shows the number of hospital medical staff in the radiology group of specialties in each year since 1997.
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|Radiology Group||Clinical radiology||Nuclear medicine||Radiology Group||Clinical radiology||Nuclear medicine|
Between September 1997 and June 2005, the number of consultants in the radiology group of specialties increased by 544 or 37 per cent. Between 200203 and 200405, 166 new centrally funded specialist registrar posts were allocated. An additional 60 new posts were allocated in 200506, including posts for the new clinical radiology academies.
It is the responsibility of NHS organisations to analyse their local situation and develop plans to deliver high quality NHS services and recruit the appropriate staff required to deliver these services.
Ms Rosie Winterton: Information is not held centrally by the Department. The confidential inquiry into suicide and homicide, which is funded by the National Patient Safety Agency, has been extended to cover all sudden, unexplained deaths in psychiatric units. It will report on the use of control and restraint in due course.
From 1 January 2004, the Mental Health Act Commission, as part of its programme of monitoring vulnerable patient groups, has asked providers of acute mental health services to notify every occasion when a detained patient sustains an injury which requires medical intervention as a consequence of an incident of restraint. Findings from the notifications received and visits undertaken will be included in their next report.
The National Patient Safety Agency has developed a national reporting and learning system to promote comprehensive national learning about patient safety incidents. This includes reporting of patient safety incidents involving control and restraint. This information will facilitate feedback on identified issues.
The new annual census of mental health inpatients records incidents of restraint as well as recent injuries. The first report, which was published by the Healthcare Commission and the Mental Health Act Commission on 7 December 2005, provides information about the use of restraint in mental health settings.
Ms Rosie Winterton: No such assessment has been made by the Department. The National Institute for Health and Clinical Excellence reviewed the available evidence on physical interventions in producing its clinical guidelines on the short-term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments.
Individual authorities are required to have clear policies on the use of restraint which include provision of a review of each incident of restraint, and its application audited and reported to hospital managers. This is set out in the Code of Practice of the Mental Health Act 1983.
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One of the key objectives of the National Institute for Mental Health in England and National Patient Safety Agency project on the prevention and management of violence is to identify gaps in research in the area of recognising, preventing and managing aggression and violence. A full report will be produced in 2006.
Ms. Rosie Winterton: Best practice around the use of physical interventions for adults presenting disturbed/violent behaviour in in-patient psychiatric settings is set out in the clinical guidelines published by the National Institute for Health and Clinical Excellence in 2004. When determining which interventions to employ clinical need, safety of service users and others, and, where possible, advance directives should be taken into account. The intervention selected must be a reasonable and proportionate response to the risk posed by the service user.
The National Institute for Mental Health in England and National Patient Safety Agency project on the prevention and management of violence will publish guidance and a checklist early in 2006 to ensure that all restraint procedures meet rigorous standards. The project team is also developing proposals for the accreditation and regulation of physical intervention trainers.
Mr. Byrne: Guidance on the use of restraint is set out in the Mental Health Act Code of Practice, paragraphs 19.6 to 19.15. This states that restraint by physical means should take place only as a last resort and never as a matter of course. In addition the guidance states that any restraint used should be reasonable in the circumstance; apply the minimum force necessary to prevent harm to the patient or others; be used for only as long as is necessary; and be sensitive to gender and race issues. The advice applies in all healthcare settings and to all age ranges. Trusts should regularly audit their physical restraint procedures consistent with the framework of clinical governance and safeguarding children arrangements.
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