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Lord Clement-Jones asked Her Majesty's Government:
- What plans they have to discuss the basic principles of quality management within the National Health Service, together with the appropriate training of National Health Service staff in these principles, with professional bodies like the Institute of Quality Assurance; and[HL603]
What training in quality management principles is provided to National Health Service management and personnel.[HL605]
Lord Hunt of Kings Heath: The NHS Modernisation Agency is a recently launched major initiative within the National Health Service enabling a wide variety of NHS organisations to involve staff and patients in improving services. The agency is using a variety of quality improvement methods and procedures in its work to support NHS organisations on the ground.
The NHS Modernisation Agency combines the work of several pre-existing national teams including the NHS clinical governance support team, national patients access team and primary care development team. The Leadership Centre within the NHS
Modernisation Agency also provides access to quality management principles, tools and techniques for NHS leaders.Individual NHS organisations also provide opportunities for their own managers to develop necessary quality management skills through continuing professional development and through other forms of management development offered by academic institutions (for example, Master of Business Administration courses) and professional bodies (for example, the Institute of Health Management).
Lord Clement-Jones asked Her Majesty's Government:
- What model of quality management system is in use in the National Health Service to establish and evaluate basic performance measures; and[HL604]
What steps they have taken to ensure better quality management within the National Health Service.[HL606]
Lord Hunt of Kings Heath: Quality is the heart of the Government's agenda for modernising the National Health Service. Quality of care is increasingly being taken into account when judging the performance of NHS organisations.
The basic elements of the NHS quality management system--as set out in A First Class Service-Quality in the new NHS, published in 1998--are all now in place; these are: clear national standards to help raise standards of care and reduce unacceptable variations for specific treatments, conditions and for patient safety, through routes including the National Institute for Clinical Excellence, national service frameworks and a National Cancer Plan; modern organisational delivery mechanisms to implement national standards effectively, dependably and safely--coordinated through comprehensive clinical governance arrangements; and strong monitoring mechanisms--including the Commission for Health Improvement, the NHS Performance Assessment Framework, national and local patient surveys.
This agenda is underpinned by the Health Act 1999, which places a statutory duty of quality on NHS organisations continuously to monitor and improve the quality of the health care that they provide.
The NHS Plan, published July 2000, takes this quality agenda further to cover improving customer service and patient/citizen representation and also sets out plans for a new mandatory reporting scheme for adverse healthcare events, to help minimise risks to patients and improve the quality and safety of patient care.
This is a substantial agenda of reform, requiring major changes to culture and working practices throughout the NHS. However, we have made a good start towards implementing this agenda--increasingly NHS systems and practices are beginning to be re-focused on improving quality and people are beginning to get better care as a result.
Clinical Negligence
Lord Hunt of Wirral asked Her Majesty's Government:
- What is the additional cost to the Department of Health for damages in clinical negligence cases (over and above provisions and estimates totalling £3.9 billion at 31 March as noted by the National Audit Office) arising from the lowering of the discount rate for personal injury cases from 3 to 2- per cent announced by the Lord Chancellor on 27 June.[HL617]
Lord Hunt of Kings Heath: The Lord Chancellor's Department is carrying out a full assessment of the impact of the new discount rate, which is being prepared and will be published in due course.
NHS Waiting Lists
Lord Jacobs asked Her Majesty's Government:
- How many National Health Service patients are waiting more than four weeks for:
How many National Health Service patients have been waiting for an operation for more than four weeks; which are the 10 operations making up the highest percentage of this waiting list; and how many patients have been waiting more than four weeks for each of these 10 operations.[HL689]
(a) cataract removal;
(b) heart bypass;
(c) hernia operation; and
(d) knee replacement; and[HL619]
Lord Hunt of Kings Heath: Data on the number of patients currently waiting are only collected by specialty not by procedure and by the number waiting over three months not over four weeks. Therefore, data cannot be provided on the number of patients currently waiting over four weeks for operations.
The percentage of patients waiting over three months at the end of May 2001 was 50 per cent.
Lord Jacobs asked Her Majesty's Government:
Lord Hunt of Kings Heath: The costs within the National Health Service compare favourably with those quoted in the article. The following list shows the straightforward comparison, based on the definitions used in the NHS.
