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.
What's New in ISD?
Development of NHS Performs website
Information Services Division (ISD) and Health Protection Scotland (HPS) are collaborating with the Scottish Government to develop a new website - NHS Performs.
Over time NHS Performs will bring together a range of different information about the performance of NHS Boards and hospitals in an easy to access format.
On 3rd March 2015, ISD and HPS will provide the latest available information for an initial range of NHS Board and hospital performance indicators, as well as outlining plans for the development of NHS Performs.
Infection Intelligence Platform
The Infection Intelligence Platform (IIP) is an integrated resource for healthcare associated infection surveillance and research. It is an exciting innovation in the prevention and management of infection and confirms Scotland's position as a world leader in healthcare informatics. The latest IIP newsletter contains updates on progress and dates of forthcoming presentations. [23 February 2015]
'Open Data' is data that is freely available for anyone to use, re-use or redistribute it for any purpose without restriction or charge. Our Transforming Information Programme (TRIP) is running pilot projects to explore how ISD can release more data in this way. Margaret McLeod, workstream lead has written this short post about Open Data on the TRIP blog. [23 February 2015]
- For Scotland as a whole there has been a steady improvement in the recording of ethnic group over the last two years. Completeness of recording has improved by 5 percentage points to 82% for inpatient and day case records (SMR01) and by 9 percentage points to 74% for new outpatient appointment records (SMR00).
- Increased recording of code ‘98’ –‘Refused/Not provided’ in SMR01 and SMR00 data has been seen at some Boards over the last eight quarters. This variation is being investigated locally.
As at 31st December 2014
- In 2009, the Scottish Government committed central funding to expand the CAMHS workforce of NHSScotland. This has resulted in a steady increase in the CAMHS workforce from 764.6 WTE (883 headcount) in 2009 to 942.4 WTE (1096 headcount) as at 31st December 2014.
- The most significant staff increases have been in Psychology (72% since 2009), and Nursing (22% since 2009).
- The headcount has remained relatively stable over the past year. There are currently 1096 clinical staff (942.4 WTE). Nationally, this represents a staffing level of 17.7 WTE clinical workers per 100,000 of the population of Scotland.
- An additional 48.8 WTE posts throughout NHS Scotland CAMHS were between being advertised and being filled. A further 11.2 WTE posts were approved for recruitment but not yet advertised.
As at 31st December 2014:
- The total number of clinical staff employed in NHSScotland Psychology Services continues to rise, with 1253 staff (1057.2 WTE) including 905 (756.8 WTE) Clinical and Other Applied Psychologists in post as at 31st December 2014.
- There has been a significant increase over time in the number of Clinical and Other Applied Psychologists employed in NHSScotland from 426 (371.0 WTE) in 2003 to the current level of 905 (756.8 WTE) as at 31st December 2014.
- This total of 905 (756.8 WTE) equates to 844 (705.3 WTE) Clinical Psychologists plus 61 (51.5 WTE) Other Applied Psychologists. This represents a national staffing level of 14.2 WTE Applied Psychologist per 100,000 of the general population of Scotland.
- The total of 1253 staff also includes Graduates of the MSc in Psychological Therapies in Primary Care (64.2 WTE), Graduates of the MSc in the Applied Psychology of Children and Young People (37.1 WTE), Cognitive Behavioural Therapists (47.8 WTE), Counsellors (26.8 WTE), other therapists (17.2 WTE), and other clinical staff (20.1 WTE).
- As at 31st December 2014, an additional 49.0 WTE posts throughout NHSScotland Psychology Services were between being advertised and being filled with start dates commencing in January 2015. A further 13.5 WTE posts were approved for recruitment but not yet advertised.
- The Resource Allocation Formula aims to predict healthcare need for every territorial NHS Board based on statistical characteristics of the population.
- It covers a range of healthcare programmes: Acute Hospital Care; hospital care for Mental Health & Learning Difficulties, Care of the Elderly and Maternity; Community Care and GP Prescribing.
- The final shares for 2015/16 may be different from the calculated target shares as the results are used to inform the final allocation, not to determine them.
