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1 Sep 2008 : Column 1774W—continued


The purpose of the NHS Bursary award is to support students with their day-to-day living costs. Those students who are eligible for NHS bursaries do not normally need to fund their own tuition fees as these are paid by the NHS through the Multi Professional Education and Training budget.

Nurses

Mr. Lansley: To ask the Secretary of State for Health what the baseline year is for the threefold increase in nurse and midwife preceptorships, as referred to on page 72 of High Quality Care for All, Cm 7432; how much was spent on nurse and midwife preceptorships in that year; in what year he expects to achieve a threefold increase in spending on preceptorships; whether he expects a threefold increase in spending on preceptorships to result in a threefold increase in the number of preceptorships; and if he will make a statement. [221056]

Mr. Bradshaw: £10 million has been allocated to strategic health authorities (SHAs) in 2008-09 to support the development of work based learning and post registration support for nurses, midwives and some other professional staff. This includes preceptorship support for newly qualified staff.

This funding will be increased to £20 million in 2009-10 and to £30 million in 2010-11.

It is too early to identify actual spend on preceptorship support by the local national health service in the 2008-09 financial year, or the actual number of preceptorships offered.


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Nutrition

Mr. Stephen O'Brien: To ask the Secretary of State for Health what guidance he has issued to NHS organisations on obligations under the Human Rights Act 1998 to provide appropriate nutritional care. [212195]

Mr. Ivan Lewis: In March 2007 the Department of Health published “Human Rights in Healthcare—A Framework for Local Action” which raised awareness of human rights in general including the Human Rights Act 1998 and also addressed how national health service trusts could use a human rights based approach to improve service design and delivery, including the right to food.

Individual nutritional care is addressed at a local level, with each NHS trust setting its own policies of nutritional care in hospitals and out reach care. I launched the Nutrition Action Plan in October 2007, setting out a range of resources, guidance and best practice on how to improve nutrition delivered in health and social care settings. A Nutrition Action Plan Delivery Board has been established to steer implementation of the document, which is chaired by Gordon Lishman, Director General of Age Concern.

Obesity

Mrs. Riordan: To ask the Secretary of State for Health what steps his Department is taking to reduce levels of obesity. [220030]

Dawn Primarolo: In the six months since the £372 million Healthy Weight, Healthy Lives: a Cross Government Strategy for England was published there has been substantial progress. The forthcoming progress newsletter Healthy Weight, Healthy Lives: six months on, has been placed in the Library.

The newsletter highlights the steps forward for the next six months across all five themes of the Strategy: children, healthy growth and weight; promoting healthier food choices; building physical activity into our lives; creating incentives for better health; and personalised advice and support for all.

Palliative Care

Mr. Stephen O'Brien: To ask the Secretary of State for Health what measures he has set for the assessment of the (a) implementation, (b) achievement against objectives and (c) effect on end of life care of his Department’s end of life care strategy. [221426]

Mr. Ivan Lewis: The number of deaths which occur in the home is one of the national indicators which have been agreed with the Department for Communities and Local Government. Local areas are required to report progress against these indicators. Supporting care provision in the community, and enabling more people to die at home, is a central component of the End of Life Care Strategy.

The Government are committed to delivering increased investment in end of life care services.


1 Sep 2008 : Column 1776W

National quality standards are also being developed against which primary care trusts and providers can assess themselves and be assessed by regulators.

The Department will also undertake piloting work to develop a national survey of bereaved relatives, which will provide important information on the quality of care provision.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what estimate he has made of the cost of implementation of the end of life care strategy; and how it will be funded from the NHS and from (a) the voluntary and (b) the independent sectors. [221427]

Mr. Ivan Lewis: The impact assessment for the End of Life Care Strategy sets out the estimated costs associated with the implementation of the strategy.

The Government have made £286 million of funding available in the two years to 2011 to cover the costs of implementation. The majority of this funding will be made available to primary care trusts and strategic health authorities, who are responsible for commissioning services and education and training from local providers, including the independent and voluntary sector. The additional resources also include a capital fund of £40 million, to be made available in 2010-11, for the voluntary hospice sector.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what funding mechanisms his Department has examined for the facilitation of the flow of funds from the commissioners to the providers of end of life care services. [221428]

Mr. Ivan Lewis: Several local health economies are currently investigating Payment by Results (PbR)-type funding approaches for specialist palliative care and community services, as PbR “development sites”. However, we currently have no timetable for including end of life care in PbR.

The End of Life Care Strategy sets out the importance of strong commissioning of services by both primary care trusts (PCTs) and local authorities (LAs). This will be informed by the Joint Strategic Needs Assessment that all PCTs and LAs are required to produce from April 2008.

The strategy also reminds PCTs and LAs of the need to comply with the Compact on Relations between Government and the voluntary and community sector in England, which should provide a fair playing field for all service.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what steps he plans to take to ensure that health and social care staff receive training in end of life care to enable them to deliver the objectives of the end of life care strategy. [221431]

Mr. Ivan Lewis: To underpin and support training for health and social care staff, the Department has commissioned Skills for Health and Skills for Care to develop end of life care competence frameworks. e-Learning for Healthcare are also being commissioned to develop end of life care e-learning modules that will provide free access to registered users across both health and social care.


