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21 Jun 2010 : Column 62W—continued

Keith Vaz: To ask the Secretary of State for Health how many adults have been treated by the NHS for high blood pressure attributable to alcohol misuse (a) nationally, (b) in the East Midlands and (c) in Leicester in each of the last five years. [2562]

Anne Milton: The information is shown in the following table. The proportion of hypertension caused by alcohol is an estimate. It should be noted that the figures include admissions where hypertension is a secondary diagnosis, as well as those
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where it is the primary diagnosis. A secondary diagnosis will not in all cases be a cause of admission.

Number of finished admissions of patients aged over 18 with a diagnosis of hypertension attributable to alcohol

2004-05 2005-06 2006-07 2007-08 2008-09







East Midlands












Note s :
1. Includes activity in English national health service hospitals and English NHS commissioned activity in the independent sector.
Finished admission episodes
2. A finished admission episode is the first period of in-patient care under one consultant within one health care provider. Finished admission episodes are counted against the year in which the admission episode finishes. It should be noted that admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
Primary diagnosis
3. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.
Secondary diagnosis
4. As well as the primary diagnosis, there are up to 19 (13 from 2002-03 to 2007-08 and six prior to 2002-03) secondary diagnosis fields in HES that show other diagnoses relevant to the episode of care.
Data quality
5. HES are compiled from data sent by more than 300 NHS trusts and primary care trusts 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.
Assessing growth through time
6. 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 out-patient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time.
Assignment of Episodes to Years
7. Years are assigned by the end of the first period of care in a patient's hospital stay.
Cause code:
8. The ICD-10 codes for hypertension are I10 to I15. From work carried out by the North West Public Health Observatory we are able to estimate what the proportion of hospital admissions are due to alcohol consumption, this is known as the alcohol attributable fraction (MF). Hypertensive diseases have an MF of 0.34 for males and 0.24 for females.
Hospital Episode Statistics (HES), The NHS Information Centre for health and social care

Autism: Children

Andrew Gwynne: To ask the Secretary of State for Health (1) what assessment he has made of the adequacy of the provision of mental health services for children with autism; [2871]

(2) what assessment he has made of the effectiveness of mental health services provision in improving the mental health for children with autism. [2873]

Mr Burstow: It is for local partners to agree how the commissioning process can best meet the complex needs of children with autism who have mental health problems. We are looking at what might need to be done to improve child and adolescent mental health services, including meeting the particular needs of this group.

Continuing Care

Miss Anne McIntosh: To ask the Secretary of State for Health what criteria apply in deciding whether a primary care trust pays for continuing health care; what assessment his Department has made of levels of
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regional variation in provision of continuing health care; how many patients are receiving continuing health care in (a) County Durham, (b) North Yorkshire, (c) Cumbria, (d) Leeds and (e) London; and if he will make a statement. [2942]

Mr Burstow: Anyone assessed as having a certain level of care needs may receive national health service continuing health care. Eligibility is decided after an assessment has been made by a multidisciplinary team using the National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care.

The Department is working closely with the strategic health authority (SHA) continuing health care leads to investigate the variation in provision of continuing health care between regions, and between individual primary care trusts (PCTs). The SHAs have a managerial responsibility to investigate and manage this variation.

The number of people in receipt of continuing health care, for the period January to March 2010, is given in the following table:

Organisation Number

County Durham PCT


North Yorkshire and York PCT


Cumbria PCT


Leeds PCT


London SHA


Darent Valley Hospital

Gareth Johnson: To ask the Secretary of State for Health how many patients were treated in the accident and emergency department at Darent Valley Hospital in each of the last five years. [3087]

Mr Simon Burns: The information is not available in the format requested. Such information as is available is in the following table:

Attendances at Type 1 Accident and Emergency (A&E) Departments, Dartford and Gravesham NHS Trust (Darent Valley Hospital), 2005-06 to 2009-10

First attendances Follow-up attendances Total attendances





















Notes: 1. The Department collects these data from NHS trusts rather than hospital sites. 2. Information is not collected on the number of patients treated at A&E departments. However, data on the number of attendances at A&E departments are available and published quarterly via the Department's QMAE dataset. This includes patients who attended A&E but who were not subsequently treated and counts each attendance by the same patient separately. 3. Definition of a Type 1 A&E department: A consultant-led 24-hour service with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients. Source: Department of Health: The Quarterly Monitoring Accident and Emergency Data Set (QMAE)

Dementia: Drugs

Mr Mike Hancock: To ask the Secretary of State for Health which (a) individuals and (b) organisations contributed to the national audit on the prescribing of anti-psychotic drugs referred to in his Department's response to Professor Sube Banerjee's report on the prescribing of anti-psychotic drugs to people with dementia of 12 November 2009. [3420]

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Mr Burstow: The National Audit will be starting shortly, with the results anticipated to be available in October 2010.

