§ Dr. StoateTo ask the Secretary of State for Health how many patients were(a) diagnosed with heart failure and (b) diagnosed with myocardial infarction in each of the last five years. [160607]
§ Yvette CooperThe table contains data for National Health Service hospitals in England in the years 1995–96 to 1999–2000. The figures show the number of finished consultant episodes where the main diagnosis was myocardial infarction or heart failure.
Myocardial infarction Heart failue 1995–96 107,591 104,391 1996–97 105,230 109,506 1997–98 109,898 113,588 1998–99 106,895 111,722 1999–2000 104,428 111,048 A finished consultant episode is defined as a period of patient care under one consultant in one health provider. The figures do not represent the number of patients, as one person may have several episodes within a year. The figures will also not show those people who received care wholly in a primary care setting.
398WThe main diagnosis is the first of seven diagnosis fields in the hospital episode statistics dataset and provides the main reason why the patient was in hospital.
Data for 1995–96 to 1997–98 are grossed for both coverage and unknown/invalid clinical data: 1998–99 and 1999–2000 are ungrossed.
§ Dr. StoateTo ask the Secretary of State for Health what estimate he has made of the total number of undiagnosed heart failure sufferers. [160608]
§ Yvette CooperData published in the British Heart Journal in 1994 states that heart failure affects between 0.4 per cent. and 0.8 per cent. of the general population in the United Kingdom. However, the authors of that report estimated that the prevalence of heart failure is more likely to be in the region of 1.5 per cent., which suggests about two thirds of people with heart failure are undiagnosed.
We recognise that heart failure is a previously under-recognised area, which is why Chapter Six of the National Service Framework for coronary heart disease deals specifically with its diagnosis and treatment.
§ Dr. StoateTo ask the Secretary of State for Health what assessment he has made of the use of(a) beta blockers and (b) ACE inhibitors in the treatment of heart failure; and if he will make a statement. [160600]
§ Yvette CooperOur position on treatment of heart failure is set out in the National Service Framework for coronary heart disease. The NSF standard states that people with a confirmed diagnosis of heart failure should be offered treatments most likely to both relieve symptoms and reduce their risk of death. First line treatment should be with ACE inhibitors, which can be used in combination with beta-blockers.
We have also commissioned the National Institute for Clinical Excellence to produce a clinical guideline on the management of heart failure. Work on this should start shortly.
Information on the use of ACE inhibitors and beta-blockers for heart failure is not currently collected. However, as part of the NSF implementation programme, by 2002, every hospital will have clinical audit data describing the delivery of key treatments such as ACE inhibitors and beta-blockers for heart failure. By 2003, every primary care team will collect audit data including the number and percentage of people with confirmed heart failure or left ventricular dysfunction who are being prescribed an ACE inhibitor.
§ Dr. StoateTo ask the Secretary of State for Health what recent guidance he has issued to enable general practitioners accurately to identify heart failure patients. [160601]
§ Yvette CooperThe National Service Framework for coronary heart disease, published on 6 March 2000, provides guidance on the identification and diagnosis of heart failure patients. This includes advice on service models and an algorithm for the assessment of suspected heart failure.
We have also commissioned the National Institute for Clinical Excellence to produce a clinical guideline on the investigation and management of heart failure. Work on this is due to start later in the year.
399W
§ Dr. StoateTo ask the Secretary of State for Health what recent steps he has taken to enable(a) hospitals and (b) general practitioners to develop accurate and speedy diagnoses of heart failure. [160602]
§ Yvette CooperOur position on the treatment of heart failure is set out in chapter 6 of the National Service Framework for coronary heart disease. The NSF standard states that doctors should arrange for people with suspected heart failure to be offered appropriate investigations that will confirm or refute the diagnosis.
We need to improve access to echocardiography to help more people to get a quick and accurate diagnosis of heart failure. As a first step, money from the Treasury Capital Modernisation Fund has funded the purchase of over 50 echocardiography machines.
We have also commissioned the National Institute for Clinical Excellence to produce a clinical guideline on the investigation and management of heart failure. Work on this is due to start later this year.