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Arthritis

Volume 508: debated on Wednesday 24 March 2010

To ask the Secretary of State for Health what steps he (a) is taking and (b) plans to take to provide nurses in primary care settings with training to (i) identify, (ii) diagnose and (iii) assess the care requirements of patients with rheumatoid arthritis; what recent representations he has received on those matters; and if he will make a statement. (323124)

Training for nurses in primary care is quite rightly the responsibility of employers. It is they who are best placed to understand local services and the training needs of their staff.

To ask the Secretary of State for Health how many finished episodes of care there were for patients with rheumatoid arthritis of each (a) sex and (b) age group resident in Southend in each year since 1997. (323125)

The following tables show the number of finished consultant episodes with a mention of rheumatoid arthritis, by sex, age group and primary care trust (PCT) of residence.

The NHS Information Centre (IC) are unable to provide data for 2008-09 due to data quality issues with the data submitted whereby it cannot be determined which patients were resident in this area during this period.

Count of finished consultant episodes with mention of rheumatoid arthritis by sex, age group and South East Essex PCT of residence, 2006-07 to 2007-08

Activity in English NHS hospitals and English NHS commissioned activity in the independent sector

Male

Female

Total

0 to 44

45 to 64

65 to 74

75+

0 to 44

45 to 64

65 to 74

75+

2007-08

48

170

114

160

112

241

240

343

1,428

2006-07

38

124

111

95

91

206

177

281

1,123

Count of finished consultant episodes with a mention of rheumatoid arthritis by sex, age group and Southend-on-Sea PCT of residence, 1997-98 to 2005-06

Activity in English NHS hospitals and English NHS commissioned activity in the independent sector

Male

Female

Total

0 to 44

45 to 64

65 to 74

75+

0 to 44

45 to 64

65 to 74

75+

2005-06

24

51

53

46

27

78

70

163

512

2004-05

6

30

39

34

28

84

82

156

459

2003-04

*

38

*

25

24

98j

48

90

345

2002-03

*

15

9

0

*

22

10

11

76

2001-02

*

*

8

*

*

9

7

9

47

2000-01

*

7

10

*

*

9

6

8

49

1999-2000

*

8

*

6

*

12

6

7

53

1998-99

*

16

21

11

*

24

28

48

157

1997-98

*

22

25

25

*

54

68

65

275

Count of finished consultant episodes with a mention of rheumatoid arthritis by sex, age group and Castle Point and Rochford PCT of residence, 1997-98 to 2005-06

Activity in English NHS hospitals and English NHS commissioned activity in the independent sector

Male

Female

Total

0 to 44

45 to 64

65 to 74

75+

0 to 44

45 to 64

65 to 74

75+

2005-06

16

50

69

78

23

103

73

144

556

2004-05

16

54

39

43

20

107

99j

119

497

2003-04

20

49

36

62

32

93

74

105

471

2002-03

10

15

10

*

*

18

7

7

69

2001-02

12

13

19

0

6

27

12

8

97

2000-01

*

17

15

10

*

25

6

7

87

1999-2000

*

7

*

*

*

26

11

*

59

1998-99

*

16

15

*

*

31

22

15

110

1997-98

8

24

23

15

15

52

60

39

236

Notes: 1. A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one health care provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as the same person may have been admitted on more than one occasion. 2. The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 and seven prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record. 3. Data provided are for Southend-on-Sea PCT of residence (the PCT containing the patient's normal home address). This identifies patients who resided within Southend-on-Sea and were in hospital with a primary and/or secondary diagnosis of rheumatoid arthritis. These patients may not have been treated in Southend-on-Sea. 4. From 1 October 2006, Southend-on-Sea PCT merged with Castle Point and Rochford PCT to create South East Essex PCT. 5. 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 out-patient settings and so are no longer included in admitted patient HES data. 6. To protect patient confidentiality, figures between one and five have been replaced with "*" (an asterisk). Where it was still possible to identify numbers from the total an additional number (the next smallest) has been replaced. Source: Hospital Episode Statistics (HES), the NHS Information Centre for health and social care.

To ask the Secretary of State for Health if he will make it his policy to collect information on the number of newly diagnosed cases of rheumatoid arthritis; what recent representations he has received on the number of people with rheumatoid arthritis; and if he will make a statement. (323126)

The Department currently has no plans to collect information on the number of newly diagnosed cases of rheumatoid arthritis.

There are various estimates of the incidence and prevalence of rheumatoid arthritis. These estimates suggest prevalence ranging between 400,000 and 580,000, and incidence between 12,000 and 26,000. For example, the National Audit Office report ‘Services for People with Rheumatoid Arthritis’ estimates that 580,000 adults have rheumatoid arthritis, with approximately 26,000 new diagnoses each year. National Institute for Health and Clinical Excellence clinical guidance on the management of rheumatoid arthritis in adults, published in February 2009, estimates prevalence of 400,000 and annual incidence of 12,000.

The variation in estimates reflect the different data sources used to calculate incidence and prevalence.

To ask the Secretary of State for Health if he will make it his policy to ensure that GPs receive (a) pre-registration training and (b) continuing professional development training in the diagnosis of rheumatoid arthritis; and if he will take steps to encourage the Royal College of General Practitioners to offer additional support to GPs on the diagnosis of rheumatoid arthritis. (323221)

We recognise the importance of training in rheumatoid arthritis. The Government do not specify the content of the general practitioners (GPs) training curriculum. This is developed by the Royal College of General Practitioners. Responsibility for approval of the curriculum reset with the Postgraduate Medical Education and Training Board (PMETB), which is the competent authority for postgraduate medical training in the United Kingdom. PMETB is an independent professional body.

From 1 April 2010, the content of postgraduate medical training will be the responsibility of the General Medical Council following a merge of the two organisations.

Post-registration training needs of GPs are determined by regulatory requirements and local national health service priorities, through appraisal processes and training needs analyses informed by local delivery plans and the needs of the service.

To ask the Secretary of State for Health with reference to the oral evidence given to the Public Accounts Committee by the Chief Executive of the NHS on 23 November 2009, what progress his Department is making in establishing whether there is a correlation between the amount spent per head of population on rheumatoid arthritis services and the quality of the provision of such services. (323317)

The Department is considering the findings and recommendations made by the Public Accounts Committee in its report “Services for people with rheumatoid arthritis”. The Department will respond formally to the recommendations made by the Committee in the form of a Treasury minute in due course.

To ask the Secretary of State for Health how much was spent by each primary care trust on rheumatoid arthritis services per head of population in each of the last two years. (323318)

The information requested is not available. Estimated expenditure data on musculoskeletal system problems, which includes rheumatoid arthritis, are available and have been placed in the Library.