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5 Jun 2006 : Column 383W—continued


We are still considering what marketing or advertising activity may be required for this year.

Justine Greening: To ask the Secretary of State for Health what discussions her Department has had with strategic health authorities regarding local nursing levels and recruitment requirements for nursing staff in the next 12 months; and if she will make a statement. [75152]

Ms Rosie Winterton: Nursing levels and recruitment requirements are matters for local determination.

Projected levels of demand for and supply of nurses at a strategic health authority (SHA) level form part of their local delivery plan (LDP).

The content of and performance against the LDP are issues discussed between SHA and the Department.

Justine Greening: To ask the Secretary of State for Health how many of those enrolled on pre-registration nursing courses completed their course successfully in each year since 2001-02; how many of those had found a nursing position within six months of successful completion of their course; and if she will make a statement. [75158]

Ms Rosie Winterton: The information requested is not collected centrally.

The Higher Education Statistics Agency (www.hesa.ac.uk) has partial data for students completing training in 2003-04.

The Nursing and Midwifery Council records the number of students who completed training in England and registered to practice. It does not record whether those nurses took up employment in the national health service.

Opiate-based Medicines

Patrick Mercer: To ask the Secretary of State for Health how many opiate-based medicinal products are manufactured in the UK. [74191]


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Andy Burnham: There are 16 different types of opiate-based medicinal products manufactured in the United Kingdom. The 16 different drug substances are licensed under approximately 264 individual marketing authorisations for various product strengths and formulations and to various marketing authorisation holders.

Orthodontic Services

Mr. Sheerman: To ask the Secretary of State for Health what steps her Department is taking (a) to ensure adequate orthodontic services and (b) to increase the number of orthodontists. [70306]

Ms Rosie Winterton: On 1 April 2006, primary care trusts were given the responsibility for commissioning and developing primary care dental services, including orthodontic services, in their area to reflect the needs of the local population.

At the same time, a new framework for orthodontic treatment was introduced. This is designed to ensure that assessment of need for orthodontic treatment is carried out more fairly and consistently in order to make the best use of available resources. The national health service invests around £150 million annually in primary care orthodontic services and it is important to ensure that these resources are used as effectively as possible to meet the needs of children and other orthodontic patients.

PFI Repayments

Harry Cohen: To ask the Secretary of State for Health what the cost of private finance initiative repayments was for each health trust in each of the last five years was; and what that is as a percentage of the trust's annual income excluding land sales in each year. [66777]

Andy Burnham: Details of unitary payments for each private finance initiative scheme which has become operational and what percentage these payments are against trust's annual turnover over the last five years have been placed in the Library.

Detailed information on land sales is not collected centrally.

Prescription Drug Costs

Stephen Williams: To ask the Secretary of State for Health what estimate her Department has made of the cost of prescription drugs that were returned unused and unopened in each of the last five years, broken down by primary care trust. [74529]

Andy Burnham: The annual cost of prescription drugs that are returned unused and unopened is not held centrally by the Department.

It has been previously estimated that unused medicines returned to pharmacies are probably worth £100 million per year.


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The statistical bulletin “General Pharmaceutical Services in England and Wales 1995-96 to 2004-05”, which is available on the Information Centre for health and social care's website at www.ic.nhs.uk/pubs/genphmsvcengwaldecade05, provides details of the weight of unwanted medicines collected and disposed of through community pharmacies, listed by primary care trust. Pharmacies do not separate out unused and unopened medicines from those that have been partially used.

Prostate Acid Phosphatase Test

Mr. Gregory Campbell: To ask the Secretary of State for Health what research she has evaluated on the accuracy of the prostate acid phosphatase test. [74414]

Andy Burnham: There has been no central or local national health service research activity concerned with the prostate acid phosphatase test. This test was largely superseded by the test for prostate specific antigen (PSA) some years ago.

Reconstituted Milk

Steve Webb: To ask the Secretary of State for Health what assessment she has made of the health implications for infants drinking reconstituted milk made from milk powder and fluoridated water; and if she will make a statement. [64186]

Ms Rosie Winterton: Research evidence shows, that apart from the benefits to oral health, the only negative effect of adding fluoride to drinking water to a level of one part per million is on the incidence of dental fluorosis. In 2003, the independent expert advisory committee on toxicity of chemicals in food, consumer products and the environment (COT), issued a report "Fluorine in the 1997 Total Diet Study", which noted that fluoride intakes of formula-fed infants may exceed the

for dental fluorosis. However, COT concluded that infants are at lesser risk of dental fluorosis than older children because the critical time for development of aesthetically significant dental fluorosis is during formation of the permanent teeth at age three to four. COT went on to recommend that more research is needed to determine the impact of the cosmetic effect of dental fluorosis on the affected individual and on any possible long-term health outcomes in people affected by dental fluorosis.

