Grant Shapps:
To ask the Secretary of State for Health what recent discussions his Department has had with outside organisations to discuss policy on reducing the effect of the recession on matters within his Department’s responsibility. [254056]
Mr. Bradshaw:
The Department has regular engagement with a range of outside organisations and stakeholders. The Department will continue to maintain this dialogue including on issues related to the economy and the implications for health and social care.
General Practitioners
Mr. Bone:
To ask the Secretary of State for Health with reference to the answer of 6 November 2008, Official Report, column 693W, on general practitioners, what reasons have been identified for the reduction in numbers of GP referrals to consultants between 2003-04 and 2007-08. [255620]
Mr. Bradshaw:
The Department has not undertaken any specific research into the reasons for the slight decrease in general practitioner (GP) referrals to first consultant-led outpatient appointments between the period 2003-04 to 2007-08.
GP written referrals for first outpatient appointment (consultant-led): All specialties, England provider based
Number of GP referrals made
1997-98
8,991,722
1998-99
9,139,785
1999-2000
9,141,425
2000-01
9,362,770
2001-02
9,470,342
2002-03
9,655,874
2003-04
9,802,237
2004-05
9,776,914
2005-06
9,785,960
2006-07
9,337,136
2007-08
9,639,029
Source:
Department of Health, QM08, KH09, QAR (Quarterly Activity Return).
To improve the appropriateness of care patients receive, i.e. the right treatment from the right health care professional, in the right place and at the right time, the Department has issued guidance to the NHS ‘Care and Resource Utilisation’ (December 2006) (a copy of which has been placed in the Library), which sets out a range of ways in which primary care trusts and clinicians can work together to improve care provided to patients.
9 Feb 2009 : Column 1755W
Health Services: Milton Keynes
Mr. Lancaster:
To ask the Secretary of State for Health what the (a) average, (b) maximum and (c) minimum wait time has been at the Milton Keynes walk-in centre in January 2009. [255044]
Mr. Bradshaw:
This information is not held centrally, but can be obtained from Milton Keynes Primary Care Trust.
Health Services: Public Consultation
Roger Berry:
To ask the Secretary of State for Health how many responses the Department has received to the consultation, The case for change - why England needs a new care and support system. [254546]
Phil Hope:
I refer the hon. Member to the answer given to the hon. Member for Buckingham (John Bercow) on 15 December 2008, Official Report, column 238W.
Healthcare Commission
Mr. Clifton-Brown:
To ask the Secretary of State for Health what estimate he has made of the cost to the Healthcare Commission of investigating healthcare complaints in 2008-09. [254254]
Ann Keen:
We understand from the chairman of the Healthcare Commission that for the period April to December 2008 the cost to it of investigating complaints was £6.6 million. There were 6,011 complaints resolved in this period at an average cost of £1,102.
Mr. Clifton-Brown:
To ask the Secretary of State for Health how many complaints the Healthcare Commission has referred to the Health Services Ombudsman in 2008-09. [254255]
Ann Keen:
We understand from the chairman of the Healthcare Commission that in the period April to 9 Feb 2009 : Column 1756W
December 2008, 16 complaints were referred to the Parliamentary and Health Service Ombudsman.
Mr. Clifton-Brown:
To ask the Secretary of State for Health whether the Healthcare Commission has targets for the time it takes to (a) accept and (b) resolve complaints; and if he will make a statement. [254256]
Ann Keen:
We understand from the chairman of the Healthcare Commission that there are no targets for accepting cases. The Commission has a target of closing 95 per cent. of independent review requests within 12 months of the date of receipt. The Commission is currently closing 95 per cent. of cases within six months of receipt.
We are reforming the way complaints are responded to across health and social care. A new single system will be in place from April 2009. We have already started trying out the new approach in over 90 national health service and social care organisations across the country, known as ‘Early Adopters’.
The new approach is about making it easier and simpler for people wishing to make a complaint. Under the new arrangements for health, instead of the current three tiers of complaints handling (local NHS provider, the Healthcare Commission, then the Health Service Ombudsman) there will be a two tier system, with local resolution by the provider and then recourse to the Health Service Ombudsman.
Heart Diseases
Dr. Kumar:
To ask the Secretary of State for Health how many people were (a) diagnosed with and (b) received treatment for heart disease in (i) England, (ii) the North East, (iii) the Tees Valley district and (iv) Middlesbrough South and East Cleveland constituency in each of the last 10 years. [253426]
Ann Keen:
Please see the following tables and notes.
