|Previous Section||Index||Home Page|
Mr. Stephen O'Brien:
To ask the Secretary of State for Health what estimate has been made of the
potential savings to the NHS (a) nationally and (b) in each primary care trust of full implementation of the National Institute for Health and Clinical Excellence's February 2006 guidance on nutrition support in adults. 
Gillian Merron: In 2009-10, the Department allocated £69 million to primary care trusts (PCTs), as part of their overall PCT allocations, to support our obesity strategy. This includes funding for child weight management services.
Norman Lamb: To ask the Secretary of State for Health how many and what proportion of (a) overweight and (b) obese children are participating in child weight management programmes in each primary care trust area. 
Gillian Merron: The Department does not hold information on the number of children who have been referred to a child weight management programme. It is up to primary care trusts (PCTs) to commission these programmes according to their local needs.
PCTs are encouraged to evaluate their programmes with the standard evaluation framework provided by the National Obesity Observatory, and we are in the process of developing systems to help PCTs to monitor the number of children being referred to a weight management programme.
However, we are unable to divide the data into partial or full amputation as there is a risk of double counting. For instance, there are occasions when a person could have more than one amputation during an episode of care, for example, initially it might be intended for the patient to have a 'partial limb amputation' which may proceed to a 'full limb amputation.'
|A count of finished consultant episodes( 1) where a main or secondary procedure( 2) of amputation of the limb( 3) was carried out, 2004-05 to 2008-09- Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector|
|Operation description||Operation code||2004-05||2005-06||2006-07||2007-08||2008-09|
|(1) Finished Consultant Episode (FCE)|
A finished consultant episode (FCE) is defined as a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. It should be noted that the figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.
(2) Number of episodes with a (named) main or secondary procedure
These figures represent the number of episodes where the procedure (or intervention) was recorded in any of the 24 (12 from 2002-03 to 2006-07 and four prior to 2002-03) operative procedure fields in a Hospital Episode Statistics (HES) record. A record is only included once in each count, even if the procedure is recorded in more than one operative procedure field of the record. It should be noted that more procedures are carried out than episodes with a main or secondary procedure. For example, patients under going a 'cataract operation' would tend to have at least two procedures-removal of the faulty lens and the fitting of a new one-counted in a single episode.
(3) Ungrossed data
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
(4) Data quality
HES are compiled from data sent by more than 300 NHS trusts and primary care trusts (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.
(5) Changes to coding classifications: OPCS-4
Operative procedure codes were revised for 2006-07 and 2007-08. The 2008-09 and 2007-08 data uses OPCS 4.4 codes, 2006-07 data use OPCS 4.3 codes, data prior to 2006-07 uses OPCS 4.2 codes. All codes that were in OPCS 4.2 remain in later OPCS 4 versions, however the introduction of OPCS 4.3 codes enable the recording of interventions and procedures which were not possible in OPCS 4.2. In particular, OPCS 4.3 and OPCS 4.4 codes include high cost drugs and diagnostic imaging, testing and rehabilitation. Some activity may have been coded under different codes in OPCS 4.2. These changes need to be borne in mind when analysing time series and may explain some apparent variations over time. Please note that care needs to be taken in using the newer codes as some providers of data were unable to start using the new codes at the beginning of each data year. More information about OPCS 4 changes is on the Connecting for Health website:
(6) 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.
(7) The following codes were used for amputation of limb:
Amputation of arm
X07.1 Forequarter amputation
X07.2 Disarticulation of shoulder
X07.3 Amputation of arm above elbow
X07.4 Amputation of arm through elbow
X07.5 Amputation of arm through forearm
X07.8 Other specified amputation of arm
X07.9 Unspecified amputation of arm
Amputation of leg
X09.1 Hindquarter amputation
X09.2 Disarticulation of hip
X09.3 Amputation of leg above knee
X09.4 Amputation of leg through knee
X09.5 Amputation of leg below knee
X09.8 Other specified amputation of leg
X09.9 Unspecified amputation of leg
Amputation of hand, foot and toe
X08.1 Amputation of hand at wrist
X08.2 Amputation of thumb
X08.3 Amputation of phalanx of finger
X08.4 Amputation of finger NEC
X08.8 Other specified amputation of hand
X08.9 Unspecified amputation of hand
X10.1 Amputation of foot through ankle
X10.2 Disarticulation of tarsal bones
X10.3 Disarticulation of metatarsal bones
X10.4 Amputation through metatarsal bones
X10.8 Other specified amputation of foot
X10.9 Unspecified amputation of foot
X11.1 Amputation of great toe
X11.2 Amputation of phalanx of toe
X11.8 Other specified amputation of toe
X11.9 Unspecified amputation of toe
The following code may apply to any site, and is not restricted to arm, leg, hand, foot, finger, or toe:
X12.1 Reamputation at higher level
Hospital Episode Statistics (HES); Outpatients, The NHS Information Centre for health and social care
|Next Section||Index||Home Page|