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23 Oct 2007 : Column 266W—continued

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This year, the Department will introduce a set of newly designed performance indicators to assess the quality of prison health care services. These bring together a number of existing systems to support a mainstream approach to performance monitoring at a local level.

It is planned that the indicators will contribute to measuring the effectiveness of the transfer and corresponding significant increased investment in prison health. They will also act as a tool to strengthen local commissioning, governance and performance management arrangements and inform national strategy and policy development.

HM Inspectorate of Prisons (HMIP) and the Healthcare Commission have worked in partnership by virtue of a memorandum of understanding since April 2006 to monitor health care standards in prisons. The Healthcare Commission now includes prison health services in its assessment of the effectiveness of commissioning arrangements in the national health service, while HMIP continues to inspect and report on health outcomes for prisoners in all public sector establishments.

Hearing Aids: Waiting Lists

Mr. Boswell: To ask the Secretary of State for Health if he will make a statement on NHS performance against targets for supply of hearing aids, with particular reference to (a) the wait for a first instrument, (b) the wait for exchange from an analogue to a digital aid, (c) the wait from referral to hearing assessment and (d) differences in performance between primary care trusts and regions in meeting those targets. [159087]

Mr. Ivan Lewis: We do not collect information on the length of time people are having to wait for a first instrument or for the wait for an exchange from an analogue to a digital aid.

The number of people having to wait for a hearing assessment has fallen significantly since the launch of the national audiology framework “Improving Access to Audiology Services in England”. A copy is available in the Library. Latest data for August 2007 shows that since March 2007 the number of people waiting over six weeks has fallen by 29,000 or 28 per cent.

As part of delivering 18 weeks from GP referral to treatment, there is a milestone for diagnostic tests, including audiology assessments, of a six-week maximum wait by March 2008. Information on the number of waits for audiology assessments by primary care trust has been placed in the Library.

Hearing Impaired: Health Services

Anne Milton: To ask the Secretary of State for Health (1) what assessment his Department has made of the impact of the removal of the exemption for audiology from the 18 week GP referral to assessment target on patients; and if he will make a statement.; [159234]

(2) what assessment his Department has made of the impact of the removal of ring-fenced funding for the NHS hearing aid services on patients; and if he will make a statement; [159235]

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(3) what safeguards are in place to ensure that the contracting-out of audiology services to the private sector does not damage NHS services; and if he will make a statement; [159236]

(4) what (a) financial analysis, (b) review of current audiology services and (c) evidence was used when writing his Department’s audiology plan; [159237]

(5) how follow-up care will be provided for those using the independent sector for NHS audiology treatment; how such patients will be assessed; how the quality of (a) service and (b) the hearing aids dispensed to such patients will be monitored; and if he will make a statement. [159238]

Mr. Ivan Lewis: There has been no change to the position in relation to audiology services and the 18 week target.

The most complex audiology cases, those properly referred to Ear Nose and Throat Departments for surgical or medical consultant-led care, will be covered by the target of treatment within 18 weeks of referral by December 2008. The remaining routine adult hearing loss cases are not included in the 18 weeks target and should be assessed within six weeks by March 2008. This is in line with the diagnostic waiting time milestone on which local commissioning plans are based.

No assessment has been made of changes to the funding mechanism for national health service hearing aid services. Funding of £125 million over the five years of the Modernising Hearing Aid Services programme was made available to enable services to modernise the way that they operated and routinely fit digital hearing aids.

Current funding for audiology services, along with the majority of other services, is provided through the general allocations to national health service trusts and primary care trusts (PCTs). It is the responsibility of local health organisations to allocate resources to audiology services based on their knowledge of the needs of their local populations and the resources available.

The Department developed the national framework for audiology “Improving Access to Audiology Services in England”, published in March 2007 using views and evidence from a wide range of stakeholders. A copy is available in the Library. Nine development sites were also used to develop good practice aimed at improving access to audiology services through commissioning, service redesign, choice, information and incentives.

As set out in “Improving Access to Audiology in England”, additional capacity is needed to address long waiting times for some audiology services. PCTs are responsible for commissioning the full range of health services for their local populations including audiology and for ensuring that they meet their capacity needs through improving existing NHS.

Hospitals: Waiting Lists

Mr. Lansley: To ask the Secretary of State for Health when he intends to publish referral-to-treatment waiting times for non-admitted patients. [160199]

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Mr. Bradshaw: Collection of referral to treatment data for non-admitted patients has been mandatory since April 2007 and is due to be published in the autumn.

Macular Degeneration

Mr. Byers: To ask the Secretary of State for Health if he will provide match funding for the London Project’s research into dry macular degeneration. [160298]

Dawn Primarolo: The Department’s National Institute for Health Research has this year awarded £14 million over five years to fund a Specialist Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust. The award supports five research themes. One of these is concerned with age-related macular degeneration and incorporates the privately sponsored London Project.

Mentally Ill: Deaths

Jeremy Corbyn: To ask the Secretary of State for Health (1) how many inpatients died in NHS mental health accommodation in each of the last five years for which figures are available; [159138]

(2) what mechanisms are in place (a) to record and (b) to publish the cause of death of inpatients who die in NHS mental health accommodation. [159139]

Mr. Ivan Lewis: Information on the total number of in-patient deaths in national health service mental health accommodation in England from 2001-02 to 2005-06 is shown in the following table.

