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21 Apr 2009 : Column 570W—continued
Accident and Emergency Departments: Standards
Mr. Lansley: To ask the Secretary of State for Health what assessment his Department has made of the effect on (a) patient care and (b) clinical priorities of the four-hour waiting time target for accident and emergency departments. [267698]
Mr. Bradshaw: In 2007-08, 72 per cent. of trusts achieved the four hour standard of 98 per cent. of patients being seen, diagnosed and treated within four hours of their arrival at accident and emergency (A and E). As shown in the latest Healthcare Commission emergency department patient survey (2008), the percentage of respondents rating their overall care as excellent, very good or good was high at 88 per cent. It is important that patients have access to high quality timely care in A and E. However, we recognise that there are still areas for improvement and would encourage all trusts to examine their results and use these as a means to continue to improve patients' experience of A and E services.
Investment and reform is working. Our drive to eliminate long waits in A and E has made local health services work in new and better ways resulting in faster access to treatment for patients.
There are occasions when, for clinical reasons, patients may need to remain in A and E for longer than four hours—but it is for clinicians to make that judgment. That is why the minimum operating figure of 98 per cent. was introduced in 2003, following discussions with clinicians, to allow for the minority of patients that clinically require more than four hours in A and E.
It is a local matter for national health service trusts to ensure that they meet the A and E four hour operational standard while not compromising patient care and clinical priorities. In cases of underperforming trusts it is for the primary care trusts and strategic health authorities (SHAs) to ensure that there are plans in place for improvement so all patients can expect the same high quality service. Where there is sustained underperformance, the Department seeks assurances via the SHA that NHS trusts have robust plans in place for improvement in A and E performance, in providing high quality, timely care to patients.
Air Pollution
Colin Challen: To ask the Secretary of State for Health (1) what recent assessment he has made of the effects of levels of particulate pollution on the mortality rate; [269077]
(2) if he will publish the Committee on the Medical Effects of Air Pollutants’ draft paper entitled, Long-term exposure to air pollution: effect on mortality, produced in 2007. [269199]
Dawn Primarolo: The Department’s Committee on the Medical Effects of Air Pollutants (COMEAP) advises the UK Health Department on the effects on health of both outdoor and indoor air pollutants.
The most recent assessment of the effects of particulate pollution on mortality was published in 2007 by COMEAP: draft report—“Long-term Exposure to Air Pollution: Effect on Mortality”. This report indicated that the collected evidence pointed strongly to an association between long-term exposure to particulate air pollution and effects on mortality. The report suggests that air pollution has a greater effect on mortality in the United Kingdom than previously thought, with a 10 microgramme increase in fine particles being associated with a 6 per cent. increase in risk of death from all causes.
The final version of the report, previously published for technical comment for a period of six weeks, will be published in May 2009.
The Department for the Environment, Food and Rural Affairs (DEFRA) has calculated the estimated loss of life expectancy linked to particulate pollution in its 2007 review of the UK’s Air Quality Strategy. This calculation utilised the recommendations made by COMEAP in its 2007 draft report. DEFRA estimated that the level of man-made particulate air pollution experienced in the UK in 2005 would be expected to reduce life expectancy averaged over the whole population of the UK by up to about seven to eight months.
Alcoholic Drinks: Misuse
Ms Keeble: To ask the Secretary of State for Health what estimate he has made of the number of males (a) between (i) 10 and 16, (ii) 17 and 21 and (iii) 22 and 26 and (b) over 26 years who have been admitted to hospital for alcohol-related conditions in each of the last five years. [269090]
Dawn Primarolo: Data on the number of individual boys and young men hospitalised for alcohol-related conditions and not available, however data on the number of alcohol-related hospital admissions for boys and young men are available and are given in the following table. It is important to note that:
an individual may account for more than one admission;
the data given are for alcohol-related hospital admissions only, as data are not available centrally from which alcohol-related attendances in accident and emergency (A&E) departments can be identified; and
most attendances at A&E will not result in admission to hospital.
James Brokenshire:
To ask the Secretary of State for Health how many finished accident and emergency admission episodes there were in each NHS trust where the primary or secondary diagnosis was alcohol-related and the (a) male and (b) female patient was aged
(i) under 10, (ii) between 11 and 15, (iii) between 16 and 18, (iv) between 19 and 25, (v) between 26 and 35 and (vi) 36 years and over in each of the last five years. [269773]
Dawn Primarolo: The information requested is not collected centrally in relation to attendances in accident and emergency departments.
Sandra Gidley: To ask the Secretary of State for Health how many (a) men and (b) women in each age group have been admitted to hospital for stomach pumping procedures as a result of alcohol poisoning in each month of the last three years. [269788]
Ann Keen: There were zero admissions to hospital for stomach pumping procedures in 2005-06, 2006-07 and 2007-08. This is most likely due to the fact that stomach pumping usually takes place in accident and emergency departments, without the need for the patient to be admitted to hospital. Data on stomach pumping procedures in accident and emergency departments are not collected centrally.
