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30 Oct 2007 : Column 1244W—continued

Patients: Nutrition

Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 3 September 2007, Official Report, columns 1883-4W, on patients: nutrition, in what ways the National Patient Safety Agency is actively promoting the comprehensive screening of patients on admission to hospital; and what expenditure the National Patient Safety Agency (a) committed to this purpose in (i) 2005-06, (ii) 2006-07 and (b) has committed in 2007-08. [161759]

Ann Keen: The National Patient Safety Agency (NPSA) have been actively promoting the screening of patients on admission to hospital.

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Between January and April 2007, the NPSA hosted two workshops for frontline staff from 10 acute national health service trusts in England. The aim of these workshops was to identify the barriers to nutritional screening in hospitals. The Agency has also asked patients for their views on nutritional care in hospitals.

The NPSA actively supported and promoted the British Association of Parental and Enteral Nutrition nutritional screening week which took place on 25-27 September 2007. They are currently working with the Royal College of Nursing on their Nutrition Now campaign.

The NPSA are also currently involved in the development of the Department’s Nutritional Action Plan which is due to be released shortly.

Committed expenditure
Amount (£)





1. The figures include pay and non-pay costs for NPSA staff members working on this project.
2. Overheads have been absorbed into the pay cost. In financial year 2005-06 staff were not in post and therefore no specific funds were allocated to this work.

Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 3 September 2007, Official Report, columns 1882-4W, on patients: nutrition, what the count of bed days was for finished episodes where the (a) primary and (b) secondary diagnosis was nutritional anaemias in each year since 1997-98. [161779]

Mr. Bradshaw: It has not been possible to respond to the hon. Member in the time available before the Prorogation

Patients: Wales

Ian Lucas: To ask the Secretary of State for Health how many completed patient episodes relating to patients from Wales took place in primary care trusts in (a) North West England and (b) the West Midlands region of the NHS in each of the last three years for which records are available. [161434]

Mr. Bradshaw: The requested information has been placed in the Library.

Prescriptions: Fraud

Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) how many penalty charges on those wrongfully claiming free prescriptions in accordance with the Health Act 1999 were served in each year since that Act came into force; [161705]

(2) how many checks on free prescription claims were made by the NHS Counter Fraud and Security Management Service in each year since the Health Act 1999 came into force. [161706]

Ann Keen: From August 2001 to March 2003, the Prescription Pricing Authority undertook prescription penalty charge functions as per the provisions of the Health Act 1999.

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From April 2003 to March 2005, the National Health Service Counter Fraud and Security Management Service (CFSMS) undertook these functions.

From April 2005 these functions were devolved to primary care trusts with the CFSMS providing a central support process to facilitate verification checks.

The numbers of checks and penalties are provided in the following table.

Checks Penalties

August 2001 to March 2005









Data for the period August 2001 to March 2005 is not available by year.

Primary Care Trusts: Finance

Andrew George: To ask the Secretary of State for Health what the (a) weighted capitation targets and (b) recurrent baselines were for each primary care trust budget in each of the last five financial years; what the difference was between the largest and the smallest baseline in each year; and what the targets and recurrent baselines are for the next five financial years for which indicative budgets have been set. [160855]

Mr. Bradshaw: Weighted capitation targets and allocations for the 303 primary care trusts (PCTs) in existence when the Department announced these allocations are shown in table 4.2 of 2003-04, 2004-05 and 2005-06 PCT initial revenue resource limits exposition book which is available in the Library and at:

and in table 3.2 of “2006-07 and 2007-08 PCT initial revenue resource limits exposition book” which is available in the Library and at:

The difference between a PCTs weighted capitation target and a PCTs allocation gives its closing distance from target (DFT). If a PCTs weighted capitation target is greater than its allocation a PCT is under target. If a PCTs weighted capitation target is smaller than its allocation, a PCT is over target. The following table shows the largest closing percentage DFTs for the most under and over target PCTs between 2003-04 and 2007-08.

Closing DFT of most under target PCT Closing DFT of most over target PCT
















The Department is still determining weighted capitation targets and allocations for 2008-09 to 2010-11 following the 2007 comprehensive spending
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review. The Department will not determine allocations for 2011-12 and 2012-13 until after the next spending review.

Radiotherapy: Lincolnshire

Mark Simmonds: To ask the Secretary of State for Health how many NHS linear accelerators there are in Lincolnshire; what the capacity of each is in number of fractions per annum; how many years each has been in service; how many new linear accelerators are expected to be available in Lincolnshire in each of the next five years; and if he will make a statement. [161521]

Ann Keen: The Department does not collect data in the format requested.

The United Lincolnshire Hospitals NHS Trust has three linear accelerators. However, the Department does not hold information on whether all these machines are in routine clinical use. Some may be used for clinical research, training purposes, or as back up when another machine requires maintenance.

For information relating to fractions per annum for linear accelerators I refer the hon. Member to the reply to the hon. Member for South Cambridgeshire (Andrew Lansley) on 16 October 2007, Official Report, column 1066W.

The acquisition of resources is a matter for local determination based on local needs. The recent report National Radiotherapy Advisory Group (NRAG) published in May 2007 has recommended that the Department sets out a trajectory of the numbers of new linear accelerators it would expect to see coming into use over the next 10 years and monitors local action delivery of this expansion progress in line with this trajectory. This recommendation along with others made by NRAG are being considered as part of the development of the Cancer Reform Strategy.

Rapid Review Panel

Mr. Lansley: To ask the Secretary of State for Health how many product assessments the Rapid Review Panel has undertaken since December 2003; how many assessed products were recommended to his Department for use (a) in the NHS and (b) by the NHS Purchasing and Supplies Agency; and how many products in use by the NHS were recommended by the panel. [160715]

Ann Keen: The Panel has undertaken 184 assessments since its first meeting.

