Scotland has some of the best health service data in the world. Few other countries have information which combines high quality data, consistency, national coverage and the ability to link data to allow patient based analysis and follow up. The Information Services Division (ISD) is a division of National Services Scotland, part of NHS Scotland. ISD provides health information, health intelligence, statistical services and advice that support the NHS in progressing quality improvement in health and care and facilitates robust planning and decision making.
More about ISD
What's New in ISD?
Health and Social Care Integration
The Scottish Government's integrated adult health and social care bill requires each Health and Social Care Partnership to produce joint commissioning strategies and delivery plans. This will mean having the ability to assess and forecast needs, link investment to desired outcomes, consider options, plan for the nature, range and quality of future services and work in partnership to put these in place. The Bill acknowledges that to do this requires an effective information system and has identified ISD to deliver this.
We are developing a platform to inform intelligent commissioning strategies, support decisions on investment and disinvestment and improve service redesign. The team leading this work are exhibiting at two events in Edinburgh this month - Integration of Health and Social Care (11 September) and Integrating Adult Health and Social Care Scotland Conference (27 September). You are welcome to come and visit the team at these events; alternatively you can find out more here. [10 September 2013]
Our Publications Process
Users of statistics published by ISD may be aware of recent media reports about the number of statistical releases published on a single day. To help explain the process of how and when publications are released, we have updated the 'About our Statistics' section of our website. [05 September 2013]
Welcome to myISD. This is a feature that allows you to personalise your homepage and keep all the parts of the website you use regularly in one easy to find place. You can sign up for the newsletters you like to see and set any preferences. You will need to fill in a simple form to register for myISD. That lets us see the features you use regularly so we can make the site better for you.
- Waiting times information for CAMH services is still in development. NHS Boards are working with ISD and the Scottish Government to improve the consistency and completeness of the information. The 26 week target was due for delivery from March 2013, reducing to 18 weeks from December 2014.
- To report on CAMHS waiting times, NHS Boards have had to develop, for the first time, systems to report on CAMHS waiting times.
- During the quarter ending September 2013, around 3,300 children and young people started treatment at CAMH services in Scotland.
- The initial estimates from data still in development indicate that around 94% of people were seen within 26 weeks and 85% of people were seen within 18 weeks.
- In September 2013, 90.9% of patients whose 18 Weeks RTT journey could be fully measured were reported as being within 18 weeks, the figures for July and August are 91.6% and 91.1% respectively. This has decreased from 91.6% in June 2013.
- In September 2013, a total of 110,642 patient journeys eligible under the 18 Weeks RTT Standard were identified. The waiting time could be measured for 102,087 of these patients (92.3%). It was not possible to calculate the waiting time fully for 8,555 patients.
- NHS Boards are in the process of fully implementing upgrades to their systems to improve the data collection.
- The Scottish Government has determined the 18 Weeks RTT Standard has to be delivered for at least 90.0% of patients in NHS Scotland.
1. Inpatients and Day cases
- During the quarter ending 30 September 2013, 98.3% of inpatients and day cases were seen within the TTG of 12 weeks (84 days). There has been no change in performance since quarter ending 30 June 2013.
- At 30 September 2013, 98.6% of inpatients and day cases had been waiting 12 weeks or less. This has decreased from 98.7% at 30 June 2013.
- At 30 September 2013, 50,323 patients were on the inpatient and day case waiting list, of which 18.0% were recorded as unavailable. This compares to 19.2% at 30 June 2013.
2. New Outpatients
- At 30 September 2013, 95.4% of new outpatients had been waiting 12 weeks or less for an appointment. Performance against the national waiting time standard has decreased from 97.0% at 30 June 2013.
- During the quarter ending 30 September 2013, 93.0% of new outpatients seen had waited less than 12 weeks. This has decreased from 94.3% at 30 June 2013.
- At 30 September 2013, 4.7% of patients were reported as unavailable for a new outpatient appointment. This compares to 4.5% at June 2013.
- At 30 September 2013, 47,269 patients in NHS Scotland were waiting for one of the eight key diagnostic tests and investigations.
- 97.4% of patients waiting for a key diagnostic test had been waiting less than six weeks. This has increased from 97.0% at 30 June 2013.
- While combined performance for the eight key diagnostic tests has improved, the proportion of patients waiting over six weeks for a Cystoscopy or MRI Scan has increased by 4.9% and 3.9% respectively since 30 June 2013.
- 92.4% of patients waiting for a key diagnostic test had been waiting less than four weeks which is an increase from 91.7% at 30 June 2013. This is the local target that NHS Boards are working to.
- During the quarter ending 30 September 2013, 26 385 patients were seen by an Audiology Specialist following either referral to Audiology assessment (first contact) or a one-stop clinic.
