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18 Dec 2008 : Column 1102W—continued

Mentally Ill

John Bercow: To ask the Secretary of State for Health what recent progress has been made by the National Social Inclusion working group on the co-ordination and establishment of regional employment partnerships for people with mental health problems; and if he will make a statement. [240716]

Phil Hope: The National Social Inclusion Programme's regional employment teams (RETs) on Mental Health initiative is a two year project to implement action 23 of the Social Exclusion Task Force report “Reaching Out, An Action Plan on Social Exclusion” (Cabinet Office, 2006). Action point 23 relates to improving employment outcomes for people with severe mental health conditions. It also aims to encourage local activity to achieve the mental health employment target of public service agreement 16 (PSA 16), to improve employment and housing outcomes for socially excluded groups.

During their first year of operation the range of activity undertaken by RETs included regional summits of key partners, the creation of strategy groups with partnership meetings and stakeholder events and the development of a regional action plan and statement of priorities.

The RETs have also looked at how best to influence existing policies and strategies, such as the development of the city strategy initiative and roll out of Pathways to Work and Increasing Access to Psychological Therapies programmes.

As well as local activity the RETs provide ongoing input into development of national policy. This includes working with the Cabinet Office on data collection and measuring progress against mental health employment target under PSA16, and input into the cross-Government group on mental health and employment.

The other critical policy development for the RETs activity is the cross Government response to Dame Carol Black’s report “Working for a healthier tomorrow” in which mental health is both a cross cutting theme as well as forming a separate work stream.

National Support for Local Implementation

John Bercow: To ask the Secretary of State for Health what assessment he has made of the extent of local use of his Department's resource tool National Support for Local Implementation in relation to long-term conditions. [245735]

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Ann Keen: We have made no assessment of the extent of local use of the resource tool National Support for Local Implementation.


John Bercow: To ask the Secretary of State for Health what progress has been made towards achieving the 11 quality requirements to improve treatment, care and support from diagnosis to end of life for people with neurological conditions in 2008. [245736]

Ann Keen: We have made no assessment of the progress made towards the 11 quality requirements to improve the treatment, care and support to those with neurological conditions published in the National Service Framework for Long-term (neurological) Conditions (the NSF), a copy of which has been placed in the Library.

Since publication of the NSF, the Department has provided service planners, commissioners and providers with guidance, expert advice and support to help them to deliver the NSF's quality requirements. However, in line with devolving responsibility to local organisations, we are moving to new phase with much greater emphasis on local health and social care communities and the third sector taking responsibility for driving forward service change and improvement.

NHS: Finance

Chris Ruane: To ask the Secretary of State for Health (1) with reference to the answer of 26 November 2008, Official Report, column 2066W, on departmental public expenditure, whether the weighted capitation formula for National Health Service allocations takes into account (a) transience of, (b) levels of alcohol and drug abuse in, (c) the number of elderly people in, (d) the number of households not meeting the decent housing threshhold in, (e) the number of people on incapacity benefit in and (f) the number of vulnerable children and adults in local populations; [244404]

(2) whether the weighted cap funding for health used by his Department includes weighting for the number of (a) houses of multiple occupation, (b) caravan parks and (c) other forms of housing associated with transient populations. [244847]

Mr. Bradshaw: Revenue allocations to primary care trusts (PCTs) in England for 2009-10 and 2010-11 were announced on 8 December 2008. They were informed by the new weighted capitation formula for England developed by the independent Advisory Committee on Resource Allocation (ACRA).

The weighted capitation formula for England is based on an assessment of the relative need for health care services, which takes account of the size, age, health status and socio-economic characteristics of PCTs’ populations. The weighted capitation formula takes direct account of the number of elderly people, and for the health and community health services component, the number of people on incapacity benefit. The formula also takes into account the number of asylum seekers. The other characteristics listed are not taken into account directly within the formula.

As part of the review that informed the new formula, ACRA commissioned independent research on the appropriate elements to be included in the weighted
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capitation formula. The new formula includes a range of socio-economic characteristics and indicators of deprivation, all of which have been tested for technical robustness and materiality.