In addition the following points should be noted for the figures supplied on the costs within the NHS:
(i) the NHS costs are the full costs of the NHS service, including ward and nursing costs etc. associated with the inpatient or day case stay and not just the costs of the surgery itself, except for any stay in critical care;
(ii) the average cost of a stay in a coronary care (intensive) care ward is £388 per day and the length of stay in critical care will be dependent on the individual patient;
(iii) any ongoing physiotherapy etc. undertaken after the surgery on an outpatient basis is not included;
(iv) the day case cost is quoted for cataract surgery as the majority of this type of surgery is undertaken as day cases (81 per cent in 1999-2000);
(v) any costs associated with outpatient attendances before and after surgery are separately identified. This is standard practice across the NHS and allows comparison with the private sector, which charges for each element separately.
Source:
Reference Costs 2000 (published November 2000 by Department of Health).
Lord Goodhart asked Her Majesty's Government:
Lord Hunt of Kings Heath: There have been no such meetings.
Lord Mancroft asked Her Majesty's Government:
Lord Hunt of Kings Heath: The draft national minimum standards for care homes for younger adults place strong emphasis on meeting the assessed needs of service users and providing appropriate programmes of care. The Government have carried out an in-depth consultation exercise targeted specifically at service users with drug or alcohol problems and we will continue to take users' views into account when developing these standards.
Baroness Barker asked Her Majesty's Government:
Lord Hunt of Kings Heath: No work has been done at this stage to explain the recent trends in prescribing of anti-psychotic medication although the figures are monitored. The National Institute for Clinical Excellence is expected to issue guidance on the use of atypical anti-psychotic drugs in December. The available information relates to anti-psychotic medicines dispensed in the community for 1999 and 2000 only; these are set out in the table and are estimates derived from a 1 in 20 sample of prescription items.
Notes:
1. The age related information is based on an analysis of those not required to pay a charge indicated by the categories completed on the back of the prescription form. The estimates are based on a 1 in 20 sample of all prescription items submitted to the Prescription Pricing Authority by community pharmacists and appliance contractors only. Dispensing doctor prescriptions were not analysed into categories in 1999. Personally administered items are free of charge. Small numbers in the original sample may cause some variation in the estimates.
2. Antipsychotics are defined within British National Formulary paragraph 4.2.1, antipsychotic drugs.
3. Charged prescriptions also includes prescriptions obtained by patients with a pre-payment certificate.
