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22 Nov 2007 : Column 1122W—continued

Drugs: Rehabilitation

Dr. Fox: To ask the Secretary of State for Health what the proposed Drug Treatment Agency allocation is for (a) Bristol and (b) north Somerset for each year covered by comprehensive spending review. [164427]

Dawn Primarolo: No decisions have been finalised about the pooled drug treatment budget allocations from April 2008 onwards.

East and West Kent NHS Hospitals Trust: Clostridium

Hugh Robertson: To ask the Secretary of State for Health what the infection rates were for Clostridium difficile in the East and West Kent NHS Hospitals Trust in each of the last three years; and on what basis these rates are calculated. [166616]

Ann Keen [holding answer 20 November2007]: The mandatory surveillance system operated by the Health Protection Agency provides data on the number of reports of Clostridium difficile (C. difficile) infection
22 Nov 2007 : Column 1123W
(CDI). All acute national health service trusts in England are obliged to report all cases of CDI processed by their laboratories and the data is published at trust level.

Mandatory surveillance of Clostridium difficile was introduced in 2004 for patients aged 65 and over and has been extended to all patients aged two and over from April this year.


22 Nov 2007 : Column 1124W

The data provided in the following table are for the acute NHS trusts that fall within the Kent region. This information and any further information on the number of CDIs for NHS acute trusts is available at:

Number of reported cases of Clostridium difficile infections
Patients >65 years
January to December 2004 January to December 2005 January to December 2006
Trust Number of Clostridium difficile reports Rate per 1,000 bed days Number of Clostridium difficile reports Rate per 1,000 bed days Number of Clostridium difficile reports Rate per 1,000 bed days

Dartford and Gravesham NHS Trust

167

1.74

130

1.36

211

2.20

East Kent Hospitals NHS Trust

638

1.97

705

2.19

528

1.64

Maidstone and Tunbridge Wells NHS Trust

484

3.27

464

3.14

545

3.69

Medway NHS Trust

246

2.29

251

2.34

225

2.10

Note:
Data are provisional.
Source:
Health Protection Agency.

The numerator used is the number of Clostridium difficile reports for each trust for each year (January to December).

The denominator used is based on the total bed days for patients 65 years and over for January to December 2004 for each trust as derived from the Hospital Episode Statistics data.

The number of bed days was calculated from the total length of consultant episodes for patients 65 years and over for that trust during the period. The number was adjusted to take account of the leap year in 2004.

East Sussex Hospitals NHS Trust: Clostridium

Mr. Waterson: To ask the Secretary of State for Health how many people have (a) contracted and (b) died from clostridium difficile at East Sussex NHS Trust hospitals in the last 10 years. [165309]

Dawn Primarolo: The information requested is not available in the format requested.

The best available data on the number of reports of Clostridium difficile infections are for patients aged 65 and over and come from the mandatory surveillance scheme run by the Health Protection Agency. The following table shows data for East Sussex Hospital NHS Trust from January 2004 to June 2007.

Number of C. difficile reports for patients aged 65 years and over

January to December 2004

393

January to December 2005

387

January to December 2006

374

January to June 2007

128

Source:
Health Protection Agency—provisional data.

It is not possible to identify where the infection was acquired.

Heart Diseases: Drugs

Dr. Kumar: To ask the Secretary of State for Health what his assessment is of the effectiveness of traditional coronary heart disease drugs on (a) women and (b) men; and if he will make a statement. [166597]

Dawn Primarolo: Medicinal products licensed for treatment of coronary heart disease are assessed for safety, efficacy and quality, in both men and women. Post marketing surveillance continues the monitoring of safety signals after approval for use of these products in a wider population. Products currently approved for treatment of coronary heart disease are safe and effective in men and women when used in accordance with their approved prescribing recommendations.

Heart Diseases: West Midlands

Mr. Cash: To ask the Secretary of State for Health how many (a) angioplasty and (b) revascularisation procedures were carried out in (i) Stoke, (ii) south Staffordshire, (iii) north Staffordshire, (iv) Telford and Wrekin and (v) Shropshire county primary care trusts in each year since 2003, broken down by type. [165216]

Dawn Primarolo: The information requested is shown in the table. The source of the data is the hospital episode statistics (HES) held by the information centre for health and social care (IC). The data are provided for five primary care trusts (PCTs), in their commissioning, rather than provider of treatment role.


