HC Deb 18 July 2003 vol 409 cc957-9W
Mr. Burstow

To ask the Secretary of State for Health what progress has been made towards the target of 100 per cent.of general hospitals to have a specialist stroke unit by April 2004. [126525]

Dr. Ladyman

A monitoring exercise conducted at the end of 2002 suggested that 83 per cent. of hospitals had plans in place to have a specialist stroke service by April 2004.

The Department of Health will be monitoring formally the overall stroke milestone in April 2004, as this is included as one of the key targets in "Improvement, Expansion and Reform", the priorities and planning framework for 2003–06. Progress on this key target will be monitored through the 2003–04 local delivery plan reporting mechanism and information will be available later in the year.

Mr. Burstow

To ask the Secretary of State for Health how many patients were treated for strokes(a) in each NHS trust and (b) in each strategic health authority in each year since 1997. [126526]

Dr. Ladyman

The information requested has been placed in the Library.

Mr. Burstow

To ask the Secretary of State for Health what progress has been made towards the Saving Lives: Our Healthier Nation, target for reducing strokes in those under 75 years. [126531]

Dr. Ladyman

There is no target in Saving Lives: Our Healthier Nation specifically for reducing strokes.

There is a target in Saving Lives: Our Healthier Nation for reducing the rate of mortality from 'All Circulatory Diseases'. This includes stroke, also coronary heart disease and related diseases. The Our Healthier Nation target is "to reduce the death rate from all circulatory diseases in people under age 75 years by at least 40 per cent.by 2010".

Progress in respect of the Our Healthier Nation mortality target for all circulatory diseases is monitored using a three year moving average of the age standardised mortality rate for people aged under 75 years.

The most recent data show a fall of almost 19 per cent. in the rate since the baseline period of 1995 to 1997.

All circulatory Diseases (ICD-10 100–199) Persons Agea Under75 years
Death rate per 100,000 population in England (European age standardised, and adjusted for ICD-10)
Years Three-year average mortality rate
1995/6/71 (Baseline) 141.5
1996/7/81 135.7
1997/8/91 128.7
1998/9/20001 122.0
1999/2000/011 114.8
Milestone (2004/5/6) 106. 1
Farget (2009/10/11 84.9
Percentage change in rale since baseline —18.9

Source:

Office for National Statistics.

1 Rates for years other than 1999 and 2001 calculated using numbers of deaths coded under ICD9. Adjusted to be on the same basis as ICD10. See note B below.

Single year rates and numbers of deaths from stroke among people in England aged under 75 over the same time period are shown in the following table:

Cerebrovascular Disease (Stroke) (ICD-10–160–169) persons aged under 75
Death rate per 100,000 population in England (European age standardised, and adjusted for ICD 10)
Year Single year Mortality rate1 Number of deaths
19951 26.5 13,465
19961 26.3 13,190
19971 25.0 12,498
19981 24.4 12,140
1999 23.2 12M293
20001 21.2 10,561
2001 20.6 10,947

Note:

Change:1995 to 2001—17.9 per cent.

Source:

Office for National Statistics.

1 Rates calculated using numbers of deaths coded under ICD9 adjusted to be on the same basis as ICD 10—see Note B below:

Note B: Causes of death in England and Wales were coded to the Ninth Revision of the International Classification of Diseases (ICD-9) from 1979 to 2000. Cerebrovascular diseases which includes stroke and related conditions, were coded to 430–438. In the Tenth Revision (ICD-10), introduced in 2001, the same conditions are coded to 160–169. However, the way in which the underlying cause of death is selected from the conditions written on the certificate changed in ICD-10. This led to an increase of about 13 per cent. in the number of deaths attributed to cerebrovascular diseases in men and 9 per cent. in women. Time trends should therefore be interpreted with caution. The effects of the change in classification has been described in detail in ONS publicaions.

Mr. Burstow

To ask the Secretary of State for Health (1) what monitoring arrangements are in place to ensure that(a) primary care trusts and (b) NHS trusts have reviewed arrangements to identify those at greatest risk of stroke; [126536]

(2) what monitoring arrangements are in place to ensure that (a) primary care trusts and (b) NHS trusts have agreed local priorities to improve the rates of identification and effective intervention in stroke. [126537]

Dr. Ladyman

The Department of Health will be monitoring formally the overall stroke milestone in April 2004 as this is included as one of the key targets in Improvement, Expansion and Reform, the priorities and planning framework for the National Health Service for 2003–06. It is now for strategic health authorities to plan, deliver and monitor progress locally on the other stroke milestones in the national service framework for older people.

Mr. Burstow

To ask the Secretary of State for Health, what progress has been made to ensure that by April 2004 every general practice, using protocols agreed with local specialist services, can identify and treat patients identified as being at risk of a stroke because of high blood pressure, atrial fibrillation or other risk factors. [126541]

Dr. Ladyman

The Department of Health will be monitoring formally the overall stroke milestone in April 2004, as this is included as one of the key targets in Improvement, Expansion and Reform, the priorities and planning framework for the National Health Service for 2003–2006. It is now for strategic health authorities to plan, deliver and monitor progress locally on the other stroke milestones in the national service framework for older people. Therefore progress on this key target will be monitored through the 2003–04 local delivery plan reporting mechanism and information will be available later in the year.

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