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Mr. Lansley: To ask the Secretary of State for Health what assessment he has made of the impact of NHS Direct on demand for GP out-of-hours services in those areas where NHS Direct (a) is and (b) is not integrated with GP out-of-hours services; with how many GP out-of-hours providers NHS Direct is integrated; and if he will make a statement. 
Mr. Bradshaw: Out-of-hours services are commissioned by primary care trusts and do not form part of the national services commissioned by the Department from NHS Direct. Further information may be available from the Chairman of NHS Direct NHS Trust.
Annette Brooke: To ask the Secretary of State for Health what training is provided to general practitioners in identifying and treating children with a speech, language or communication disability. 
Ann Keen [holding answer 26 November 2007]: The Government do not specify the content of the general practitioner (GP) training curriculum. This is the job of the Postgraduate Medical Education and Training Board (PMETB), which is the competent authority for postgraduate medical training in the United Kingdom. PMETB is an independent professional body.
PMETB has recently approved a new curriculum for postgraduate general practice training developed by the Royal College of General Practitioners to accompany the introduction of new training programmes in August 2007 as part of the Modernising Medical Careers reforms, available at:
Mr. Lansley: To ask the Secretary of State for Health whether his Department has a traffic light assessment, or other risk monitoring, system in place for individual NHS trusts to monitor performance against targets that patients should wait no more than 18 weeks for treatment. 
Mr. Bradshaw: The Department publishes performance information on 18 weeks on [www.gnn.gov.uk]. The performance information is regularly reviewed with strategic health authorities as part of routine management discussions.
|Number of heart only transplants performed in the UK, by year|
|Number of heart only transplants performed|
Mike Penning: To ask the Secretary of State for Health (1) what percentage of hearts removed from donors (a) were transplanted into recipients, (b) reached their destination hospital within the safe limit of ischaemic time and (c) were not transplanted into recipients, in the latest period for which figures are available; 
Ann Keen [holding answer 26 November 2007]: The three most common reasons for not retrieving the heart were poor function (40 per cent.), donor unsuitablepast history (17 per cent.) and no suitable recipients (12 per cent.). Overall 734 of the 1,044 hearts (70 per cent.) not retrieved were not retrieved due to medical issues with the organ or donor (50 per cent. of all hearts offered). This is shown in the following table.
The reasons given for not transplanting 14 hearts, which were retrieved, were: donor unsuitablepast history (four), poor function (three), transport difficulties (two), unknown (two), organ damaged (one), donor unsuitableage (one) and donor unsuitablesize (one).
There is no official safe length of ischaemia time for donor hearts, but it is generally accepted that ischaemia times should be kept under four hours wherever possible. For adult deceased heartbeating donor hearts offered for transplant, 1 April 2004 to 31 March 2007, 70 per cent. of ischaemia times were four hours or less, 86 per cent. were 4.5 hours or less, 96 per cent, were five hours or less.
Ischaemia times relates to the time the heart is reperfused in the recipient, not to the time the heart arrives at the destination hospital.
|Final outcome of UK adult deceased heartbeating donor hearts offered for transplant, 1 April 2004 to 31 March 2007|
|Financial year||Hearts offered, not retrieved( 1)||Hearts retrieved, not transplanted||Hearts transplanted||Total hearts offered|
|(1) Includes hearts offered for transplant but subsequently retrieved for heart valves only.|
Includes hearts declined for transplant and subsequently used for research.
Andrew Rosindell: To ask the Secretary of State for Health what the average waiting time is for hip replacement operations in (a) Barking, Havering and Redbridge NHS Trust and (b) London NHS trusts. 
|Count of finished admission episodes (FAE) and mean and median time waited for hip replacements where strategic health authority was London by provider data for NHS hospitals England for 2005-06|
|Provider code||Provider code description||Total admission episodes||Median time waited|
|(1) There was no time waited data available. This may be due to poor recording of the admission date and/or decision to admit date. Note: FAE A FAE is the first period of in-patient care under one consultant within one healthcare provider. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year. Data Quality Hospital Episode Statistics (HES) are compiled from data sent by over 300 NHS Trusts and Primary Care Trusts (PCTs) in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. Whilst this brings about improvement over time, some shortcomings remain. 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. OPCS 4.2 codes used: W37,W38,W39,W46,W47,W48|
Time Waited (days) Time waited statistics from HES are not the same as the published waiting list statistics. HES provides counts and time waited for all patients admitted to hospital within a given period whereas the published waiting list statistics count those waiting for treatment on a specific date and how long they have been on the waiting list. Also, HES calculates the time waited as the difference between the admission and decision to admit dates. Unlike published waiting list statistics, this is not adjusted for self-deferrals or periods of medical/social suspension. Source: (HES), The Information Centre for health and social care.
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