Hospital Beds
Dr Poulter: To ask the Secretary of State for Health (1) how many (a) beds and (b) beds per 100,000 population there were (i) in the NHS and (ii) in each strategic health authority area in each year since 1997-98; [68288]
(2) how many acute care beds per 100,000 population have been provided in (a) England and (b) each strategic health authority area in each financial year since 1997-98. [68297]
Mr Simon Burns: The information requested has been placed in the Library.
Hospital Wards: Gender
Dr Poulter: To ask the Secretary of State for Health if he will publish any reviews commissioned by his Department regarding Mixed Sex Accommodation in NHS trusts between 1997 and 2010. [68423]
Mr Simon Burns: Mixed sex accommodation has no place in a modern national health service that puts patients first. The greater transparency that this Government have introduced has now driven unjustified instances of mixed sex accommodation down by over 84% since December 2010.
During the period in question, major reviews of progress were carried out in 2004 (published 2005), 2007 and 2009. These reviews, “Elimination of Mixed Sex Hospital Accommodation, Privacy and Dignity—a report by the Chief Nursing Officer into mixed sex accommodation in hospitals” and “The Story so far—Delivering same-sex accommodation—a progress report” respectively, have been placed in the Library.
In addition, a number of less formal exercises to gather information were undertaken. The cost to identify and publish these reviews is deemed to be disproportionate.
Hospitals: Admissions
Dr Poulter: To ask the Secretary of State for Health how many emergency bed days there have been in the NHS in England (a) in total and (b) expressed as a proportion of the total number of bed days in each financial year since 1997-98. [68224]
Mr Simon Burns: The information requested is in the following table.
5 Sep 2011 : Column 158W
| Total finished consultant episode (FCE) bed days and count and proportion of FCE bed days (1) where the method of admission (2) was a emergency in England from 1997-98 to 2009-10 (3) : Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector | |||
|
|
Total FCE bed days | Emergency FCE bed days | Proportion of emergency FCE bed days (percentage) |
| (1) Episode duration (FCE bed days) Episode duration is calculated as the difference in days between the episode start date and the episode end date, where both are given. Episode duration is based on FCEs and only applies to ordinary admissions, i.e. day cases are excluded (unless otherwise stated). (2) Method of admission This is the sum of the episode duration for all FCEs that ended within the financial year. This field does not include bed days where the episode was unfinished at the end of the financial year. To identify bed days as emergency bed days we have filtered the total bed days figures by admission method indicating the admission was an emergency (codes 21 to 24 and 28). 21 = Emergency: via Accident and Emergency (A&E) services, including the casualty department of the provider 22 = Emergency: via general practitioner (GP) 23 = Emergency: via Bed Bureau, including the Central Bureau 24 = Emergency: via consultant out-patient clinic 28 = Emergency: other means, including patients who arrive via the A&E department of another health care provider (3) Assessing growth through time Hospital Episode Statistics (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 out-patient settings and so no longer include in admitted patient HES data. Note: Data quality: HES are compiled from data sent by more than 300 NHS trusts and primary care trusts in England and from some independent sector organisations for activity commissioned by the English IMHS. 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. Source: Hospital Episode Statistics (HES), The NHS Information Centre for Health and Social Care | |||
Dr Poulter: To ask the Secretary of State for Health how many emergency readmissions there have been in the NHS in each financial year since 1997-98; and what the rate of patients readmitted as an emergency in the NHS was for each such year. [68286]
Mr Simon Burns: Information on the number of emergency admissions within 28 days of previous discharge from hospital, both in absolute numbers and as a percentage of the total number of hospital admissions, is set out in the following table for the years currently available. Admissions for maternity and obstetrics, mental health specialities, and cancer treatment are excluded. Figures for different years are not fully comparable because of differences in case mix.
5 Sep 2011 : Column 159W
5 Sep 2011 : Column 160W
Hospitals: Information
Mr Russell Brown: To ask the Secretary of State for Health what assessment he has made of potential cost savings in using existing patient bedside systems to deliver information to (a) patients and (b) service users. [68670]
Mr Simon Burns: No assessments have been made of potential cost savings in using the existing patient bedside systems in delivering information to patients and service users. The Department does not collect information relating to the cost of these services.
It is not appropriate for Ministers to become involved in the micromanagement of these services; these are matters for national health service organisations to determine locally.