The Department is committed to a research programme to strengthen the evidence base on the fluoridation of water and we will be considering how research on dental fluorosis can be incorporated into this programme.

Royal Surrey Hospital

Sir Paul Beresford: To ask the Secretary of State for Health if, following the further recommendation of the Epsom and St. Helier NHS Hospital Trust on the St. Helier site, if she will request that the trust revises its decision (a) following a consultation with the
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residents of Mole Valley and Esher and Walton constituencies and (b) taking into account the proposed removal of accident and emergency services at the Royal Surrey Hospital at Guildford. [74463]

Caroline Flint: The Department has received the response from the local national health service on St. Helier and is currently considering the situation. We are aware that Surrey and Sussex have commenced discussions with stakeholders on the “Fit for the Future” review. It would be inappropriate to comment further on this.

Shrewsbury and Telford Hospitals Trust

Mr. Stephen O'Brien: To ask the Secretary of State for Health what levels of (a) debt and (b) deficit the Shrewsbury and Telford hospitals trust inherited from its predecessors at its inception; and whether these amounts were paid by her Department. [71602]

Ms Rosie Winterton: Shropshire and Staffordshire strategic health authority reports that at the time that Shrewsbury and Telford hospital national health service trust was established in October 2003, the historical deficit of the Royal Shrewsbury hospital NHS trust and the Princess Royal hospital NHS trust was in the region of £4.1 million.

When an NHS trust is newly established it may inherit the net assets and liabilities of any predecessor organisations; consequently it is required to manage the financial challenges that may arise from this.

Shropshire Ambulance Service

Daniel Kawczynski: To ask the Secretary of State for Health whether the Shropshire Ambulance Service will be merged into a West Midlands Ambulance Service within 24 months; and if she will make a statement. [74413]

Ms Rosie Winterton: Shropshire Ambulance Service has been part of the current West Midlands Ambulance Service National Health Service Trust since April 2001. Three of the four ambulance trusts in the West Midlands region, West Midlands, Coventry and Warwickshire, and Hereford and Worcester, will form a single trust on 1 July 2006. Staffordshire Ambulance Service NHS Trust will remain separate, working in partnership with the new West Midlands Ambulance Service NHS Trust, but will merge with it at a later date.

Skin Cancer

Mr. Baron: To ask the Secretary of State for Health what steps she is taking to monitor the extent to which National Institute for Health and Clinical Excellence guidance on the use of photodynamic therapy for skin cancer patients is being followed. [72169]

Ms Rosie Winterton: In February 2006 as part of its programme of work on interventional procedures, the National Institute for Health and Clinical Excellence (NICE) issued guidance on the use of photodynamic therapy in the treatment of non-melanoma skin tumours.

The need for healthcare organisations to protect patients by following NICE interventional procedures guidance is a core standard as set out in “National Standards,
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Local Actions”. The Healthcare Commission has responsibility for determining whether core standards have been met.

Tees, Esk and Wear Valleys NHS Trust

Mr. Kevan Jones: To ask the Secretary of State for Health what the cost of recruiting staff for the Tees, Esk and Wear Valleys NHS Trust has been; and what total pension liabilities resulted from setting up the trust. [71257]

Ms Rosie Winterton: The County Durham and Tees Valley Strategic Health Authority reports that the trust has not recruited any staff as a specific result of the creation of the new organisation. The Tees, Esk and Wear Valleys National Health Service Trust has continued to recruit clinical staff to meet the needs of local people, but nothing more has been spent on this recruitment process than its two predecessor trusts would have spent recruiting to the same clinical posts.

Mr. Kevan Jones: To ask the Secretary of State for Health how many job reductions were made in the setting up of the Tees, Esk and Wear Valleys NHS Trust in the local health economy; and what the cost of redundancy payments has been. [71258]

Ms Rosie Winterton: The County Durham and Tees Valley Strategic Health Authority reports that currently only one chief executive has been made redundant. As a single trust board and executive team structure is implemented there will be further managerial redundancies. The final cost of these redundancies will be available in the final accounts for the trust.

Mr. Kevan Jones: To ask the Secretary of State for Health (1) what the total cost was of setting up the Tees, Esk and Wear Valleys NHS Trust; what proportion of this total was accounted for by cost overruns; and if she will list the cost overruns involved; [71259]

(2) how much was spent providing new (a) signs and (b) stationery for Tees, Esk and Wear Valleys NHS Trust; [71261]

(3) what the total costs were of re-branding in setting up the Tees, Esk and Wear Valleys NHS Trust. [71262]

Ms Rosie Winterton: This information is not held centrally but can be obtained from the Tees, Esk and Wear Valleys National Health Service Trust.

