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Mr. Graham Stuart: To ask the Secretary of State for Health how many people in the Hull and East Yorkshire Hospital NHS Trust area had their appointments cancelled by the trust (a) once, (b) twice, (c) three and (d) more than three times in the last five years; and if she will make a statement. 
Mr. Andrew Turner: To ask the Secretary of State for Health what the average waiting time was for an appointment with the child and adolescent mental health service in each primary care trust area in 2005-06. 
Mr. Ivan Lewis [holding answer 22 May 2006]: The requested information is not collected centrally. The child and adolescent mental health service (CAMHS) mapping exercise for 2004 found that just over 50 per cent. of new cases were seen within four weeks, an improvement on the 24 per cent. of new cases in 2002. Similarly, the number of cases waiting over 13 weeks has reduced from just over 50 per cent. to just over 30 per cent.
Mrs. Dorries: To ask the Secretary of State for Health what steps the Government are taking to improve the provision and quality of care in children's wards in England; and if she will make a statement. 
Mr. Ivan Lewis: The national service framework (NSF) for children, young people and maternity services, copies of which are available in the Library, includes a standard on hospital care for children. We expect all hospitals providing services to children to implement these standards, and to consider good practice examples included in the Department's database of emerging practice.
The Healthcare Commission, which is required to pay particular attention to the need to safeguard and promote the rights and welfare of children and the effectiveness of measures taken to do so, is currently concluding an improvement review to assess the quality of healthcare for children in hospital, based on elements of the NSF hospital standard. The NSF is available on the Department's website at www.dh.gov.uk/childrensnsf/.
Kerry McCarthy: To ask the Secretary of State for Health if she will revise the minimum requirement for care homes and nursing homes to have one announced and one unannounced visit by the Commission for Social Care Inspection per year, so as to require all visits to be unannounced; and if she will make a statement. 
Mr. Ivan Lewis: On 2 March 2006, my hon. Friend the Member for Birmingham, Hodge Hill (Mr. Byrne) announced changes, effective from 1 April 2006, to the Commission for Social Care Inspection (Fees and Frequency of Inspections) Regulations, which govern inspections by the Commission for Social Care Inspection (CSCI).
The new regulations permit the CSCI to inspect any adult social care service at any time, as long as every service is inspected at least once in three years. In the past, CSCI was required to inspect adult services at least twice a year (less frequently for some services). The changes will enable CSCI to work more efficiently, by focusing its efforts on services that need attention, while a small number of the very best adult services will notice a longer period between their inspections. There will be more unannounced inspections and more focus on the experiences of people using the services.
Mr. Andrew Turner: To ask the Secretary of State for Health if she will list the responsibilities which her Department has lost since 1997; what the (a) date and (b) destination Department was in each case; what responsibilities the Department has taken on since 1997; and what the (i) date and (ii) source Department was in each case. 
Mr. Ivan Lewis [holding answer 15 May 2006]: Ministerial responsibilities are set out in the List of Ministerial Responsibilities, which is updated regularly. A revised version will be published shortly. Copies of previous versions are available in the Library.
Mrs. Curtis-Thomas: To ask the Secretary of State for Health what the (a) maximum and (b) average amount of time was that a person with a disability had
to wait to be assessed for assistance from social services in Sefton in the last two years. 
Mr. Ivan Lewis: I understand from the Chair of the Commission for Social Care Inspection that, as at 23 March 2006, the latest available figures, the number of care homes registered for older people with mental illness was 1,752.
Mr. Harper: To ask the Secretary of State for Health whether the NHS provides (a) treatment and (b) resources specifically for ex-service personnel following injury or illness while serving in the armed forces. 
Caroline Flint [ holding answer 27 February 2006]: The national health service is responsible for the medical care of ex-service personnel, provided the individual is entitled to residency in the United Kingdom, on the same basis as any other member of the public.
Guidance issued by the Department in 2004 states that for those leaving the armed services with significant or debilitating illness or injury, the Ministry of Defence (MOD) should engage with the relevant primary care trust to ensure a seamless transfer of care between that managed by the MOD and that to be provided by the NHS.
Ms Abbott: To ask the Secretary of State for Health how many general practitioner surgeries in (a) England and (b) Hackney, North and Stoke Newington are operating appointment booking systems by which appointments may only be booked a certain maximum time in advance. 
Mr. Ivan Lewis: The Department is continuing to work with strategic health authorities to get primary care trusts (PCTs) to ensure their general practices offer patients flexible as well as fast access.
In support of this aim, the Department collects information each month from PCTs on the
appointment arrangements operated by their practices. In April 2006, there were 20 practices nationally whose PCTs reported that they do not allow patients to book more than two days in advance. A further 126 practices did not have any appointment system in place.
Hackney, North and Stoke Newington is served by City and Hackney PCT and Haringey PCT. The former reported one practice and the latter two practices without appointment systems. Otherwise, both PCTs reported that their practices allow patients to book ahead.
A new independent national patient experience survey will be introduced in 2006-07 which will incentivise practices making accessing a general practitioner easier, with rewards linked directly with patients' experiences of how their practice is improving.
