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A FAE is the first period of in-patient care under one consultant within one health care provider. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
HES are compiled from data sent by over 300 national health service 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. While this brings about improvement over time, some shortcomings remain.
Assessing growth through time
HES figures are available from 1989-90 onwards. During the years that these records have been collected by the NHS, there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Changes in NHS practice also need to be borne in mind when analysing time series. For example a number of procedures may now be undertaken in out-patient settings and may no longer be included in the HES data. This may account for any reductions in activity over time.
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
All operations count of mentions
These figures represent a count of all mentions of an operation in any of the 12 operation fields in the HES data set. Therefore, if an operation is mentioned in more than one operation field during an episode, all operations are counted.
Hospital Episode Statistics (HES), The Information Centre for health and social care.
Mike Penning: To ask the Secretary of State for Health (1) for what reasons his Department's Whole System Demonstrator project sites in (a) Newham, (b) Kent and (c) Cornwall did not go live in accordance with the expected timetable; and when he expects each such project site to begin providing services to patients; 
(3) what the (a) titles and (b) dates of all documents held by his Department are which concern the (i) planning and (ii) implementation of the Whole System Demonstrator pilot sites in (A) Newham, (B) Kent and (C) Cornwall; and if he will place in the Library a copy of each such document. 
Ann Keen: The Long Term Condition Whole System Demonstrators (WSDs) promised in the White Paper Our Health, Our Care, Our Say are exploring the effectiveness of telehealth and telecare in supporting integrated care for those with complex health and social care needs.
The demonstrators involve the provision of integrated care supported by telehealth and telecare to thousands of individuals over a two year period. The demonstrators are charged with determining the business case for the effectiveness of this model of care. This is being facilitated by the development of a robust independent evaluation drawing upon relevant academic expertise.
The development of the evaluation methodology, in conjunction with the three sites, has been complex and a number of research design and operational issues have had to be addressed. However, since a randomised control trial provides an unbiased, balanced, and reliable method for determining whether the complex intervention is effective we have allowed more time for the evaluation methodology to be developed than originally planned. There has also been a requirement for review by a multi-site research ethics committee. We have delayed launching services on a large scale until the evaluation methodology is approved because we want each installation to contribute to the knowledge base we are generating.
The three WSD sites will be subject to a single evaluation and as such the target population and evaluation methodology is common across all three sites. It is essential to clearly define the target population for the WSD programme so that the results of the detailed evaluation can be set in context. The criteria proposed for individuals in the trial is as follows:
individuals with health care needs of any age who are at risk of current or future hospital admission, due to at least one of the following conditions: heart failure, chronic obstructive pulmonary disease or diabetes. The detailed severity criteria is defined using quality outcome framework indicators.
individuals with social care needs aged 18 and over who:
are currently in receipt of, or considered to have a need for night sitting;
receiving seven or more hours per week of home care or 3.5 or more hours per week of home care plus a meals service (defined by individual not household);
receiving one or more days per week of day care;
have had a fall or who are considered at high risk of falling;
a live-in nearby informal carer facing difficulties carrying their current burden of responsibilities; and
cognitive impairment/confusion people fulfilling this criterion who are unable to provide written informed consent and do not have a primary informal caregiver available or an advocate will not be approached to participate in the questionnaire study.-
individuals with both health and social care needs as defined above.
patterns of health and social care utilisation;
user reported quality of life, independence and psychological well-being;
carers' quality of life;
practitioners working lives and relationships with patients/service users;
clinical effectiveness; and
cost effectiveness of care.
The WSD sites are being supported by the Department, and their project management partner KPMG, to ensure that each site manages to the principles outlined by the OGC's Managing Successful Programmes (MSP) guidance. All the sites have a requirement to produce and manage a consistent set of programme documentation. Each site has a dedicated WSD team and reports to the Department with a weekly flash report and a monthly progress report.
A comprehensive list of planning and control documentation has been produced by each site. The nature of such documentation is that it evolves over the lifecycle of the programme and so there are multiple versions of many documents that reflect this evolution. For each of the three programmes, and their associated sub-projects, there are for example project initiation documents, project plans, risk/issue and dependency logs and communications plans.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what plans he has to support the involvement of patients and the public in monitoring the effectiveness of services provided for the NHS by the third sector and the private sector. 
Ann Keen: The Local Government and Public Involvement in Health Act 2007, set out important new arrangements for the involvement of patients and the public in health and social care, including local involvement networks (LINks). LINks will enable local people to monitor local services irrespective of who provides them.
LINks will build on the work of voluntary and community sector groups; and, enable genuine involvement of a far greater number of people than is currently available, ensuring local communities have a stronger voice in the process of commissioning health and social care and enabling them to influence key decisions about the services they both use and pay for.