Arthritis: Medical Treatments
Andrew George: To ask the Secretary of State for Health (1) how long the National Institute for Health and Clinical Excellence's review of the (a) use of and (b) segregated use of anti-TNF drugs for the treatment of rheumatoid arthritis has lasted; and when he expects the appraisal of sequential use of anti-TNFs to be completed; [268870]
(2) what assessment he has made of the (a) scheduling and (b) timescale of the reappraisal process undertaken by the National Institute for Health and Clinical Excellence in respect of the sequential use of anti-TNF drugs for rheumatoid arthritis; and what representations he has received on this matter. [268871]
Dawn Primarolo: The National Institute for Health and Clinical Excellence (NICE) issued its current technology appraisal guidance to the NHS on the initial use of adalimumab, infliximab and etanercept for the treatment of rheumatoid arthritis in October 2007, which is 40 months from the date that Ministers referred adalimumab for the treatment of rheumatoid arthritis to NICE's technology appraisal work programme. The guidance partially updated NICE's existing guidance on etanercept and infliximab for rheumatoid arthritis.
NICE is currently developing separate appraisal guidance on the use of adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor (TNF) inhibitor. NICE currently expects to publish updated guidance on this topic in July 2010. Until NICE publishes final guidance for this appraisal, NICE'S existing guidance on the use of etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of an anti-TNF in technology appraisals TA36, TA126 and TA141 remains in place.
The scheduling of work on specific technology appraisal reviews is a matter for NICE, but we understand that in this case the guidance development process has been particularly complex because of the need to address issues identified at the appeal stage.
Between April and December 2008, the Department of Health has received 135 pieces of correspondence relating to NICE and the use of TNF inhibitors.
Autism
Mrs. Gillan: To ask the Secretary of State for Health what assessment he has made of the cost to local authorities of identifying the number of disabled children and adults with autism in their area. [269145]
Phil Hope: The Department has made no assessment of the costs to local authorities of identifying the number of disabled children with autism in their area.
With regard to adults with autism, Departmental officials are currently estimating possible costs of a survey of prevalence, as well as the likely annual costs of additional staffing input to joint strategic needs assessments to include this group of people.
Burns: Health Services
Graham Stringer: To ask the Secretary of State for Health what plans he has to review the structure of the burns service in the North West; and if he will make a statement. [269511]
Ann Keen: The provision of burns services in the North West is a matter for the Northern Network of the National Burn Care Group (NBCG). The NBCG is a sub-group of the National Specialised Commissioning Group, a body established on 1 April 2007. The Northern Burn Care Network is developing recommendations on the future of burn care services across the North West, North East and Yorkshire and the Humber Strategic Health Authority regions and North Wales.
Cancer: Drugs
Dr. Gibson: To ask the Secretary of State for Health when the National Institute for Health and Clinical Excellence will produce its guidance on the use of (a) bevacizumab, (b) sorafenib, (c) sunitinib (second-line) and (d) temsirolimus for the treatment of advanced and metastatic renal cell carcinoma in the NHS. [268705]
Dawn Primarolo: The National Institute for Health and Clinical Excellence currently expects to issue final guidance to the national health service on bevacizumab, sorafenib and temsirolimus for the first line treatment and sorafenib and sunitinib for the second-line treatment of advanced and/or metastatic renal cell carcinoma in June 2009.
Cancer: Nurses
Mr. Lansley: To ask the Secretary of State for Health what proportion of multi-disciplinary cancer teams for each type of cancer do not have clinical nurse specialist cover. [269305]
Ann Keen: This information is not centrally collected.
We recognise the critical role that clinical nurse specialists (CNSs) have in multi-disciplinary teams (MDTs), as set out in the National Institute for Health and Clinical Excellence series of Improving Outcomes guidance. The
National Cancer Review Programme for 2004-07 looked at whether MDTs had full core membership and found that there were significant gaps in some areas, including in CNSs. Another round of peer review is now under way, and this will provide information about what progress has been made in this area.
Contaminated Blood and Blood Products Inquiry
Jenny Willott: To ask the Secretary of State for Health pursuant to the answer of 19 March 2009, Official Report, column 1302W, on contaminated blood and blood products, what timetable he has set for responding to the recommendations made by Lord Archer; by what mechanism that response will be made; and if he will make a statement. [269473]
Dawn Primarolo: Ministers have met Lord Archer to discuss his recommendations. These recommendations are receiving very careful consideration, and we will respond in due course.
Drugs: Misuse
Norman Lamb: To ask the Secretary of State for Health how many admissions to hospital there were as a result of drug-related mental health conditions in each of the last five years. [269730]
Dawn Primarolo: The information is shown in the following table.
| Count of finished admission episodes with a primary diagnosis of mental and behavioural disorders due to psychoactive substance use for the last five years: Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector: Data years 2003-04 to 2007-08 | |
| Finished admission episodes | |
| Note: These figures include admissions for alcohol-induced mental health conditions. Source: Hospital Episode Statistics (HES), The NHS Information Centre for health and social care. | |
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