- The Scottish Government set a target for the NHS in Scotland to deliver a maximum wait of 26 weeks from a patient’s referral to treatment for specialist CAMH services from March 2013, reducing to 18 weeks from December 2014. The target should be delivered for at least 90% of patients.
- During the quarter ending December 2014, over 4,100 children and young people started treatment at CAMH services in Scotland.
- During the quarter ending December 2014, 86.0% of people were seen within 26 weeks and 78.9% of people were seen within 18 weeks.
- For this reporting period, 9 Boards met the 26 week HEAT target and 5 did not, namely NHS Fife, NHS Forth Valley, NHS Grampian, NHS Lothian and NHS Tayside.
- Waiting times information for Psychological Therapies are developmental. NHS Boards are working with ISD and the Scottish Government to improve the consistency and completeness of the information. The target that at least 90% of people waiting for Psychological Therapies should start treatment within 18 weeks is due for delivery from December 2014.
- NHS Boards have had to develop new systems to enable reporting on Psychological Therapies waiting times.
- During the quarter ending December 2014, just over 10,500 people started treatment for psychological therapies in Scotland. The initial estimates from data at this stage of development indicate that around 81% of people were seen within 18 weeks.
- In December 2014, across NHS Scotland, 89.2% of patients whose 18 Weeks RTT journey could be fully measured, were reported as being seen within 18 weeks, compared to the amended previous publication (excluding NHS Highland) for September 2014 of 90.1%. The figures for October and November 2014 are 89.8% and 88.4% respectively.
- In December 2014, 9 of the fourteen NHS Boards who submitted valid data met the 90.0% standard; 5 NHS Boards did not, NHS Ayrshire and Arran, NHS Fife, NHS Forth Valley, NHS Grampian and NHS Lothian, who achieved 82.8%, 86.7%, 89.7%, 84.9% and 86.3% respectively.
- In December 2014, a total of 100,939 of patient journeys eligible under the 18 weeks RTT standard were identified. The waiting time could be fully measured for 93,616 of these patients (92.7%). It was not possible to calculate the waiting time fully for 7,323 patients due to the complexity of linking individual patient journeys.
Inpatients and Day cases
This publication release for quarter ending 31 December 2014, presents for the second time since the introduction of TTG, Inpatient and Day case statistics sourced directly from patient level data held by NHS Boards. This has allowed statistics to be compiled centrally using nationally consistent definitions and methods and will allow better comparison across the country and more robust data quality assurance.
- During quarter ending 31 December 2014, 97.1% of Inpatients and Day cases were seen within the 12 week TTG. This has decreased from 97.3% during quarter ending 30 September 2014. Additionally, 9 out of 10 patients were seen within 77 days (11 weeks).
- Of the 2,342 patients who were not treated within 12 weeks during quarter ending 31 December 2014, 45.9% were seen in NHS Lothian, 19.9% in NHS Grampian and 19.8% in NHS Highland.
- At 31 December 2014, 96.9% of patients waiting for Inpatient or Day case admission had been waiting 12 weeks or less, this has decreased from 97.6% at 30 September 2014.
- At 31 December 2014, 20.7% of patients waiting were recorded as being unavailable for treatment. This has increased from 18.8% of patients waiting at 30 September 2014.
Figures from 01 April 2014 incorporate changes to the calculation of waiting times for New Outpatients. Although not enshrined in law, approval was given to use the same waiting times calculation for new outpatients as applies to Inpatients and Day cases under the TTG. This change will impact on the comparability of New Outpatient waiting times statistics over time.
- At 31 December 2014, 90.8% of patients waiting for a new outpatient appointment had been waiting 12 weeks or less. This has decreased from 93.2% at 30 September 2014.
- Of the 24,530 patients who were waiting over 12 weeks as at 31 December 2014 for a new outpatient appointment, 21.8% were reported by NHS Grampian, 17.2% by NHS Ayrshire & Arran and 16.3% by NHS Highland.
- During the quarter ending 31 December 2014, 90.0% of new outpatients seen had waited less than 12 weeks. This has decreased from 90.6% during quarter ending 30 September 2014.
