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20 Oct 2008 : Column 70Wcontinued
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1. Assignment of episodes to years: Years are assigned by the end of the first period of care in a patient's hospital stay.
2. Finished admission episodes: A finished admission episode is the first period of in-patient care under one consultant within one health care provider. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
3. Cause codestab wounds(1): The cause code is a supplementary code that indicates the nature of any external cause of injury, poisoning or other adverse effects. HES has used the following ICD-10 external cause codes when referring to stab wounds.
W26Contact with knife, sword or dagger.
X99Assault by sharp object.
4. Data quality: Hospital episode statistics (HES) are compiled from data sent by over 300 NHS Trusts and Primary Care Trusts (PCTs) in England. The NHS 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.
5. 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. Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity. 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 outpatient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time.
6. Ungrossed data: Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
7. Low numbers: Due to reasons of confidentiality, figures between 1 and 5 have been suppressed and replaced with * (an asterisk).
8. Primary care trust (PCT) and strategic health authority (SHA) data quality: PCT and SHA data was 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 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.
Hospital Episode Statistics (HES), The NHS Information Centre for Health and Social Care
Primary Care Trust (PCT) and Strategic Health Authority (SHA) Population data
1997-2006 SHA Mid Year Estimates, 2001 Census based. Source: ONS Population Estimates Unit
2002-06 PCT population data is calculated out on the new ONS methodology and are the recognised population estimates. Previous methodology was applied to data of 2001 only but has been disregarded for the purpose of this PQ as the totals of the old methodologies and new methodologies will not be the same.
Mr. Vara: To ask the Secretary of State for Health what the average cost of medical care per head of prison population was in each of the last 10 years. 
Phil Hope: For 2008-09, a £202 million investment has been made in prison health care. Based on Current population figures, this equates to £2,435 per head.
The Department does not hold details of clinical care on a cost per case basis nor is information on previous years held centrally.
Mr. Baron: To ask the Secretary of State for Health when he expects his Department to respond to the letter sent by the hon. Member for Billericay to the Under-Secretary of State for Health, dated 25 September, on the subject of the accord between the NHS Litigation Authority and FirstAssist. 
Ann Keen: Information regarding the accord between FirstAssist and the NHS Litigation Authority (NHSLA) is not held by the Department. It is necessary to obtain the information from the NHSLA and every effort will be made to respond within the Department's Whitehall Standard target of 20 working days from receipt of the letter.
Mrs. Moon: To ask the Secretary of State for Health how much was spent on average in providing child and adolescent mental health services for each young offenders institution in each of the last eight years; and if he will make a statement. 
Phil Hope: Transfer of the responsibility for commissioning health services in young offender institutions, and adult prisons in England, commenced in 2003 and was fully devolved to the NHS by April 2006. Primary care trusts (PCTs) work with their partner establishments to develop a comprehensive health needs assessment of the population and commission on the basis of that need.
Since 2006 all funding, including funding for mental health, forms part of the wider health care allocation and is paid out as part of the NHS bundle and part of the PCT main allocation.
The Department has provided £1.5 million additional funding for 2007-08, repeated in 2008-09, to extend the range of child and adolescent mental health services in the secure estate for children and young people.
Mrs. Moon: To ask the Secretary of State for Health which child and adolescent mental health service inreach teams which carry out psychological assessments of young offenders at young offender institutions routinely carry out assessments of all offenders at those institutions; and if he will make a statement. 
Phil Hope: This information is not held centrally.
All young offenders receive health screening including mental health on reception into custody. This is via an evidence-based health screen used throughout all prisons in England and originally developed by Professor Grubin of the University of Newcastle.
Mrs. Moon: To ask the Secretary of State for Health if he will estimate the number of people who were serving sentences at each young offender institution who had been receiving treatment from child and adolescent mental health services prior to commencing their sentence in each of the last eight years. 
Phil Hope: This information is not available centrally.
The availability of health care records is something which Connecting for Health are actively pursuing through general practitioner (GP) to GP links. These systems are currently available in the wider community, but not yet available to the offender population.
Work is under way within the Department to look at GP registration for offenders and the road map for Prison Health IT as part of the future proofing for the current prison IT programme, and in recognition of any recommendations which fall out of the Bradley Review, CAMHS Review and the Children and Young People Health and Social Care Strategy, to ensure those wider Connecting for Health processes (such as GP registration and connectivity to the NHS spine) are made available to the wider offender population including young people.
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