Hospitals: Waiting Lists
Dr Poulter: To ask the Secretary of State for Health what the size of the NHS waiting list per 100,000 population was in each year since 1997. [68427]
Mr Simon Burns: The following table shows the available data for total numbers of patients waiting for an in-patient admission, for a first out-patient appointment and on referral to treatment (RTT) pathways and the numbers per 100,000 population, at the end of March in each financial year from 1996-97 to 2010-11.
|
|
In-patient waiting list | Out-patient waiting list | RTT incomplete pathways | England population (Thousands) | In-patient waiting list per 100,000 population | Out-patient waiting list per 100,000 population | RTT incomplete pathways per 100,000 population |
| Definitions: In-patient—patients waiting for inpatient admission following a decision to admit. Out-patient—patients waiting for first outpatient appointment following general practitioner referral. RTT—patients on an incomplete pathway following referral, regardless of position on pathway. Sources: Department of Health monthly monitoring and RTT returns. Office for National Statistics population figures. | |||||||
5 Sep 2011 : Column 161W
Hotels
Dr Poulter: To ask the Secretary of State for Health what the cost to the public purse was for (a) hotel accommodation and (b) four or five star hotel accommodation for (i) civil servants in his Department, (ii) Ministers in his Department and (iii) special advisers in his Department in each financial year since 1997. [68210]
Gavin Williamson: To ask the Secretary of State for Health what the cost to the public purse was of (a) four star, (b) five star and (c) other hotel accommodation for (i) staff, (ii) Ministers and (iii) special advisers in his Department between (A) May 2006 and June 2007 and (B) June 2009 and May 2010. [68371]
Mr Simon Burns: Data from our central contracts is not available before November 2006. It is not possible to distinguish between the class of hotel or traveller without incurring disproportionate cost. The cost of hotel accommodation from the central contract data is as follows:
|
|
£ |
James Cook University Hospital: Ambulance Services
Mrs Chapman: To ask the Secretary of State for Health what the average emergency ambulance journey time was to James Cook University hospital from Darlington in the latest period for which figures are available. [67980]
Mr Simon Burns: The information requested is not centrally held. The Department does not collect information on the average ambulance journey times by national health service ambulance trusts. The hon. Member may wish to approach the chief executive of Newcastle Primary Care Trust, which is the lead commissioner for the North East Ambulance Service NHS Trust, and the chief executive of the North East Ambulance Service NHS Trust direct, which may hold some relevant information.
Learning Disability
Tom Blenkinsop: To ask the Secretary of State for Health if he will estimate the average minimum lifetime financial requirements of an adult with learning disabilities who has (a) high, (b) moderate and (c) low care needs. [68040]
Paul Burstow: This information is not held centrally.
5 Sep 2011 : Column 162W
Mass Media
Dr Poulter: To ask the Secretary of State for Health what the cost to the public purse has been for the production of his Department's national media coverage evaluations in each month for which one was produced since May 1997. [68214]
Mr Simon Burns: The Department does not hold central records on the cost of media coverage evaluation and attempting to gather information for each month since 1997 would incur disproportionate costs.
Dr Poulter: To ask the Secretary of State for Health how many press briefings were held by his Department in each month between May 1997 and May 2010; and what the subject of each such press briefing was. [68218]
Mr Simon Burns: The Department has held a number of briefings for media since 1997 on policy announcements and public health issues, including weekly briefings on pandemic flu in 2009.
The Department does not maintain a central record of when media briefings have been held, or on which subject. Nor as a matter of routine does the Department's media centre keep the dates and subject matter of media briefings from each year.
Since May 2010, media briefings have included one on 30 November 2010 on publication of the White Paper “Healthy Lives, Healthy People”, and on 12 July 2010 on publication of the White Paper “Equity and Excellence: Liberating the NHS”.
Gavin Williamson: To ask the Secretary of State for Health what the total cost to the public purse was of his Department's national media coverage evaluations in each month between (a) May 2006 and June 2007 and (b) June 2009 and May 2010. [68366]
Mr Simon Burns: The Department does not hold central records on the cost of media coverage evaluation in each month between (a) May 2006 and June 2007 and (b) June 2009 and May 2010, and attempting to gather information for each month would incur disproportionate costs.
Maternity Services
Mr Amess: To ask the Secretary of State for Health pursuant to the answer of 20 October 2010, Official Report, columns 782-3W, on maternity services, whether the national assessment of midwifery workforce needs has completed; and if he will make a statement. [68698]
Anne Milton: The Department has commissioned the Centre for Workforce Intelligence (CfWI) to provide intelligence and information on the national maternity workforce. The CfWI will report back early in 2012 with their findings to inform future local workforce planning and commissioning decisions.
