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To ask the Secretary of State for Health, when the Committee on Safety of Medicines was first informed of the risk of stroke in certain atypical antipsychotics used for the treatment of elderly people with dementia; what arrangements his Department has for sharing information between the Committee on Safety of...

Asked by

Paul Burstow (Liberal Democrat)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

10 March 2004

For answer on

24 March 2004

Answered on

24 March 2004

Mr. Burstow: To ask the Secretary of State for Health (1) when the Committee on Safety of Medicines was first informed of the risk of stroke in certain atypical antipsychotics used for the treatment of elderly people with dementia; [161249] (2) what arrangements his Department has for sharing information between the Committee on Safety of Medicines and similar organisations in other countries on the safety of medicines used internationally; [161250] (3) what representations he received on the risk of stroke with antipsychotics before the announcement of 9 March 2004 on the treatment of people with dementia; [161251] (4) what facilities the Committee on Safety of Medicines has for basing its decisions on medicines used in the UK on clinical trials held in other countries. [161252] Dr. Ladyman: The safety of medicines is continually monitored by the Medicines and Healthcare products Regulatory Agency (MHRA), with expert advice from the Government's independent expert advisory committee, the Committee on Safety of Medicines (CSM). Early information on the risk of stroke in dementia patients treated with risperidone was assessed by the MHRA in 2002, resulting in changes to the product information to include appropriate warnings. However, it was not until later in 2003, when further data became available, that revealed the magnitude of the risk and potential public health implications. The CSM was consulted in December 2003, as soon as all the data and subsequent analyses had been compiled and assessed by the MHRA. The CSM considered an assessment of all available data from clinical trials with risperidone and advised that additional analyses of the risperidone clinical trials in dementia and analysis of the risk of alternative treatments were required, as well as expert advice in the treatment of patients with dementia. An expert working group, including geriatricians, psychogeriatricians and psychiatrists, met on 19 January 2004 to consider a formal meta-analysis of clinical trial data for risperidone and clinical trial data on olanzapine, which had recently become available. The CSM considered the recommendations of the expert working group at the end of January and advised that the risks of stroke with risperidone and olanzapine should be communicated accompanied by comprehensive treatment guidelines to inform the necessary changes in prescribing practice. In the case of a third atypical antipsychotic quetiapine, there were insufficient data to draw conclusions. Risperidone has a United Kingdom marketing authorisation, whereas olanzapine has a European authorisation valid throughout the European Community. The communication in the UK on 9 March 2004 on risperidone and olanzapine was planned to coincide with a Europe-wide communication on olanzapine following consideration by the European scientific committee, the Committee for Proprietary Medicinal Products (CPMP) at itsFebruary meeting. The CSM, through the MHRA, has close links with regulatory authorities world-wide. The MHRA is represented on the CPMP and its Pharmacovigilance Working Party (PhVWP), which meet monthly and provide a regular forum for discussion of drug safety issues within the European Union. An electronic communication system allows rapid exchange of drug safety information between member states. The PhVWP has regular videoconferences to share drug safety information with the Food and Drug Administration in the United States of America. The MHRA is a member of the Vigimed mailing list, which is an e-mail distribution list set up to facilitate rapid exchange of information between National Centres participating in the World Health Organisation International Drug Monitoring Programme. The MHRA also has informal links with other regulatory authorities world-wide. There is an obligation on companies making an application for a marketing authorisation to provide the MHRA with all information relevant to the assessment of risks and benefits on the product at the time of the application; this includes data from clinical trials conducted outside the UK. For marketed drugs, the marketing authorisation holder's "qualified person", who is responsible for their pharmacovigilance system, has an obligation to inform the MHRA of any information relevant to the evaluation of the risks and benefits of the product. Aside from the data and interpretation received from the company, and their corresponding applications to vary the Marketing Authorisation, no representations were received on the risk of stroke with antipsychotics before the announcement of 9 March.

Date

24 March 2004

Reference

419 c913-4W;419 c915-6W; 161249;161250;161251;161252

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, when mental health service improvements announced in the national service framework for mental health and the NHS plan in respect of (a) crisis teams, (b) assertive outreach programmes, (c) home treatment, (d) early intervention in psychosis and (e) primary care mental health...