Four products have demonstrated sufficient research and development, validation and recent in use evaluations to enable the Rapid Review Panel (RRP) to make a recommendation to the Department that the product should be made available to national health service bodies. This constitutes a recommendation one from the Panel.

Of the four products given a recommendation one, three have been made available to the NHS by the NHS Purchasing and Supply Agency via the NHS Supply Chain and are contained in their product supply catalogue.

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NHS trusts are free to choose which infection control products to purchase and will maintain their own records.

The NHS Purchasing and Supply Agency does not recommend particular products.


Mr. Skinner: To ask the Secretary of State for Health how many people had strokes in (a) England and (b) the East Midlands in each of the last five years. [161061]

Ann Keen: Hospital Episode Statistics (HES) from 2004-05 suggest there were around 73,000 emergency admissions with a primary diagnosis of stroke. However, this figure under-represents the true incidence of stroke for two reasons: firstly some hospital patients who have a stroke may also have another condition as their primary diagnosis; secondly, not all stroke patients currently attend hospital. HES cannot provide data that is robust enough to give numbers either nationally or regionally.

Academic estimates suggest there are around 110,000 strokes in England per annum.

Strokes: Health Services

Mr. Jim Cunningham: To ask the Secretary of State for Health what provisions have been made since 1997 to improve the quality of healthcare for stroke sufferers. [158300]

Ann Keen: Between 1996-97 and 2007-08, spending on the national health service has increased from £33 billion to just over £90 billion, representing an average annual increase in real terms of 6 per cent. The improvements seen in stroke services have undoubtedly benefited from these increases over the last 10 years.

The National Service Framework (NSF) for long-term conditions was published in 2004 to improve the quality of life and independence for people with long-term neurological conditions. It set out general guidelines for a range of conditions, including stroke, to establish faster diagnosis, more rapid treatment and a comprehensive package of care based around individual patient needs.

Prior to this the “NSF for Older People”, published in 2001, included a chapter on stroke services. It set out a range of measures to reduce the incidence of stroke and improve stroke treatment, which have led to a widespread development of services: the Royal College of Physicians’ (RCP) shows that all trusts caring for people who have had a stroke now have a specialist stroke service and 97 per cent. of hospitals in England now have a stroke unit, these were uncommon a decade ago. The audit also shows that in 2006, around two thirds of stroke patients were treated on a stroke unit. This is a significant improvement since 2004 when the figure was less than half. Length of stay in hospital for stroke patients is falling from 34 days in 2001 to 28 days in 2004. The results of the RCP audit also show that the proportion of trusts with a stroke unit meeting five or six of the audit’s criteria has increased from 33 per cent. to 41 per cent. between 2004 and 2006.

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Stroke mortality is falling. For people under 65, the three year average death rate from stroke has fallen by 23 per cent. over the period from 1993-95 to 2002-04. For people aged 65-75 the death rate has dropped by 30 per cent. over the same period. We have made greater progress in reducing premature deaths from coronary heart disease than from stroke. This is because we have begun by focusing on coronary heart disease, the biggest killer in the country. However, because of the significant progress we have made in this area we are now able to redouble our efforts in addressing the challenge of stroke. This is why the Department launched a stroke strategy document for consultation on 9 July 2007. It followed an 18-month programme of work, setting out the views of six expert working groups who represented a wide range of key stakeholders. The strategy aims to accelerate the emergency response to stroke, by setting out a framework for care of stroke patients, and raising awareness about stroke symptoms and risk factors. It is due for publication by the end of 2007.

In addition to developing the strategy, in 2006 the Department published “Mending hearts and brains”, a report by Professor Roger Boyle, the National Director for Heart and Stroke. The report makes the clinical case for reconfiguring stroke services. In particular, it emphasises the need to treat stroke as an emergency, including the delivery of thrombolysis at specialist centres and a possible ‘hub and spoke’ model for stroke services.

Last year, the Department also launched “Action on stroke services: an evaluation toolkit”, (ASSET ) to help health care providers compare their performance with others. It considers four aspects of acute treatment setting out how these mean fewer people experiencing death or disability, and more efficient hospital services with people able to return home faster. An additional version, ASSET 2 for commissioners has also been introduced which uses analytical modelling to advise hospitals and primary care trusts of what the impact of making specific changes to their services would be. We have also published a guide for commissioners, setting out key questions they need to consider and a series of best practice case studies.

As well as helping to improve existing stroke services, the Department is investing £20 million over five years (2005-2010) into the development of the UK Stroke Research Network.

Mr. MacDougall: To ask the Secretary of State for Health if his Department will increase funding for stroke rehabilitation therapies. [161458]

Ann Keen [holding answer 29 October 2007]: The Government have been consulting on the recommendations of the working groups contributing to the development of a National Stroke Strategy. It will publish this National Strategy at the end of the year setting out its plans to modernise service provision and deliver the newest treatments for stroke.

Tobacco: Civil Proceedings

Mr. David Anderson: To ask the Secretary of State for Health if he will consider the merits of using litigation against tobacco companies in relation to damage caused by their products to the health of British citizens. [160824]

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Dawn Primarolo: Smoking is the biggest cause of premature death and one of the most significant causes of health inequality in the United Kingdom. The Department’s approach to tobacco control is based on a six-strand strategy to reduce smoking prevalence through the following action:

While the Department has no intention at this point in time to use litigation against tobacco companies in relation to the damage their products cause to health, individuals may take such action.

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