- Approximately half of patients seen by an Audiology Specialist during the quarter ending 30 September 2013 had their assessment (first contact) appointment within 5 weeks of being referred and 93.4% within 12 weeks.
- Approximately half of patients were fitted with a hearing aid within 5 weeks of their assessment appointment and 97.7% within 12 weeks.
- For those sites which report on one-stop clinics, 91.6% of patients attended and were treated within 18 weeks (within 126 days) of their referral to that service.
- Waiting times information for Psychological Therapies is still at an early stage of development. NHS Boards are working with ISD and the Scottish Government to improve the consistency and completeness of the information. The target is due for delivery from December 2014.
- To report on Psychological Therapies waiting times, NHS Boards have had to develop, for the first time, systems to report on Psychological Therapies waiting times.
- During the quarter ending September 2013, nearly 8,200 people started treatment for psychological therapies in Scotland (this excludes NHS Ayrshire & Arran entirely and NHS Grampian prior to September).
- The initial estimates from data at an early stage of development indicate that around 83% of people were seen within 18 weeks.
- During the quarter ending 30 September 2013, the proportion of new attendances at A&E services across Scotland that were admitted, transferred or discharged within four hours were: July– 95.9%; August – 95.1%; September – 94.8%
- In September 2013 five NHS Boards achieved the waiting time standard of 98% of patients admitted, transferred or discharged from A&E within four hours; the remaining nine NHS Boards achieved over 92% compliance with the standard.
- In the year ending September 2013, 93.3% patients were admitted, transferred or discharged from A&E within four hours, against the HEAT target of 95% by the year ending September 2014.
- In the 12 months to 30 September 2013, the average Emergency Department attendance rate was 2,142 per 100,000 population. The HEAT target is to reduce the rate of new attendances at Emergency Departments to 2,095 per 100,000 population by March 2014.
- Total A&E attendances increased from 1.60 million in 2008/09 to 1.65 million in 2012/13.
- 126,000 bed days were occupied by delayed discharge patients in NHS Scotland during the quarter July to September 2013.
- At the October 2013 census, 156 patients were delayed over 4 weeks. This compares with 118 at the July 2013 census and 220 at the October 2012 census.
- At the October 2013 census there were 100 patients delayed for over 6 weeks. This compares with 59 at the July 2013 census and 95 at the October 2012 census. 383 patients were delayed over 2 weeks.
- The Scottish Patient Safety Programme (SPSP) was established with the overall aim of reducing hospital mortality by 15% by December 2012. This was then extended to a 20% reduction by December 2015.
- HSMRs are calculated when crude mortality data are adjusted to take account of some of the factors known to affect the underlying risk of death.
- HSMR at Scotland-level has decreased by 12.4% between October-December 2007 and April-June 2013.
- Rolling annual HSMRs show that there was a sustained reduction in hospital mortality between 2009 and 2011; the level thereafter has remained relatively constant.
- Hospital mortality has fallen for all types of admission; non-elective medical patients consistently account for the majority of deaths within 30-days of admission.
- Patients from the least deprived areas of Scotland consistently have lower levels of crude 30-day mortality than patients from more deprived areas.
- Data show that a headcount of 1067 clinical staff (908.5 wte) were working in CAMHS in Scotland as at 30th September 2013; this is an decrease of 1.5 % in staff in post wte since 30th June 2013 (-1.4% for headcount). From 30th September 2012 it is an increase of 2.6% wte (2.4% headcount).
- Nationally, this represents a staffing level of 17.1 wte clinical workers per 100,000 of the population of Scotland.
- As at 30th September 2013, an additional 47.1 wte posts throughout NHS Scotland CAMHS were between being advertised and being filled. A further 16.3 wte posts were approved for recruitment but not yet advertised.
- In total there were 800 (670.3wte) Clinical and Other Applied Psychologists employed in NHSScotland as at 30th September 2013. This is an increase in headcount of 3.9% (+30 hc) which equates to 3.9% wte (+25.3wte) since 30th September 2012. This staff group includes Clinical Psychologists, Forensic Psychologists, Counselling Psychologists and Health Psychologists.
- This represents a national staffing level of 12.6 wte Applied Psychologists per 100,000 of the population of Scotland.
- Mental Health is the principal area of work for staff in post, employing 349.1 wte Clinical and Other Applied Psychologists.
- At 30th September 2013 there were 71.0 wte vacancy posts advertised and filled, with the majority of staff due to be in post from October 2013.
- Psychology services employ a skill-mix of other clinical staff including masters level graduates in Psychological Therapies in Primary Care (56wte), masters level graduates in Applied Psychology of Children& Young People (30wte), Assistant Psychologists (59wte), and Cognitive Behavioural Therapists (38wte), and Counsellors (27wte).