5 Sep 2011 : Column 163W
Milk: Contamination
Tessa Munt: To ask the Secretary of State for Health when milk supplies from dairy farms in Somerset were last tested for contamination with (a) iodine 131, (b) strontium 90, (c) caesium 137 and (d) plutonium. [68556]
Anne Milton: The Food Standards Agency (FSA) advise that, as part of a routine radiological monitoring programme, samples of milk are regularly taken from six farms around the Hinkley Point nuclear site in Somerset. The most recent testing of milk samples from Somerset was in May 2011. The analytical method used can detect for the presence of both Caesium-137 and Iodine-131. Neither of these radionuclides were detected in the samples in May and are not routinely detected in samples from Somerset.
No routine testing for plutonium or strontium is carried out on milk samples from around nuclear power stations as they do not routinely discharge any of these radionuclides. However, dairy milk samples are collected from 34 locations and analysed for strontium. Although two of these locations are in the south west, none are in Somerset.
Results of this monitoring programme are published annually in the Radioactivity in Food and the Environment report (RIFE) at:
www.food.gov.uk/science/surveillance/radiosurv/rife/
and interim provisional results are published twice per year on the FSA website at:
www.food.gov.uk/science/surveillance/radiosurv/rife/radsurv2010
NHS Walk-in Centres
Dr Poulter: To ask the Secretary of State for Health how many attendances at walk-in centres there have been in each year since 2002; what the cost has been for the (a) establishment and (b) maintenance of walk-in centres in each year; and what the average cost of an attendance at (i) a walk-in centre and (ii) a GP surgery was in each year since 2002. [68293]
Mr Simon Burns: Since 2003-04, data on the numbers of visits to national health service walk-in centres have been collected on a quarterly basis. Annual figures are set out in the following table:
| Accident and Emergency (A&E) attendances | |
|
|
Type 4 Departments—NHS walk-in centres |
| Source: Department of Health—Quarterly Monitoring of A&E | |
NHS walk-in centres are now the responsibility of primary care trusts (PCTs) and are funded and run in the same way as other front-line NHS services. Before this responsibility was handed over in 2005-06, host
5 Sep 2011 : Column 164W
PCTs for these sites received 75% to 80% of their funding from a central budget of £33 million—an average of £750,000 per site, ranging from £390,000 to £1.3 million. The Department has no further figures relating to the costs of NHS walk-in centres.
No central data are held on the average cost of a consultation at a NHS walk-in centre The following table shows average cost per consultation undertaken in general practice.
| GP average surgery consultation costs | |
|
|
Average cost per consultation (£) |
NHS: Competition
Dr Poulter: To ask the Secretary of State for Health if he will publish any reviews commissioned by his Department regarding the use of (a) patient choice and (b) competition in NHS trusts between 1997 and 2010. [68422]
Mr Simon Burns: Reports received by or commissioned by the Department would not normally be published by the Department but rather published by the institution responsible for the work.
For example, the Department commissioned a comprehensive report on Patient Choice from the Kings fund which was published in 2010:
www.kingsfund.org.uk/publications/patient_choice.html
Further evidence that the Department has considered in relation to choice and competition can be found in the relevant impact assessments relating to the Health and Social Care Bill 2011 (published in January 2011):
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegislation/DH_123583
and to the guidance on extending patient choice of provider (published July 2011):
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_128455
Additionally, it is the responsibility of the Co-operation and Competition Panel (CCP) to publish completed reviews regarding potential breaches of the Principles and Rules for Co-operation and Competition, and proposed mergers of providers of NHS services.