1. The age related information is based on an analysis of those not required to pay a charge indicated by the categories completed on the back of the prescription form. The estimates are based on a 1 in 20 sample of all prescription items submitted to the Prescription Pricing Authority by community pharmacists and appliance contractors only. Dispensing doctor prescriptions were not analysed into categories for most of 2000. Personally administered items are free of charge. Small numbers in the original sample may cause some variation in the estimates.
2. Antipsychotics are defined within British National Formulary paragraph 4.2.1, antipsychotic drugs.
3. Charged prescriptions also includes prescriptions obtained by patients with a pre-payment certificate.
How the cost of the following operation in the United Kingdom National Health Service compares with the costs in France shown in brackets, as reported in The Sunday Times on 22 July:
(a) cataract removal (£1,000);
(b) heart bypass (£7,000);
(c) hernia operation (£1,000); and
(d) knee replacement (£4,000).[HL620]
NHS Article
(a) cataract removal (day cases) £568 £1,000
(b) coronary bypass £4,956 £7,000
(c) hernia operation £809 £1,000
(d) knee replacement £4,390 £4,000
Which faith-based organisations have had meetings with Department of Health Ministers specifically to discuss policy in the last year.[HL624]
Whether, in the light of the latest findings of the national treatment outcome research study, they will consider whether the national minimum standards for care homes for younger adults will undermine the ability of drug and alcohol treatment services to ensure residents' engagement with therapy and to prevent social isolation.[HL647]
14 Sept 2001 : Column WA17
What work has been undertaken to explain the trend in prescribing of anti-psychotic medication;
14 Sept 2001 : Column WA18what are the key findings; and whether they will set out prescription numbers for such medication in each of the last five years for each region and health authority for each of the following age groups (i) 0 to 15 years, (ii) 16 to 59 years, and (iii) 60 years and over.[HL671]
Prescription items dispensed by community pharmacists and appliance contractors only Prescription items dispensed by dispensing doctors and items personally administered All prescription items dispensed in the community
(Thousands) (Thousands)
Health authority in which item was dispensed Children aged 0-15 years Elderly people aged 60 and over Aged 16 to 59 years All ages All ages
Exempt Charged (3) Bedfordshire 0.1 16.0 13.5 4.2 3.2 37.0
North Essex 0.4 32.1 29.2 6.6 7.6 75.8
South Essex 0.9 23.9 20.3 4.9 0.3 50.3
North West Anglia 0.0 3.4 3.6 1.0 1.8 9.8
Suffolk 0.3 27.6 16.8 5.2 10.1 60.0
East and North Hertfordshire 0.1 18.1 13.6 4.2 1.4 37.4
West Hertfordshire 0.1 19.4 16.0 5.2 0.3 41.0
Cambridgeshire 0.3 20.0 17.0 5.5 10.7 53.5
Norfolk 0.2 30.1 34.6 7.9 14.7 87.5
Total Eastern Region 2.4 190.6 164.5 44.7 50.0 452.3
Hillingdon 0.0 5.8 6.9 2.0 0.0 14.7
Kensington and Chelsea and Westminster 0.1 7.0 14.4 2.5 0.0 24.0
Enfield and Haringey 0.1 16.3 22.7 3.8 0.0 42.8
Redbridge and Waltham Forest 0.3 16.9 15.7 3.4 0.0 36.3
Bexley and Greenwich 0.2 15.6 12.1 3.0 0.0 30.9