1 Sep 2008 : Column 1777W

Mr. Stephen O'Brien: To ask the Secretary of State for Health what estimate he has made of the cost of training health and social care staff in end of life care to enable them to deliver the objectives of the end of life care strategy. [221432]

Mr. Ivan Lewis: The Impact Assessment for the End of Life Care Strategy sets out the estimated costs, and the rationale behind them, associated with training the health and social care work force to support the delivery of the strategy.

Patient Choice Schemes

Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 20 May 2008, Official Report, column 204W, on patient choice schemes, which hospitals were affected by the system error; which specialisms the affected bookings were for; and how many cases were adversely affected. [221275]

Mr. Bradshaw: The systems error is known to have affected 272 bookings, between 11 April 2008 and 24 April 2008, out of some 180,000 bookings made during that period. To our knowledge, no patients had their treatment delayed as a result.

A list of the service providers which were affected by the system error, along with names of the services to which patients had been referred, has been placed in the Library.

Anne Main: To ask the Secretary of State for Health how many primary care trusts commission the patient choice service; and if he will make a statement. [221729]

Mr. Bradshaw: Free Choice was introduced on 1 April. The introduction of Free Choice has removed the requirement for primary care trusts to carry out local commissioning of elective care hospital-based services. Patients can choose to be referred to any clinically appropriate provider that meets national health service eligibility criteria. This will include NHS foundation trusts, NHS acute trusts and a large number of independent sector providers and their hospitals.

Anne Main: To ask the Secretary of State for Health which NHS foundation trusts put their services on the national menu under the patient choice scheme; which primary care trusts commission this scheme; and how
1 Sep 2008 : Column 1778W
his Department plans to monitor the effectiveness of the scheme. [221730]

Mr. Bradshaw: All new foundation trusts and existing foundation trusts whose contracts expired by 31 March adopted the standard national health service contract for acute services. The standard contract requires all signatories set out relevant services in Choose and Book through a Directory of Service. Foundation trusts whose contracts extended beyond this date were able to choose to adopt the standard contract or to retain their existing contracts until the required period of notice to change had expired. These foundation trusts are not legally obliged to set out their services on Choose and Book and to accept patients under free choice though, under payment by results, this would mean a possible loss of potential income. At the current time, all foundation trusts have published a Directory of Service on Choose and Book.

The introduction of Free Choice has removed the requirement for primary care trusts to carry out local commissioning of elective care hospital-based services. The Department monitors free choice services available through the Choose and Book system and also monitors the offer of choice through the bimonthly National Patient choice survey.

Anne Main: To ask the Secretary of State for Health whether he plans to extend the patient choice scheme to infertility services. [221731]

Dawn Primarolo: Since January 2006 most patients have had choice of where they are seen when they are first referred by their general practitioner for an out-patient appointment. This includes couples who are being referred to a specialist, either for tests to determine the cause of infertility or where the cause is known.

Patients: Safety

Mr. Lansley: To ask the Secretary of State for Health how many patient safety incidents of each type in each strategic health authority area have been reported to the National Reporting and Learning System since it was established. [221026]

Ann Keen: The following tables show patient safety incidents of each type in each strategic health authority (SHA) area that have been reported to the National Reporting and Learning System since it was established in 2003.


1 Sep 2008 : Column 1779W

1 Sep 2008 : Column 1780W
Incidents reported to the NRLS (1 Nov 2003 - 30Jun 2008) by SHA, broken down by incident type
Incident Category N/A North East North West Yorkshire and the Humber East Midlands West Midlands

Access, admission, transfer, discharge (including missing patient)

12,023

29,916

24,272

16,506

11,408

Clinical assessment (including diagnosis, scans, tests, assessments)

4,995

19,250

12,532

8,731

5,648

Consent, communication, confidentiality

3,577

17,954

9,310

8,087

6,048

Disruptive, aggressive behaviour

11,237

15,085

17,202

11,393

6,784

Documentation (including records, identification)

5,056

18,159

15,270

10,023

12,562

Infection Control Incident

2,364

5,289

2,943

3,566

3,080

Implementation of care and ongoing monitoring / review

3,291

7,993

6,044

5,100

4,179

Infrastructure (including staffing, facilities, environment)

3,496

21,887

18,267

10,080

7,570

Medical device/equipment

(1)

2,910

12,600

8,348

6,178

5,860

Medication

9,804

29,306

26,172

16,325

13,683

Patient abuse (by staff/third party)

1,477

2,536

1,259

1,783

1,924

Patient accident

55,132

135,863

119,306

64,714

65,329

Self-harming behaviour

7,242

13,245

9,952

9,795

6,350

Treatment, procedure

9,930

33,162

23,783

14,191

15,954

Not stated

18

75

45

33

32

Other

5,594

10,376

7,329

4,360

5,739

Total

1

138,146

372,696

302,034

190,865

172,150


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