| London | South East Coast | South Central | South West | England | ||||||
| Period | Mean | Median | Mean | Median | Mean | Median | Mean | Median | Mean | Median |
| 1 Duration to assessment: This is the total amount of time in minutes between the patients’ arrival and their initial assessment in the accident and emergency (A&E) department. This is calculated as the difference in time from arrival at A&E to the time when the patient is initially assessed. | ||||||||||
| Table 2: Mean and median duration to treatment1 for accident and emergency departments (all types) in minutes by strategic health authority and month. England: April 2011 to March 2012 | ||||||||||||
| North East | North West | Yorkshire and the Humber | East Midlands | West Midlands | East of England | |||||||
| Period | Mean | Median | Mean | Median | Mean | Median | Mean | Median | Mean | Median | Mean | Median |
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| London | South East Coast | South Central | South West | England | ||||||
| Period | Mean | Median | Mean | Median | Mean | Median | Mean | Median | Mean | Median |
| 1 Duration to treatment: This is the total amount of time in minutes between the patients’ arrival and the start of their treatment. This is calculated as the difference in time from arrival at A&E to the time when the patient began treatment. | ||||||||||
| Table 3: Mean and median duration to departure1 for accident and emergency departments (all types) in minutes by strategic health authority and month. England: April 2011 to March 2012 | ||||||||||||
| North East | North West | Yorkshire and the Humber | East Midlands | West Midlands | East of England | |||||||
| Period | Mean | Median | Mean | Median | Mean | Median | Mean | Median | Mean | Median | Mean | Median |
| London | South East Coast | South Central | South West | England | ||||||
| Period | Mean | Median | Mean | Median | Mean | Median | Mean | Median | Mean | Median |
| 1 Duration to departure: This is total amount of time spent in minutes in an A&E department. This is calculated as the difference in time from arrival at A&E to the time when the patient is discharged from A&E care. This includes being admitted to hospital, dying in the department, discharged with no follow up or discharged and referred to another specialist department. Notes: 1. Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector. 2. This data indicates the SHA area within which the organisation providing treatment was located. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre. | ||||||||||
Air Pollution
Luciana Berger: To ask the Secretary of State for Health what assessment he has made of the public health effect of removing obligations on local authorities to monitor air quality in their area. [175903]
Dan Rogerson: I have been asked to reply on behalf of the Department for Environment, Food and Rural Affairs.
The Government have not carried out such an assessment. A recent consultation sought views on options
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to improve the delivery of local air quality management duties by local authorities, and a summary of responses to that consultation will be published by the end of the year.
Ambulance Services: West Midlands
James Morris: To ask the Secretary of State for Health how many qualified ambulance staff were employed by the NHS in the West Midlands in (a) the latest period for which figures are available and (b) May 2010. [175609]
Dr Poulter: Information on the number of qualified ambulance staff in the West Midlands Health Education England (HEE) area at 31 July 2013 and 31 May 2010 is shown in the following table.
| Full-time equivalent | ||
| May 2010 | July 2013 | |
| Notes: 1. Full-time equivalent figures are rounded to the nearest whole number. 2. West Midlands organisations for May 2010 have been mapped to the new HEE area boundary that was introduced in April 2013, to ensure a consistent timeseries. 3. Monthly data: As from 21 July 2010 the HSCIC has published provisional monthly NHS workforce data. As expected with provisional statistics, some figures may be revised from month to month as issues are uncovered and resolved. The monthly workforce data is not directly comparable with the annual workforce census; it only includes those staff on the Electronic Staff Record (ie it does not include Primary care staff or Bank staff). Source: Health and Social Care Information Centre (HSCIC), Provisional NHS Hospital and Community Health Service Monthly Workforce Statistics. | ||
Cancer
Mr Amess: To ask the Secretary of State for Health what the effect on cancer services in England is of Welsh-registered patients seeking access to those cancer medicines not approved in Wales by the National Institute for Health and Care Excellence or the All Wales Medicines Strategy Group; and if he will make a statement. [174851]
Norman Lamb: Information on cancer medicines accessed in England by Welsh-registered patients is not collected centrally.
