NHS: Standards

Health written question – answered on 3rd June 2009.

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Photo of Nicholas Winterton Nicholas Winterton Conservative, Macclesfield

To ask the Secretary of State for Health what information his Department holds on England's position among Western European states for (a) prevalence of and (b) treatment standards for (i) heart, (ii) kidney disease and (c) stroke; and what plans he has to improve this ranking over the next 10 years.

Photo of Ann Keen Ann Keen Parliamentary Under-Secretary (Health Services), Department of Health

Data from the 2006 Health Survey for England suggest the prevalence of coronary heart disease (CHD) in England was 6.5 per cent. in men and 4.0 per cent. in women. Prevalence rates increase with age, with more than one in three men and around one in four women aged 75 and over living with CHD.

Overall we estimate that there are just over 1.1 million men living in the United Kingdom who have had angina and around 970,000 who have had a heart attack and around 850,000 women who have had angina and around 439,000 who have had a heart attack. Combined, these estimates suggest that 2.1 million men and 1.3 million women, around 3.4 million adults, in the UK reporting angina and/or a heart attack. This is likely to be an overestimate as those suffering from angina are not an independent group to those suffering from a heart attack.

Comparable data on prevalence of the cardiovascular diseases are difficult to access. At present there is no routinely updated source of Europe-wide data.

With regards to plans for tackling heart disease, the Department is commissioning an external review of the implementation and delivery of the Coronary Heart Disease National Service Framework. We are also undertaking an analysis of the trends in the burden of cardiac disease including patient expectations and needs, technology and working practices and how these are likely to affect future demand and patterns of service provision.

We understand that a report on Access to Cardiac Care in the UK commissioned by the Cardio and Vascular Coalition, the British Heart Foundation and the British Cardiovascular Society was launched on 2 June 2009, which includes some comparison with other European countries. This will be a helpful contribution to our work on future needs.

The Department contributed information to the Euro Consumer Heart Index in 2008, which provides comparisons between European countries across a number of indicators including access to treatment, prevention, national guidelines and outcomes. In this index, the UK ranked 9 out of 29 European countries. No separate score was available for England.

The number of people with chronic kidney disease (CKD) is not accurately known, because a lack of symptoms in the early stages means it often remains undiagnosed. However, a survey of blood samples in South East England in 2000-01 indicated the prevalence of CKD to be 5,554 per million population. Also the introduction of CKD into the Quality and Outcomes Framework has determined that there are 1.5 million people with CKD stages 3-5 (5 being established as renal failure).

Part 1 of the National Service Framework for Renal Services, published in January 2004, sets five standards and identifies 30 markers of good practice in the areas of dialysis and transplantation, aimed at improving fairness of access, patient choice about the type of treatment they receive and reducing variation in the quality of dialysis and kidney transplant services. These standards and markers of good practice will help the national health service and its partners to manage the increasing demand for renal services.

Future plans for renal services are to identify people at risk of kidney disease in a timely manner to optimise care, ensure kidney patients receive high quality care and to offer patients a choice of all forms of replacement therapy.

Stroke is the third leading cause of death and the leading cause of adult disability in England, with over 110,000 strokes happening every year.

The National Stroke Strategy for England (December 2007) sets 20 'quality markers' which outline the features of a good service in the assessment and treatment of strokes, and those support services needed for stroke survivors to return to as full as possible a life in their community.

The National Stroke Strategy was launched on 5 December 2007 following extensive consultation. It provides a 10-year framework setting out key elements of an improved stroke service. At the launch of the strategy, my right hon. Friend the Secretary of State for Health (Alan Johnson) announced £105 million of central funding over three years would be spent to support implementation.

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