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Cardiovascular System: Diseases

Lorely Burt: To ask the Secretary of State for Health what recent meetings she has had with groups representing patients with peripheral arterial disease. [144551]

Ms Rosie Winterton: There have been no ministerial meetings with groups representing patients with peripheral arterial disease in the past year, but officials have met interested stakeholders from the University of Dundee.

Lorely Burt: To ask the Secretary of State for Health what consideration her Department has given to the inclusion of strategies to manage peripheral arterial disease in the national stroke strategy. [144553]

Ms Rosie Winterton: The national stroke strategy had a project group looking at issues around prevention and raising public awareness. This made broad recommendations which are relevant to peripheral arterial disease, and which will be published for consultation this summer.

Lorely Burt: To ask the Secretary of State for Health what discussions have taken place with regard to identification of patients with peripheral arterial disease as part of the vascular disease risk management programme. [144556]


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Ms Rosie Winterton: The Department's Vascular Programme Board has considered a presentation about the impact of peripheral arterial disease. This will be considered as part of a broader programme of work exploring the feasibility of a comprehensive vascular risk management programme.

Lorely Burt: To ask the Secretary of State for Health what guidance has been issued by her Department on the use of the ankle brachial pressure index as a means of assessing vascular disease risk. [144557]

Ms Rosie Winterton: The Department has not issued guidance on the use of on the ankle brachial pressure index on how to assess vascular disease risk.

Carers: Grants

James Brokenshire: To ask the Secretary of State for Health what plans she has to continue the carers’ grant after April 2008. [145095]

Mr. Ivan Lewis: I refer the hon. Member to the answer I gave on 25 April 2007, Official Report, column 1193W.

Dental Services

Mr. Amess: To ask the Secretary of State for Health what assessment she has made of the impact the new dental contract has had on (a) care of patients and (b) working conditions of dentists; and if she will make a statement. [142326]

Ms Rosie Winterton: The Department will shortly be publishing a report, assessing the first 12 months of the new arrangements for local commissioning of dental services and the new contractual arrangements. The new arrangements are designed to support dentists in carrying out less complex and invasive courses of treatment that allow more time for preventative care. This should help promote clinically appropriate care for patients while reducing workload for dentists. It will take time to build up detailed evidence on the impact on patient care and on dental workload and expenses. However, the available evidence suggests that the new arrangements are, as intended, supporting dentists in carrying out less complex courses of treatment.

Mr. Amess: To ask the Secretary of State for Health what assessment she has made of the impact of the new dental contract on access to NHS dentistry; and if she will make a statement. [142327]

Ms Rosie Winterton: The Department will be publishing a report later in the summer, assessing the first 12 months of the new arrangements for local commissioning of dental services and the new contractual arrangements. The most recent data show that the proportion of the population accessing national health service dental services in the two-year period ending December 2006 is the same as in the two-year period immediately preceding the reforms. This suggests that access has remained broadly stable during the transition to the new arrangements. The
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evidence also so far indicates that the NHS is commissioning a steadily increasing volume of NHS dental services.

Mr. Lancaster: To ask the Secretary of State for Health whether her Department has a target for the number of NHS dentists per head of population in (a) each primary care trust area and (b) England. [142901]

Ms Rosie Winterton: The Department has not set targets for numbers of national health service dentists. Under the dental reforms implemented from April 2006, it is for primary care trusts to assess local oral health needs and develop dental services to reflect these needs.

Mr. Kemp: To ask the Secretary of State for Health what proportion of (a) adults and (b) children are registered for NHS dentistry in (i) the City of Sunderland, (ii) the North East region and (iii) England. [143345]

Ms Rosie Winterton: Under the new national health service dental contractual arrangements, patients do not have to be registered with a dentist to receive NHS care. Information is available on the number of patients receiving NHS dental care or treatment at least once over a 24-month period (patients seen). This is not comparable to registration data for the period before April 2006.

Section F2 of Annex 3 of the NHS Dental Statistics for England Q4: 31 March 2007 report contains information on the number of adult and child patients seen in the 24-month periods ending 31 March, 30 June, 30 September, 31 December 2006 and 31 March 2007 in England, NHS North East and Sunderland teaching primary care trust, expressed as a proportion of the estimated population for each area. This report is available in the Library.