Care Quality Commission
Liz Kendall: To ask the Secretary of State for Health how much the Care Quality Commission has spent on consultancy services in (a) 2010-11, (b) 2011-12, (c) 2012-13 and (d) 2013-14 to date. [Official Report, 5 December 2013, Vol. 571, c. 15MC.] [175541]
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Norman Lamb: The Care Quality Commission (CQC) has provided the following information:
| The CQC's expenditure on consultancy services | |
| Amount (£ million) | |
| 1 Up to and including 30 September 2013. Source. The CQC annual accounts, reports and monthly Department of consultancy returns. Definitions of ‘consultancy’ were taken from the Cabinet Office's Guidance on Actions and Processes. | |
Cervical Cancer
Luciana Berger: To ask the Secretary of State for Health what recent estimate he has made of uptake rates for cervical cancer screening in England; and what steps he is taking to improve uptake amongst younger age groups. [175638]
Jane Ellison: Information is not available on the number of women who have taken up an invitation for cervical screening (uptake). However, information is available on coverage. Coverage is the percentage of women in a population who were eligible for screening at a particular point in time and who were screened adequately within a specified period.
As the frequency with which women are invited for screening is dependent on age, coverage is calculated differently for different age groups. For those aged 25 to 49 (who are invited for routine screening every three years), coverage is calculated as the number of women in this age group who have had an adequate screening test within the last 3.5 years, as a percentage of the eligible population aged 25 to 49. For those aged 50 to 64 (who are invited for routine screening every five years) and for the total target age group (aged 25 to 64), coverage is calculated as the number of women who have had an adequate screening test within the last five years, as a percentage of the eligible population.
The following table shows coverage for women aged 25 to 64 by age group, as at 31 March 2012 and 2013.
| Coverage for women aged 25 to 64 by age group, England, 2012 and 2013, as at 31 March | ||
| Percentage | ||
| Age group | 2012 | 2013 |
| Source: KC53 Health and Social Care Information Centre. | ||
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The figures from the table above are available in table 1 (Statistics on cervical cancer and the NHS Cervical Screening Programme) of the report “Cervical Screening Programme, England 2012-13”. The full report is available on the Health and Social Care Information Centre website at:
www.hscic.gov.uk/searchcatalogue?productid=12601&q=title%3a+ cervical+screening+programme&sort=Relevance&size= 10&page=1#top
There is a lack of published evidence regarding the effectiveness of interventions designed to increase cervical screening attendance among women aged under 35. The National Institute for Health Research Health Technology Assessment programme has commissioned a £1 million study to determine which interventions are effective at increasing screening uptake among women who are receiving their first invitation from the NHS Cervical Screening Programme at around age 25. The “Strategies to increase cervical screening uptake at first invitation” (STRATEGIC) study is trialling interventions such as: a pre-invitation leaflet; internet appointment booking; timed appointments; the provision of personal support through nurse navigators; and human papillomavirus (HPV) self-sampling. The study began in November 2011 and is due to run until October 2015.
Children: Smoking
Dr Offord: To ask the Secretary of State for Health what estimate his Department has made of the number of children who routinely smoke cigarettes in (a) England, (b) London and (c) Hendon constituency. [174881]
Jane Ellison: Information is not available in the format requested. Information on children (11-15) in England is available for 1982-2012. Information by England region is available for 2011-12, 2010-11 and 2006-08 combined.
Information is also available on smoking by children (8-15) in England for 1997-2011 at the following:
Table 2.1a of the ‘Smoking, drinking and drug use among young people in England in 2012’ provides information on pupils aged (11-15) smoking behaviour (including 'regular smoker' and ‘ever smoked’, by sex for England: 1982-2000. Table 2.1b shows the same information for the period 2001-12.
Tables 6.1 and 6.2 of the ‘Smoking, drinking and drug use among young people in England in 2012’ provide information on the proportion of pupils who have ever smoked, by region and sex: 2011-12 and prevalence of regular smoking, by region and sex: 2011-12.