Total number of discharge episodes ending in the death of in - patients in NHS acute hospital and NHS mental health accommodation in England from 2001-02 to 2005-06: finished consultant episodes, male and female c ombined, all ages, all regions( 1)











(1 )Totals include deaths from all causes
Ungrossed data: the figures have not been adjusted for shortfalls in data.
Hospital Episode Statistics, the Information Centre for Health and Social Care.

Data on in-patient deaths which are due to suicide, homicide and sudden, unexpected causes is published by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) based at the University of Manchester. NCISH is funded by the National Patient Safety Agency and published its report, ‘Avoidable Deaths’, in December 2006. It covers data on homicides in England and Wales from April 1999 to December 2003 and on suicides from April 2000 to December 2004.

The data on homicides is collected from the Home Office Homicide Index (HI). Where available, psychiatric reports prepared for the trial are obtained. Information on previous offences is collected from the National Crime Operations Faculty. Case details are submitted to mental health services in each individual’s
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district of residence and adjacent districts to identify those with a history of using mental health services, including those with a lifetime contact. These individuals become inquiry cases and those cases with recent service contact (within 12 months of the offence) are analysed as the main sample.

Information on inquiry cases is obtained from a questionnaire sent to the consultant psychiatrist within the applicable clinical team. For all homicide convictions, data are collected on methods and victims from the HI, including data on diminished responsibility and hospital orders. Data on mental illness at the time of offence comes from psychiatric reports prepared for the Crown Prosecution Service, including details of mental health, drug and alcohol use at the time of the offence. The questionnaire also provides data covering demographic details, clinical history, details of the homicide, details of in-patient/community care received, details of final contact with services, events leading to the homicide and respondents’ views on prevention.

The Mental Health Act Commission (MHAC) collects data on all detained patient deaths and publishes data on those from non-natural causes in its biennial report. MHAC, under its general remit to keep under review the operation of the Mental Health Act 1983, asks providers to notify it of all deaths of detained patients within three working days.

MHAC reviews the deaths of patients who have died from non-natural causes to establish whether good practice, as defined in the ‘Mental Health Act 1983 Code of Practice’, has been followed and whether lessons for future practice and policy need to be learned. This review may include sending a Commissioner to the inquest, which considers the circumstances of the death or arranging a visit to the hospital to consider the issues arising.

Midwives: Manpower

Anne Milton: To ask the Secretary of State for Health (1) what estimate his Department has made of the number of midwives that will be needed in (a) 2008, (b) 2009, (c) 2010 and (d) 2011; [159723]

(2) how many full-time equivalent midwives entered the NHS in each year since 1997. [159725]

Mr. Bradshaw: Work force planning is a matter for local determination as local work force planners are best placed to asses their local midwifery needs for their local population.

There are sufficient new midwives being trained to increase the midwifery work force by over 1,000 leading up to 2009. In addition to this planned increase, local organisations are reviewing their work force capacity in line with the 2007-08 Operating Framework, and may identify the need to invest in their maternity services and increase staffing capacity.

‘Maternity Matters’ takes account of staffing levels up to 2009. No further assessments have been made centrally.

The Department does not collect information centrally on ‘new joiners’ in the national health service each year. The census however collects information on the number of full-time equivalent (FTE) staff in post
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as at 30 September each year. This information is shown in the following table. The number of FTE midwives has increased by 809 or 5 per cent. since 1997.

FTE number of midwives employed in the NHS as at 30 September each year, England





















(1) 286 duplicate records were identified and removed.
Department of Health Non-Medical Workforce Census

NHS Direct

Mr. Hoban: To ask the Secretary of State for Health which team in his Department has lead responsibility for the work of NHS Direct. [159963]

Mr. Bradshaw: The Service Design Division, within the Commissioning and System Management Directorate, has lead responsibility for the work of NHS Direct. The officials in this division work closely with colleagues across the Department given the cross-cutting nature of NHS Direct’s work.

NHS: Doctors

Mr. Lansley: To ask the Secretary of State for Health how many (a) first finished consultant episodes and (b) finished consultant episodes there were in the NHS in each year since 1990-91. [158467]

Mr. Bradshaw: The following table shows the number of first finished consultant episodes (FFCEs) in each year since 1996-97 and the number of finished consultant episodes (FCEs) since 1990-91. Data on the number of FFCEs is not available prior to 1996-97. FFCE data is collected for general and acute specialties which do not include mental health, learning difficulties or maternity services. To enable comparison, FCE data has been supplied for general and acute, and the total for all specialties.

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FCEs, England, 1990-91 to 2006-07
Commissioner-based Provider-based
FFCEs general and acute only( 1, 2, 4, 6) FCEs general and acute only( 3, 7) FCEs all specialties( 7)























































(1) Figures for years prior to 2006-07 have been rebased to allow direct comparison.
(2) General and acute specialities do not include mental health, learning difficulties or maternity services.
(3) General and acute main specialties defined as the following main specialty codes: 100-460, 502, 601, 620, 800-950.
(4) 1996-97 to 1999-2000 figures are from health authorities. With the abolition of health authorities, figures for 2001-02 and 2002-03 are based on returns from national health service trusts.
(5) Figures are subject to revision when final outturn figures are received.
(6) Quarterly monitoring and monthly monitoring, Department of health.
(7) Hospital Episode Statistics, the Information Centre for health and social care.

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