Bromley 0.1 11.9 8.0 2.4 0.0 22.4
Croydon 0.0 11.9 15.9 2.9 0.0 30.7
Kingston and Richmond 0.1 11.5 9.6 3.2 0.0 24.4
Lambeth, Southwark and Lewisham 0.2 25.5 32.2 4.0 0.0 61.9
Merton, Sutton and Wandsworth 0.1 21.8 22.8 4.7 0.0 49.3
Barking and Havering 0.2 14.0 12.8 3.4 0.0 30.4
Barnet 0.1 16.3 10.1 3.2 0.0 29.8
Brent and Harrow 0.1 12.7 17.5 3.5 0.0 33.9
Camden and Islington 0.0 9.5 26.3 2.8 0.0 38.6
Ealing, Hammersmith and Hounslow 0.2 20.2 29.6 5.2 0.0 55.1
East London and The City 0.5 13.5 33.8 3.2 0.0 51.1
Total London Region 2.0 230.4 290.4 53.3 0.0 576.2
South Lancashire 0.1 12.8 9.5 3.5 0.2 26.1
Liverpool 0.4 26.1 33.9 2.7 0.0 63.0
Manchester 0.1 22.8 39.8 3.7 0.0 66.4
Morecambe Bay 0.1 18.8 14.7 3.4 2.0 39.0
St Helens and Knowsley 0.1 17.5 23.6 2.9 0.0 44.1
Salford and Trafford 0.2 29.7 29.8 4.8 0.0 64.5
Sefton 0.1 17.9 23.7 2.7 0.0 44.4
Stockport 0.2 26.5 19.9 4.7 0.0 51.2
West Pennine 0.1 19.8 22.5 3.9 0.0 46.4
Bury and Rochdale 0.3 21.1 23.7 4.2 0.0 49.3
North Cheshire 0.1 15.2 17.8 3.4 0.1 36.6
South Cheshire 0.2 32.7 22.9 5.6 2.5 63.8
East Lancashire 0.2 25.2 30.3 6.0 0.6 62.2
North West Lancashire 0.1 27.9 24.2 5.2 0.9 58.2
Wigan and Bolton 0.0 28.5 24.6 5.1 0.0 58.2
Wirral 0.0 17.9 25.1 3.8 0.0 46.8
Total North West Region 2.4 360.3 385.9 65.3 6.2 820.2
Bradford 0.2 21.7 26.9 4.0 0.8 53.7
County Durham and Darlington 0.3 28.7 27.4 6.4 5.1 67.8
East Riding and Hull 0.1 25.2 22.4 5.0 3.3 55.9
Gateshead and South Tyneside 0.3 19.4 18.5 3.4 0.2 41.8
Leeds 0.2 37.5 38.7 8.0 0.5 84.8
Newcastle and North Tyneside 0.2 28.5 29.0 4.4 0.0 62.1
North Cumbria 0.2 13.2 13.3 3.4 2.9 32.9
Northumberland 0.1 11.4 10.9 2.3 1.5 26.2
Sunderland 0.1 13.2 11.5 1.9 0.0 26.7
Tees 0.3 27.5 25.9 4.5 0.1 58.4
Wakefield 0.2 15.0 13.2 3.6 1.5 33.5
North Yorkshire 0.3 27.6 18.0 5.7 8.2 59.8
Calderdale and Kirklees 0.3 28.9 23.3 5.5 0.6 58.6
Total Northern & Yorkshire Region 2.8 297.9 278.9 58.0 24.6 662.3
Berkshire 0.2 24.1 20.8 7.2 2.4 54.8
Buckinghamshire 0.2 20.0 16.8 5.2 2.5 44.7
East Kent 0.4 27.9 24.5 4.2 3.5 60.5
West Kent 0.3 33.8 31.1 8.9 3.9 78.1
East Surrey 0.0 16.9 11.1 3.8 0.9 32.8
West Surrey 0.1 21.9 17.4 6.1 0.7 46.3
East Sussex, Brighton and Hove 0.2 38.1 35.5 6.8 2.1 82.7
West Sussex 0.2 40.3 19.9 7.8 3.4 71.6
Northamptonshire 0.3 19.7 19.9 5.2 3.2 48.2
Oxfordshire 0.1 14.8 14.3 4.9 6.6 40.7
North and Mid Hampshire 0.4 18.8 15.9 6.1 3.7 44.9
Portsmouth and South East Hampshire 0.3 26.3 19.6 4.1 0.4 50.7
Southampton and South West Hampshire 0.3 24.6 21.4 6.7 1.0 54.1
Isle Of Wight 0.1 7.5 5.5 0.9 0.4 14.4
Total South East Region 3.2 335.0 273.7 77.9 34.7 724.4
Somerset 0.4 18.5 13.8 3.3 3.4 39.4
South and West Devon 0.3 29.4 32.3 5.4 1.5 68.9
Wiltshire 0.2 23.3 19.5 5.5 2.8 51.3
Avon 0.5 41.6 38.4 8.3 1.8 90.6
Cornwall and Isles Of Scilly 0.6 19.9 19.6 3.5 8.2 51.7
Dorset 0.7 34.1 24.3 6.9 3.6 69.6
North and East Devon 0.5 20.3 19.5 4.2 4.8 49.3
Gloucestershire 0.5 19.5 15.2 5.4 4.7 45.4
Total South West Region 3.8 206.7 182.5 42.4 30.7 466.1
Barnsley 0.1 11.0 11.0 2.7 0.9 25.7
North Derbyshire 0.1 16.0 13.3 3.1 2.3 34.7
Southern Derbyshire 0.2 25.6 18.0 5.0 2.1 50.8