Any reviews which the CCP has completed are available to view on their website:
www.ccpanel.org.uk
The following is a list of evidence the Department has considered for choice and competition policies. This list is not exhaustive, but an indication of some of the key evidence sources of which the Department is aware:
Bloom, N., Propper, C, Seller, S. and Van Reenan, J. (2010) The Impact of Competition on Management Quality: Evidence from Public Hospitals CMPO WP 10/237
Cooper, Z., Gibbons, S., Jones, S. and McQuire, A. (2010a) Does Hospital Competition Save Lives? Evidence from The English NHS Patient Choice Reforms, LSE WP 16/2010
5 Sep 2011 : Column 165W
Copper, Z., Gibbons, S., Jones, S. and McQuire, A. (2010b) Does Hospital Competition Improve Efficiency? An Analysis of the Recent Market-Based Reforms to the English NHS CEP discussion paper no.988
Dixon, A. and LeGrand. J., (2006) “Is greater patient choice consistent with equity? The case of the English NHS”. “Journal of Health Services Research & Policy, vol 11, no3, pp 162-6
Dranove, D and Statterthwaite, M. (1992) Monopolistic Competition When Price and Quality Are Not Perfectly Observable Rand Journal of Economics, 23,247-262
Gaynor, M., Moreno-Serra, R. and Propper, C. (2010) Death by Market Power: Reform, Competition and Patient Outcomes in the NHS CMPO WP 10/242
Gaynor, M. (2004) Competition and quality in hospital markets. What do we know? What don't we know? Economic Publique 15, 3-40
Gowrisankaran, G. and Town, R. J. (2003) Competition, Payers, and, Hospital Quality Health Services Research 38, 1403-1422
Hamilton, B. H. and Bramley-Harker, R. E. (1999) The impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence from hip fracture Patients The Economic Journal 109, 437-462
Hughes, R. G. and Luft, H. (1991) Service Patterns in Local Hospital Markets: Complementary or Medical Arms Race Health Service Management Research 4, 131-139
Joskow, P (1980) The effects of Competition and Regulation on Hospital Bed Supply and the reservation Quality of the Hospital Bell Journal of Economics III, 421-447
Klein, R. (1999) Markets, Politicians and the NHS British Medical Journal 319, 1383-1384 Le Grand, J. (1999) Competition, Cooperation or Control? Tales from the British National Health Services Health Affairs 18, 27-39
OECD Health Data 2010
Propper, C, (1996) Market Structure and Prices: The response of Hospitals in the UK National Health Service to Competition Journal of Public Economics
Propper, C, Burgess, S., and Gossage, D. (2008) Competition and Quality: Evidence from the internal Market 1991-1996 The Economic Journal 118,138-170
Propper, C, Burgess, S., and Green, K. (2004) Does Competition Between Hospitals Improve the Quality of Care? Hospital Death Rates and the NHS Internal Market Journal of Public Economics, 88, 1247-1272
Propper, C, Wilson, D. and Soderlund, N. (1998) The effects of Regulation and Competition in the NHS Internal Market: The case of GP Fundholder Prices Journal of Health Economics 17, 645-674
Soderland, N., CSABA, I., Gray, A., Milne, R. and Raferty, J. (1997) Impact of the NHS Reforms on English hospital productivity: an analysis of the first three years British Medical Journal 315, U26-9
Nolte, E. McKee, CM., Measuring the Health of Nations: analysis of mortality amenable to healthcare BMJ 2003; 327:1129 (2003)
Eurocare-4, www.eurocare.it
OECD, Health at a Glance 2009 (2009)
European Antimicrobial Resistance Surveillance System (EARSS) incidence of MRSA per 100,000 patient days (2008)
The Tallinn Charter, Health Systems for Health and Wealth Draft Charter World Health Organisation (2008)
Is the NHS becoming more patient centred? Trends from the national surveys of patients in England 2002 to 2007 Picker Institute (2007)
British Social Attitudes Survey, NatCen,
http://www.natcen.ac.uk/study/british-social-attitudes-25th-report/our-findings - (2009)
The Patient Association's response to “Liberating the NHS: Greater Choice and Control” The Patient Association (2011)
5 Sep 2011 : Column 166W
Taylor, R., Implications of offering “Patient Choice” for routine adult surgical referrals. (2004) Dr Foster Limited, University of Nottingham
Picker Institute
Thorlby, R. and Gregory, S., Free Choice at the point of referral. London King's Fund (2008)
British Social Attitudes Survey, NatCen,
www.natcen.ac.uk/study/british-social-attitudes-25th-report/findings - (2009)
Dixon, A., Robertson, R., Appleby, J, Burge, P., Devlin, N., Magee, H., Patient Choice: How patients choose and how providers respond The Kings Fund (2010)
Dixon, S., Report on the national patient choice survey—February 2010 England Department of Health (2010)
NHS: Drugs
Dr Poulter: To ask the Secretary of State for Health what drugs have been made available for the first time to patients on the NHS since 5 May 2010; and how many patients have received such drugs. [68174]
Mr Simon Burns: The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for licensing medicines in the United Kingdom. Since May 2010 five medicines containing new active substances were licensed by the MHRA for the UK only. Since January 2010 another 56 medicines containing new active substances were licensed in the European Union by the European Medicines Agency (EMA) through the centralised procedure to which the MHRA contributed by providing scientific expertise. When a medicine containing a new active substance is licensed it does not mean it automatically becomes available on the national health service.