Departmental Reviews

Andrew Miller: To ask the Secretary of State for Health pursuant to the answer of 8 June 2010, Official Report, column 137W, on Government departments: reviews, what reviews his Department is undertaking; and what the (a) purpose and (b) timescale of each is. [2586]

Mr Simon Burns: We will bring forward detailed information about reviews in due course.

Dietary Supplements: EU Law

Robert Halfon: To ask the Secretary of State for Health (1) what the pay band is of each official assigned to handling negotiations at EU level on behalf of the Government in relation to the setting of maximum permitted levels for vitamins and minerals in food supplements under the provisions of Article 5 of the EU food supplements directive; [3152]

(2) what his objective is for negotiations at EU level on maximum permitted levels for vitamins and minerals in food supplements under the provisions of Article 5 of the EU food supplements directive; and what steps Ministers in his Department plan to take to ensure that those objectives are achieved. [3153]

Anne Milton: The Food Standards Agency (FSA) represents the United Kingdom in negotiations at European Union level on the setting of maximum permitted levels for vitamins and minerals in recommended daily doses of food supplements. The FSA has advised that the European Commission has indicated that discussions will continue at working group level later in 2010.

A team of officials of varying pay bands are responsible for this issue. Whilst FSA officials at Grade 7 and above in seniority will normally represent the UK in EU level discussions, the FSA deploys staff resources flexibly, using to the best effect the available skills and expertise, to ensure that the UK is best positioned to deliver its objectives.

The objective in the negotiations is to ensure that levels are set on the basis of science and safety in accordance with the requirements of the EU Food Supplements Directive 2002/46/EC.

Disability: Social Services

Mr Andrew Smith: To ask the Secretary of State for Health (1) if he will publish a code of practice for the assessment and management of support packages for social care of severely disabled children and adults; [2029]

(2) if he will take steps to ensure that care assessments and support packages for severely disabled children and adults are readily portable from one authority to another. [2030]

Mr Burstow: The current Guidance on Eligibility Criteria for Adult Social Care, England 2010 "Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care", published in February 2010, states:

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A copy of the guidance has already been placed in the Library.

The Government have announced their intention to establish a commission on funding long-term care. The portability of adult social care across English local authorities could be an important issue that the commission needs to take into account when considering how to implement any future funding model for the social care system.

Transferability of care packages across local authority boundaries would run counter to the way in which local government is organised, in terms of local discretion and their budget responsibilities. When children move from one local authority to another, their new local authority should not necessarily start their assessment afresh, but should base the local assessment and service provision on information about the effectiveness of their package of support in their previous authority.

General Practitioners: Equality

Glenda Jackson: To ask the Secretary of State for Health if he will ensure that women and men general practitioners are equally represented on the proposed NHS GP Commissioning Board. [2902]

Mr Simon Burns: We will bring forward proposals for the NHS Commissioning Board in due course. The constitution of the board will be consistent with all the requirements of employment and equalities legislation.

Mental Health Services

Emma Reynolds: To ask the Secretary of State for Health what guidance his Department provides to healthcare providers on the priority to be given to use of cognitive behavioural therapy and other talking therapies for people with severe mental illness. [3098]

Mr Burstow: We have set out, in Our Programme for Government, a commitment to ensure greater access to talking therapies to reduce long-term costs for the national health service. This is a clear public health priority for us and we are currently working to identify how we will take forward this commitment.

Revised National Institute for Health and Clinical Excellence (NICE) guidance on schizophrenia was published in March 2009. This outlines the best way to treat and manage adults with schizophrenia in primary and secondary care. The guidance recommends that treatments such as cognitive behavioural therapy (CBT) should be offered to all people with schizophrenia.

Psychological therapies can be a key element of the treatment of people with severe and enduring mental health conditions, particularly when these conditions are experienced alongside depression and anxiety disorders. In these cases, the delivery of CBT and other NICE-compliant therapies is the recommended treatment. Services
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for these clients is largely provided by psychology departments in specialist mental health trusts. The implementation of Improving Access to Psychological Therapies services for people in community settings with mild to moderate conditions can reduce the number of referrals to specialist mental health trusts and enable them to focus on providing services to those with severe and enduring mental illness.

General practitioners or consultant psychiatrists can prescribe any medicine or treatment which they consider to be necessary for treating NHS patients, including NICE-approved treatments, provided that the local primary care trust or NHS trust agree to supply it on the NHS. Clinicians are responsible for deciding on the most appropriate form of treatment for their patients, and in doing so they are expected to take NICE guidance fully into account. The Department does not become involved in making clinical decisions.

Mental Health Services: Children

Grahame M. Morris: To ask the Secretary of State for Health if he will make it his policy to require staff working in child and adolescent mental health services to receive basic training on autism. [3067]

Mr Burstow: Staff working in Child and Adolescent Mental Health Services (CAMHS) should have the necessary values, competencies, skills, and ongoing training to enable them to recognise and respond to the identified needs of children, including those with autism. We are looking at what might need to be done to ensure CAMHS offer proper support to those with autism spectrum disorders.

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