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|Non-NHS staff spend (£ million)|
|(1) Not currently available|
A figure for 2009-10 is not currently available, as the 2009-10 Financial Returns data are subject to internal review and potential resubmissions.
Trust, Primary Care Trust and Strategic Health Authority Financial Returns and Monitor consolidated accounts for Foundation Trusts
Mr Simon Burns: Departmental officials are working closely with the London Strategic Health Authority (SHA) to identify the most appropriate financing solution for the health and safety repairs required at North West London Hospitals NHS Trust, and we expect to reach a conclusion by the end of September 2010. Departmental officials have been assured by the SHA that the short term financing can be managed locally, while this long term financing solution is put in place.
Gloria De Piero: To ask the Secretary of State for Health how many surgical procedures of each type to treat obesity in patients under the age of 18 years were carried out on the NHS in (a) England and (b) Nottinghamshire Primary Care Trust in each of the last five years. 
|Count of finished consultant episodes( 1) with a primary diagnosis of obesity( 2) who had 'bariatric surgery'( 3) by type of surgery among those aged under 18 in England, 2004-05 to 2008-09|
|Activity in English NHS hospitals and English NHS commissioned activity in the independent sector|
|Gastric bypass||Gastric band||Stomach stapling||Gastric bubble|
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). In particular improvements in how 'bariatric surgery' is coded, with the introduction of new codes in various versions of the Office of Population, Censuses and Surveys (OPCS), growth due to better recording of procedures should not be misinterpreted as growth solely due to increases in activity.
These data should not be described as a count of people as the same person may have been admitted on more than one occasion. Also it is not possible to get a total 'bariatric surgery' figure from this data, as adding the types of 'bariatric surgery' together may include double counting, as a patient may have more than one type of 'bariatric surgery' within the same year.
(1) Finished Consultant Episode (FCE)
A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one healthcare 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) Primary diagnosis
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 HES data set and provides the main reason why the patient was admitted to hospital.
ICD-10 code used:
(3) Number of episodes with a (named) main or secondary procedure
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) procedure fields in a HES record. A record is only included once in each count, even if the procedure is recorded in more than one procedure field of the record. Note 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.
See clinical codes sheet for OPCS codes used for 'bariatric surgery'.
HES are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England and from some 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. While this brings about improvement over time, some shortcomings remain.
Strategic Health Authority (SHA)/PCT of residence
The SHA or PCT containing the patient's normal home address. This does not necessarily reflect where the patient was treated as they may have travelled to another SHA/PCT for treatment.
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 include in admitted patient HES data.
Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector
Bariatric Surgery OPCS codes
|Gastric Bypass codes|
G27.1-Total gastrectomy and excision of surrounding tissue
G27.2-Total gastrectomy and anastomosis of oesophagus to duodenum
G27.3-Total gastrectomy and interposition of jejunum
G27.4-Total gastrectomy and anastomosis of oesophagus to transposed jejunum
G27.5-Total gastrectomy and anastomosis of oesophagus to jejunum nec
G27.8-Other specified total excision of stomach
G27.9-Unspecified total excision of stomach
G28.1-Partial gastrectomy and anastomosis of stomach to duodenum
G28.2-Partial gastrectomy and anastomosis of stomach to transposed jejunum
G28.3-Partial gastrectomy and anastomosis of stomach to jejunum nec
G28.8-Other specified partial excision of stomach
G28.9-Unspecified partial excision of stomach
G31.1-Bypass of stomach by anastomosis of oesophagus to duodenum