Information on the number of people prescribed a medicine, the dosage or the medical condition being treated, is not collected centrally.
New active substances licensed in the UK only
1. PL 00133/0234 - Blistex
2. PL 18024/0009 - Sativex
3. PL 19364/0033 - Normicron
4. PL 32363/0001 - Livazo
5. PL 32828/0001 - Plenaxis.
New active subs tances licensed through the EMA
1. EU/1/11/703/ - Xgeva
2. EU/1/11/700/ - Benlysta
3. EU/1/11/698/ - Yervoy
4. EU/1/11/696/ - Bydureon
5. EU/1/11/695/ - Leganto
6. EU/1/11/694/ - Nulojix
7. EU/1/11/692/ - Yellox
8. EU/1/11/691/ - Eliquis
9. EU/1/11/688/ - Cinryze
10. EU/1/11/687/ - Hizentra
11. EU/1/11/686/ - Rasilamlo
12. EU/1/11/681/ - Trobalt
13. EU/1/11/680/ - Riprazo HCT
14. EU/1/11/679/ - Pravafenix
15. EU/1/11/678/ - Halaven
16.EU/1/11/677/ - Gilenya
17. EU/1/11/676/ - Jevtana
18. EU/1/11/674/ - Repso
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19. EU/1/11/673/ - Ifirmacombi
20. EU/1/11/672/ - Xeplion
21. EU/1/11/671/ -Xiapex
22. EU/1/11/669/ - Teysuno
23.EU/1/11/668/ - Daliresp
24. EU/1/11/667/ - Esbriet
25. EU/1/11/666/ - Libertek
26. EU/1/10/664/ - Pumarix
27. EU/1/10/661/ - Fluenz
28. EU/1/10/660/ - Potactasol
29. EU/1/10/659/ - Iasibon
30. EU/1/10/658/ - Aflunov
31. EU/1/10/657/ - Prepandemic Influenza vaccine (H5N1)
32. EU/1/10/656/ - Possia
33. EU/1/10/655/ - Brilique
34. EU/1/10/648/ - Twynsta
35. EU/1/10/647/ - Myclausen
36. EU/1/10/646/ - VPRIV
37. EU/1/10/645/ - Brinavess
38. EU/1/10/644/ - PecFent
39. EU/1/10/643/ - Rapiscan
40. EU/1/10/641/ - Ruconest
41.EU/1/10/640/ - Sycrest
42. EU/1/10/638/ - Ozurdex
43. EU/1/10/636/ - Daxas
5 Sep 2011 : Column 168W
44. EU/1/10/632/ - Tolura
45. EU/1/10/631/ - Nivestim
46. EU/1/10/630/ - Docefrez
47. EU/1/10/628/ - Votrient
48. EU/1/10/625/ - Arzerra
49. EU/1/10/623/ - DuoCover
50. EU/1/10/622/ - Tepadina
51. EU/1/10/621/ - Ristaben
52. EU/1/10/620/ - Ristfor
53. EU/1/10/619/ - DuoPlavin
54. EU/1/10/618/ - Prolia
55. EU/1/10/614/ - Menveo
56. EU/1/10/612/ - Revolade.
NHS: Expenditure
Mr Marcus Jones: To ask the Secretary of State for Health what NHS spending per head of population in (a) England, (b) Warwickshire and (c) Nuneaton was in each of the last five years. [68149]
Mr Simon Burns: The amount spent per capita in total in England by all primary care trusts (PCTs) and by Warwickshire PCT and its predecessor organisations, in each of the last five years, is shown in the following table.
| £ | |||||
| Organisation | 2005-06 | 2006-07 | 2007-08 | 2008-09 | 2009-10 |
Data in respect of expenditure per capita in Nuneaton are not held centrally.
Dr Poulter: To ask the Secretary of State for Health what the average cost was of delivering an episode of care in the NHS in (a) 1997 and (b) 2010 at constant prices. [68295]
Mr Simon Burns: The average cost of delivering an episode of care in the NHS was £1,410 in 1997-98 and £1,395 in 2009-10.
The figures include elective in-patients (including excess bed days), non-elective in-patients (including excess bed days) and day case activity. The 2009-10 figure covers costs to national health service providers (NHS trusts, foundation trusts and primary care trust (PCT) provider arms) of providing these services, as reported to the Department through the annual reference cost collection. The 1997-98 figure does not include costs reported by PCT provider arms, as the reference cost collection for that year covered acute trusts only. Both figures are inclusive of the Market Forces Factor.