The full list of factors taken into account in the weighted capitation formula is set out in the Department’s publication “Resource Allocation: Weighted Capitation Formula, Sixth Edition”, which has been placed in the Library, and is also available at:

The “Report of the Advisory Committee on Resource Allocation” has already been placed in the Library and is also available at:

The research reports supporting ACRA’s review will also be published shortly.

NHS: Stress

Mr. Breed: To ask the Secretary of State for Health what steps he plans to take in response to the finding in the Healthcare Commission’s report State of Healthcare 2008 that 33 per cent. of NHS staff report that they are stressed at work. [244225]

Ann Keen: The 33 per cent. figure quoted in the State of Healthcare Report 2008 is taken from the NHS Staff Survey Report 2007.

It is important that the staff survey results inform future work to improve the working lives of NHS staff at national, regional and local level.

NHS Employers has developed a range of advice, guidance and tools to support employers in addressing stress in the workplace and these can be found at:

For example in spring 2009 NHS Employers, working in partnership with the Health and Safety Executive, staff side organisations and the NHS Litigation Authority will be running a series of workshops to exchange good practice already developed with the service.

Peterborough and Stamford Hospitals NHS Foundation Trust: Strokes

Mr. Stewart Jackson: To ask the Secretary of State for Health how many specialist stroke nurses were employed by the Peterborough and Stamford Hospitals NHS Foundation Trust in each year since 2001; and if he will make a statement. [244130]

Ann Keen: The information requested is not held centrally.

Mr. Stewart Jackson: To ask the Secretary of State for Health how many patients were treated for stroke-related conditions in the Peterborough and Stamford Hospitals NHS Foundation Trust and its predecessor trust in each year since 1997; and if he will make a statement. [244131]

Ann Keen: The information requested is not available in the format requested.

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Only data on hospital admissions and activity within hospitals are collected and not all incidences of strokes are treated within a hospital setting.

The Department holds information on patients treated in an in-patient setting who have a diagnosis of stroke or late effects of a stroke recorded. Together, these do not cover all stroke-related conditions as there are a huge number of diagnoses a clinician may or may not include as being a result of a late effect of stroke.

Information on the total admissions to hospital in which the patient had a primary diagnosis of stroke and total admissions in which a patient had a secondary diagnosis of sequelae (late effects) of stroke for Peterborough and Stamford NHS Foundation Trust in years 2002-03 to 2006-07 is shown in the following table.

Primary diagnosis of stroke( 1) Sequelae (late effects) of stroke( 2)
















(1 ) Primary diagnosis:
The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital.
Primary Diagnosis of Stroke:
160—Subarachnoid haemorrhage
161—Intracerebral haemorrhage
162—Other nontraumatic intracranial haemorrhage
163—Cerebral infarction
I64—X Stroke, not specified as haemorrhage or infarction.
(2) Secondary diagnoses:
As well as the primary diagnosis, there are up to 19 (13 from 2002-03 to 2006-07 and six prior to 2002-03) secondary diagnosis fields in HES that show other diagnoses relevant to the episode of care.
Sequelae (late effects) of Stroke:
169.0—Sequelae of subarachnoid haemorrhage
169.1—Sequelae of intracerebral haemorrhage
169.2—Sequelae of other nontraumatic intracranial haemorrhage
169.3—Sequelae of cerebral infarction
169.4—Sequelae of stroke, not specified as haemorrhage or infarction.
1. Quality of care:
Data derived from HES cannot be used in isolation to evaluate the quality of care provided by national health service trusts or clinical teams. There are many factors that can affect the outcome of treatment and it is beyond the scope of HES to adequately record and reflect all of these.
2. Ungrossed data:
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
3. Finished admission episodes:
A finished admission episode is the first period of in-patient care under one consultant within one health care provider. Finished admission episodes are counted against the year in which the admission episode finishes. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
4. Data quality:
HES are compiled from data sent by more than 300 NHS trusts and primary care trusts in England. Data is also received from a number of independent sector organisations for activity commissioned by the English NHS. 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.
5. Assessing growth through time:
HES figures are available from 1989-90 onwards. The quality and coverage of the data have improved over time. 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.
Hospital Episode Statistics (HES), the Information Centre for health and social care.