The report, published by The Information Centre for health and social care, is also available online at:

Alison Seabeck: To ask the Secretary of State for Health in which primary care trusts patients seeking an NHS dentist are (a) able to make their own arrangements to choose which NHS dentist they see, (b) allocated a dentist from a central list after a wait of no more than three months and (c) allocated a dentist from a central list after a wait in excess of three months. [143929]

Ms Rosie Winterton: This information is not held centrally. Primary care trusts (PCTs) are responsible for providing or commissioning primary dental care services to reflect local needs. It is for PCTs to agree locally with the providers of these services the most effective arrangements to support patients in accessing services.

Alison Seabeck: To ask the Secretary of State for Health which primary care trusts have undertaken patient surveys in order to assess patient demand for NHS dentistry in their area. [143930]


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Ms Rosie Winterton: This information is not held centrally. Primary care trusts (PCTs) are responsible for providing or commissioning primary dental care services to reflect local needs. It is for PCTs to decide locally, in consultation with local clinicians and patients, how most effectively to assess these needs.

Martin Horwood: To ask the Secretary of State for Health on what basis comparisons can be made between the number of NHS patients registered at a dental practice and units of dental activity to assess levels of dental provision before and after the introduction of the new general dental services contract. [144844]

Ms Rosie Winterton: The Information Centre for health and social care regularly publishes information on the number of individual patients seen by national health service dentists in England over a 24 month period. The latest data show the position for the 24 months ending 31 March 2007 and is contained in “NHS Dental Statistics for England: Quarter 4: 31 March 2007”, which is available in the Library.

To support comparisons of access before and after the dental reforms introduced in April 2006, the Information Centre reports include information on numbers of individual patients seen in the last 24 months of the previous contractual arrangements, i.e. the period ending 31 March 2006. These data show that the number of patients seen has remained broadly stable throughout the first transitional year of the reforms.

Units of dental activity are a way of measuring the courses of dental treatment provided for NHS patients, based on grouping courses of treatment into three main bands and applying different weightings to reflect the relative complexity of these bands. The corresponding number of patients seen will vary depending on the complexity of the treatment they require and the frequency with which they re-attend for new courses of treatment.

Martin Horwood: To ask the Secretary of State for Health which indicators her Department intends to use to compare NHS dental provision before and after the introduction of the new general dental services contracts. [142613]

Ms Rosie Winterton: Data are available at national level on the numbers of patients receiving national health service dental services within the most recent two-year period and on the number of courses of treatment provided annually for NHS patients (by treatment band). The Department is supporting primary care trusts in developing a wider range of indicators that can be used locally to measure and benchmark the development of primary dental services.

Martin Horwood: To ask the Secretary of State for Health whether the number of individual NHS patients registered and treated under general dental services contracts is recorded. [142614]

Ms Rosie Winterton: Patients no longer have to be formally registered with a practice to receive national health service dental services. The information centre for heath and social care published quarterly data on
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the numbers of individual patients receiving NHS dental care at least once within the most recent two-year period. Numbers of patients seen in the previous 24 months ending 31 March, 30 June, 30 September and 31 December 2006 are available in Section Fl of Annex 3 of the NHS Dental Statistics for England Q3: 31 December 2006 report. This report is available in the Library and also at:

Dental Services: East Sussex

Mr. Waterson: To ask the Secretary of State for Health what total value of NHS orthodontic treatment was carried out in (a) Eastbourne and (b) East Sussex in each of the last five years. [141891]

Ms Rosie Winterton: Data identifying the value of orthodontic courses of treatment alone by financial years and for specific local areas is not available centrally and could be obtained only at disproportionate cost.

However a special analysis of general dental services (GDS) costs over a 12 month reference period from 1 October 2004 to 30 September 2005 was prepared to help calculate funding levels for the new primary dental service arrangements introduced from 1 April 2006. The following table draws on that analysis and sets out the total payments during that twelve month reference period for all courses of treatment which included an element of orthodontic care in each of the primary care trusts (PCTs) in East Sussex operational at the time.