The 1997-98 figures have been uplifted by using the Gross Domestic Product (GDP) deflator.
NHS: Manpower
Dr Poulter: To ask the Secretary of State for Health if he will place in the Library a copy of all estimates for NHS work force changes commissioned by his Department between January 1997 and May 2010. [68425]
Mr Simon Burns: We interpret my hon. Friend's question as to referring to estimates in changes to NHS work force numbers between January 1997 and May 2010.
Two tables giving this detail have been placed in the Library.
Dr Poulter: To ask the Secretary of State for Health how many people have been made redundant by primary care trusts and subsequently re-employed within the NHS (a) directly and (b) on a temporary or contract basis in each financial year since 1997-98. [68431]
Mr Simon Burns: The estimated numbers of people made redundant by primary care trusts and subsequently re-employed (up until 30 April 2011) within the national health service directly and on a temporary or contract basis in each financial year are shown in the following table.
5 Sep 2011 : Column 169W
|
|
Permanent | Fixed term |
These estimates are based on data extracted from the Electronic Staff Record (ESR) Data Warehouse and therefore do not include staff who may have been re-employed by general practices, or Moorfields Eye Hospital NHS Foundation Trust or Chesterfield Royal Hospital NHS Foundation Trust. ESR has been used across the NHS since 2008. Information pertaining to prior to 2008 is not held centrally.
NHS: Standards
Miss McIntosh: To ask the Secretary of State for Health what steps he is taking to improve patients' outcomes in the NHS. [68195]
Mr Simon Burns: The ‘NHS Outcomes Framework 2011/12’ was published in December 2010 and signals the direction of travel for the national health service in focusing on outcomes. It is intended to support continuous improvements in outcomes for patients across the range of activities the NHS is responsible for delivering.
For example, in Domain 5: ‘Treating and caring for people in a safe environment and protecting people from avoidable harm’, there are two indicators which will track the progress of the NHS in reducing incidences of healthcare associated infections. Existing data show that in the year ending March 2011 the number of methicillin-resistant Staphylococcus aureus bloodstream infections decreased by 22% and Clostridium difficile infections decreased by 15% on the year before. These are positive outcomes in this domain, and we expect improvements to occur across all five domains.
To support the outcomes and indicators in each domain of the NHS Outcomes Framework, a suite of National Institute for Health and Clinical Excellence (NICE) Quality Standards are being developed, and we have commissioned NICE to produce two Quality Standards on patient experience.
Nursing Home Properties
Emily Thornberry: To ask the Secretary of State for Health if he will examine the financial position of Nursing Home Properties. [68460]
Paul Burstow: It is for the Care Quality Commission, as the regulator of adult social care services, to satisfy itself that a care service provider is financially viable.
Obesity
Dr Poulter: To ask the Secretary of State for Health what proportion of (a) adults and (b) children were (i) overweight and (ii) obese in each primary care trust area in each year since 1997; and if he will estimate the number of (A) adults and (B) children who were (1) overweight and (2) obese in each primary care trust in each year since 1997. [68428]
Anne Milton: Information is not available in the format requested.
5 Sep 2011 : Column 170W
Information on the prevalence of overweight and obesity in adults is not available by primary care trust (PCT) and is available only by strategic health authority (SHA) for 2008. Information on the prevalence of overweight and obesity in children by PCT is available only for certain age groups and from 2006-07. Information on the number of adults and children who were overweight or obese is available only at a disproportionate cost.
Information on the percentage of overweight and obese adults aged 16 and over in England is available in the “Health Survey for England—2009 trend tables”, Adult trend tables, Table 4. Information is provided for adults in England for the years 1993 to 2009. This information is available at:
www.ic.nhs.uk/pubs/hse09trends
The proportion of adults aged 16 and over recorded as overweight and obese by SHA for 2008 is available in Table 7.3 on page 194 of the “Health Survey for England—2008: Physical activity and fitness”. The information is available at:
www.ic.nhs.uk/pubs/hse08physicalactivity
Information on the percentage of overweight and obese children in England is available in the “Health Survey for England—2009 trend tables”, Child trend tables, Table 4. Information is provided for children aged 2 to l5 in England for the years 1995 to 2009. This information is available at:
www.ic.nhs.uk/pubs/hse09trends
The proportion of children aged 2 to 15 recorded as overweight and obese by SHA for 2008 is available in Table 13.3 on page 327 of the “Health Survey for England—2008: Physical activity and fitness”. The information is available from the following link:
www.ic.nhs.uk/pubs/hse08physicalactivity
Further information on the prevalence of overweight and obesity in children at a PCT level is available through the National Child Measurement Programme. Information is available for children in Reception (4 to 5 years) and year 6 (10 to 11 years) for the years 2006-07 to 2009-10. Information showing prevalence of overweight and obesity among children in those two school years by PCT is available for each year from the following links.
