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Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 23 February 2009, Official Report, column 234W, on maternity services, which of the maternity units listed on the NHS Choices website are (a) consultant-led and (b) midwife-led. 
We do not routinely collect details of maternity services led by consultants or midwives. However, the Dr. Foster website has a tool where it is possible to
search for details of maternity services that are either consultant or midwife led. The search can be further defined by birth unit or by postcode. The web address for this tool is:
David Taylor: To ask the Secretary of State for Health what mechanisms are in place to guarantee access to general practice services for patients who wish to opt out of having their clinical information uploaded to the national database under the National Programme for IT. 
Mr. Bradshaw: The right of access to general practitioner services is not conditional on patients agreeing to have their clinical information uploaded to the national database. Patients who opt out by choosing not to have a summary care record are advised to make their wishes known to their general practice. Guidance has been issued to all general practices on how they should respond to patients' enquiries about their options in relation to summary care records, including ensuring that patients fully understand the implications of their decision.
Sir Michael Spicer: To ask the Secretary of State for Health when the Minister of State for Public Health plans to reply to the email from the hon. Member for West Worcestershire of 13 February 2009, on measles and mumps infections in the UK. 
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 30 March 2009, Official Report, column 900W, on NHS: death rate, which NHS organisations were the subject of alerts in the first year; what the reason for each alert was; what steps were taken in response to the alert; and what the reasons for the alert were determined to be. 
Mr. Bradshaw: The Care Quality Commission (CQC), which took over from the Healthcare Commission (HCC) on 1 April 2009, has informed us that the reasons for the 85 alerts were because data received by HCC suggested that the rates of mortality in relation to a number of specific clinical areas were statistically higher than otherwise would have been expected. Statistical alerts relating to mortality rates do not necessarily equate to problems with clinical care. The alerts could be caused as a result of poor data quality, chance events, differences in the complexity of conditions treated or there could be evidence of poor quality care.
|Number of alerts by patient group and outcome (first 85 cases up to July 2008)|
|Patient group||Resolved by Healthcare Commission||Followed up||Total|
As regards the steps taken, for each alert further statistical analysis was undertaken, which was considered with any other relevant information that was known (such as local intelligence from local field staff in the
Commission and clinical advice where necessary). The results of this work are in the published report.
One of CQC's first pieces of work is to review the alerts programme. As part of this review, CQC will decide whether it can release the names of the organisations that were subject to these alerts. A decision on this matter is imminent.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what progress has been made on the deployment of Lorenzo and Cerner Millennium in each early adopter site for the National Programme for IT. 
Mr. Bradshaw: Lorenzo release 1.0 provides functionality for clinical documentation, and requests and results. Of the three Lorenzo release 1.0 early adopter sites, the University Hospitals of Morecambe Bay NHS trust is currently using the radiology requests and results functionality in its general surgery and urology wards, and has begun making plans for its use for inpatient, outpatient, and accident and emergency discharge summaries. South Birmingham Primary Care Trust (PCT) has a number of podiatrists using the system, working in eight different physical locations in the PCT. Bradford Teaching Hospitals NHS Foundation Trust went live for radiology results and requests in a nurse-led orthopaedic clinic at the end of March 2009.
In London, three acute trusts, Barnet and Chase Farm Hospitals, Queen Mary's Sidcup and Barts and The London NHS Trusts, are live with the first phase of the Cerner Millennium system. In June 2008 the Royal Free Hampstead NHS Trust went live with the next phase Cerner Millennium which features a link to the NHS spine. The trust uses the system to manage patient admission, transfer and discharge details and is linked to accident and emergency, theatre scheduling, maternity, therapies, as well as electronic radiology and pathology test ordering and reporting.
In October 2008, following a review of the progress of the deployment of the Cerner Millennium system, an improvement programme was set up to concentrate on resolving the issues that were being experienced by the live trusts. At the Barts and The London NHS Trust some unresolved issues are being tackled as part of a wider comprehensive improvement programme that is addressing identified weaknesses in the trusts information management and administration systems. At the other three trusts improvement programmes have been substantially delivered.
Due to the good progress made with the improvement programmes and greater confidence in the functionality and stability of the system, the London Acute Programme Board recommended in January 2009 that the implementation of Cerner Millennium should continue in London.
In the south, eight health communities have to date gone live with the Cerner Millennium system. Each health community typically comprises an acute trust and the associated primary care trust sites in its area. The acute trusts are Winchester and Eastleigh Healthcare NHS trust; Surrey and Sussex Healthcare NHS trust; Weston Area Health NHS trust; Taunton and Somerset NHS Foundation trust; Nuffield Orthopaedic Centre
NHS trust; Milton Keynes General Hospital NHS trust; Buckinghamshire Hospitals NHS trust; and Worthing and Southlands Hospitals NHS trust.
Since the local service provider contract with Fujitsu was terminated in May 2008, new arrangements to support and develop the services in the eight live sites in the south, together with agreement to deploy the Cerner product to a further four acute organisations have been agreed with BT. Under these arrangements, the eight live sites in the south will first be transferred to a BT data centre and then upgraded to the post- improvement programme configuration of the electronic patient record software that has been developed for London Cerner trusts. The transfer to the BT data centres and the subsequent upgrade of software are expected to be completed for the live sites by the end of 2010.
Further planned Cerner Millennium implementations at trusts in both London and the south are being informed by the lessons learnt from the improvement programmes at the live sites, and will enable more localisation and tailoring of the system, as well as close working between clinicians and solution experts as the system is being built for each trust.
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