The national Quality and Outcomes Framework (QOF) records the number of people recorded on practice disease registers with a diagnosis of dementia. Alzheimer’s disease accounts for 50-75 per cent. of cases of dementia so the count of patients with dementia gives an indication of the number with Alzheimer’s disease. This register count is available only for the two latest releases of QOF, covering 2006-07 and 2007-08.
We are unable to supply this information for Hemel Hempstead as the data are only available for practices but can be aggregated to primary care trust (PCT) level. We have supplied information for the health area that best fits Hemel Hempstead, namely West Hertfordshire PCT.
These QOF figures are given in table 1. They are the totals for patients with dementia.
Financial year Number 2007-08 2,030 2006-07 1,996 Notes: 1. QOF is the national Quality and Outcomes Framework, introduced as part of the new General Medical Services (GMS) contract on 1 April 2004. 2. Participation by practices in the QOF is voluntary, though participation rates are very high, with most Personal Medical Services (PMS) practices also taking part. 3. The published QOF information was derived from the Quality Management Analysis System (QMAS), a national system developed by NHS Connecting for Health. 4. QMAS uses data from general practices to calculate individual practices’ QOF achievement. QMAS is a national IT system developed by NHS Connecting for Health to support the QOF. 5. The system calculates practice achievement against national targets. It gives general practices, primary care trusts (PCTs) and strategic health authorities (SHAs) objective evidence and feedback on the quality of care delivered to patients. 6. The Quality Management Analysis System captures the number of patients on the various disease registers for each practice. The number of patients on the clinical registers can be used to calculate measures of disease prevalence, expressing the number of patients on’ each register as a percentage of the number of patients on practices' lists. 7. Figures presented here are just the number of patients on the disease register for dementia. Source: The data supplied in table 1 are published on the website of the Information Centre for health and social care. (a) For 2007-08 see the “Quality and Outcomes Framework 2007/08” publication data tables at the following link (published 30 September 2008). http://www.ic.nhs.uk/statistics-and-data-collections/supporting-information/audits-and-performance/the-quality-and-outcomes-framework/qof-2007/08/data-tables The table for PCT level QOF for 2007-08 can be found at this link: http://www.ic.nhs.uk/webfiles/QOF/2007-08/NewFilesGS/QOF0708_PCTs_Prevalence.xls This publication has already been placed in the Library. (b) For 2006-07 see “Quality and Outcomes Framework 2006/07” publication data tables at the following link (published 28 September 2007). http://www.ic.nhs.uk/statistics-and-data-collections/supporting-information/audits-and-performance/the-quality-and-outcomes-framework/qof-2006/07/qof-2006-07-data-tables The table for PCT level QOF for 2006-07 can be found at this link: http://www.ic.nhs.uk/webfiles/QOF/2006-07/QOF0607_PCTs_Prevalence.xls This publication has already been placed in the Library.
QOF information is not available for hospital trusts. Hospital Episode Statistics (HES) are available and give the number of finished consultant episodes in which the patient had a primary or secondary diagnosis of Alzheimer’s disease, shown in table 2.
St. Albans and Hemel Hempstead NHS Trust and Mount Vernon and Watford Hospital West Hertfordshire Hospitals NHS Trust 1997-98 112 — 1998-99 95 — 1999-2000 89 — 2000-01 — 89 2001-02 — 116 2002-03 — 124 2003-04 — 139 2004-05 — 149 2004-05 — 156 2006-07 — 191 Notes: 1. West Hertfordshire Hospitals NHS Trust was set up in 2000-01 by merging St. Albans and Hemel Hempstead NHS Trust and RQL Mount Vernon and Watford Hospital. Therefore figures prior to 2000-01 were provided as the total of RPW and RQL. 2. Numbers provided are for finished consultant episodes and for cases for patients admitted to NHS hospitals only. They do not represent the number of people as one person can have more than one episode during the year. They also do not represent the prevalence of people with Alzheimer’s disease. 3. A finished consultant episode (FCE) is defined as a period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which the FCE finishes. Please note that the figures do not represent the number of patients, as a person may have more than one episode of care within the year. 4. Primary diagnosis is the first of up to 14 (seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was in hospital. 5. Secondary diagnoses, as well as the primary diagnosis, there are up to 13 (six prior to 2002-03) secondary diagnosis fields in Hospital Episode Statistics (HES) that show other diagnoses relevant to the episode of care. 6. Number of episodes in which the patient had a (named) primary diagnosis: these figures represent the number of episodes where the diagnosis was recorded in the primary diagnosis field in a Hospital Episode Statistics (HES) record. 7. Number of episodes in which the patient had a (named) primary or secondary diagnosis: these figures represent the number of episodes where the diagnosis was recorded in any of the 14 (seven prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once in each count, even if the diagnosis is recorded in more than one diagnosis field of the record. 8. Small numbers: due to reasons of confidentiality, figures between one and five have been suppressed and replaced with “*” (an asterisk). Where it was possible to identify numbers from the total due to a single suppressed number in a row or column, an additional number (the next smallest) has been suppressed in order to protect patient confidentiality. 9. Data Quality: Hospital Episode Statistics (HES) are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England. Data are also received from a number of independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. 10. Assessing growth through time: HES figures are available from 1989-90 onwards. During the years that these records have been collected by the NHS there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. 11. Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity. 12. Changes in NHS practice also need to be borne in mind when analysing time series. For example, a number of procedures may now be undertaken in outpatient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time. Source: Hospital Episode Statistics (HES), the NHS Information Centre for health and social care