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NHS Dental Services
Lord Colwyn asked Her Majesty's Government:
Further to the remarks by the Parliamentary Under-Secretary of State for Health, Dr Stephen Ladyman MP, in 15 July (HC Deb, col. 1637), how many dental practices have, since 1997, "taken the National Health Service shilling in order to expand their practice, then decided to abandon the National Health Service". [HL3957]
Lord Warner: The information requested is not available centrally.
Osteoporosis
Baroness Greengross asked Her Majesty's Government:
How they ensure there is a coordinated national osteoporosis and falls service in the National Health Service; and [HL3971]
How they ensure primary care trusts provide an osteoporosis and falls service; and how they monitor that provision. [HL3972]
Lord Warner: The National Service Framework for Older People (NSF) requires integrated falls services to be in place locally by April 2005. This should include appropriate links to osteoporosis. The Department of Health will be monitoring formally the April 2005 milestone at strategic health authority (SHA) level as this is included as one of the key targets in Improvement, Expansion and Reform, the priorities and planning framework for 2003–2006. SHAs are the key link between the department and primary care trusts. They ensure that national priorities, such as the development of falls services, are integrated into plans for the local health service. The Healthcare Commission will be undertaking a review of progress in delivery of the NSF for Older People including falls services, over the coming year.
Baroness Greengross asked Her Majesty's Government:
How National Health Service Modernisation Agency initiatives on osteoporosis and falls will be implemented when that body is abolished. [HL39733]
Lord Warner: Ensuring the appropriate local delivery of osteoporosis and falls care and treatment is the responsibility of local health organisations.
By April 2005 the NHS Modernisation Agency will transfer most of its staff to modernisation within local settings. The Modernisation Agency will be succeeded by a new, smaller national organisation, which will preserve a strong central focus on modernisation and innovation in the National Health Service. The Modernisation Agency's devolved staff will be well placed to provide any necessary on-going support to the local services that will have been established.
Baroness Greengross asked Her Majesty's Government:
How they ensure National Institute for Clinical Excellence guidelines are consistent with osteoporosis clinical guidelines. [HL3974]
Lord Warner: The National Institute for Clinical Excellence is the independent organisation responsible for providing national guidance on treatments and care for those using the National Health Service in England and Wales. The institute takes account of the best available evidence and consults widely when formulating its advice to the NHS. The consultees may
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include guidance producing bodies, such as the Royal Colleges. The Royal College of Physicians has produced clinical guidelines on the prevention and treatment of osteoporosis and NICE will take these into account when formulating its guidance.
Acrylamide
Baroness Byford asked Her Majesty's Government:
Whether, in the last two years, ways have been found to reduce levels of acrylamide in processed foods; and, if so, what methods have been used, and what reductions attained. [HL3996]
Lord Warner: The Food Standards Agency advises that there is no evidence of a general decrease in acrylamide levels in food since the discovery of unexpected levels in April 2002. Some food processors have however identified ways of achieving reductions which are specific to their processes.
There is at present insufficient scientific information on reliable methods of consistently reducing acrylamide while maintaining the safety and nutritional quality of food. A considerable body of research is in progress on this issue. The FSA is directly funding a number of research projects which will be reported over the next year. The agency is also taking a central role in the co-ordination of European and international efforts to develop an understanding of acrylamide in food. These activities will provide information for the Joint FAO/WHO Expert Committee on Food Additives evaluation of acrylamide in 2005.
Rural Ambulance Trusts: Response Times
Baroness Byford asked Her Majesty's Government:
How many rural ambulance trusts are now meeting government targets on response times; what percentage of rural trusts that number represents; and what are the comparative numbers and percentages for urban trusts. [HL4000]
Lord Warner: The latest available information, for the year 2003–04 is given in the table:
Current ambulance performance requirement:
1. All ambulance trusts to respond to 75 per cent of category A calls within 8 minutes.
2. All ambulance trusts to respond to 95 per cent of category A calls within 14 (urban)/19 (rural) minutes.
3. All ambulance trusts to respond to 95 per cent of category B calls within 14 (urban)/19 (rural) minutes.
4. Urgent cases: In addition to emergency 999 calls, ambulance services are required to take patients to hospital where the need is identified by a doctor as urgent and these patients should arrive at hospital within 15 minutes of the arrival time specified by the doctor in 95 per cent of cases.
The available data are published in the statistical bulletin Ambulance services, England: 2003–04 and is available at www.publications.doh.gov.uk/public/sb0313.htm. A copy will be made available in the Library.
Oxygen: Home Treatment Service
Earl Russell asked Her Majesty's Government:
Whether the projected contract to supply oxygen to patients who use it for home treatment will involve (as some concentrate systems do) full emergency cover at night and out-of-hours; and whether they have made an analysis of the cost of such cover weighed against the cost of emergency hospital admissions caused by its absence. [HL4005]
Lord Warner: The proposed service specification for the new contract includes a requirement for the contractor to provide a home oxygen service on a 24-hour, seven day a week basis.
Skin Cancer
Earl Howe asked Her Majesty's Government:
Whether they will consider providing incentives to health professionals to encourage them to check patients' skin for potentially cancerous lesions. [HL4010]
Lord Warner: Every general practitioner has a duty to provide appropriate care to their patients, including where suitable, checking for potentially cancerous lesions.
It is possible that indicators on skin lesions could be included in a future review of the Quality and Outcomes Famework (QOF), which is part of the new General Medical Services contract that incentivises good practice by general practitioners. An independent review group will be established by the end of 2004 to make recommendations for changes to the QOF. Recommendations which are agreed can be implemented from April.
7 Sept 2004 : Column WA149
Earl Howe asked Her Majesty's Government:
What guidance they will produce to encourage health professionals to take an opportunistic approach to checking patients' skin for potentially cancerous lesions. [HL4011]
Lord Warner: Cancer Research UK has printed 40,000 posters designed to assist general practitioners and practice nurses in the identification of suspicious skin lesions, including actinic keratosis. The poster, which contains photographs and explanations of various lesions, has been distributed to all UK doctors' surgeries.
The Department of Health has also published referral guidelines for suspected cancer to assist general practitioners in determining those patients with suspected skin cancer who need to be referred urgently to see a specialist within two weeks, those patients that can be referred for a routine appointment and those who can be safely watched at a primary care level. The guidelines include a section on skin cancer.
The National Institute for Clinical Excellence is updating these guidelines and is currently consulting on the first draft of the revised guidance.
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