Tables 6.1 and 6.2 of the ‘Smoking, drinking and drug use among young people in England in 2011’ provide information on the proportion of pupils who have ever smoked, by region and sex: 2010-11 and prevalence of regular smoking, by region and sex: 2010-11.
Tables 1 and 2 of the ‘Smoking, drinking and drug use among young people in England, findings by region 2006 to 2008’ provide information on the proportions of young people (11-15) who have ever smoked, by Government Office Region and sex: 2006-08 combined and prevalence of regular smoking, by Government Office Region and sex: 2006-08 combined.
Table 5 of the 'Health Survey for England—2011: Children trend tables' provides information on Children aged (8-15) self-reported cigarette smoking status, by survey year, age and sex in England, 1997-2011. Note, this shows data for those who have ‘ever smoked’.
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Copies of these publications have already been placed in the Library and are available from the following links:
Smoking, drinking and drug use among young people in England in 2012:
www.hscic.gov.uk/searchcatalogue?productid=12096&.q= title%3a%22Smoking%2c+Drinking+and+Drug+Use+Among +Young+People+in+England%22&sort=Relevance&size=10&page =l#top
Smoking, drinking and drug use among young people in England in 2011:
www.hscic.gov.uk/article/2021/Website-Search?productid= 7911&q=Smoking%2c+Drinking+and+Drug+Use+Among+ Young+People+&sort=Relevance&size=10&page=l&area=both#top
Smoking, drinking and drug use among young people in England, findings by region 2006 to 2008:
www.hscic.gov.uk/article/2021/Website-Search?productid=1321&q=SDD+findings+by +region&sort=Relevance8isize=108ipage=l&area=both#top
Health Survey for England—2011, Trend tables:
www.hscic.gov.uk/catalogue/PUB09302
Commissioning Support Units
Liz Kendall: To ask the Secretary of State for Health (1) how much commissioning support units spent on consultancy services in (a) 2012-13 and (b) 2013-14 to date; [175584]
(2) how many commissioning support units there are; and what the current (a) budget, (b) number of staff employed and (c) budget for staff salaries is for each such unit. [175586]
Jane Ellison: In June 2011, the Department agreed that NHS England (the NHS Commissioning Board at the time) would temporarily host commissioning support units (CSUs) for no more than three years (from April 2013-2016) while they undergo further transition and development so that they are as competitive as possible when they move to independent forms within a more plural market.
There are 18 NHS commissioning support units (CSUs), hosted by NHS England providing a range of professional bespoke and at scale commissioning support to clinical commissioning groups (CCGs) and other customers. They employ 8,447 staff and generate a total income of £719 million, £605.million of which comes from CCGs.
CSUs are due to move to more autonomous forms by April 2016 and are already actively competing in market where CCGs and other commissioners have choice over where to source their support services. NHS England therefore advises that releasing information on individual staff costs could jeopardise CSUs commercial position and give potential competitors an advantage when competing for work.
The following table indicates headcount and whole-time equivalent (WTE) staff for each CSU. These figures have been supplied by NHS England.
| Commissioning support unit | Headcount | WTE |
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|
Surrey and Sussex (disbanded from end October and staff being transitioned to alternative suppliers) | ||
The total CSU consultancy spend was £10 million from April 2013 to September 2013. This is the only period which NHS England has data for.
Conditions of Employment
John McDonnell: To ask the Secretary of State for Health how many direct employees and contracted workers of his Department and its arm's lengths bodies are paid less than the rate defined by the Living Wage Foundation as a living wage; and how many direct employees are on zero hours contracts. [174979]
Dr Poulter: All civil servants employed by the Department are paid at rates for which the hourly equivalent is greater than the living wage rates defined by the Living Wage Foundation.
Contracted workers in the Department engaged as agency workers via the Department's current Hays Master Vendor Agreement are entitled to treatment in respect to basic terms and conditions—working time, holiday entitlement, pay—after a 12-week qualifying period under the Agency Workers Regulations.
No civil servants are employed by the Department on zero hours contracts.
The rates in the agreement with the Department's Master Vendor, Hays, for new starting agency workers are at the living wage rates which have been in place from November 2012. These will be uprated to the new living wage rate from November 2013.