Table 1: Number of people diagnosed with heart disease
Financial year
Stockton on Tees Teaching primary care trust (PCT)( 1)
Middlesbrough PCT( 2)
Redcar and Cleveland PCT( 3)
North East total( 4)
England
2007-08
7,943
6,513
6,901
127,972
1,892,432
2006-07
8,007
6,537
6,982
129,478
1,898,565
2005-06
8,063
8,485
5,204
131,123
1,900,640
2004-05
8,079
8,541
5,313
131,668
1,893,184
(1) Formerly North Tees PCT. Following the PCT reconfiguration in 2006 (2) a part of Middlesbrough PCT joined with others to form Redcar and Cleveland PCT. Middlesbrough PCT remained but as a smaller PCT. (3) Langbaurgh PCT merged with a part of Middlesbrough PCT and became Redcar and Cleveland PCT. (4) For 2007-08 and 2006-07 the North East total is the total for North East Strategic Health Authority (SHA). For 2005-06 and 2004-05 the North East total is the sum of Northumberland, Tyne and Wear SHA and County Durham and Tees Valley SHA.
Table 2: Number of people who received treatment for heart disease—Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector
Financial year
Stockton on Tees Teaching PCT( 1)
Middlesbrough PCT( 2)
Redcar and Cleveland PCT( 3)
North East( 4)
England
2006-07
1,033
639
608
16,374
310,642
2005-06
1,145
885
491
16,363
312,164
2004-05
1,234
1,028
554
16,987
311,532
2003-04
1,134
1,146
609
17,934
310,418
2002-03
1,163
1,188
644
18,465
306,380
2001-02
1,159
1,275
734
18,812
295,050
2000-01
1,124
1,372
738
20,113
293,911
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9 Feb 2009 : Column 1758W
1999-00
1,109
1,474
779
19,723
289,729
1998-99
974
1,500
752
19,691
290,391
1997-98
957
1,352
665
18,289
284,269
(1) Formerly North Tees PCT. Following the PCT reconfiguration in 2006 (2) a part of Middlesbrough PCT joined with others to form Redcar and Cleveland PCT. Middlesbrough PCT remained but as a smaller PCT. (3) Langbaurgh PCT merged with a part of Middlesbrough PCT and became Redcar and Cleveland PCT. (4) For 2007-08 and 2006-07 the North East total is the total for North East SHA. For previous years the North East total is the sum of the constituent organisations existing at the time. Notes: The Information Centre (IC) have provided data from the national Quality and Outcomes Framework (QOF) to answer part (a) and data from the Hospital Episode Statistics (HES) to answer part (b). (a) The national QOF records the number of people recorded on practice disease registers. A register exists for coronary heart disease (CHD). Register counts are available for the last four financial years. The IC are unable to supply information for all the areas requested as some are not health regions. Where this occurs we have supplied information for the health areas that best fit those requested. Furthermore, some of these health areas have changed under the reconfiguration of PCTs and SHAs in 2006. (b) Figures from the HES give a count of hospital admission episodes with a primary diagnosis of “coronary heart disease” (CHD). This is not a count of people treated as the same person could have been admitted several times and this also excludes treatment taking place in primary care. Definitions Table 1 QOF is the national Quality and Outcomes Framework, introduced as part of the new General Medical Services contract on 1 April 2004. Participation by practices in the QOF is voluntary, though participation rates are very high, with most Personal Medical Services practices also taking part. The published QOF information was derived from the Quality Management Analysis System (QMAS), a national system developed by NHS Connecting for Health. QMAS uses data from general practices to calculate individual practices' QOF achievement. QMAS is a national IT system developed by NHS Connecting for Health to support the QOF.
The system calculates practice achievement against national targets. It gives general practices, PCTs and SHAs objective evidence and feedback on the quality of care delivered to patients. The QMAS captures the number of patients on the various disease registers for each practice. The number of patients on the clinical registers can be used to calculate measures of disease prevalence, expressing the number of patients on each register as a percentage of the number of patients on practices' lists. CHD Register—definition In order to call and recall patients effectively in any disease category and in order to be able to report on indicators for coronary heart disease, practices must be able to identify their patient population with CHD. This will include all patients who have had coronary artery revascularisation procedures such as coronary artery bypass grafting (CABG). Patients with Cardiac Syndrome X should generally not be included in the CHD register. Practices should record those with a past history of myocardial infarction as well as those with a history of CHD. Table 2 Ungrossed data Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed). Finished admission episodes (hospital admissions)
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. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year. 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. The ICD-10 codes used to identify CHD are as follows: 120—Angina pectoris 121—Acute Myocardial infarction 122—Subsequent myocardial infarction 123—Certain current complications following acute myocardial infarction 124—Other acute ischaemic heart diseases. 125—Chronic ischaemic heart disease. Number of episodes in which the patient had a (named) primary diagnosis
These figures represent the number of episodes where the diagnosis was recorded in the primary diagnosis field in a Hospital Episode Statistics (HES) record. Data quality HES are compiled from data sent by more than 300 NHS trusts and 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. PCT/SHA data quality
PCT and SHA data were 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 general practitioner (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. 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. 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. Source: Hospital Episode Statistics (HES), The NHS Information Centre for health and social care.
