Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking before the introduction of new guidelines on the recognition and treatment of Lyme disease expected by July 2018 to ensure that people with that disease are diagnosed quickly.
Answered by Jane Ellison
As services for the treatment of Lyme disease are commissioned locally information on the costs associated with laboratory testing and treatment of late stage Lyme disease is not collected centrally. Nor is information collected centrally on the average time to diagnose cases of Lyme disease.
The National Institute for Health and Care Excellence (NICE) is developing a clinical guideline on Lyme disease and reports progress on its website. NICE recently consulted on a draft scope for the guideline, and expects to publish final guidance in July 2018.
Public Health England and NHS Choices publish information on their websites to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection. Given the need to maintain public awareness these or similar mechanisms are expected to continue beyond 2018. Increased awareness is likely to encourage early consultation but no information on the time taken to seek medical advice is available.
There are no plans to set targets for diagnosis and treatment as most cases of Lyme disease are diagnosed empirically by general practitioners using their clinical judgement rather than relying on a laboratory test, thus treatment can start immediately. Diagnosis of patients with late or complicated Lyme disease can be difficult and the National Health Service will continue to provide care taking account of the existing evidence base.
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the average time taken is for the NHS to diagnose cases of Lyme disease.
Answered by Jane Ellison
As services for the treatment of Lyme disease are commissioned locally information on the costs associated with laboratory testing and treatment of late stage Lyme disease is not collected centrally. Nor is information collected centrally on the average time to diagnose cases of Lyme disease.
The National Institute for Health and Care Excellence (NICE) is developing a clinical guideline on Lyme disease and reports progress on its website. NICE recently consulted on a draft scope for the guideline, and expects to publish final guidance in July 2018.
Public Health England and NHS Choices publish information on their websites to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection. Given the need to maintain public awareness these or similar mechanisms are expected to continue beyond 2018. Increased awareness is likely to encourage early consultation but no information on the time taken to seek medical advice is available.
There are no plans to set targets for diagnosis and treatment as most cases of Lyme disease are diagnosed empirically by general practitioners using their clinical judgement rather than relying on a laboratory test, thus treatment can start immediately. Diagnosis of patients with late or complicated Lyme disease can be difficult and the National Health Service will continue to provide care taking account of the existing evidence base.
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what targets his Department has set to increase early diagnosis and treatment of Lyme disease.
Answered by Jane Ellison
As services for the treatment of Lyme disease are commissioned locally information on the costs associated with laboratory testing and treatment of late stage Lyme disease is not collected centrally. Nor is information collected centrally on the average time to diagnose cases of Lyme disease.
The National Institute for Health and Care Excellence (NICE) is developing a clinical guideline on Lyme disease and reports progress on its website. NICE recently consulted on a draft scope for the guideline, and expects to publish final guidance in July 2018.
Public Health England and NHS Choices publish information on their websites to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection. Given the need to maintain public awareness these or similar mechanisms are expected to continue beyond 2018. Increased awareness is likely to encourage early consultation but no information on the time taken to seek medical advice is available.
There are no plans to set targets for diagnosis and treatment as most cases of Lyme disease are diagnosed empirically by general practitioners using their clinical judgement rather than relying on a laboratory test, thus treatment can start immediately. Diagnosis of patients with late or complicated Lyme disease can be difficult and the National Health Service will continue to provide care taking account of the existing evidence base.
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how much the NHS spent on late-stage Lyme disease treatment in each of the last three years.
Answered by Jane Ellison
As services for the treatment of Lyme disease are commissioned locally information on the costs associated with laboratory testing and treatment of late stage Lyme disease is not collected centrally. Nor is information collected centrally on the average time to diagnose cases of Lyme disease.
The National Institute for Health and Care Excellence (NICE) is developing a clinical guideline on Lyme disease and reports progress on its website. NICE recently consulted on a draft scope for the guideline, and expects to publish final guidance in July 2018.
Public Health England and NHS Choices publish information on their websites to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection. Given the need to maintain public awareness these or similar mechanisms are expected to continue beyond 2018. Increased awareness is likely to encourage early consultation but no information on the time taken to seek medical advice is available.
There are no plans to set targets for diagnosis and treatment as most cases of Lyme disease are diagnosed empirically by general practitioners using their clinical judgement rather than relying on a laboratory test, thus treatment can start immediately. Diagnosis of patients with late or complicated Lyme disease can be difficult and the National Health Service will continue to provide care taking account of the existing evidence base.
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what guidelines are in place for the diagnosis of primary hyperparathyrodism; and what steps his Department is taking to reduce misdiagnosis of that condition.
Answered by Jane Ellison
Hyperparathyroidism is a rare hormone disorder caused by the parathyroid glands in the neck producing too much parathyroid hormone. This causes blood calcium levels to rise (hypercalcaemia) and blood phosphorus levels to fall (hypophosphatemia).
Best Practice guidance concerning the diagnosis and management of both primary and secondary hyperparathyroidism has been published by the British Medical Journal. The guidance can be found via the Best Practice portal at the following link:
http://bestpractice.bmj.com/best-practice/welcome.html
In addition to this, the National Institute for Health and Care Excellence’s Clinical Knowledge Summaries website provides similar information on the management of hyperparathyroidism in the context of it being a cause of hypercalcaemia.
cks.nice.org.uk/hypercalcaemia#!scenario:1
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many cases of toxocariasis have been identified in England in each year since 2010.