Table 2 of the accompanying excel file of the “National Child Measurement Programme: England, 2009/10 school year” report is available on the NHS Information Centre website at:
www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesity/national-child-measurement-programme-england-2009-10-school-year
Table 2 of the accompanying excel file of the “National Child Measurement Programme: England, 2008/09 school year” report is available on the NHS Information Centre website at:
www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesity/national-child-measurement-programme-england-2008-09-school-year
Table 2 of the accompanying excel file of “National Child Measurement Programme: results from the 2007/08 school year, headline results” report is available on the NHS Information Centre website at:
www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesity/national-child-measurement-programme-results-from-the-school-year-2007-08
5 Sep 2011 : Column 171W
Table 2 of the accompanying excel file of “National Child Measurement Programme: results from the 2006/07 school year, headline results” report is available on the NHS Information Centre website at:
www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesity/national-child-measurement-programme-results-from-the-2006-07-school-year
Copies of all these publications have already been placed in the Library.
Organs: Donors
Chris Ruane: To ask the Secretary of State for Health what progress his Department has made in implementing the recommendation of the Organ Donation Taskforce to increase the number of organs available for transplantation. [68506]
Anne Milton: Implementation of the Organ Donation Taskforce recommendations has seen donor rates rise by around 28% since 2008 and over 18 million people—some 28% of the United Kingdom population—have registered on the Organ Donor Register. Work continues at a local, regional and national level to increase donor rates still further to the 50% by 2013 anticipated by the Organ Donation Taskforce.
Future action will focus on increasing consent rates; ensuring that the potential for donation can be optimised in all cases; and increasing donation from emergency medicine. This will be achieved through a variety of means, including through the clinical leads for organ donation, donation committees and donation chairs in acute trusts driving improvement locally; regional collaboration to share learning and ongoing work to raise the profile and benefits of organ donation and transplantation with the national health service, professional groups and with the public.
Chris Ruane: To ask the Secretary of State for Health whether he has considered the merits of implementing a soft opt-out system for organ donation in England. [68507]
Anne Milton: In 2008, the independent Organ Donation Taskforce examined the case for moving to a system of presumed consent for organ donation. It recommended against it, concluding that while such a system might have the potential to deliver benefits, it would present significant difficulties which might not bring about the desired increase in organ donation rates. Action has been taken to strengthen the donation infrastructure and since the publication of the taskforce's report in 2008, organ donor rates have increased by around 28%. We need to give time for these improvements to work through fully and assess their success, before looking to change the system further.
Osteoporosis: Health Services
Tracey Crouch: To ask the Secretary of State for Health (1) if he will take steps to include osteoporosis in the Quality and Outcomes Framework of the GP contract; [68397]
(2) if he will include indicators on reducing hospital admissions for fractures in older people as part of the new outcomes frameworks for the NHS, adult social care and public health in England; [68398]
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(3) if he will take steps to implement the recommendations of the All-Party Parliamentary Osteoporosis Group report on the role of nutrition in preventing osteoporosis and promoting good bone health. [68399]
Paul Burstow: The All-Party Parliamentary Group on Osteoporosis' report of its inquiry into the role of nutrition in preventing osteoporosis and promoting bone health sets out a number of recommendations for Government, the national health service, local authorities, social care providers, those responsible for delivering public health messages and the food, advertising, retail and cosmetics industries.
In our recently published social marketing strategy, ‘Changing Behaviours, Improving Outcomes’, we have set out our intentions to expand on the Change4Life programme to include all relevant advice to promote healthier lifestyles. This will include broader dietary and physical activity messages.
The Scientific Advisory Committee on Nutrition (SACN) is currently reviewing the data on vitamin D and health in light of the new evidence that has become available since it published its position statement ‘Update on Vitamin D’, in 2007. This review will consider the vitamin D status of United Kingdom populations, the thresholds to define deficiency and the relative contributions of diet and sunlight exposure to maintain vitamin D status. It is expected that SACN's review will take three to four years to complete.
