Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to reduce the timescale for the diagnosis of pulmonary arterial hypertension.

It is recognised it may be difficult to diagnose pulmonary arterial hypertension (PAH) because symptoms may be non-specific in the early stages.

NHS England has published service specifications for PAH centres and shared care centres which provide services closer to patient’s homes. These specifications clearly define the standards of care expected from organisations funded by NHS England to provide specialised care to PAH patients. Last year all PAH centres met the National Standard on timely diagnosis by having over 95% of patients receive a recorded diagnosed within six months of referral.

The information requested on the number of clinical commissioning groups that provide PAH services is not centrally held.

The information requested on the number of people treated for PAH is not centrally held, as the Hospital Episode Statistics (HES) database contains records of hospital episodes and attendances rather than people.

The number of finished admission episodes (FAEs)¹ with a primary diagnosis² or a primary or secondary diagnosis³ of pulmonary arterial hypertension⁴, 2014-15 to 2016-17⁵ is as follows:

Source: HES, NHS Digital

Notes:

¹FAEs

A FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.

²Primary diagnosis

The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital.

³Primary or secondary diagnosis

The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) primary and secondary diagnosis fields in a HES record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.

⁴ICD-10 Codes used

The following ICD-10 diagnosis codes were used to define pulmonary arterial hypertension:
I27.0 Primary pulmonary hypertension

I27.2 Other secondary pulmonary hypertension

⁵Assessing growth through time (Admitted patient care)

HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in National Health Service practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information.

It should be noted that HES include activity ending in the year in question and run from April to March, e.g. 2012-13 includes activity ending between 1 April 2012 and 31 March 2013.