Doncaster 0.1 13.4 12.4 2.6 0.5 29.0
Leicestershire 0.4 30.6 33.2 7.1 2.7 74.0
Lincolnshire 0.3 27.5 18.5 5.6 14.6 66.5
North Nottinghamshire 0.2 20.9 10.2 3.2 1.1 35.6
Nottingham 0.1 27.2 19.2 5.9 1.5 54.0
Rotherham 0.2 17.3 9.9 2.2 0.3 29.9
Sheffield 0.2 24.0 21.7 3.7 0.1 49.6
South Humber 0.1 13.0 12.3 3.0 4.4 32.8
Total Trent Region 2.0 226.5 179.6 44.2 30.5 482.7
Birmingham 1.1 42.1 56.4 7.4 0.0 107.0
Coventry 0.1 15.2 15.8 3.3 0.1 34.5
Dudley 0.2 13.0 12.7 3.8 0.0 29.6
Herefordshire 0.1 5.2 4.9 1.3 2.6 14.1
Sandwell 0.1 12.5 13.7 2.4 0.0 28.6
Shropshire 0.2 16.8 13.3 3.4 4.1 37.8
Solihull 0.0 5.3 7.6 2.0 0.0 14.9
North Staffordshire 0.1 24.0 18.0 5.3 1.1 48.5
South Staffordshire 0.4 22.2 15.1 5.1 4.3 47.1
Walsall 0.2 16.1 13.8 2.7 0.0 32.7
Warwickshire 0.2 19.3 15.1 4.7 4.5 43.8
Wolverhampton 0.1 10.5 11.2 2.0 0.0 23.8
Worcestershire 0.2 21.6 13.9 3.4 3.4 42.4
Total West Midlands Region 3.0 223.7 211.4 46.8 20.0 504.9
England 21.7 2,071.0 1,966.9 432.5 196.8 4,689.0
Prescription items dispensed by community pharmacists and appliance contractors only Prescription items dispensed by dispensing doctors and items personally administered All prescription items dispensed in the community
(Thousands) (Thousands)
Health authority in which item was dispensed Children aged 0-15 years Elderly people aged 60 and over Aged 16 to 59 years All ages All ages
Exempt Charged (3) Bedfordshire 0.3 17.6 15.7 4.3 3.4 41.2
North Essex 0.3 35.1 29.6 6.5 7.9 79.5
South Essex 0.7 24.7 22.7 5.9 0.3 54.2
Suffolk 0.3 29.2 18.6 5.3 10.1 63.6
East and North Hertfordshire 0.1 18.4 14.8 4.7 1.5 39.5
West Hertfordshire 0.2 22.4 14.8 5.2 0.3 42.9
Cambridgeshire 0.4 24.1 19.7 7.1 11.4 62.8
Norfolk 0.2 33.6 40.6 8.4 15.6 98.3
Total Eastern Region 2.6 205.1 176.4 47.4 50.5 482.0
Hillingdon 0.1 7.2 5.9 2.3 0.0 15.7
Kensington and Chelsea And Westminster 0.0 7.4 15.7 3.3 0.0 26.3
Enfield and Haringey 0.1 16.2 24.8 3.9 0.0 44.9
Redbridge and Waltham Forest 0.3 18.7 14.8 4.0 0.0 37.7
Bexley and Greenwich 0.2 15.7 12.7 2.9 0.0 31.5
Bromley 0.0 12.5 7.8 2.7 0.0 22.9
Croydon 0.2 13.6 16.3 2.9 0.0 33.0
Kingston and Richmond 0.1 12.6 9.6 3.9 0.0 26.1
Lambeth, Southwark And Lewisham 0.2 27.6 35.1 4.5 0.0 67.3
Merton, Sutton and Wandsworth 0.3 25.2 23.1 5.3 0.0 53.9
Barking and Havering 0.1 15.3 12.8 3.7 0.0 31.9
Barnet 0.0 16.4 11.1 3.3 0.0 30.7
Brent and Harrow 0.0 13.1 18.5 4.2 0.0 35.7
Camden and Islington 0.1 9.6 26.5 3.1 0.0 39.4
Ealing, Hammersmith and Hounslow 0.2 20.2 31.8 5.8 0.0 58.0
East London and The City 0.2 14.7 36.0 3.6 0.0 54.5
Total London Region 2.1 245.9 302.3 59.2 0.0 609.6
South Lancashire 0.2 13.3 10.9 3.7 0.2 28.2
Liverpool 0.1 26.7 36.1 3.3 0.0 66.3
Manchester 0.3 23.8 43.5 3.9 0.0 71.5
Morecambe Bay 0.2 20.0 14.3 4.1 2.2 40.8
St Helens and Knowsley 0.2 19.4 24.7 3.6 0.0 47.9
Salford and Trafford 0.2 34.2 30.8 5.2 0.0 70.4
Sefton 0.1 20.9 23.3 3.7 0.0 48.0
Stockport 0.2 26.9 21.8 4.7 0.0 53.6
West Pennine 0.1 21.5 23.4 4.4 0.0 49.4
Bury and Rochdale 0.1 22.0 24.5 5.1 0.0 51.8
North Cheshire 0.2 15.1 18.2 3.7 0.1 37.4
South Cheshire 0.2 33.8 25.5 6.4 2.3 68.2
