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|Count of emergency hospital admissions and rate per 1000 population for 2002-03 to 2006-07national health service hospitals, England, and activity performed in the independent sector in England commissioned by English NHS|
|Emergency hospital admissions||Population for England||Estimated rate per 1,000 population|
1. Population data and rates:
The population data used was provided by the Populations and Geographies team in the NHS Information Centre. These figures are for calendar years only; therefore 2006-07 HES data uses 2006 population data. Also the population data are for residents of England whereas HES data are for activity in NHS Hospitals England and activity performed in the independent sector in England commissioned by English NHS.
2. 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.
3. Data quality:
Hospital Episode Statistics (HES) are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England. Data are also received from a number of independent sector organisations for activity commissioned by the English NHS. 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.
4. Finished admission episodes:
A finished admission episode is the first period of inpatient care under one consultant within one health care provider. Finished admission episodes are counted against the year in which the admission episode finishes. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
5. The following admission methods were used to identify 'emergency hospital admissions:
21 = Emergency: via Accident and Emergency (A and E) services, including the casualty department of the provider
22 = Emergency: via general practitioner (GP)
23 = Emergency: via Bed Bureau, including the Central Bureau
24 = Emergency: via consultant outpatient clinic
28 = Emergency: other means, including patients who arrive via the A and E department of another health care provider
Hospital Episode Statistics (HES), The NHS Information Centre for health and social care
Andrew George: To ask the Secretary of State for Health (1) what methodology his Department uses to assess the (a) clinical standards, (b) safety and (c) patient outcomes of specialist (i) services and (ii) surgical procedures and support in each (A) acute hospital and (B) acute hospital trust; 
Mr. Bradshaw: The independent healthcare regulator, the Healthcare Commission, is responsible for assessing the performance of NHS trusts and has recently published the results of its annual health check for 2007-08. Departmental officials have passed on the hon. Member's queries to the Chief Executive of the Healthcare Commission who will write directly to the hon. Member on the points he has raised.
Harry Cohen: To ask the Secretary of State for Health if he will make it his policy to ensure that the additional services currently provided to patients by dispensing appliance contractors are maintained under the proposed new arrangements under Part IX of the Drug Tariff for the provision of stoma and urology services in primary care; and if he will make a statement. 
Phil Hope: Throughout the review of the arrangements under part IX of the Drug Tariff for the provision of stoma and urology appliancesand related servicesin primary care, one of the Departments key aims has been to maintain, and where applicable improve, the current quality of care to patients and to provide a consistent level of care.
The Department recognises that dispensing appliance contractors provide a number of services which many users value. However, these services are not required under the terms of their NHS service provision. Therefore, the Department wants to make sure that key services are included in the arrangements for the provision of pharmaceutical services made by primary care trusts under part 7 of the NHS Act 2006, and incorporated into the terms of service set out in the NHS (Pharmaceutical Services) Regulations 2005and that such services are provided to the same standard. The Department also proposes to make a contribution towards the cost of these services.
Proposals relating to both amendments to terms of service were set out in the consultation entitled Proposed new arrangements under Part IX of the Drug Tariff for the provision of stoma and urology appliancesand related servicesin Primary Care. June 2008. The consultation closed on 9 September and all responses are being evaluated against the Departments stated aimsparticularly those relating to patient carebefore any decisions are made.
Mr. Stephen O'Brien:
To ask the Secretary of State for Health pursuant to the answer to the hon. Member for Romsey (Sandra Gidley) of 9 January 2008, Official
Report, columns 594-95W, on influenza, what progress he has made towards the delivery of the initial phase of the National Flu Line Service by the end of 2008; what steps comprise the initial phase of implementation; what other phases of implementation are required for the service to become operational; and if he will make a statement. 
Dawn Primarolo: The National Pandemic Flu Line Service will be available in the event of a pandemic, to provide rapid access to antiviral treatment and to ease the burden on front-line health care services.
Keith Vaz: To ask the Secretary of State for Health (1) how much Leicester City Primary Care Trust spent on specialist treatment for alcohol dependency in (a) 2007 and (b) 1997; how many cases of alcohol dependency it dealt with in each of those years; and what treatments it makes available for people with alcohol dependency; 
(2) what the Leicester City Primary Care Trust budget for preventative measures against alcohol dependency was in (a) 2007 and (b) 1997; what the average waiting time for specialist treatment for alcohol dependency in the trust area was in each of those years; how much the trust spent on residential treatment for alcohol dependency in each of those years; and what its budget for alcohol awareness campaigns was in each of those years. 
Safe. Sensible. Social. The next steps in the National Alcohol Strategy was published in 2007 and sets out this Government's strategy to tackle harmful and binge drinking. A copy of this document is already in the Library.
Funding is allocated directly to primary care trusts (PCTs), including Leicester City PCT, who are responsible for commissioning appropriate services to meet the needs of their local populations. This includes investing in preventing and treating harm caused by alcohol. Leicester City PCT will be receiving £150,000 as part of a pilot scheme to trailblaze new approaches to tackle alcohol misuse in health inequality hotspots across the city.