Technology Appraisal guidance published by the National Institute for Health and Clinical Excellence (NICE) supports calcium and vitamin D supplementation in post-menopausal women receiving osteoporosis treatment unless clinicians are confident that the patient already has adequate levels. Healthcare professionals are expected to take the guidance fully into account when exercising their clinical judgment. However, the guidance does not override the individual responsibility of health care professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Commissioners and providers are reminded by NICE of their responsibilities to implement this guidance in light of local circumstances.
Resources published as part of the prevention package for older people, are designed to support the NHS and local authorities in prioritising and effectively commissioning services that support the health, well-being and independence of older people. The document “Falls and fractures: effective interventions in health and social care” sets out a systematic approach to falls and fracture prevention. This includes an objective to prevent frailty, preserve bone health and reduce accidents through preserving physical activity, healthy lifestyles and reducing environmental hazards.
The NHS Outcomes Framework 2011-12 includes an indicator, which focuses on:
‘improving recovery from fragility fractures—the proportion of patients recovering to their previous levels of mobility/walking ability at (i) 30 days and (ii) 120 days’.
Following consultation on the draft Adult Social Care Outcomes Framework, an indicator on the proportion of people suffering fragility fractures who recover their previous level of mobility/walking after 120 days was excluded for 2011-12 as further work was required on
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data development and the analysis of the impact of social care. However, this does not preclude the inclusion of such an indicator in future years.
In the recent consultation on proposals for a public health outcomes framework, an indicator on ‘Acute admissions as a result of falls or fall injuries for over 65s’ was included. This was selected for inclusion on the basis that falls account for the majority of admissions to hospital for unintentional injury among older people, and so falls prevention is a key public health priority. The response to the consultation was, in general, very supportive of the broad concept of the outcomes framework, its breadth and the focus on life-course and health inequalities, which are both particularly relevant to the rates of falls in older people. As we develop the final outcomes framework which we intend to publish later this year, we will consider the full range of responses from stakeholders to the consultation to determine the final set of indicators for inclusion in the final framework.
Work to reduce hospital admissions due to fractures among older people will require joint effort across the wider public health, NHS and adult social care systems. Alongside the development of the public health outcomes framework over the next few weeks and months, we will work with stakeholders to clarify and publicise the close alignment of all three outcomes frameworks, supporting local Health and Well-being Boards in their work to improve outcomes across the board and to encourage joint work across the NHS, local authority and providers to support older people in this case to live longer, healthier lives.
The prioritisation of potential indicators for inclusion in the Quality and Outcomes Framework is the responsibility of NICE. Following publication of the indicators, NHS Employers negotiate with the British Medical Association on which indicators should be included within the Quality and Outcomes Framework, achievement levels and the value of those indicators.
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Out-patients: Attendance
Dr Poulter: To ask the Secretary of State for Health how many out-patient appointments were missed (a) in England and (b) in each relevant NHS area in each financial year since 1997-98; what proportion of the number of out-patient appointments such missed out-patient appointments represented in each relevant NHS area; and what estimate he has made of the overall cost to the NHS of such missed appointments in each financial year since 1997-98. [68291]
Mr Simon Burns: The information requested is shown in the following tables:
| Proportion of patients not attending out-patient appointments for NHS providers in England 1997-98 to 2010-11 | |||
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Total out-patient appointments | Total DNAs (1) | DNA (1) rate ( % ) |
| (1)Did not attend. Note: For 2001-02 the England level data does not equal the sum of health authorities in the following table due to an organisation that does not have an associated health authority. Source: Department of Health; Quarterly Activity Return. | |||
| Proportion of patients not attending out - patient appointments for NHS providers in each relevant NHS area 1997-98 to 2010-11 | |||||||||
| 1997-98 | 1998-99 | 1999-2000 | |||||||
| Name | Total appointments | Total DNAs (1) | DNA (1) rate (%) | Total appointments | Total DNAs (1) | DNA (1) rate (%) | Total appointments | Total DNAs (1) | DNA (1) rate (%) |
| 2000-01 | 2001-02 | 2002-03 | |||||||
| Name | Total appointments | Total DNAs (1) | DNA (1) rate (%) | Total appointments | Total DNAs (1) | DNA (1) Rate (%) | Total appointments | Total DNAs (1) | DNA (1) rate (%) |
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North and East Yorkshire and Northern Lincolnshire Health Authority |
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Leicestershire, Northamptonshire and Rutland Health Authority |
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