Asked by

Robert Key (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

11 March 2003

For answer on

21 March 2003

Answered on

21 March 2003

Mr. Key: To ask the Secretary of State for Health when mental health service improvements announced in the national service framework for mental health and the NHS plan in respect of (a) crisis teams, (b) assertive outreach programmes, (c) home treatment, (d) early intervention in psychosis and (e) primary care mental health teams will be launched in Salisbury. [103080] Jacqui Smith: [holding answer 18 March 2003]: A mental health national service framework (NSF) was published in September 1999 which spells out national standards for mental health, what they aim to achieve, how they should be developed and delivered and how to measure performance in every part of the country. It concentrates on the mental health needs of working age adults, and covers health promotion, assessment and diagnosis, treatment, rehabilitation and care, encompassing primary and secondary care and the roles of partner agencies. Work to develop mental health services is ongoing. In order to improve local services the local primary care trust has committed, in its three year local delivery plan, to increased investment in mental health, including investment in services for older people and dementia provision. The Avon and Wiltshire Mental Health Partnership National Health Service Trust has advised of specific mental health services in place as follows: Crisis teams and home treatment: The intensive home support service already provides out-of- hours crisis support in Salisbury and south Wiltshire. Supports run from 9.00 am to 9.00 pm on weekdays and bank holidays and from 10am to 6pm on weekends. Assertive Outreach programmes: There is a small team currently seeing 14 clients in south Wiltshire, with the aim of increasing this to serve around 40 clients over the next few years. The programme will be considered under a major data led review of adult mental health services to be undertaken during 2003. Across the whole Avon, Gloucestershire, and Wiltshire Strategic Health Authority area there have been substantial service improvements in line with NSF Guidance including: six more crisis resolution teams eight more assertive outreach teams at least 12 more community gateway staff at least 14 more staff to give breaks to carers and strengthen carer support fully comprehensive community mental health teams in the three Wiltshire LIT areas better services for mentally-disordered offenders including expansion of two court assessment schemes and in-reach provision for prisoners better services for mental-disordered offenders including expansion of two court assessment schemes and in-reach provision for prisoners better medium secure services including advocacy and social care services in keeping with the Lewis Report increased security High Secure Hospitals There have also been substantial improvements in the integrated care programme approach, mental health commissioning, and information sharing.

Date

21 March 2003

Reference

103080; 401 c964-5W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how many beds in (a) Sunderland Royal Hospital, (b) Hartlepool General Hospital and (c) Ryhope Hospital are accepted by EMI patients who could be cared for in the community; and if he will make a statement. - Info requested not held centrally.

Asked by

John Cummings (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

24 February 2003

Reference

97161; 400 c33W;400 c34W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how many elderly patients have received community-based psychiatric provision in each of the last five years. - Inc table.

Asked by

Liam Fox (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

13 May 2002

For answer on

17 June 2002

Answered on

17 June 2002

Dr. Fox: To ask the Secretary of State for Health how many elderly patients have received community-based psychiatric provision in each of the last five years. [56958] Jacqui Smith: The number of first contacts with patients aged 65 and over by community psychiatric nurses is set out in the table. Community psychiatric nurses--number of first contacts with patients aged 65 and over, 1996-97 to 2000-01 Thousand _________________________________________________________________________________________________. Number of persons 1996-97 146 1997-98 152 1998-99 162 1999-2000 158 2000-01 154 _________________________________________________________________________________________________. Further information about patient contacts with community psychiatric nurses is contained in the statistical report "Patient care in the community, Community Psychiatric Nursing, summary information for 2000-01, England". A copy of the summary is in the Library and also available on the Department website at www.doh.gov.uk/ public/kc570001. Older people also receive other community-based psychiatric services, either as well as or separately from services from community psychiatric nurses, but information is not available on the numbers receiving other services.

Date

17 June 2002

Reference

56958; 387 c156W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, what estimate he has made of the total savings to public funds of the Private Finance Initiative contract for the old age psychiatry services for the Stockport NHS Trust by comparison with a non-Private Finance Initiative alternative. - Inc table.

Asked by

John Bercow (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

17 June 2002

Reference

49521; 387 c154W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how many old-age in-patient psychiatry beds there have been in each of the past five years. - Table given.

Asked by

Liam Fox (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

15 April 2002

Reference

47832; 383 c792-3W;383 c790-1W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how many psychogeriatricians (a) there were in England by region in the last five years and (b) he estimates there will be in post in the next five years. - Inc table.

Asked by

Paul Burstow (Liberal Democrat)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