- The total number of staff in post was 134,171.4 whole time equivalent (WTE), excluding General Medical Practitioners (GPs) and General Dental Services (GDS). This is an increase of 1.8% (2,326.2) since September 2012 and of 0.6% (792.5) since June 2013. The overall headcount was 157,383. This is an increase of 1.4% (2,102) since September 2012, and 0.5% (758) since June 2013.
- The largest group in the workforce was nursing and midwifery, which accounted for 42.8% of all staff (excluding GPs & GDS). Administrative services accounted for 18.3%, support services, 10.3%, and medical and dental, 9.1% (all WTE).
- The number of nursing and midwifery staff in post was 57,368.9 WTE. This is an increase of 2.0% (1,105.4) since September 2012 and of 0.4% (216.2) since June 2013. The corresponding headcount was 66,367, an increase of 1.5% (987) since September 2012, and 0.3% (192) since June 2013. The nursing and midwifery tables have been updated in this publication to reflect the introduction of new definitions to improve reporting on the midwifery and neonatal nursing workforce.
- The number of allied health professionals in post was 11,042.0 WTE. This is an increase of 17.2% (1,619.7) since September 2012 and of 0.6% (70.8) since June 2013. The corresponding headcount was 13,077, an increase of 14.8% (1,682) since September 2012 and of 0.7% (95) since June 2013. These annual changes are due to paramedics being reclassified as AHPs from 1st April 2013; previously they were included in the emergency services job family.
- The number of consultants in post was 4,584.6 WTE. This is an increase of 2.4% (108.4) since September 2012, and of 1.3% (58.7) since June 2013. The corresponding headcount was 4,880, an increase of 2.5% (117) since September 2012, and of 1.2% (60) since June 2013.
- Total consultant vacancies were 213.1 WTE, a rate of 4.4% of the total establishment. Total nursing and midwifery vacancies were 1,784.6 WTE, a rate of 3.0% of the total establishment.
- Over the last ten years, the overall age-standardised cancer (excluding non-melanoma skin cancers) mortality rate has fallen by 11.2%. The rate has fallen by 15.5% for males and 5% for females.
- There is considerable variation in trends for different types of cancer. For example, the rate of female deaths due to breast cancer has decreased by 17.7% over the last 10 years, while female death rates due to lung cancer have increased by 10.1% over the same time period. For males, the death rate due to lung cancer has decreased by 21.7% over the last ten years.
- Although the age-standardised rate of death due to cancer has decreased, the actual number of deaths due to cancer has increased: this largely reflects an increase in older age groups within the population, and the fact that cancer is a relatively common disease among the elderly.
- Significant patterns exist when examining incidence and mortality rates by deprivation in Scotland. The most deprived areas have higher incidence and mortality rates for all cancers combined (excluding non-melanoma skin cancers). There are variations in this pattern for specific types of cancer. For example, malignant melanoma of the skin has higher incidence and mortality in the less deprived areas of Scotland.
- The data presented here for Scotland and for the NHS boards are the numbers and percentages of 3- and 4-year-old children resident in that NHS board area who received two or more applications of FV in the previous year, along with the estimated populations of 3- and 4-year-old children, by deprivation quintile for the period 1st April 2012 to 31st March 2013.
- Nationally the total number of children receiving two or more FV treatments has increased from 8,873 3-year olds and 11,016 4-year olds in 2011/12 to 12,192 3-year olds and 13,068 4-year olds in 2012/13, an increase in the number of children of 37.4% and 18.6% respectively.
- The national percentage of 3 and 4 year olds receiving two or more FV treatments was 20.2% and 22.5% respectively, but there was much higher use of FV for children living more deprived SIMD quintiles than for children living in the less deprived quintiles.
- There was extensive variation between the NHS boards, but again children living in the more deprived SIMD quintiles had higher use of FV treatments.
- ISD reports these data quarterly on the HEAT dashboard, and based on trajectories made by each NHS board these figures are expected to increase – across quintiles – towards the March 2014 end-point (of this HEAT target’s clinical activity), as Childsmile activity increases.
- As at 30th September 2013, over 4.4 million patients were registered with an NHS GDS dentist in Scotland, an increase of 1.8 million since March 2007.
- The level of the Scottish population registered with an NHS GDS dentist increased from 50.5% in March 2007 to 83.4% in September 2013.
- Within the 6-12 age group, over 99% of the population was registered with an NHS GDS dentist.
- 3.4 million registered patients attended an NHS dental practice for examination or treatment in the two-year period up to 30th September 2013, an increase of over 365,000 in the two years prior to September 2010.
- Nationally, the rate of participation was 85.9% for children and 74% for adults (down slightly from 86.6% and 75.4% respectively, as at 31st March 2013).
- Participation rates were lowest for patients aged 75 and over (66.6%) and highest in the 0-2 age group (97.6%).
This Experimental Report presents further results from the 2013 Primary Care Workforce Survey. The main results from the survey were released as an Official Statistics Publication on 24 September 2013.