§ Dr. Evan Harris
To ask the Secretary of State for Health (1) whether he expects his Department to meet milestone 3 of the milestones for hospitals admitting patients for the management of heart failure in the national service framework for coronary heart disease; what additional milestones he plans to set to promote quality of care; and if he will make a statement; 
(2) whether he expects his Department to meet the primary care milestone 3 in the heart failure standard in the national service framework for coronary heart disease; and if he will make a statement; 
(3) whether his Department has met milestones 1 and 2 in the milestones for hospitals admitting patients for the management of heart failure in the heart failure secton of the national service framework for coronary heart disease; and if he will make a statement; 
(4) whether his Department has met the primary care milestones 1 and 2 on the standard of heart failure in the national service framework; and if he will make a statement on coronary heart disease. 430W
§ Ms Blears
Evidence from the primary care and coronary heart disease (CHD) collaboratives suggest that the primary care milestones 1 and 2 of the national service framework (NSF) for CHD are largely being met although we realise that the heart failure element is lagging behind the development of CHD registers more generally. Reports from the former regional offices indicate that hospital milestone 1 has also been met.
Progress towards the milestones is being monitored locally by strategic health authorities. The national focus has been on monitoring the immediate priorities. These were:
- developing smoking cessation services
- improving ambulance response times to category "A" calls
- increasing access to thrombolysis in accident and emergency departments for patients admitted following heart attack
- reducing time taken to deliver thrombolysis (reducing "door to needle" time)
- improving the use of effective medicines after heart attack establishing Rapid Access Chest Pain clinics across the country increasing the total number of revascularisation procedures.
We are aware from individual contacts that protocols in both primary care and hospital settings are being developed. However, progress could be patchy as implementation of the NSF for CHD to date has focused on the immediate priorities. In due course, the commission of health improvement will provide an independent assessment of progress, including a specific review of the NSF for CHD.
With the focus on the immediate priorities, progress in the management of heart failure has not been as rapid as that in other areas. However, heart failure will be one of our key priorities during the middle phase of the overall 10-year NSF implementation programme. We are currently developing more detailed plans for improving services. We will consider whether there is a need for any additional milestones as part of this process.