- At 31 December 2014, 3.8% of patients waiting were recorded as being unavailable to attend a new outpatient appointment. This has decreased from 5.0% of patients waiting at 30 September 2014.
On 31 March 2009, the Scottish Government introduced the waiting time standard that patients waiting for one of the eight key diagnostic tests and investigations would be waiting no longer than six weeks.
As at 31 December 2014:
- 51,954 patients in NHS Scotland were waiting for one of the eight key diagnostic tests and investigations. This is 10% higher than list size at 31 December 2013.
- 90.3% of patients waiting for a key diagnostic test had been waiting less than six weeks. When comparing to the position at 30 September 2014 and 31 December 2013, this has decreased from 91.0% and 96.2% respectively.
- The majority of the 5,018 patients waiting over six weeks in NHS Scotland were waiting to be seen in NHS Grampian (28.3%), NHS Fife (21.6%), NHS Ayrshire & Arran (17.6%) and NHS Lothian (13.1%).
- During the quarter ending December 2014, 427 eligible patients were screened at an IVF Centre in Scotland.
- The initial estimates from data at this early stage of development indicate that during the quarter ending December 2014 around 80% of eligible patients were screened for IVF treatment within 365 days. This compares to 71% in the quarter ending September 2014.
- There were 1512 Upper GI cancer patients treated across NHSScotland in 2013, of which 364 were treated in NOSCAN, 725 in WoSCAN and 413 in SCAN.
- Overall performance against the 11 Upper GI cancer QPIs is generally good across all NHS Boards; however no individual NHS Board met all 11 QPI targets. This suggests that the target levels for the QPIs are challenging and that there are areas for improvement.
- Overall the postoperative mortality rates following Upper GI cancer resection in Scotland were low at 4% and below the QPI target of 10%.
- The target of 35% of patients receiving curative treatment was not met by any of the three Networks. It is believed this reflects the advanced stage of disease at diagnosis and other health problems of patients. The best way to achieve this target is through earlier detection of Upper GI cancer.
- In school year 2013/14 a total of 54,573 valid height and weight measurements were recorded for children in Primary 1 in Scotland. This is approximately 92% of children in Primary 1.
Based on epidemiological thresholds used for population monitoring purposes:
- In 2013/14, 76.4% of children in Primary 1 were classified as healthy weight, a small decrease on the 2012/13 figure of 77.5%.
- The BMI distribution of children in Primary 1 has remained broadly similar over the period 2004/05 to 2013/14 with between 21% to 23% of children at risk of overweight and obesity combined and around 1-2% at risk of underweight. In 2013/14, 22.6% of children in Primary 1 were at risk of overweight and obesity combined and 1.0% at risk of underweight.
- The prevalence of healthy weight amongst children in Primary 1 decreases as deprivation increases. In the least deprived areas (SIMD quintile 5), 81.1% of children were classified as healthy weight while in the most deprived areas (SIMD quintile 1) 73.2% were classified as healthy weight.
- The prevalence of healthy weight is slightly higher amongst girls than boys. In school year 2013/14, 77.2% of girls were classified as healthy weight compared to 75.7% of boys.
- The HSMR for Scotland has decreased by 16.3% between October-December 2007 and July-September 2014.
- The aim of the Scottish Patient Safety Program (SPSP) is to reduce hospital mortality by 20% by December 2015.
- Six hospitals have already shown a reduction in excess of 20%.
- Since October-December 2007, there has been a reduction in HSMR in 30 of the 31 hospitals participating in the SPSP.
- The number of attendances at A&E services across Scotland over the last 3 years were: 2014 – 1,645,200; 2013 – 1,608,789; 2012 – 1,642,816
- During the quarter ending 31 December 2014, the proportion of attendances at A&E services that were seen and subsequently admitted, transferred or discharged within four hours were: October – 91.8%; November – 91.8%; December – 89.9%
- During the quarter ending 31 December 2014, 4028 (1%) patients spent more than 8 hours in the department, and 517 (0.1%) spent more than 12 hours in the department.
- During the quarter ending 31 December 2014, 27% of attendances at A&E led to an admission to hospital.