The Department does not hold centrally the information requested about its arm's length bodies, so this was sought from the arm's length bodies. Information provided as at 31 October 2013 is set out in the following table.
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Continuing Care
Catherine McKinnell: To ask the Secretary of State for Health if he will take steps to ensure that individuals who develop long-term conditions will be able to access insurance products to cover the sum of the social care cap. [175056]
Norman Lamb: We believe, as did the independent Dilnot Commission, that the funding reforms for care and support service creates an opportunity for the development of more financial products, such as insurance policies, to help people pay for their care. These are products that can only be developed by the financial services industry and we have been working with them to help understand what products could be developed and how the Government could help create the right conditions for them to develop.
Doctors: West Midlands
James Morris: To ask the Secretary of State for Health how many hospital and community health service doctors were employed by the NHS in the West Midlands in (a) the latest period for which figures are available and (b) 2010. [175554]
Dr Poulter: The information is not available in the format requested.
Information on the number of medical and dental staff in the West Midlands Health Education England (HEE) area at 31 July 2013 and 31 May 2010 is shown in the following table:
Fracking
Paul Flynn: To ask the Secretary of State for Health with reference to the report published by Public Health England on 31 October 2013, what steps he plans to take to mitigate the hazards to health of householders from exposure to radon gas transported to homes in methane gas streams obtained from the hydraulic fracturing of shale reserves. [175073]
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Jane Ellison: Public Health England (PHE) has identified that radon may be present in natural gas obtained by hydraulic fracturing of shale reserves, as is the case for natural gas derived from some other sources. Further information can be found at:
www.gov.uk/government/news/shale-gas-extraction-emissions-are-a-low-risk-to-public-health
Radon in domestic gas supply has been assessed previously for its radiological significance in relation to natural gas from the North sea and it leads to domestic gas customers receiving very small radiation exposures, compared with other naturally occurring radiation.
Measurements from the United States of America of radon in shale gas methane suggest that the concentrations are similar to those found in natural gas from other sources, and that radiation exposure to domestic gas users from this source will also be very low.
Radiation exposures received by domestic gas consumers are related to the concentration of radon in gas delivered to homes. This will be lower than the initial well-head concentration because of radioactive decay of radon during transit or storage, which is assessed in relation to the 3.8 day radioactive half-life of the relevant radon isotope, and of dilution of radon resulting from blending and mixing of methane from different sources.
PHE has recommended that it will be appropriate to determine the initial radon concentrations in natural gas from shale sources in the United Kingdom.
PHE has further recommended that the existing radiological assessment, of radon in natural gas, should be reviewed using measurements of radon in UK shale gas together with assessment parameters that reflect the processing and transport network that will apply to UK shale gas methane.
The Government are considering PHE's recommendations and will respond in due course.
Health
Luciana Berger: To ask the Secretary of State for Health how many people in his Department have been (a) seconded and (b) hired from organisations that have signed up to responsibility deal pledges. [175905]
Dr Poulter: The Department does not hold information centrally about the organisations from which it seconds or hires individuals. Gathering that information could be done only at disproportionate cost.
Health Services: Hearing Impairment
Stephen Lloyd: To ask the Secretary of State for Health (1) when his Department will begin monitoring outcomes from adult hearing services delivered through the Any Qualified Provider model as part of a long-term evaluation of the policy; and if he will make a statement; [175140]
(2) what recent evaluation his Department has made of the Any Qualified Provider model for delivering adult hearing services; and if he will publish any such evaluation. [175151]
Norman Lamb:
The Department has no plans to begin such monitoring. It is the responsibility of commissioners to monitor the outcomes being delivered for their local populations as a result of the contracts
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for NHS services that they have entered into with providers, including those contracts awarded through an ‘any qualified provider’ (AQP) process.
An initial survey on the implementation of AQP in audiology services was commissioned by Professor Sue Hill, currently the Chief Scientific Officer at NHS England, and is in the process of being finalised.
A wider evaluation of any AQP programme is planned as part of the Department's Health Reform Evaluation Programme.