22 Nov 2007 : Column 1125W

Historical information for new PCTs (i.e. pre 1 October 2006) has been calculated by the 1C based on information previously provided by predecessor organisations.

Rather than grouping procedures under the headings ‘angioplasty’ and ‘revascularisation’ the 1C has
22 Nov 2007 : Column 1126W
provided a more detailed break-down of the operative procedures that sit under these headings so there is no confusion as to what has been included and counted. Angioplasty has been classed as those codes between K49-K50 and ‘revascularisation’ has been classed as those codes between K40-K46.


22 Nov 2007 : Column 1127W

22 Nov 2007 : Column 1128W
Selected operative procedures North Staffordshire PCT Shropshire County PCT South Staffordshire PCT Stoke on Trent PCT Telford and Wrekin PCT

2003-04

K40

Saphenous vein graft replacement of coronary artery

87

170

233

107

71

K41

Other autograft replacement of coronary artery

*

15

14

15

12

K43

Prosthetic replacement of coronary artery

*

K44

Other replacement of coronary artery

*

11

*

K45

Connection of thoractic artery to coronary artery

83

160

231

106

70

K49

Translumical balloon angioplasty of coronary artery

156

103

353

189

63

K50

Other therapeutic transluminal operations/coronary artery

*

*

*

*

2004-05

K40

Saphenous vein graft replacement of coronary artery

143

155

273

151

85

K41

Other autograft replacement of coronary artery

8

22

15

16

*

K42

Allograft replacement of coronary artery

*

K43

Prosthetic replacement of coronary artery

*

K44

Other replacement of coronary artery

*

*

*

*

*

K45

Connection of thoractic artery to coronary artery

126

153

259

139

75

K49

Translumical balloon angioplasty of coronary artery

294

194

531

376

107

K50

Other therapeutic transluminal operations/coronary artery

*

*

*

*

2005-06

K40

Saphenous vein graft replacement of Coronary Artery

93

142

259

127

68

K41

Other autograft replacement of coronary artery

7

35

*

K42

Allograft replacement of coronary artery

*

K44

Other replacement of coronary artery

*

*

*

*

*

K45

Connection of thoractic artery to coronary artery

83

128

249

105

65

K46

Other bypass of coronary artery

*

K49

Translumical balloon angioplasty of coronary artery

233

163

541

279

119

K50

Other therapeutic transluminal operations/coronary artery

*

*

15

*

*

Notes:
All operations count of mentions—These figures represent a count of all mentions of an operative procedure in any of the 12 (four prior to 2002-03) operative procedure fields in the HES data set. Therefore, if a operative procedure is mentioned in more than one operative procedure field during an episode, all operative procedure are counted.
Finished Consultant Episode (FCE)—An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Episodes do not represent the number of patients, as a person may have more than one episode of care within the year.
Main operation—The main operation is the first recorded operation in the HES data set and is usually the most resource intensive procedure performed during the episode. It is appropriate to use main operation when looking at admission details, e.g. time waited, but the figures for “all operations count of episodes” give a more complete count of episodes with an operation.
Secondary procedure—As well as the main operative procedure, there are up to 11 (three prior to 2002-03) secondary operation fields in HES that show secondary or additional procedures performed on the patient during the episode of care.
PCT and strategic health authority (SHA) data quality—PCT and SHA data were added to historic data-years in the HES database using 2002-03 boundaries, as a one-off exercise in 2004. The quality of the data on PCT of treatment and SHA of treatment is poor in 1996-97, 1997-98 and 1998-99, with over a third of all finished episodes having missing values in these years. Data quality of PCT of general practitioner (GP) practice and SHA of GP practice in 1997-98 and 1998-99 is also poor, with a high proportion missing values where practices changed or ceased to exist. There is less change in completeness of the residence-based fields over time, where the majority of unknown values are due to missing postcodes on birth episodes. Users of time series analysis including these years need to be aware of these issues in their interpretation of the data.

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