PCT name Orthodontic earnings 1 October 2004 to 30 September 2005

Bexhill and Rother

11,398

Brighton and Hove City

918,052

Eastbourne Downs

493,349

Hastings and St. Leonards

225,155

Sussex Downs and Weald

351,487

Notes:
1. The data relate to claims from dentists working under the terms of the former General Dental Services only. It includes the value of interim payments made during the 12 month period for orthodontic treatments. It excludes orthodontic work carried out within former Personal Dental Service pilots, where the value of orthodontic as opposed to general dental treatments can be less easily identified. This may mean the GDS data above is not fully representative of all elements of orthodontic care in every area.
2. The data is presented by the PCT areas that were operational during the reference period, rather than the new PCTs that assumed responsibility for services from 1 October 2006.
Source:
Dental Practice Division of the NHS Business Services Authority.

Dental Services: Fees and Charges

Mrs. May: To ask the Secretary of State for Health what the (a) definition and (b) value is of the units used to calculate NHS dentists' fees. [144606]

Ms Rosie Winterton: Under the new contractual arrangements introduced from April 2006, dentists are no longer paid on the basis of separate fees for individual treatments. Dentists or dental practices instead have an agreed annual contract value, paid in
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monthly instalments, in return for which they carry out an agreed volume of dental services over the course of the year.

These annual service levels are defined primarily in terms of the courses of treatment provided for national health service patients, but with courses of treatment categorised into three main bands and with different weightings to reflect the relative complexity of these bands. There are separate, though similar, arrangements for defining annual service levels for specialist dental services such as orthodontics. Within the overall contract value, primary care trusts (PCTs) and practices may also arrange for the provision of other services that are not measured through courses of treatment.

A course of treatment which consists of an examination, diagnosis, e.g. x-rays and oral health advice, and a scale and polish if needed, is recorded as a band 1 treatment. This equates to one unit of dental activity.

A course of treatment which includes band 1 items together with additional treatment such as fillings, root canal work or extractions, is recorded as a band 2 treatment. This equates to three units of dental activity.

A course of treatment which includes band 1 and 2 items together with more complex procedures such as crowns, dentures or bridges is recorded as a band 3 treatment. This equates to12 units of dental activity.

There are additional arrangements for urgent courses of treatment and for certain other categories of treatment such as the issue of prescriptions.

The relationship between annual contract values and annual service levels, expressed in terms of units of dental activity, varies between contracts. For dentists or dental practices, who had previously provided services under the old general dental services arrangements, the calculation of annual contract values and annual service levels was based on an assessment of overall NHS earnings and corresponding courses of treatment during a 12-month reference period before the start of the reforms. The resulting variations in contract prices reflect, in turn, historic differences in treatment patterns and patients’ oral health needs. Subject to these transitional protections, the calculation of annual contract values and corresponding service levels is a matter for agreement locally between primary care trusts and dentists or dental practices.

Dental Services: Manpower

Mr. Vara: To ask the Secretary of State for Health what the (a) dentist to patient and (b) orthodontist to patient ratio is in each (A) strategic health authority and (B) primary care trust area in England; and what those ratios were in each of the last five years. [142418]

Ms Rosie Winterton: The requested information has been placed in the Library and shows the number of patients registered with a national health service dentist per number of NHS dentists, by strategic health authority (SHA) and primary care trust (PCT) in England, as at 31 March for each of the years from 2001 to 2006.

This information is based on the old contractual arrangements. Under the new NHS dental contractual
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arrangements, patients do not have to be registered with a dentist to receive NHS care. Information is, however, collected on the number of patients receiving NHS care or treatment at least once within the most recent two-year period (patients seen). This is not comparable to registration data for earlier years.

The information placed in the Library also shows the number of patients seen in the previous 24 months per number of dentists on open NHS contracts, by SHA and PCT in England, as at 31 December 2006.

Both these sets of data include NHS orthodontic services, but these services could only be separately identified at disproportionate cost.

Annex F of the “NHS Dental Activity and Workforce Report, England: 31 March 2006” contains information comparing the numbers of people resident in each SHA and PCT area with the numbers of dentists providing NHS services in that area as at March for each year from 2001 to 2006.

This report is available in the Library and is also available on-line at:

Section G of Annex 3 of the “NHS Dental Statistics for England Q3: 31 December 2006” report contains information comparing the numbers of people resident in each SHA and PCT area with the numbers of dentists on open NHS contracts in that area as at 30 June, 30 September and 31 December 2006.

This report is available in the Library and is also available on-line at:


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