Mrs Moon: To ask the Secretary of State for Health if he will review the compatibility of the services provided by the NHS with the Prague Declaration signed by the National Association of Deafened People; and if he will make a statement. [175239]
Norman Lamb: NHS England advises that:
NHS England supports the UN Convention on the Rights of Persons with Disabilities, to which the Prague Declaration refers.
NHS England agrees that people who are deaf, deafened, hard of hearing or otherwise affected by hearing loss should be able to participate fully in society, and should be able to access information in a format appropriate for them, and any communication support that they need.
NHS England recognises the duties placed upon all providers of services and on public sector bodies by the Equality Act 2010, and seeks to provide advice and guidance to NHS bodies and providers of NHS services in this regard.
Health Services: Males
Luciana Berger: To ask the Secretary of State for Health following the recent issue of commissioning guidance to local authorities, where responsibility lies for commissioning (a) the treatment of erectile dysfunction, (b) the treatment of testosterone deficiency syndrome and (c) other health services for men. [175637]
Jane Ellison: In most cases the commissioning responsibility for the treatment of erectile dysfunction, the treatment of testosterone deficiency syndrome and other health services for men lies with clinical commissioning groups. However, in circumstances where erectile dysfunction and testosterone deficiency are a direct result of a rare and/or complex condition classified under specialised commissioning, then the commissioning responsibility for erectile dysfunction and testosterone deficiency syndrome would fall to NHS England.
Health Services: Merseyside
Mr Frank Field: To ask the Secretary of State for Health when he expects to establish an NHS England unit to reflect the six local authorities of the Merseyside city region. [175743]
Jane Ellison: The structure of area teams is a matter for NHS England. Currently, the Cheshire, Warrington and Wirral Area Team covers Wirral local authority and the Merseyside Area Team covers Sefton, Liverpool, Knowsley, St Helens and Halton. NHS England has advised that there are no current plans to change the existing area team structure in the region.
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Health Services: Worcestershire
Karen Lumley: To ask the Secretary of State for Health what recent assessment he has made of the reconfiguration of health services in Worcestershire and any effects on Alexandra Hospital, Redditch. [175325]
Jane Ellison: The reconfiguration of local health services is a matter for the local national health service. Commissioners in Worcestershire are currently working with local providers and stakeholders to develop proposals for the future provision of acute services across the county, including Alexandra hospital, which will be subject to public consultation.
Health Services: Young Offender Institutions
Dan Jarvis: To ask the Secretary of State for Health what health providers provide services in young offender institutions. [175580]
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Norman Lamb: Young offenders who are aged between 15 and 21 years may be detained in young offender institutions (YOIs) or, if aged over 18 years, in young offender wings within adult prisons. All female young offenders are detained within young offender wings in women's prisons.
Since 1 April 2013, NHS England has commissioned health services for people in prison or other secure accommodation in England. Health services in YOIs, publicly-run prisons and contracted prisons are provided by either national health service, private or voluntary sector organisations with the current health care providers for each establishment housing young offenders shown in the following table.
Many current health provider contracts were established prior to NHS England acquiring its commissioning role. NHS England is re-tendering contracts as they expire and has advised that current providers are subject to change after April 2014.
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| Source: NHS England and HM Inspectorate of Prisons. | |
Health Visitors: West Midlands
James Morris: To ask the Secretary of State for Health how many qualified health visitors there were in the West Midlands in (a) the latest reported period and (b) May 2010. [175407]
Dr Poulter: Information on the number of health visitors in the West Midlands Health Education England (HEE) area at 31 July 2013 and 31 May 2010 is shown in the following table:
| Full time equivalent | ||
| May 2010 | July 2013 | |
| Notes: 1. Full-time equivalent figures are rounded to the nearest whole number. 2. West Midlands organisations for May 2010 have been mapped to the new HEE area boundary that was introduced in April 2013, to ensure a consistent time series. 3. Monthly data: from 21 July 2010 the HSCIC has published provisional monthly NHS workforce data. As expected with provisional statistics, some figures may be revised from month to month as issues are uncovered and resolved. The monthly workforce data is not directly comparable with the annual workforce census; it only includes those staff on the Electronic Staff Record (i.e. it does not include primary care staff or bank staff). Source: Health and Social Care Information Centre (HSCIC), Provisional NHS Hospital and Community Health Service monthly workforce statistics. | ||
Health: Finance
Luciana Berger: To ask the Secretary of State for Health when he will announce his decision on public health funding allocations for local authorities NHS England and clinical commissioning groups; and if he will make a statement. [175906]
Jane Ellison: A two-year local authority public health allocation was announced on 10 January 2013 for 2013-14 and 2014-15 to support local authorities in carrying out their new public health functions.