16 January 2002

For answer on

21 January 2002

Answered on

21 January 2002

Mr. Burstow: To ask the Secretary of State for Health how many psychogeriatricians (a) there were in England by region in the last five years and (b) he estimates there will be in post in the next five years. [28880] Mr. Hutton: The information requested is in the table. Latest projections suggest that by 2006 there will be an additional 143 trained specialists available to work within the specialty. Hospital medical staff within the old age psychiatry speciality by region As at 30 September Number _________________________________________________________________________________________________. 1996 1997 1998 1999 2000 All staff Consultant All staff Consultant All staff Consultant All staff Consultant All staff Consultant England 640 230 710 240 760 270 820 310 860 330 Eastern 60 20 70 20 70 30 70 30 80 30 London 100 40 110 40 120 40 110 40 130 50 North West 60 20 60 20 70 30 90 40 80 40 Northern and 90 40 100 50 120 60 150 70 130 60 Yorkshire South East 130 40 140 40 150 40 160 50 170 60 South 60 20 60 20 60 20 70 20 70 20 Eastern Trent 90 30 100 30 110 30 100 30 120 30 West 70 30 80 30 70 30 80 40 80 40 Midlands _________________________________________________________________________________________________. Note: Where regions are shown, staff holding appointments in more than one region are included separately in each region. The sum of regional totals therefore differs slightly from the England total and a direct comparison between England totals is not advised. Source: Department of Health medical and dental work force census

Date

21 January 2002

Reference

28880; 378 c689-90W;378 c685-6W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how many psycho-geriatricians there were in England in each of the last five years; and how many will be in post by 2004. - Includes table.

Asked by

Paul Burstow (Liberal Democrat)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

17 December 2001

Reference

377 c170W; 23290

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how may psycho-geriatricians there were in England and Wales at the last date for which figures are available.

Asked by

Paul Burstow (Liberal Democrat)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

10 December 2001

Reference

376 c724W; 19924

House

House of Commons

Scottish Office

Answered by

Lord Selkirk of Douglas (Conservative)

Answering body

Scottish Office

Type

Oral answers to questions

Date

24 May 1995

Reference

260 c897-8

House

House of Commons

Scottish Office

Answered by

Lord Selkirk of Douglas (Conservative)

Answering body

Scottish Office

Type

Oral answers to questions

Date

24 May 1995

Reference

260 c897-8

House

House of Commons

Scottish Office

How many NHS continuing care beds for the elderly there were in 1985; how many there are now; and how many he expects there to be in 10 years' time.

Asked by

Malcolm Chisholm (Labour)

Answering body

Scottish Office

Oral questions - Lead

Status

Answered

Date

24 May 1995

Reference

260 c897-8

House

House of Commons

Scottish Office

1st supplementary on Lothian. - Inc figs.

Asked by

Malcolm Chisholm (Labour)

Answering body

Scottish Office

Oral questions - 1st Supplementary

Status

Answered

Date

24 May 1995

Reference

260 c897-8

House

House of Commons

Scottish Office

What guidance the Scottish Office has issued to Scottish health boards relating to the closure of staffed beds for the treatment of mental health and psycho-geriatric patients.

Asked by

Brian H Donohoe (Labour)

Answering body

Scottish Office

Type

Written questions

Status

Answered

Date

21 March 1995

Reference

257 c175W

House

House of Commons

Scottish Office

How much money has been transferred from each health board in Scotland to local authorities under resource transfer arrangements in respect of reductions in National Health Service continuing care beds for (a) learning disabilities, (b) psychiatric care, (c) geriatric care, (d) psycho-geriatric care and (e) physical disabilities in each year...

Asked by

Lord Robertson of Port Ellen (Labour)

Answering body

Scottish Office

Type

Written questions

Status

Answered

Date

3 November 1994

Reference

248 c1320W;248 c1322W

House

House of Commons

Lords debate on unstarred question on Govt's policy on provision of National Health Service psychogeriatric continuing care beds

Lords debate on unstarred question on Govt's policy on provision of National Health Service psychogeriatric continuing care beds.

Lead member

Lord Stallard

Answering member

Baroness Jay of Paddington

Department

Department of Health

Type

Questions for short debate

Date

30 June 1994

Reference

556 c968-82

House

House of Lords

Dept of Health

If she will list each health authority which does not provide psychogeriatric continuing care beds.

Asked by

Baroness Primarolo (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

15 June 1994

Reference

244 c592W

House

House of Commons

Scottish Office

What was the total number of (a) geriatric and (b) psychogeriatric beds in NHS hospitals in Scotland on the most recent available date; and what were the equivalent numbers for the same date three years previously. (Failed OPQ) - Figures given.

Asked by

Lord Foulkes of Cumnock (Labour)

Answering body

Scottish Office

Type

Written questions

Status

Answered

Date

25 May 1994

Reference

244 c201W

House

House of Commons

Dept of Health

If she will list for the last four years the number of psychogeriatricians employed by the NHS. - Table given.

Asked by

Lord Jones (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

2 February 1994

Reference

236 c719-20W

House

House of Commons

Dept of Health

If she will list those district health authorities which do not employ a psychogeriatrician.

Asked by

Lord Jones (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

2 February 1994

Reference

236 c720W

House

House of Commons

Librarians' tools

Type

House

Session

Year

Department

Member

Primary member

Answering member

Legislative stage

Legislation

Subject

Publisher