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Gillian Merron: Cumulative, provisional data on the uptake of swine influenza vaccine each month since the beginning of the vaccination programme (October 2009) are given in the following tables for those in the usual seasonal influenza clinical risk groups, pregnant women, healthy children aged six months to below five years and front line healthcare workers. Healthcare worker data are collected weekly, so data to the end of the closest week to the end of each month are given in table 2.
There are no data available on the uptake of swine influenza vaccine by household contacts of the immunocompromised and frontline social care workers-the other groups identified to receive swine flu vaccine.
|Uptake by those in clinical risk groups aged under 65 years (including pregnant women)||Uptake by those in clinical risk groups aged 65 years and older||Uptake by pregnant women||Uptake by healthy ch ildren aged six months to under five years|
|Uptake by frontline health care workers (percentage)|
|(1 )The earliest data available|
Ann Keen: No funding has been allocated directly to the Venous Thromboembolism (VTE) Exemplar Network. The aim is to mainstream good practice on VTE within the national health service, and the network demonstrates what a number of NHS organisations have achieved.
John Smith: To ask the Secretary of State for Health (1) how much funding has been allocated to the National Venous Thromboembolism (VTE) Strategy in each of the last five years, excluding funding allocated to the National VTE Commissioning for Quality and Innovation goal; 
(2) how much funding has been allocated to the (a) Healthcare Acquired Infection Reduction Strategy, (b) National Venous Thromboembolism Strategy and (c) National Cervical Cancer Vaccination Programme in each of the last five years. 
The following table represents funding from the Department and its arm's length bodies on the Healthcare Acquired Infection Reduction Strategy. Other organisations have had a role in tackling HCAIs but their expenditure could not be separately identified. For a more detailed breakdown of these costs, please see sections 15 and 16 (p.31-36) of the National Audit Office Report, which can be found at:
| Source: National Audit Office (NAO) report: Reducing Healthcare Associated Infections in Hospitals in England-12 June 2009.|
The following table shows funding for venous thromboembolism (VTE) prevention strategy for the past five years and the current financial year. These figures do not include any of the funding related to the national VTE Commissioning for Quality and Innovation (CQUIN) goal. Prior to 2007 the funding of VTE prevention work was limited to expenses for the VTE Expert Working Group members and other related domestic costs for hosting meetings.
A national vaccination programme against human papillomavirus, which causes cervical cancer, began in September 2008. The Department has allocated funds to PCTs for the implementation of the programme. The funding levels (which do not include the cost of the vaccines as this is commercially confidential), which varied by year depending on the number of catch-up cohorts that the vaccine was offered to, were as follows:
|Current and future funding (£ million)|
John Smith: To ask the Secretary of State for Health what guidance his Department has issued on the implementation of the Venous Thromboembolism National Commissioning Goal to (a) strategic health authority managers, (b) primary care trust managers, (c) acute trust managers and (d) other healthcare professionals. 
Ann Keen: The following guidance and support has been made available on the implementation of the Venous Thromboembolism (VTE) National Commissioning Goal within the Commissioning for Quality and Innovation (CQUIN) payment framework:
Details of the national CQUIN goal on VTE risk assessment for 2010-11 were included within published guidance on the CQUIN payment framework in December 2009.
Draft guidance on data collection was put onto UNIFY on 26 January 2010 for UNIFY users.
Some basic information on VTE and CQUIN has been put on the Department's website at:
Inquiries on the VTE goal within CQUIN from staff in the national health service are being answered individually by the Department and the queries that come up regularly will also be used to form a Frequently Asked Questions section in guidance currently being prepared.
John Smith: To ask the Secretary of State for Health what guidance he has issued to NHS healthcare professionals on the revised 2010 National Venous Thromboembolism Risk Assessment Model on 2 March 2010; and if he will make a statement. 
Ann Keen: The Department's venous thromboembolism (VTE) risk assessment template was revised in February 2010 in conjunction with the National Institute for Clinical Excellence (NICE) to ensure it was fully compliant with the guidance issued by NICE in January 2010. This then became a National VTE Risk Assessment Tool for hospitals to use. To raise awareness about the risk assessment, information has been put on the Department's website at:
Ann Keen: The National Patient Safety Agency (NPSA) have been key stakeholders and supportive of the work on preventing venous thromboembolism (VTE) from the outset. As we move into implementation of VTE prevention, appropriate opportunities for greater involvement of NPSA are now emerging.
Ann Keen: Information on admitted patients in hospital who have a diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) is shown in the following table-Patients treated by their general practitioner or as out-patients are not included.
|Counts of finished consultant episodes( 1) with a main or secondary diagnosis( 2) of DVT and PE, 2004-05 to 2008-09, England( 3)|
|Finished consultant episodes by diagnosis( 4)|
|DVT( 5)||PE( 6)|
|All relevant ICD codes||ICD10 I80.2|
|(1) A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one health care provider. FCEs are counted against the year in which they end. 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) The information is the number of episodes where this diagnosis was recorded in any of the 20 (14 from 2004-05 to 2006-07) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.
(3) Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.
(4) Counts for the different diagnoses shown are not necessarily mutually exclusive and therefore summing the different diagnoses is not possible (e.g. a patient may have a DVT and a PE in a single episode, and would be counted once in each relevant column-double counting would occur if the values were summed).
(5) Diagnosis is recorded in HES using ICD10 codes. ICD10 code I80.2 is used for a diagnosis of DVT where there is no further information on the site of the thrombosis. However DVT may also be recorded under a number of different codes, although these codes may also include cases which are not considered deep. The full list of relevant ICD10 codes is as follows:
I80.0 Phlebitis and thrombophlebitis of superficial vessels of lower extremities
I80.1 Phlebitis and thrombophlebitis of femoral vein
I80.2 Phlebitis and thrombophlebitis of other deep vessels of lower extremities
I80.3 Phlebitis and thrombophlebitis of lower extremities, unspecified
I80.8 Phlebitis and thrombophlebitis of other sites
I80.9 Phlebitis and thrombophlebitis of unspecified site
O22.2 Superficial thrombophlebitis in pregnancy
O22.3 Deep phlebothrombosis in pregnancy
O87.0 Superficial thrombophlebitis in the puerperium
O87.1 Deep phlebothrombosis in the puerperium
(6) Pulmonary embolisms are coded as 126.0 (Pulmonary embolism with mention of acute cor pulmonale) and 126.9 (Pulmonary embolism without mention of acute cor pulmonale).
Assessing growth through time: HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer included in admitted patient HES data.
Hospital Episode Statistics (HES), The NHS Information Centre for health and social care
Ann Keen: At a joint meeting of the Department, Academy of Royal Colleges and Strategic Health Authority Medical Directors in October 2009, it was agreed to work together on tackling venous thromboembolism prevention through professional leadership provided by the Academy coupled with national health service system levers. The Academy confirmed their commitment to provide the necessary leadership in November 2009.
John Smith: To ask the Secretary of State for Health pursuant to the answer of 8 February 2010, Official Report, column 717W, on thrombosis, what format of the electronic version of the National Venous Thromboembolism Risk Assessment Model will take; and if he will make a statement. 
Ann Keen: Work to develop a prototype venous thromboembolism (VTE) risk assessment tool is ongoing. A prototype tool is being piloted at three national health service secondary care locations. The pilot work is aimed at testing the utility of a VTE risk assessment checklist on mobile and hand-held digital equipment.
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