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Palliative Care

John Mann: To ask the Secretary of State for Health what his Department’s policy is on “do not resuscitate” decisions. [228447]

Ann Keen: Individual decisions about resuscitation, like all treatment decisions, are a matter for the health professionals and patients involved. Health professionals should discuss possible treatment options with patients, including, where appropriate, whether resuscitation should be attempted. If it is agreed that resuscitation should not be attempted, then this agreement should be noted in the person’s medical records (a “do not attempt resuscitation” order). As with other treatments, a person with capacity can make an advance decision to refuse resuscitation, which must be followed if it is valid and applicable.

If the patient does not have the capacity to make the decision, then health professionals will need to make treatment decisions in line with the Mental Capacity Act. The decision must be made in the person’s best interests, which includes consideration of the person’s wishes and preferences and the person’s medical condition and the likely success of resuscitation, in discussion with the person’s family and friends.

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Trusts and other organisations should have resuscitation policies in place that reflect clinical best practice and the legal position.


Mr. Evans: To ask the Secretary of State for Health how many GP dispensaries there are in (a) Ribble Valley constituency, (b) Lancashire and (c) England. [228536]

Mr. Bradshaw: Data are only available by primary care trust area and for England only. Information relating to Wales, Scotland and Northern Ireland is a matter for each Devolved Administration.

The Ribble Valley constituency is covered by two PCTs—Central Lancashire PCT and East Lancashire PCT. There are five PCTs covering the Lancashire area—Central Lancashire PCT; East Lancashire PCT; North Lancashire PCT; Blackpool PCT and Blackburn and Darwen PCT.

Information on the number of dispensing practices in each PCT area is given in the following table.

Dispensing Non-dispensing

Blackburn and Darwen PCT (5CC)



Blackpool PCT (5HP)



Central Lancashire PCT (5NG)



East Lancashire PCT (5NH)



North Lancashire PCT (5NF)






1. Hyndburn and Ribble Valley PCT became part of East Lancashire PCT on 1 October 2006.

As at 16 October 2008, there were 1,122 dispensing general practitioner practices in England.

Pharmacy: Licensing

Mr. Burns: To ask the Secretary of State for Health how many pharmaceutical licences have been awarded under Section 13 of the NHS (Pharmaceutical Services) Regulations 2005 in (a) West Chelmsford parliamentary constituency, (b) Chelmsford local authority area and (c) England. [228033]

Phil Hope: One pharmacy application under regulation 13 of the 2005 regulations was granted in the period 2005-06 to 2006-07 in mid-Essex primary care trust (PCT) and its predecessor organisations (Chelmsford, Maldon and South Chelmsford and Witham, Braintree and Halstead PCTs)—the local geographic area for which data is collected centrally. There were 542 such applications approved in England in the same period. Figures for 2007-08 will be published by the Information Centre for health and social care in due course.

Physiotherapy: Waiting Lists

Sarah Teather: To ask the Secretary of State for Health what steps his Department is taking to reduce
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waiting times for physiotherapy for elderly and vulnerable patients. [225482]

Ann Keen: Information about waiting times for physiotherapy is not collected centrally. It is for primary care trusts in partnership with local stakeholders, including practice-based commissioners, local government and the public to determine how best to use their funds to meet national and local priorities for improving health and to commission services accordingly. This process provides the means for addressing local needs within the health community including access to physiotherapy.

The national health service has seen historical levels of investment and a period of expansion in the work force to improve services and reduce waiting times since 1997. The number of physiotherapists employed in the NHS has increased by 41 per cent. since 1997, from 14,243 to 20,146 in 2007.

In the White Paper, “Our Health our care, our say” (CM 6737) (copies of which are available in the Library), we set out the future direction for health care, including access to physiotherapy. We have collaborated with the Chartered Society of Physiotherapy to pilot and evaluate self-referral to physiotherapy. The conclusions from these pilots will be included in a report to be published shortly.

Physiotherapy services are included in the 18-week patient pathway if their intervention forms part of a consultant-led pathway. The Allied Health Professions (AHP) Service Improvement Programme was undertaken to support AHP service improvement through information management. The outcomes of the programme are the Physiotherapy Pathway Improvement Tool and the Information Management Handbook for AHP Services. Both interactive documents build on good practice to provide guidance for benchmarking current practice, making improvements and monitoring progress. The tools are available on the 18 weeks website at:

The “NHS Next Stage Review: Our Vision for Primary and Community Care” outlined an intention to support the NHS and community clinicians in making radical change through the transforming community services programme (TCS). Copies of this publication are available in the Library. The clinical and service development workstream within TCS will focus on six clinical areas that will support the improvement of AHP services including physiotherapy for older and vulnerable people.

Social Services

Mr. Lansley: To ask the Secretary of State for Health which local authorities have responsibility for social care services. [226278]

Phil Hope: There are 150 councils with social services responsibilities in England. They are:

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