Prescriptions: Contraceptives

Mr. Amess: To ask the Secretary of State for Health what pilot schemes on dispensing of the morning-after pill through pharmacies have taken place in each of the
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last five years; and what assessment he has made of the outcomes of each scheme. [245079]

Dawn Primarolo: These are local schemes and no national assessment has been made.

Primary Care Trusts

Mr. Burstow: To ask the Secretary of State for Health how many cases of exception reporting in each category of reason there were in each primary care trust area in each of the last three years for which figures are available. [244156]

Mr. Bradshaw: This information is not collected centrally.

Social Services: Coastal Areas

Chris Ruane: To ask the Secretary of State for Health with reference to the answer of 26 November 2008, Official Report, column 1516W, on social services: coastal areas, (1) if he will make it his policy centrally to collect data at (a) town and (b) ward level on out-of-county placements of vulnerable adults in the principal seaside towns of England and Wales; [244443]

(2) if he will consider the merits of collecting statistics on the placements of vulnerable people by social services departments, broken down by (a) county, (b) town, (c) ward and (d) lower super output area. [244991]

Phil Hope: The requirements for statistical returns from Councils with Adult Social Services Responsibilities (CASSRs) were set out in the answer of 26 November 2008, Official Report, column 1516W. These are national requirements made upon all relevant local authorities in England, including those areas constituting the principal seaside towns. There are no specific requirements which relate only to seaside towns, nor do these requirements extend to local authorities in Wales.

The current data requirements include information on out-of-area placements in residential care. Following the implementation of the new Local Performance Framework for Local Authorities and their Partners from April 2008, the Department has undertaken a review of its national adult social care collections. This review, facilitated by the NHS Information Centre for Health and social care, has been wide ranging and culminated in a public consultation on proposals for the future, conducted under national statistics rules. One of the recommendations of the review was to consider how the current information on out-of-area placements can be better collected to achieve an improved information resource for local partners. This is currently in discussion with partners, including the Commission for Social Care Inspection, to determine options for improving this data source, and further recommendations are expected to be made in 2009.

Tuberculosis: Disease Control

Harry Cohen: To ask the Secretary of State for Health what recent considerations his Department has given to measures to tackle tuberculosis infection in the UK. [244283]

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Dawn Primarolo: In June 2007 we launched a national TB Toolkit to support commissioning of tuberculosis (TB) services tailored to local needs, and reinforce the need for providers to follow the National Institute for Health and Clinical Excellence (NICE) guidelines on treatment of tuberculosis. The NICE guidelines make specific recommendations about active screening for TB infection among high-risk groups including homeless people and prisoners and among people who have been in close contact with someone with TB.

London TB services are funded by the Department to run a pilot study using a mobile X-ray unit (MXU) to screen homeless hostels and prisons. Evaluation of the pilot showed the MXU to be an effective case-finding tool among these populations. In addition, since October 2007 the Department has funded Find and Treat, a small multidisciplinary team of tuberculosis nurse specialists, social and outreach workers, to provide practical support and advice to TB services across London for around 300 patients with complex and challenging needs. Support includes: locating and re-engaging patients who have been lost to follow-up care; providing links between prison health and the MXU to NHS tuberculosis services; organising case conferences and directly observed therapy (DOT) partnerships and engaging relevant allied support services in the community to help patients complete treatment.

The Home Office has a long standing policy of referring passengers from countries with a high risk of TB seeking entry to the UK for more than six months for medical examination at ports of entry. Heathrow and Gatwick have X-ray machines, and any chest X-ray consistent with TB leads to the person being referred to local services.

There is also a programme of pre-entry screening for TB in some countries before a visa can be obtained (Bangladesh, Sudan, Tanzania, Pakistan, Thailand, Kenya and Ghana).

The prevention of tuberculosis relies on the early diagnosis and treatment of those with active disease so that they do not infect others and we are keeping emerging technologies for detection of latent disease under close review.

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