HC Deb 12 March 2002 vol 381 cc1021-4W
Paul Holmes

To ask the Secretary of State for Health (1) whether the national specialist commissioning advisory group studied comparisons of success rates between transplant centres, contrasting percentage survival rates with the number of transplants performed in each centre each year; [4512]

(2) whether the national specialist commissioning advisory group compared waiting times for pre-transplant assessment between transplant centres with the number of transplants performed in each centre each year; [4513]

(3) whether the national specialist commissioning advisory group assessed existing figures on after-care services provided by centres in relation to the number of transplants performed in each centre each year; [4514]

(4) whether the national specialist commissioning advisory group examined best practice in other countries with regard to transplants. [4515]

Mr. Hutton

[holding answer 19 July 2001]: I apologise to the hon. Member for the delay in responding to this question. I refer him to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

Our long-term goal for the cardiothoracic service is to increase the number of patients who receive successful heart and lung transplants, to ensure that today's high quality service is sustained in the future and to improve the working lives of the professionals who provide this crucial service.

To meet this goal, we issued a discussion document on 21 September 2001. It announces that all six cardiothoracic transplant units will continue to provide a service to NHS patients. To do so, they will need to meet the clear and explicit requirements set out in the new monitoring framework proposed in the discussion document. These requirements include staffing levels and qualifications, arrangements for retrieval of organs, the number of transplants carried out or the number of patients seen in follow-up clinics and survival and rejection rates. All six units will be inspected against these requirements.

The new service standards and effective monitoring will help ensure continued improvement to the quality of cardiothoracic transplant services, and provide patients with a national service of the highest possible quality. A copy of the discussion document, which invites comments on the standards and specification for the service, is in the Library.

Ms Stuart

To ask the Secretary of State for Health what factors underlay the recommendations by NSCAG about transplant centres in England and Wales. [4380]

Mr. Hutton

[holding answer 20 July 2001]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The key factor, which underlay the recommendations, was to ensure high quality clinical skills are maintained within our cardiothoracic transplant teams so as to ensure patients continue to receive the highest care possible.

Ms Stuart

To ask the Secretary of State for Health upon what evidence NSCAG based its recommendation concerning the number of transplants individual surgeons should perform each year. [4381]

Mr. Hutton

[holding answer 20 July 2001]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The recommendation as to the number of transplants individual surgeons should perform comes from the Royal College of Surgeons Expert Working Party chaired by Professor Sir Peter Morris which reported in January 1999.

Ms Stuart

To ask the Secretary of State for Health what estimate NSCAG has made of patient outcome if a transplant unit performs(a) 40 and (b) 50 transplants per annum. [4382]

Mr. Hutton

[holding answer 20 July 2001]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

In considering outcome data provided by United Kingdom Transplant Authority, NSCAG found that there is no statistically significant difference in the available outcome data between centres.

Ms Stuart

To ask the Secretary of State for Health what assessment NSCAG and the Royal College of Surgeons has made of the levels of skills required to perform(a) heart transplant operations, (b) heart valve operations and (c) lung transplants. [4383]

Mr. Hutton

[holding answer 20 July 200I]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

It is the responsibility of the Royal College of Surgeons to accredit those who seek to perform (a), (b) and (c) as with other forms of surgery.

The responsibility of NSCAG is to offer advice to the Secretary of State in commissioning designated national specialist services.

Ms Stuart

To ask the Secretary of State for Health what estimate has been made of the number of heart and lung transplants that could be undertaken per annum by five national centres. [4385]

Mr. Hutton

[holding answer 20 July 2001]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The number of heart and lung transplants that could be undertaken in any given number of centres depends on the availability of organs and the capacity within the centres. Over time capacity can be adjusted depending on the resources available.

Ms Stuart

To ask the Secretary of State for Health what consideration the National Specialist Commissioning Advisory Group has given to the travel and transportation needs of patients following heart transplantation for follow-up care in the first 12 months following surgery. [4377]

Mr. Hutton

[holding answer 20 July 2001]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

As part of the review of cardiothoracic transplant services, population access to centres for transplant services was one of the factors considered.

Our proposals for new national standards are set out in the discussion document "National Adult Heart and Lung Transplant Service" and will be reviewed in the light of the comments received.

Ms Stuart

To ask the Secretary of State for Health what assessment NSCAG has made of the number of people in a unit needed to perform a given number of operations; and what factors underlay the assumptions involved. [4384]

Mr. Hutton

[holding answer 20 July 2001]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The responsibility of NSCAG is to offer advice to the Secretary of State in commissioning designated national specialist services.

The work force in each unit is determined not by NSCAG but by the service agreement between the unit and the Department of Health through negotiations.

Ms Stuart

To ask the Secretary of State for Health if he will undertake a review of organ retrieval boundaries to reflect population size and ensure equal access. [4386]

Mr. Hutton

[holding answer 20 July 2001]: I apologise to my hon. Friend for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

Organ retrieval boundaries are continuously reviewed by the Cardiac Transplant Advisory Group, a subcommittee of the United Kingdom Transplant Authority. The directors of all the National Cardiothoracic Transplant centres comprise the membership of the Cardiac Transplant Advisory Group.

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