G31.2-Bypass of stomach by anastomosis of stomach to duodenum
G31.3-Revision of anastomosis of stomach to duodenum
G31.4-Conversion to anastomosis of stomach to duodenum
G31.8-Other specified connection of stomach to duodenum
G31.9-Unspecified connection of stomach to duodenum
G31.0-Conversion from previous anastomosis of stomach to duodenum
G32.1-Bypass of stomach by anastomosis of stomach to transposed jejunum
G32.2-Revision of anastomosis of stomach to transposed jejunum
G32.3-Conversion to anastomosis of stomach to transposed jejunum
G32.8-Other specified connection of stomach to transposed jejunum
G32.9-Unspecified connection of stomach to transposed jejunum
G32.0-Conversion from previous anastomosis of stomach to transposed jejunum
G33.1-Bypass of stomach by anastomosis of stomach to jejunum nec
G33.2-Revision of anastomosis of stomach to jejunum nec
G33.3-Conversion to anastomosis of stomach to jejunum nec
G33.8-Other specified other connection of stomach to jejunum
G33.9-Unspecified other connection of stomach to jejunum
G33.0-Conversion from previous anastomosis of stomach to jejunum nec
From April 2006 additional OPCS-4.3 codes were added:
G28.4-Sleeve gastrectomy and duodenal switch
G28.5-Sleeve gastrectomy NEC
G31.5-Closure of connection of stomach to duodenum
G31.6-Attention to connection of stomach to duodenum
G32.4-Closure of connection of stomach to transposed jejunum
G32.5-Attention to connection of stomach to transposed jejunum
G33.5-Closure of connection of stomach to jejunum NEC
G33.6-Attention to connection of stomach to jejunum
Gastric band procedures may include the insertion, removal or adjustment of the gastric band.
OPCS-4.2-There were no specific codes for gastric banding procedures in OPCS-4.2.
OPCS-4.3 and OPCS-4.4
Insertion of a gastric band
G30.3-Partitioning of stomach using band
Removal of a gastric band
G38.7-Removal of gastric band
Adjustment of gastric band
G30.8-Other specified plastic operations on stomach
Y03.6-Adjustment to prosthesis in organ noc
Additional OPCS-4.5 code:
G30.5-Maintenance of gastric band
OPCS-4.2 codes for 'stomach stapling' are:
G30.2-Partitioning of stomach
Y26.3-Stapling of organ noc
Both codes are necessary and need to be recorded in the order shown above, with Y26.3 directly following G30.2.
OPCS-4.3, OPCS-4.4 and 4.5 has a dedicated code for 'stomach stapling', which did not previously exist in OPCS-4.2:
G30.4-Partitioning of stomach using staples
Gastric bubble (also known as gastric balloon)
G48.1-Insertion of gastric bubble
G48.2-Attention to gastric bubble
Hospital Episode Statistics (HES), The NHS Information Centre for health and social care.
Mary Creagh: To ask the Secretary of State for Health what research his Department has (a) commissioned, (b) evaluated and (c) undertaken on the operation of (a) prescription charges, (b) the Prescription Pricing Authority and (c) the NHS Choices website since May 2010. 
Mr Simon Burns: In the period 12 May to 10 September 2010, the Department has not commissioned research on the operation of prescription charges or the NHS Prescription Services. Professor Sir Ian Gilmore's review of a prescription charge exemption for people with long term conditions was published on 27 May 2010. The Department routinely evaluates research published by many sources.
Mr Simon Burns:
'Transforming Community Services: The assurance and approvals process for PCT-provided
community services', published in February 2010, sets out the assurance and approvals process and a set of national tests for strategic health authorities (SHAs) to use when considering primary care trust (PCT) proposals.
The 'Revision to the Operating Framework for the NHS in England 2010/11', published in June 2010, reiterated the principle that separating PCT commissioning from the provision of services is a priority, and must be achieved by April 2011.
We want people to be able to make informed decisions about their health care, and have a wide range of services available to meet their needs in the community from a range of providers, to drive up quality. The first step to achieve this is to separate out PCT commissioning from the provision of services.
'Transforming Community Services: The assurance and approvals process for PCT-provided community services' and 'Revision to the Operating Framework for England 2010/11' have already been placed in the Library and are also available on the Department's website at: