Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what clinical outcomes data his Department holds for (a) sickle cell disease and (b) thalassaemia in each (i) clinical commissioning group area, (ii) trust area and (iii) national sickle cell and thalassaemia centre area.
Answered by George Freeman
NHS England requires commissioned providers to submit quality dashboard data on an annual basis. Key indicators include the percentage of patients on the National Haemoglobinopathy Register, those offered an annual review and the proportion of eligible patients offered and receiving neurological screening.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate he has made of the proportion of people from black, Asian and minority ethnic communities who have received a diagnosis of (a) sickle cell disease and (b) thalassaemia in each (i) clinical commissioning group area, (ii) trust area and (iii) national sickle cell and thalassaemia centre area; and what proportion of people from such communities were so diagnosed in the most recent year for which figures are available.
Answered by George Freeman
The National Haemoglobinopathy Registry maintains a database of patients with red cell disorders (mainly sickle cell disease and thalassaemia major) living in the United Kingdom. Detailed information on the number of patients diagnosed with sickle cell disease and thalassaemia, in England, is available from the National Haemoglobinopathy Registry Report 2013/14. This includes a breakdown of patients on the basis ethnicity, commissioning hub and specialist treatment centre.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what proportion of the at risk population have been screened for (a) sickle cell disease and (b) thalassaemia in each (i) clinical commissioning group area, (ii) trust area and (iii) national sickle cell and thalassaemia centre area; and what proportion of that population were so screened in the most recent year for which figures are available.
Answered by Jane Ellison
The Sickle Cell and Thalassaemia Screening Programme is an antenatal population screening programme which is offered to all pregnant women regardless of their risk, and to fathers to be, where antenatal screening shows that the mother is a genetic carrier. The offer to be screened is a joint offer.
Screening coverage for sickle cell and thalassaemia is reported by region only and can be accessed below:
http://www.phoutcomes.info/search/SICKLE%20CELL
Screening data for sickle cell and thalassaemia by NHS trusts and clinical commissioning groups over the last three years can be viewed:
https://www.gov.uk/government/collections/nhs-screening-programmes-national-data-reporting
Newborn babies are screened for sickle cell as part of the newborn blood spot screening programme. Data in screening for sickle cell and thalassaemia in the Newborn Blood Spot Programme over the last three years is available at:
https://www.gov.uk/government/collections/nhs-screening-programmes-national-data-reporting
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate his Department has made of the gender pay gap for employees of NHS England in (a) Stoke Newington and Hackney North constituency, (b) Hackney local authority area, (c) London and (d) England; and if he will make a statement.
Answered by Dan Poulter
We do not have an accurate estimate of the gender pay gap for employees of NHS England.
NHS England does not have offices in Stoke Newington, Hackney North constituency, or Hackney local authority area.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the level of childhood obesity is in (a) each constituency in London, (b) England, (c) Scotland, (d) Wales and (e) Northern Ireland.
Answered by Jane Ellison
Data on childhood obesity at a sub-national level for England are collected through the National Childhood Measurement Programme for two school year groups Reception (4-5 year olds) and Year 6 (10-11 years olds). The data in Table 1 below are presented by district/unitary authorities. Data are not available by parliamentary constituency.
Table 1: Number and proportion of children categorised as obese and overweight (2012-13).
| Reception (4-5 years) | Year 6 (10-11 years) | ||||||
| Prevalence of obesity | Prevalence of overweight (including obese) | Prevalence of obesity | Prevalence of overweight (including obese) | ||||
| Number of Children | % | Number of Children | % | Number of Children | % | Number of Children | % |
Barking and Dagenham | 449 | 13.4 | 866 | 25.8 | 568 | 24.4 | 926 | 39.8 |
Barnet | 371 | 10.2 | 858 | 23.6 | 559 | 19.1 | 986 | 33.6 |
Bexley | 394 | 12.3 | 855 | 26.8 | 604 | 24.3 | 986 | 39.7 |
Brent | 398 | 11.1 | 803 | 22.4 | 716 | 23.7 | 1,203 | 39.8 |
Bromley | 294 | 8.0 | 779 | 21.1 | 500 | 17.1 | 937 | 32.0 |
Camden | 134 | 9.0 | 313 | 20.9 | 284 | 21.8 | 461 | 35.5 |
Croydon | 461 | 10.2 | 1,069 | 23.8 | 788 | 22.3 | 1,349 | 38.2 |
Ealing | 461 | 10.4 | 990 | 22.4 | 754 | 22.7 | 1,258 | 37.9 |
Enfield | 536 | 12.6 | 1,115 | 26.2 | 838 | 24.1 | 1,361 | 39.1 |
Greenwich | 480 | 14.1 | 909 | 26.7 | 605 | 24.7 | 961 | 39.2 |
Hackney | 340 | 13.2 | 678 | 26.3 | 491 | 25.2 | 803 | 41.3 |
Hammersmith and Fulham | 147 | 11.2 | 331 | 25.2 | 222 | 20.1 | 400 | 36.3 |
Haringey | 325 | 11.1 | 663 | 22.7 | 569 | 23.4 | 957 | 39.4 |
Harrow | 246 | 10.2 | 508 | 21.2 | 432 | 20.4 | 723 | 34.2 |
Havering | 272 | 9.6 | 592 | 20.9 | 463 | 19.9 | 814 | 35.1 |
Hillingdon | 366 | 9.4 | 833 | 21.4 | 578 | 19.8 | 1,009 | 34.6 |
Hounslow | 390 | 11.5 | 779 | 23.1 | 578 | 24.6 | 925 | 39.4 |
Islington | 195 | 10.6 | 426 | 23.1 | 333 | 21.8 | 558 | 36.4 |
Kensington and Chelsea | 83 | 8.9 | 189 | 20.2 | 172 | 20.1 | 284 | 33.2 |
Kingston upon Thames | 117 | 6.1 | 309 | 16.1 | 233 | 17.0 | 416 | 30.3 |
Lambeth | 322 | 11.3 | 668 | 23.5 | 513 | 23.4 | 862 | 39.3 |
Lewisham | 381 | 10.7 | 891 | 25.0 | 568 | 23.3 | 936 | 38.3 |
Merton | 213 | 9.0 | 502 | 21.1 | 371 | 21.3 | 610 | 35.0 |
Newham | 565 | 12.3 | 1,137 | 24.8 | 1,014 | 27.3 | 1,559 | 42.0 |
Redbridge | 404 | 10.2 | 817 | 20.7 | 713 | 21.3 | 1215 | 36.3 |
Richmond upon Thames | 132 | 5.9 | 363 | 16.3 | 214 | 13.8 | 404 | 26.1 |
Southwark | 365 | 14.0 | 693 | 26.7 | 626 | 26.7 | 1,037 | 44.2 |
Sutton | 177 | 8.0 | 444 | 20.0 | 347 | 19.6 | 583 | 33.0 |
Tower Hamlets | 396 | 12.7 | 738 | 23.6 | 690 | 26.5 | 1,079 | 41.4 |
Waltham Forest | 355 | 10.4 | 718 | 21.0 | 603 | 22.9 | 1,001 | 38.0 |
Wandsworth | 249 | 9.8 | 558 | 22.0 | 393 | 20.2 | 684 | 35.2 |
Westminster | 148 | 11.6 | 302 | 23.6 | 334 | 25.3 | 520 | 39.4 |
London | 21,696 | 10.8 | 10,166 | 23.0 | 27,807 | 22.4 | 16,673 | 37.4 |
England | 130,648 | 9.3 | 54,457 | 22.2 | 162,987 | 18.9 | 92,538 | 33.3 |
National Health Surveys measure the height and weight of children aged 2-15 years. Table 2 shows the proportion of children classified as overweight or obese for 2012.
Table 2: Proportion of children classified as overweight or obese aged 2-15 years (2012).
| England (%) | Scotland (%) | Wales (%) |
Obese | 13.7 | 13.8 | 15.0 |
Overweight (including obese) | 27.9 | 30.6 | 34.0 |
The Health Survey for Northern Ireland, for children aged 2-10 (2012-13) states 6% of children were classed as obese, and 19% were overweight (including obese).
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many children and adolescents were admitted to hospital as a result of intentional self-harm in the last 10 years; and if he will make a statement.
Answered by Norman Lamb
Data on the number of finished admission episodes for self harm for 0 to 17 year olds for the years 2003-04 to 2012-13 is in the following table.
Count of finished admission episodes (FAEs)1 with a cause code of self harm2 for patients aged 0-17 for the years 2003-04 to 2012-133 | ||||||
Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector | ||||||
Year | FAEs | |||||
2003-04 | 11,404 | |||||
2004-05 | 11,402 | |||||
2005-06 | 13,054 | |||||
2006-07 | 12,980 | |||||
2007-08 | 13,785 | |||||
2008-09 | 12,934 | |||||
2009-10 | 12,944 | |||||
2010-11 | 13,995 | |||||
2011-12 | 13,231 | |||||
2012-13 | 14,780 | |||||
Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre | ||||||
This data should not be interpreted as a count of people as the same person may have been admitted on more than one occasion. Reference should be made to the notes when interpreting the data.
The Government is committed to reducing self-harm.
The Mental Health Action Plan, Closing the Gap: Priorities for Essential Change in Mental Health (January 2014), sets out 25 of the most important changes that we want the National Health Service and social care to make in the next few years to improve the lives of people with mental health problems and help reduce health inequalities. It highlights how we will change the way frontline health services respond to self-harm.
In the revised Public Health Outcomes Framework, we have introduced a new indicator that is specifically about self-harm. Under this indicator, we will measure:
- attendances at emergency departments for self-harm per 100,000 population;
- percentage of attendances at emergency departments for self-harm that received a psychosocial assessment.
This two-part indicator helps us not only understand the prevalence of self-harm but also how emergency departments are responding. This information can then inform future commissioning.
The National Institute for Health and Care Excellence (NICE) guidelines make it clear that anyone who attends an emergency department for self-harm should be offered a comprehensive assessment of their physical, psychological and social needs. In 2004, NICE published a clinical guideline on self-harm. This covered the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. It sets out the care people who harm themselves can expect to receive from healthcare professionals in hospital and out of hospital; the information they can expect to receive; what they can expect from treatment and what kinds of services best help people who harm themselves. Following on from this guideline, in November 2011, NICE issued a clinical practice guideline on the longer-term management of self-harm.
We expect general practitioners to refer people who disclose self-harm for psychological support as appropriate. We are investing £54 million over the period 2011 – 2015-16 in the Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT) programme which is giving children and young people improved access to the best evidenced mental health care. This includes Interpersonal Psychotherapy for Adolescents and Cognitive Behavioural Therapy for emotional disorders such as anxiety and depressive disorders, Obsessive Compulsive Disorder (OCD) and Post Traumatic Stress Disorder.
Achieving Better Access to Mental Health Services by 2020 contains the first waiting time standards for mental health.
It announces the introduction of improved investment in specialist intensive psychiatric mental health facilities for children and young people to reduce waiting times for intensive psychiatric care and to end the practice of young people being admitted to mental health beds far away from where they live or from being inappropriately admitted to adult wards. It announces the introduction of standard waiting times for Early Intervention in Psychosis services which will be of benefit to young people, and for the adult Improving Access to Psychological Therapies (IAPT) programme. It makes it clear that the waiting time standards announced are a first step. There will also be £30 million increased investment in liaison psychiatry to help people including young people presenting in accident and emergency departments with mental health problems. The vision is for comprehensive standards to be developed over the coming years for all ages, including for children and young people. However, where adult IAPT services are commissioned to provide a service to 16 and 17 year olds, the waiting time standard will apply to all those attending the service, regardless of their age.
Preventing suicide in England: A cross-government outcomes strategy to save lives was published on 10 September 2012 to coincide with the International Association for Suicide Prevention’s World Suicide Prevention Day.
The Department, through the National Institute for Health Research and the Policy Research Programme has invested significantly in mental health research and will continue to support high-quality research on suicide, suicide prevention and self-harm.
The Suicide Prevention Strategy, Preventing suicide in England: A cross-government outcomes strategy to save lives is backed by £1.5 million funding, through the Policy Research Programme, which is supporting six projects to help us better understand key aspects of suicide and self-harm, including looking at self-harm in young people and the role of the internet and social media.
The new e-portal – MindEd – launched in March 2014 includes content on self-harm, suicide and risk in children and young people.
Notes
1Finished admission episodes. A finished admission episode (FAE) is the first period of inpatient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year.
2Cause Code. A supplementary code that indicates the nature of any external cause of injury, poisoning or other adverse effects. Only the first external cause code which is coded within the episode is counted in HES. The cause codes used to identify episodes of self harm were:
A supplementary code that indicates the nature of any external cause of injury, poisoning or other adverse effects. Only the first external cause code which is coded within the episode is counted in HES.
The cause codes used to identify episodes of self harm were:
X60 – Intentional self-poisoning by and exposure to nonopioid analgesics, antipryretics and antirheumatics
X61 – Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsom and psychotropic drugs, note elsewhere classified
X62 – Intentional self-poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified
X63 – Intentional self-poisoning by and exposure to other drugs acting on the automatic nervous system
X64 – Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substances
X65 - Intentional self-poisoning by and exposure to alcohol
X66 - Intentional self-poisoning by and exposure to organic solvents and halogenated hydrocarbons and their vapours
X67 - Intentional self-poisoning by and exposure to other gases and vapours
X68 - Intentional self-poisoning by and exposure to pesticides
X69 - Intentional self-poisoning by and exposure to other and unspecified chemicals and noxious substances
X70 – Intentional self-harm by hanging, strangulation and suffocation
X71 - Intentional self-harm by drowning and submersion
X72 - Intentional self-harm by handgun discharge
X73 - Intentional self-harm by rifle, shotgun and larger firearm discharge
X74 - Intentional self-harm by other and unspecified firearm discharge
X75 - Intentional self-harm by explosive material
X76 - Intentional self-harm by smoke, fire and flames
X77 - Intentional self-harm by steam, hot vapours and hot objects
X78 - Intentional self-harm by sharp object
X79 - Intentional self-harm by blunt object
X80 - Intentional self-harm by jumping from a high place
X81 - Intentional self-harm by jumping or lying before moving object
X82 - Intentional self-harm by crashing of motor vehicle
X83 - Intentional self-harm by other specified means
X84 - Intentional self-harm by unspecified means
3Assessing growth through time (Admitted patient care).
HES figures are available from 1989-1990 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 to 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 HES patient data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information. Note that Hospital Episode Statistics (HES) include activity ending in the year in question and run from April to March, eg 2012-13 includes activity between 1 April 2012 and 31 March 2013.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many children and adolescents were admitted to hospital for injuries or illnesses caused by drinking alcohol in the last 10 years; and if he will make a statement.
Answered by Jane Ellison
The following table contains the sum of the estimated alcohol attributable fractions for admissions for patients aged between 0 – 17 years between 2003 - 2013.
The number of alcohol-related admissions is based on the methodology developed by the North West Public Health Observatory (NWPHO), which uses 48 indicators for alcohol-related illnesses, determining the proportion of a wide range of diseases and injuries that can be partly attributed to alcohol as well as those that are, by definition, wholly attributable to alcohol. Further information on these proportions can be found at
http://www.nwph.net/nwpho/publications/AlcoholAttributableFractions.pdf
Alcohol attributable fractions do not provide a count of episodes with an alcohol related diagnosis or cause code but rather an estimate of the numbers. In addition, partial alcohol attributable fractions are not applicable to children aged under 16 years therefore figures for this age group relate only to wholly-attributable admissions.
The application of the NWPHO methodology has recently been updated but is not currently available from Hospital Episode Statistics (HES).
Sum of wholly attributable alcohol fractions1 for patients aged 0 to 15, and wholly and partially attributable alcohol fractions1 for patients aged 16 or 17 for admissions in each of the last 10 years.
Year | Age Groups | ||
| 0-15 | 16-17 | 0-17 |
2003-04 | 4,977 | 7,082 | 12,059 |
2004-05 | 4,967 | 8,029 | 12,996 |
2005-06 | 5,246 | 9,184 | 14,430 |
2006-07 | 5,086 | 9,400 | 14,486 |
2007-08 | 4,740 | 9,774 | 14,514 |
2008-09 | 3,681 | 9,165 | 12,846 |
2009-10 | 3,677 | 9,153 | 12,830 |
2010-11 | 3,103 | 9,228 | 12,331 |
2011-12 | 2,578 | 8,728 | 11,306 |
2012-13 | 2,160 | 7,913 | 10,073 |
Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector
Source: HES, Health and Social Care Information Centre
Notes:
1. Alcohol–related admissions
The alcohol attributable fraction is set to 1 (100%) where the admission is considered to be entirely due to alcohol, e.g. in the case of alcoholic liver disease - these records are described as wholly alcohol attributable.
The alcohol attributable fraction is set to a value greater than 0 but less than 1 according to the NWPHO definition, e.g. the alcohol fraction of an admission with a primary diagnosis of C00 - malignant neoplasm of lip, where the patient is male and between 65 and 74 is 0.44 - these records are described as partly alcohol attributable.
These wholly and partly attributable fractions can be aggregated to supply an estimate of activity which can be considered wholly or partly attributable to alcohol.
Partly alcohol attributable fractions are not applicable to children under 16. Therefore figures for this age group relate only to wholly-attributable admissions, where the attributable fraction is one.
2. 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, changes in activity may be due to changes in the provision of care.
Note that in all cases the reporting year is from April to March (i.e. 2006-07 is April 2006 to March 2007 inclusive).
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how much and what proportion of the public health budget in (a) Hackney local authority area, (b) London and (c) England is spent on mental health.
Answered by Jane Ellison
This information is not held centrally.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to increase spending on mental health; and if he will make a statement.
Answered by Norman Lamb
The Department and NHS England continue to work together to ensure that there are consistent messages to commissioners and providers about the importance of delivering parity of esteem for people with mental health needs.
In our new five-year plan for mental health, Achieving Better Access to Mental Health Services by 2020, we identified £40 million additional spending this year and freed up a further £80 million for 2015-16. This will, for the first time ever, enable the setting of access and waiting time standards in mental health services.
Monitor and NHS England are responsible for setting the national tariff arrangements and are working together to develop a national payment system for mental health which promotes early intervention, access to effective evidence-based care, improved outcomes and recovery.
The national tariff arrangements for 2015-16 will include examples of new and innovative payment models which local commissioners and providers may choose to adopt next year.
Funding for mental health has increased by £120 million in 2014-15 seeing it rise from £8.5 billion in 2013-14 to £8.62 billion in 2014-15. These figures do not include spending on mental health in primary care or prescriptions which is estimated at £3 billion.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what recent steps his Department has taken to improve conditions for prisoners with mental health problems in prisons in England; and if he will make a statement.
Answered by Norman Lamb
NHS England is improving prison mental health services through nationally developed service specifications, which are being rolled out across the prison estate in England, ensuring that there are national standards against which services can be measured.
Identification of those offenders with problems including mental health, learning difficulties and other vulnerabilities by liaison and diversion services may facilitate relevant support to these offenders, rather than a criminal justice system intervention. This has potential to reduce caseload numbers and effectively divert away from custody or community sentences.
NHS England has rolled out a new, all age national Liaison and Diversion standard service specification and operating model to 10 trial schemes, serving 22% of the English population. Following evaluation of these schemes by 2015 and Treasury approval of a full business case in 2015, NHS England will roll out to cover 100% coverage of the population by 2017-18.
Improving offender mental health is a priority for the Government, as set out in the mental health strategy No Health, Without Mental Health in 2011. We have acted upon the recommendations of Lord Bradley’s 2009 review of people with mental health problems and learning disabilities in the criminal justice system, to ensure that prisoners have the same access to mental health services as the rest of population.
In addition, the Government’s Mandate with NHS England commits NHS England to develop better healthcare services for people in the criminal justice system. We have also asked the National Institute for Health and Care Excellence to develop guidelines on improving the mental health for people in prison, which it expects to publish in 2016.