East Lancashire 0.3 27.1 32.5 5.9 0.6 66.3
North West Lancashire 0.3 29.1 27.5 5.5 0.8 63.2
Wigan and Bolton 0.2 31.1 26.9 5.4 0.0 63.6
Wirral 0.1 21.5 23.7 3.9 0.0 49.3
Total North West Region 2.8 386.5 407.7 72.7 6.2 876.0
Bradford 0.2 23.7 26.7 4.2 0.2 54.9
County Durham and Darlington 0.5 30.1 30.4 6.9 4.9 72.7
East Riding and Hull 0.1 26.0 23.4 5.4 3.7 58.6
Gateshead and South Tyneside 0.2 19.7 18.7 2.9 0.1 41.7
Leeds 0.3 38.8 42.1 8.1 0.5 89.8
Newcastle and North Tyneside 0.4 30.4 30.9 4.4 0.0 66.1
North Cumbria 0.3 14.7 12.6 3.7 3.1 34.4
Northumberland 0.3 11.8 11.8 2.6 1.6 28.2
Sunderland 0.2 12.7 11.3 2.4 0.0 26.6
Tees 0.5 28.9 27.4 4.3 0.2 61.3
Wakefield 0.1 16.2 13.7 3.7 1.5 35.1
North Yorkshire 0.2 28.9 17.5 6.0 8.5 61.1
Calderdale and Kirklees 0.3 31.1 25.3 5.8 0.6 63.2
Total Northern & Yorkshire Region 3.5 313.0 291.8 60.4 24.9 693.5
Berkshire 0.2 26.0 21.3 8.1 2.6 58.1
Buckinghamshire 0.2 23.1 16.9 6.5 2.3 49.0
East Kent 0.9 26.6 25.4 4.8 3.5 61.2
West Kent 0.6 35.2 32.7 9.1 4.0 81.6
East Surrey 0.2 17.3 10.2 3.6 0.9 32.2
West Surrey 0.2 22.9 18.2 6.5 0.7 48.5
East Sussex, Brighton And Hove 0.4 38.6 37.4 7.5 2.1 86.0
West Sussex 0.4 42.1 22.3 9.2 3.4 77.4
Northamptonshire 0.3 19.5 19.8 6.2 3.2 48.9
Oxfordshire 0.2 16.8 14.5 5.2 7.1 43.8
North and Mid Hampshire 0.6 19.1 16.7 6.0 3.6 46.0
Portsmouth and South East Hampshire 0.3 27.9 21.4 4.6 0.3 54.5
Southampton and South West Hampshire 0.2 26.6 22.0 7.6 1.0 57.4
Isle of Wight 0.0 7.3 6.3 1.3 0.5 15.4
Total South East Region 4.6 348.8 285.2 86.1 35.2 759.9
Somerset 0.3 20.2 15.0 3.1 3.1 41.7
South and West Devon 0.4 32.4 34.9 5.7 1.4 74.8
Wiltshire 0.1 25.1 19.9 5.9 2.8 53.8
Avon 0.4 43.7 43.0 8.6 1.8 97.5
Cornwall and Isles Of Scilly 0.6 19.0 21.8 3.1 8.0 52.6
Dorset 0.6 33.7 24.5 6.1 3.4 68.3
North and East Devon 0.5 21.1 19.9 4.3 4.8 50.5
Gloucestershire 0.4 21.2 15.9 5.4 4.7 47.6
Total South West Region 3.3 216.2 194.9 42.2 30.0 486.8
Barnsley 0.0 10.8 10.5 2.6 0.9 24.6
North Derbyshire 0.1 18.3 13.8 3.7 2.3 38.2
Southern Derbyshire 0.2 25.8 19.0 5.0 2.0 51.9
Doncaster 0.2 13.5 12.8 3.0 0.5 30.0
Leicestershire 0.4 32.3 35.2 8.2 2.7 78.8
Lincolnshire 0.4 27.7 19.7 5.8 14.9 68.5
North Nottinghamshire 0.2 21.0 10.3 3.5 1.2 36.3
Nottingham 0.2 29.1 19.7 5.8 1.5 56.4
Rotherham 0.1 23.5 11.2 1.9 0.2 36.9
Sheffield 0.2 23.7 20.4 4.1 0.1 48.5
South Humber 0.3 14.0 12.2 2.8 4.3 33.6
Total Trent Region 2.3 239.5 184.9 46.4 30.5 503.7
Birmingham 1.1 44.3 58.5 8.1 0.0 111.9
Coventry 0.2 14.5 17.9 3.4 0.1 36.2
Dudley 0.2 14.7 12.9 3.7 0.0 31.5
Herefordshire 0.1 5.8 5.0 1.1 2.6 14.6
Sandwell 0.1 13.5 12.1 2.6 0.0 28.3
Shropshire 0.2 16.8 14.6 3.8 4.2 39.6
Solihull 0.0 7.3 6.7 2.1 0.0 16.2
North Staffordshire 0.1 26.0 17.6 5.3 1.0 50.0
South Staffordshire 0.5 24.2 17.2 4.8 3.9 50.6
Walsall 0.1 16.4 13.4 2.9 0.0 32.7
Warwickshire 0.3 20.2 15.8 5.2 4.6 46.2
Wolverhampton 0.1 11.0 12.2 1.8 0.0 25.1
Worcestershire 0.4 23.6 14.5 3.7 3.1 45.3
Total West Midlands Region 3.6 238.2 218.3 48.6 19.5 528.2
England 24.8 2,193.2 2,061.6 463.1 197.0 4,939.7
Notes:
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