In order to ensure that independent sector providersbe they from the private or third sectorco-operate with LINks, we will make directions requiring primary care trusts and local authorities to ensure that their contracts with the independent and third sectors allow LINks entry to appropriate premises and access to appropriate information. This will ensure that LINks will have the same levels of access as they do in the public sector. These changes are aimed at promoting open and transparent communication between communities and the health service, and will develop trust and confidence, increasing accountability to local people.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what proportion of (a) men and (b) women were underweight in (i) 2005, (ii) 2006 and (iii) 2007, (1) in total and (2) broken down by age. 
Data on underweight prevalence among men and women in England in 2005 and 2006, broken down by age group can be found in the Health Survey for England 2006 latest trends, published 31 January 2008. The data are presented in table 4 (body mass index) of the Adult trend tables 2006. This publication and the tables are available in the Library.
Mr. Hancock: To ask the Secretary of State for Health if he will introduce (a) mandatory training for staff who are involved in restraint or other physical interventions in mental health units, (b) an accreditation scheme for trainers in necessary restraint skills and (c) definitive guidance on the management of violence in mental health acute units. 
Mr. Ivan Lewis: The National Institute for Health and Clinical Excellence published guidelines in 2005 entitled Short-term Management of Violence and Disturbed Behaviour in Psychiatric In-patient Settings and Emergency Departments. These guidelines state that all service providers should have a policy for training in physical intervention that specifies the frequency and level of training required.
The NHS Security Management Service has developed training for all National Health Service staff in mental health and learning disabilities settings entitled The Promoting Safer and Therapeutic Services training-programme. This does not include training in physical intervention techniques.
The Department and the National Institute for Mental Health in England (NIMHE) are committed to the accreditation of training and regulation of trainers in the prevention and management of aggression and violence and are currently working to ensure the introduction of an effective accreditation system.
On 8 February, consultation ended on definitive guidance by NIMHE entitled The National Minimum Standards for the Safe and Therapeutic Management of Aggression and Violence in Mental Health In-patient Settings. Responses to this consultation are being considered.
Dr. Kumar: To ask the Secretary of State for Health what estimates he has made of the number of people who experience migraine in (a) England, (b) the North East, (c) Tees Valley district and (d) Middlesbrough South and East Cleveland constituency. 
Dr. Richard Taylor: To ask the Secretary of State for Health if he will require the National Centre for Involvement to provide information, advice and learning opportunities to patients, NHS service users and local involvement networks members in relation to improving consultation at national, regional and local levels in the NHS. 
The NHS Centre for Involvement (NCI) is a consortium of organisations comprising the University of Warwick, Centre for Public Scrutiny and Long Term Conditions Alliance. The NCI has been contracted by
the Department to promote more effective patient and public involvement and consultation and to provide support, advice and guidance to stakeholders in this respect. Key among those receiving the NCIs support are patients and the public themselves.
The NCI is delivering a major programme of work to support those involved in local involvement networks (LINks)patients, users of social services and the public, as well as those groups and organisations involved in supporting and participating in LINks. The NCI also provides information to members of the public more generally about patient and public involvement in the national health service.
Bob Spink: To ask the Secretary of State for Health if he will take steps to ensure that (a) the NHS Centre for Involvement, (b) NHS service users and (c) local involvement networks members improve consultation at national, regional and local levels. 
Ann Keen: The Department is taking a number of steps to improve consultation at all levels. It has contracted with the NHS Centre for Involvement (NCI) to promote and support more effective patient and public involvement and consultation throughout the national health service. The Department is in close contact with the NCI to ensure that the NCI continues to develop its work in this area and constantly seeks to improve the support it offers to the NHS.
Additionally, the Department is currently developing statutory guidance, in accordance with the requirements of section 242 of the NHS Act 2006, which will set out the requirements of NHS bodies to involve and consult patients and the public in the design, development and improvement of health services. The Department is also completing the legislative base for local involvement networks (LINks) which are to be established from April 2008 onwards.
LINks will provide a more flexible and open means by which peoples' views and experiences can inform local services, and enable the NHS to develop a more long-term and meaningful dialogue with the public. As well as the primary and secondary legislation to support LINks, the Department is also developing supportive guidance for those involved in making LINks effectivethose who participate in them as well as those organisations which will develop relationships with them. The NCI is also developing a comprehensive package of support to enable LINks to operate at their best.
Ann Keen: Patient and public involvement is key to developing and delivering responsive and accountable health and social care services. For effective involvement, people need to feel supported and that their contribution has been valued. This can be done in a number of ways, including participants being thanked and their contribution acknowledged.
It will be for each Local Involvement Network (LINk) to determine its own policy regarding payment and reimbursement. However, we will remind LINks and host organisations that the Departments Reward and Recognition document which is available in the Library and is also on the Departments website at:
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