Responsibility for resource allocation to clinical commissioning groups is now a matter for NHS England as set out in ‘The Mandate’. NHS England has been conducting a fundamental review into its approach to allocations with the aim of having initial conclusions ready in time to inform 2014-15 allocations. It is anticipated that NHS England will be in a position to announce these in late December 2013.
Health: Young People
Luciana Berger: To ask the Secretary of State for Health pursuant to the contribution of the Parliamentary Under-Secretary of State for Public Health on 7 November 2013, Official Report, column 476, on standardised tobacco packaging, which risk behaviours the dedicated youth marketing programme will be aimed at discouraging. [175664]
Jane Ellison: Public Health England has adopted a holistic approach for its Youth Marketing Programme, moving from tackling single issues to taking a life-stage approach. The programme focuses on building young people’s resilience, and challenging specific risky behaviour which impacts on their development, health and well-being. Topics addressed include smoking, substance misuse, alcohol and sex and relationships.
In addition, the programme addresses issues such as bullying, exam pressure, self-harm and body confidence that has been shown to affect the physical and mental well-being of young people. Over time, it is likely that a broader range of health issues including diet and physical exercise will be covered by the programme.
Luciana Berger: To ask the Secretary of State for Health pursuant to the contribution of the Parliamentary Under Secretary of State for Public Health of 7 November 2013, Official Report, column 476, on dedicated youth marketing programme, how much his Department has spent on public health marketing in each year since 2010. [175902]
Jane Ellison: The media and public relations (PR) spend on public health campaigns for the Department since 2010 is shown in the following tables.
On 1 April 2013 responsibility for public health marketing transferred to Public Health England. The “Public Health England Marketing Plan 2013-14” was published on 15 April 2013 and contains their spending plans for that financial year. The “Public Health England Marketing Plan 2013-14” indicates an allocation of £54.7 million for public health marketing. The plan can be accessed at:
www.gov.uk/government/uploads/system/uploads/attachment_data/file/186957/PHE_Marketing_Plan_2013-14_1651.pdf
| Table 1: Media spend on public health campaigns since 2010 | ||||
| £ million | ||||
| Media Spend | ||||
| 2009-10 | 2010-11 | 2011-12 | 2012-13 | |
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| Table 2: Public relations spend on public health campaigns since 2010 | ||||
| PR Spend (£ million) | ||||
| 2009-10 | 2010-11 | 2011-12 | 2012-13 | |
| 1 Although listed separately, in 2011-12 Alcohol was incorporated into the Change4Life campaign. Notes: 1. Figures are net plus agency fees (i.e. fees and expenses to cover time worked by agency staff and costs incurred during the work) and commissions (rounded to nearest £10,000). Figures exclude value added tax (VAT). 2. Spend between 2003-04 to 2008-09 were by several agencies on the Department's own PR framework and Centre of Information's PR framework. However, it is not possible to extract a more detailed breakdown from the Department's financial reporting system. 3. PR companies are employed to support a very wide range of marketing and policy initiatives including our major public health behaviour change programmes (such as tobacco control, sexual health, obesity prevention and drug and alcohol harm reduction programmes). 4. In addition to providing specialist knowledge of a wide range of media through which the Department needs to communicate with specific target audiences, they also provide extensive creative input to communications programmes. 5. The work commissioned through PR companies includes a wide range of marketing activity including: advertorials, newsletter production, conference and event management, research, creation of content and photography and stakeholder relations activity. | ||||