To ask the Secretary of State for Health (1) what assessment he has made of (a) the application of the incremental cost-effectiveness ratio used by the National Institute for Health and Clinical Excellence in its assessment of treatments for very rare conditions
assessed as costing between £50,000 and £300,000 per quality-assisted life year and (b) the effect of this practice on the level of uptake of medicines for rare conditions; 
(2) what representations he has received on the application by the National Institute for Health and Clinical Excellence of its incremental cost-effectiveness ratio to its assessment of treatments for very rare conditions assessed as costing between £50,000 and £300,000 per quality-assisted life year. 
Dawn Primarolo: The methodology used by the National Institute for Health and Clinical Excellence (NICE) to develop its guidance is determined by NICE itself. NICE publishes details of its appraisal methodology in its Guide to Methods of Technology Appraisal and its Social Value Judgements: Principles for the Development of NICE Guidance. Both of these documents have recently been reviewed following public consultation and are available on NICE'S website at:
I also refer the hon. Member to the Secretary of State for Health's statement to the House on 4 November about Professor Mike Richards review of current policy concerning NHS patients who wish to pay for additional private drugs. This statement reported on proposals received from NICE to apply more explicit flexibility to the appraisal of high cost drugs for less common terminal illnesses, including rarer cancers.
Mr. Bone: To ask the Secretary of State for Health if he will bring forward proposals to (a) provide better information to people about treatment available at independent sector treatment centres (ISTCs) and (b) provide free transport for patients to ISTCs. 
Mr. Bradshaw: As part of the wave 1 and phase 2 independent sector treatment centre (ISTC) contracts providers are legally required to produce referring health service bodies (RHSB) literature and patient literature. It is therefore the responsibility of the provider to provide information to people about treatment available at ISTCs.
The ISTC contracts stipulate that RHSB literature should include but not be limited to: a description of the nature of the activities provided at each facility including information for GPs and other referrers; information about the referral process; logistical information such as maps detailing the location of the ISTC.
The contracts also set out that patient literature should include but not be limited to the following: a description of the activities provided at each facility; a general explanation of the referral process and the likely length of stay and the likely time involved for the activity or length of appointment.
Patients referred to ISTCs are eligible, as are all national health service patients, for free travel to and from premises providing NHS health care and between NHS health care providers as long as it is non-urgent, planned and based on medical need. If a health care professional were to refer a patient to an ISTC, then free transport would be available provided the patient met the aforementioned criteria. However, this would be for the local NHS to decide and arrange accordingly.
Under certain circumstances, patients who are attending an ISTC for NHS-funded treatment who do not qualify for free transport may be eligible for the reimbursement of the costs they incur in travelling to and from their appointment through the Healthcare Travel Costs Scheme. This is part of the NHS Low Income Scheme and ensures that no one foregoes care because of financial constraints.
Mr. Yeo: To ask the Secretary of State for Health how many people (a) had access to and (b) were registered with an NHS dentist immediately prior to the introduction of the new NHS dental contract in (i) Suffolk and (ii) South Suffolk. 
Ann Keen: The number of patients registered with a national health service dentist in England as at 31 March from 1997 to 2006 is available in Annex A of the report NHS Dental Activity and Workforce Report, England: 31 March 2006. Information is provided by primary care trust (PCT) and by strategic health authority (SHA). Annex C provides information by constituency.
This information is based on the old contractual arrangements that were in place up to and including 31 March 2006. This report has already been placed in the Library and is also available on the website of the Information Centre for health and social care at:
Under the new dental contractual arrangements, introduced on 1 April 2006, patients do not have to be registered with an NHS dentist to receive NHS care. The closest equivalent measure to 'registration' is the number of patients receiving NHS dental services (patients seen) over a 24-month period. However, this is not directly comparable to the registration data for earlier years.
The numbers of patients seen by an NHS dentist in England in the 24-month period ending 31 March 2006 are included within Table CI of Annex 3 of the report NHS Dental Statistics for England: Quarter 3: 31 December 2007. Information is provided by SHA and PCT. Information is not available by constituency.
The Department has made no such assessment. Primary care trusts (PCTs) are responsible for commissioning dental care services to reflect local
needs and priorities. We have made increasing the number of patients seen within national health service dental services year on year a formal priority for PCTs in the NHS Operating Framework for 2008-09 (which has already been placed in the Library). We have supported this with a substantial 11 per cent. uplift in overall dental funding allocations to PCTs from 1 April 2008.
Ann Keen: The numbers of dentists with national health service activity during the years ending 31 March 2007 and 31 March 2008 are available in Table G1 of Annex 3 of the report NHS Dental Statistics for England: 2007-08. This has already been placed in the Library. Information is provided by strategic health authority and by primary care trust but is not available by constituency. This information is based on the new dental contractual arrangements, introduced on 1 April 2006.
Following a recent consultation exercise, this measure is based on a revised methodology and therefore supersedes previously published workforce figures relating to the new dental contractual arrangements. It is not comparable to the information collected under the old contractual arrangements. This revised methodology counted the number of dental performers with NHS activity recorded via FP17 claim forms in each year ending 31 March. This report has already been placed in the Library and is also available on the website of the Information Centre for health and social care at:
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