Answered by Jane Ellison
The data are available in the United Kingdom Zoonoses Report, and are published here:
The data for 2015 are not yet published.
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he is taking to support the NHS recruit, retain and help the professional development of consultants specialising in (a) rare and (b) ultra-rare diseases.
Answered by George Freeman
The Government published the UK Strategy for Rare Diseases in November 2013. The strategy is a high-level framework which sets out a strategic vision for improving the lives of all those affected by rare diseases. The strategy includes specific commitments regarding the education and training of the National Health Service workforce in the context of genomics and rare diseases.
Health Education England (HEE) was established to deliver a better healthcare workforce for England and for ensuring a secure workforce supply for the future. In addition, the HEE Genomics Education Programme was established in 2014 and is intended to build capacity and capability in response to the genomic medicine revolution. The programme includes rare diseases within its scope and will support the professional development of both new and existing members of the NHS workforce.
HEE has also published a suite of awareness raising videos to inform healthcare workers and the public about rare diseases. One video is aimed at general practitioners and highlights the importance of considering the possibility that their patient may have a rare condition.
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to support cooperation between rare diseases organisations through the EU Policy Action and Information for Rare Diseases in Europe.
Answered by George Freeman
The Government published the UK Strategy for Rare Diseases in November 2013. The strategy includes 51 specific commitments designed to improve the lives of all those affected by rare diseases.
The Government is committed to improving the lives of all those affected by rare diseases and the United Kingdom is recognised as a leader in Europe in the research, care and treatment of rare diseases. The strategy includes commitments to contribute to European Union-wide action on rare diseases.
Through the University of Newcastle upon Tyne, the UK successfully led the most recent EU Joint Action on Rare Diseases which concluded in 2015.
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the spend per head of population was on mental health in (a) England, (b) the North West and (c) Lancashire in each of the last five years.
Answered by Alistair Burt
We do not have comparable figures for spending on mental health for all years requested as financial information reporting systems changed after 2013 with the formation of NHS England.
Information is available on mental health spend by clinical commissioning groups (CCGs) in England, the North West and Lancashire for 2013/14, 2014/15 and 2015/16 only. This information has been sourced from NHS England’s financial planning and reporting systems and data weighted on CCG populations. The per head spend on mental health services is as follows:
England wide CCG spend per head on mental health services
2013/14 | £139 |
2014/15 | £146 |
2015/16 | £150 |
North West CCG spend per head on mental health services
2013/14 | Unavailable – spend data incomplete for this year |
2014/15 | £136 |
2015/16 | £139 |
Lancashire CCG spend per head on mental health services
2013/14 | £135 |
2014/15 | £134 |
2015/16 | £137 |
Source: NHS England
Asked by: Andrew Stephenson (Conservative - Pendle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many cases of sepsis there were in (a) East Lancashire, (b) the North West and (c) England in each of the last three years.
Answered by Ben Gummer
Data for finished discharge episodes (FDEs) with a primary or secondary diagnosis of sepsis for East Lancashire Clinical Commissioning Group (CCG) of Residence, North West Government Office Region of Residence, and England for years 2011-12 to 2013-14 are provided below.
These figures refer only to hospital admissions and are not a count of patients as a patient may have had more than one episode of care within the same year.
Count of FDEs1 with a primary or secondary diagnosis2 of sepsis3 for East Lancashire CCG of Residence4, North West Government Office Region of Residence5 and England for 2011-12 to 2013 -14. Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector
| 2011-12 | 2012-13 | 2013-14 |
NHS East Lancashire CCG of residence | 449 | 547 | 837 |
North West England government office region of residence | 13,109 | 14,708 | 17,221 |
England | 101,015 | 114,285 | 122,822 |
Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre
Notes:
Note that HES include activity ending in the year in question and run from April to March, eg 2012-13 includes activity ending between 1 April 2012 and 31 March 2013.
1. FDE - A discharge episode is the last episode during a hospital stay (a spell), where the patient is discharged from the hospital or transferred to another hospital. Discharges do not represent the number of patients, as a person may have more than one discharge from hospital within the period.
2. Number of episodes in which the patient had a primary or secondary diagnosis - The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) primary and secondary diagnosis fields in a HES record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.
3. ICD - 10 codes for Sepsis - A02.1 Salmonella sepsis, A20.7 Septicaemic plague. A21.7 Generalized tularaemia, A22.7 Anthrax sepsis. A26.7 Erysipelothrix sepsis, A28.0 Pasteurellosis, A28.2 Extraintestinal yersiniosis
A32.7 Listerial sepsis, A39.2 Acute meningococcaemia, A39.3 Chronic meningococcaemia, A39.4 Meningococcaemia, unspecified, A40.- Streptococcal sepsis, A41.- Other sepsis, A42.7 Actinomycotic sepsis, B37.7 Candidal sepsis, O85.X Puerperal sepsis, P36.- Bacterial sepsis of newborn
The following pair of codes is a dagger/asterisk code pair (D and A) which must be present together: A39.1 Waterhouse-Friderichsen syndrome
E35.1 Disorders of adrenal glands in diseases classified elsewhere
4. CCG of Residence - The CCG containing the patient’s normal home address. This does not necessarily reflect where the patient was treated as they may have travelled to another area for treatment.
5. Government Office Region of Residence - The Government Office Region of residence of the patient. It is derived from the patient's postcode.
6. Assessing growth through time (Admitted patient care).
HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information.