Caroline Flint [holding answer 17 May 2006]: The Departments aim is to ensure that all patients can be assured of high quality, responsive and consistent out-of-hours service wherever they live. We have put in place quality requirements, which set minimum standards for the delivery of out-of-hours care. Primary care trusts and strategic health authorities are responsible for assessing the performance of out-of-hours providers against the quality requirements. The requirements are available at the Departments website at www.dh.gov.uk/outofhours.
The National Audit Office (NAO) report The Provision of Out-of-Hours care in England published on 5 May found that 80 per cent. of patients were satisfied with the services provided but that there was room for improvement. We are working with the NAO to bring performance of all primary care trusts up to the levels of the best.
Andrew George [ holding answer 15 May 2006]:To ask the Secretary of State for Health pursuant to the answer of 8 May 2006, Official Report, columns 63-64W on hospital appointments, what other systems send messages through the care record spine; how the costs associated with the spine are accounted for; and what the (a) set-up costs and (b) annual running costs of the spine are. 
Caroline Flint: The spine is the colloquial name given to the national database of key information about patients health and care. It forms the core of the national health service care records service. It also supports other key programmes of the national programme for information technology, such as choose and book the electronic prescriptions service (EPS), and general practitioner (GP) to GP record transfer, each of them using the spines messaging capabilities as part of their own services.
Choose and book daily registers in excess of 150,000 message transactions from almost 36,000 referring
clinicians, and over 360,000 bookings have been made to date. Nearly 1.2 million prescriptions have already been processed through EPS. Almost 400 general practices are currently generating electronic prescription messages and over 800 general practices have had their systems upgraded in preparation for going live. About 1,500 pharmacies have now had their systems upgraded to enable them to receive electronic prescription messages.
personal demographics service (PDS), which holds nationally demographic information for every patient covered by the NHS in England, accessible through local systems, and is currently processing message transactions at a rate of over nine million per month;
spine directory services, which holds reference data such as users and locations. 220,000 users are now registered; almost 45,000 currently access the system on any given day;
access control framework, which registers and authenticates users, including patients, and provides a single log-in and a record of each professional accessing a NHS care record;
transaction messaging system, which processes and routes data messages, for example, from a GP to a hospital or from one GP to another.
secondary uses service (SUS), providing the NHS with high quality data to enable investigation of trends and emerging health needs which can inform public health policy. The data extracted will provide information to support performance improvement and assessment, clinical audit and governance, monitoring and benchmarking, surveillance, research and planning;
personal spine information service (PSIS), providing personal health information for a patient, for example, drug allergies, details of operations and/or conditions, medication history, pathology, radiology and other results, as well as a summary of contacts with care providers;
clinical spine application (CSA), allowing patient information on the spine to be viewed on a personal computer; users will be able to view and update patient information.
The first stage of SUS went live in June 2005 to support payment by results, and is already processing around half a million message transactions a month. PSIS and CSA are due for piloting in 2007, with rollout expected in early 2008.
Picture archiving and communications (PACS) implementations in 2007 include plans to integrate to elements of the spine such as PDS. Currently there are 31 live national programme PACS systems, with over 27 million images stored.
A total of 5,647 GP systems, 253 pharmacy systems, and over 100 patient administrations systems are currently linked to and regularly using the spine. These systems have already achieved compliance, and around 70 or so systems are in test at various development stages across the programme. Interface standards are made available to all suppliers, as well as published more widely. The standards have been developed to reflect internationally-recognised standards, and in conjunction with the programmes major suppliers.
Costs associated with the spine are accounted for by the NHS Connecting for Health agency of the
Department which is responsible for delivering the programme and for managing programme contracts. Set-up (capital) costs are incurred in phases as functionality is added to the spine through staged software releases over the implementation period. They are expected to total £335 million on completion. The ongoing service (revenue) costs average around£45 million a year, although this falls in a range between £30 to £60 million in any particular year. These sums are in line with the contracted value of the work concerned, and represent an investment of roughly one pound per NHS patient per year over the life of the contract.
Mr. Ivan Lewis: Value for money has been ensured by running a robust and competitive procurement process, and by benchmarking procedure prices between contracts and comparing them with the national health service equivalent cost and the prices paid by the NHS to the independent sector under spot purchase arrangements.
The National Centre for Health Outcomes Development (NCHOD) published a preliminary report on four independent sector treatment centre schemes in October 2005. The NCHOD audit is based on some of the 26 key performance indicators that independent sector providers are contractually obliged to collect in order to monitor clinical quality, patient experience, and productivity of services. The preliminary report is available at the NCHOD's website at www.nchod.nhs.uk. A further report is expected later this year, In addition, as announced by the Secretary of State on 26 April, the Healthcare Commission will be undertaking an audit of independent sector treatment centres.
Mr. Maude: To ask the Secretary of State for Health what the (a) complication and (b) failure rates are for orthopaedic operations at (i) each independent treatment centre (ITC) and (ii) the NHS hospital closest to each ITC. 
Mr. Ivan Lewis: We are in the process of a commercial procurement being conducted according to European Union procurement law, and as such we cannot release the value of individual schemes as they
are commercially sensitive. The total value of activities procured in phase two is expected to be £550 million.
Northumberland, Tyne and Wear;
Cumbria and Lancashire (two schemes);
Cheshire and Merseyside;
West Midland South;
Avon, Gloucestershire and Wiltshire;
Greater Manchester (two schemes);
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