Mr. Kevan Jones: To ask the Secretary of State for Health what consultations were undertaken with (a) hon. Members, (b) the public and (c) local councillors about the naming of the Tees, Esk and Wear Valleys NHS Trust. [71263]

Ms Rosie Winterton: The County Durham and Tees Valleys Strategic Health Authority confirms that approximately 50 representatives of service users and carer groups across County Durham, the Tees Valleys and North East Yorkshire attended a consultation meeting at which the name of the new trust was discussed. The most popular option was to use the river theme.

All staff in the trusts were also invited to vote on the options, with the majority in favour of Tees Valleys and North East Yorkshire National Health Service Trust.


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Local authority representatives, including County Durham council and Darlington borough council were members of the project board and were fully involved in the discussions about the name.

Trafford Surgical Centre

Tony Lloyd: To ask the Secretary of State for Health what measures of performance she collects for the Trafford Surgical Centre in Greater Manchester. [70435]

Ms Rosie Winterton: Activity data are collected from independent sector treatment centre providers to assess contract utilisation. Data are also collected on the 26 key performance indicators shown in the following table. These monitor clinical quality, patient experience and productivity of services. Data collection takes place on a monthly basis.


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Description of KPIs on ISTC Wave 1 Schemes
KPI Description

KPI 1

Incidence of in-patient and/or day case activities not commenced because of DMAs as percentage of all activities

KPI 2

Procedures cancelled by the provider for non-clinical reasons on or after day of admission. For the purposes of the performance threshold, it is measured as a percentage of all patients admitted to the facility.

KPI 3

Procedures cancelled by provider for clinical reasons on or after day of admission. For the performance threshold, this is measured as a percentage of all patients admitted in the facility.

KPI 4

Patient returning to operating theatre for procedure which was unforeseen at the time the patient’s previous procedure was completed as a percentage of all patients admitted in the facility.

KPI 5

In relation to each (HRG), the conversion rate i.e. the percentage of patients who go on to be given a patient appointment for a procedure following an out-patient assessment.

KPI 6

In respect of (the)(each) facility, the rate of rejection by the provider in respect of patients referred within the referral protocol (schedule 3) as a percentage of all patients who are referred in the contracted month.

KPI 7

For day cases, in-patient admission to the facility or to other providers’ facilities (including NHS providers) which was unforeseen at the time of admission. For the purposes of the performance, threshold is measured as a percentage of all day cases in the facility.

KPI 8

Transfers of any patient for treatment which was not in the management plan for that patient upon admission to the facility. For the purposes of the performance, threshold is a percentage of all in-patients in the facility by HRG.

KPI 9

Emergency admissions/re-admissions of patients who have received in-patient treatment and have been discharged within 28 days of such discharge where such admission or re-admission is related to or arising from the relevant in-patient treatment, for the purposes of the performance threshold measured by HRG as a percentage of all patients discharged.

KPI 10

Average length of stay in hours and minutes for day cases by HRG, measured from the time of admission to the time of discharge.

KPI 11

Average length of stay by HRG measured in in-patient whole days measured from the time of admission to the time of discharge.

KPI 12

Average procedure time, collected in minutes, by HRG, and specifying surgery where local anaesthetic surgery is used and where general anaesthetic surgery is used, broken down by: induction time on operating table recovery measured from ( ) to ( )

KPI 13

Patient receives or is listed or recommended for a further procedure to put right any aspect of the original activity less than five years from the date of discharge. For the purposes of performance threshold, measured as a percentage of all procedures carried out at the facility.

KPI 14

Numbers of procedures carried out under local anaesthetic and general anaesthetic by HRG as a percentage of all procedures.

KPI 15

Clinical outcomes specified by procedure, by reference to the Patient Care Pathways.

KPI 16

Timeliness, completeness and accuracy of provider performance data provided to the joint service review and/or to sponsor, recorded as the number of complaints in any reporting period.

KPI 17

Timeliness, completeness and accuracy of provider clinician reporting to referring health body’s clinician recorded as the number of complaints in any reporting month.

KPI 18

Patient/customer satisfaction (by survey) based on a survey of 10 per cent. of all patients at each facility in each (contract month)

KPI 19

Rate of patient complaints i.e. number of complaints received as a percentage of all patients referred for: (i) out-patient treatment (ii) day case treatment (iii) in-patient treatment

KPI 20

Patient complaints handling: complaints not handled within relevant time scales set out in the contract.

KPI 21

Incidents which are reportable to the NPSA, or other statutory body.

KPI 22

Additionally: NHS staff recruited in breach of Clause 9 of the agreement.

KPI 23

Condition of facility, measured by inspection by a sponsor and/or the provider and assessed against the requirements of the facility manual and operational procedures.

KPI 24

Breach of security related to the services where there is an identifiable risk of harm, loss or damage to people or property.

KPI 25

Breach by the provider of confidentiality and/or data protection requirements in the agreement.

KPI 26

Failure to meet treat-by date.


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