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Phil Hope: This information is not held centrally. The Departments approach is to let the Pathfinders make progress and then evaluate them. The Department has commissioned an external evaluation of the Social Enterprise Pathfinders. The evaluation report is expected in July 2009.
|Strategic health authority||Name of social enterprise pathfinder organisation||Award (£)|
|GP practice nurses in England, 1997-2007|
|Number (headcount)||Full-time equivalent|
| Notes: 1. Data as at 1 October 1997-99, 30 September 2000-07. 2. Data Quality Workforce statistics are compiled from data sent by more than 300 NHS trusts and primary care trusts 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. Processing methods and procedures are continually being updated to improve data quality. Where this happens any impact on figures already published will be assessed but unless this is significant at national level they will not be changed. Where there is impact only at detailed or local level this will be footnoted in relevant analyses. Source: The Information Centre for health and social care General and Personal Medical Services Statistics.|
Phil Hope: Primary care trusts (PCTs) are responsible for funding, developing and delivering end of life care services locally and it is for them to decide on the adequacy of the resources they allocate.
To support the End of Life Care Strategy, published in July 2008, a copy of which has already been placed in the Library, a survey was conducted of PCT expenditure on specialist palliative care, including hospices. This showed the level of local resources used in these services and provides a helpful benchmark for PCTs. However, the resources used for generalist palliative care, that is, care which could be provided by any health or social care practitioner, are impossible to determine.
Work to develop the strategy showed that money spent in end of life care is not always as well used as it might be. A key aim of the strategy is, therefore, to ensure better use of existing resources. In addition, the Government are investing an extra £286 million in end of life care services over the two years 2009-10 and 2010-11. This will help support those areas, such as training and the development of community services, that need special attention.
Mr. Lidington: To ask the Secretary of State for Health (1) what guidance his Department has issued to NHS trusts and primary care trusts about the provision of support to parents whose children are stillborn; 
Ann Keen: The maternity standard of the National Service Framework for Children Young People and Maternity Services, published in September 2004, includes guidance for national health service maternity care providers on the provision of comprehensive, culturally sensitive, multi-disciplinary policies, services and facilities for the management and support of families who have experienced a maternal or neonatal death or stillbirth. A copy of the framework has already been placed in the Library. In addition, When a patient dies: Advice on developing bereavement services in the NHS, published in October 2005, provides advice to the national health service on the basic principles and elements considered necessary in developing bereavement services locally, including for stillbirth and neonatal death. A copy has been placed in the Library.
The Government are committed to improving outcomes for both mothers and babies. We promote a number of interventions to help prevent stillbirths and neonatal deaths, including smoking cessation, eating healthily and tackling obesity, reducing teenage pregnancy and encouraging early booking with maternity services. We
also fund the confidential inquiry into maternal and child health, which publishes an annual report into perinatal mortality, including stillbirth and neonatal death that monitors changes in the rates, causes and identifies risk factors.
The latest information from the 2007-08 Child Health Mapping shows that there are 166 neonatal intensive care units (NICU) in England. The following table gives the distribution of units by strategic health authority.
|Strategic health authority||Number of NICU in 2007-08|
A profile of children's health services, child and adolescent mental health services and maternity services in England 2007-08 (Durham University)
Miss Begg: To ask the Secretary of State for Health if he will take steps to develop a commissioning pathway for rheumatoid arthritis and supporting toolkit in order to provide robust and consistent standards of care throughout the patient journey. 
The first draft of the pathway is currently being produced. This draft will then be discussed at a consensus event in April 2009 where key stakeholders will be able to challenge the pathway and reach consensus on what the ideal' pathway would look like.
Miss Begg: To ask the Secretary of State for Health if he will take steps to promote greater integration of knowledge about rheumatology treatment between primary care teams and specialist rheumatology professionals in order to (a) enable and (b) support patient self-management. 
Dawn Primarolo: Proposals for the reconfiguration of services are a matter for the national health service locally, which in this case means all four NHS organisations in Shropshire, working in conjunction with clinicians, patients and other stakeholders, as they understand the needs of local patients best.
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