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.
ISD and HPS are currently providing 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.
IVF Publication Consultation
ISD are undertaking a consultation on the format and content of the IVF Waiting Times publication. The consultation will be open until 5 p.m. on Monday 6 April 2015.
IVF Waiting Time Consultation [87Kb] [6 March 2015]
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]
Calendar year figures:
- In Scotland, uptake rates by 12 months of age for complete primary courses of immunisation against diphtheria, tetanus, pertussis, polio & Hib (the five-in-one vaccine), MenC and PCV remained high in 2014, with rates above 97%.
- In Scotland the target of the national immunisation programme is for 95% of children to complete courses of the following childhood immunisations by 24 months of age: diphtheria, tetanus, pertussis, polio and Hib (the five-in-one vaccine), MenC and PCV. In 2014, uptake rates of these vaccines remained high at 95% and above. At Scotland level, the 95% target has been met or exceeded since 2002.
- The national target is for 95% uptake of one dose of the Measles, Mumps and Rubella (MMR) vaccine by five years of age, with a supplementary measure at 24 months. In 2014, annual uptake of one dose of MMR vaccine by 24 months of age reached 95.6% (the previous figure was 95.4%). Uptake of one dose by five years of age was 97.3% (the previous figure was 97.1%). Uptake rates by five years have remained above the 95% target since 2009.
- At Scotland level, uptake rates were high across all deprivation categories. Uptake rates for completed courses of primary immunisations by 12 months of age were above 97% in all deprivation categories.
Topics updated: Asthma, Chronic Obstructive Pulmonary Disease (COPD), Deaths, Diabetes, Drugs, Epilepsy, Multiple Sclerosis and Tobacco use.
- Survival from cancer generally increased between the periods of diagnosis 1987-1991 and 2007-2011.
- For all cancers combined (excluding non-melanoma skin cancer), five-year age-standardised relative survival in the period of diagnosis 2007-2011 was estimated as 48% for males and 54% for females.
- Five-year age-standardised relative survival for males diagnosed in 2007-2011 varied from 3.6% for cancer of the pancreas to 93.4% for testicular cancer. For females, survival varied from 5.5% for cancer of the pancreas to 95.1% for malignant melanoma of the skin.
- Five-year age-standardised relative survival increased by approximately 19 percentage points in males and by approximately 14 percentage points in females over the period covered by this publication.
- Large absolute increases in five-year age-standardised relative survival were found in multiple myeloma, colorectal cancer, Non-Hodgkin’s lymphoma, kidney cancer, leukaemias and female breast cancer.
- The differences between males and females in five-year relative survival were comparatively high for some cancers. For females, survival was higher in malignant melanoma of the skin and cancers of the stomach, oral cavity and thyroid. For males, survival was higher in cancer of the bladder and multiple myeloma.
- The total number of NHSScotland staff in post was 137,511.9 whole time equivalent (WTE) and 160,524 headcount at 31 December 2014. This is an increase of 1.8% and 1.5% respectively since 31 December 2013.
- The largest group in the workforce continues to be nursing and midwifery, which accounted for 42.9% of all staff with 59,003.8 WTE at 31 December 2014.
- The number of consultants in post (including Directors of Public Health) recorded has seen an annual increase of 6.4% (294.8 WTE) to 4,900.6 WTE at 31 December 2014. This is partly due to more complete recording of data as boards move to a new national HR system.
- The total number of combined nursing and midwifery vacancies has decreased by 65.3 WTE since the last quarter to 2,088.3 WTE. However, the number of midwifery vacancies has increased by 29.8 WTE to 100.0 WTE.
- There are 395.6 WTE consultant vacancies, 163.7 WTE have been vacant for more than six months, an increase of 44.9% (50.7 WTE) since September 2014.
- During the quarter October to December 2014, 168,526 bed days were occupied by delayed discharge patients. This compares with 154,588 during the quarter July to September 2014 and 134,978 during the quarter October to December 2013.
- Almost three quarters of total delayed discharge bed days are occupied by patients aged 75 and over.
- At the January 2015 census, 329 patients were delayed over four weeks which is the national target. This compares with 321 at the October 2014 census and 254 at the January 2014 census.
- There were 224 patients delayed for over six weeks at the January census. This compares with 215 at the October 2014 census and 151 at the January 2014 census.
- At the January 2015 census, 517 patients were delayed over two weeks. This compares with 587 at the October 2014 census and 448 at the January 2014 census.
- The principal reason for delay may change during an individual’s period of delay as arrangements for discharge are put in place. The principal reasons supplied for those who had been delayed for more than four weeks at the January 2015 census (329 patients) were as follows: Awaiting place availability in a care home – 161 patients; Waiting to go home – 95 patients; Awaiting community care assessment – 26 patients; Awaiting funding for a care home placement - 5 patients; Awaiting healthcare arrangements - 11 patients; Other reasons such as disagreements – 31 patients.
- There were 336 patients reported as ‘Code 9’ delays where the current maximum delay does not apply. Of these, 61 per cent were due to the ‘Adults with Incapacity Act’.
- During the month ending 31 January 2015: There were 129,269 attendances at A&E services across Scotland; 87.1% of attendances at A&E services were seen and subsequently admitted, transferred or discharged within four hours; 3215 (3%) patients spent more than 8 hours in the department; 703 (0.6%) patients spent more than 12 hours in the department; 29% of attendances led to an admission to hospital.
- The total number of attendances in the last 12 months (1 February to 31 January 2015), and the same period in the previous 2 years were: 2015 - 1,645,639; 2014 - 1,611,887; 2013 - 1,639,159
- The percentage seen and subsequently admitted, transferred or discharged within four hours in the last 12 months (1 February to 31 January 2015), and the same period in the previous 2 years were; 2015 - 92.3%; 2014 - 93.8%; 2013 - 94.1%
- Unintentional injuries accounted for approximately 1 in 8 emergency hospital admissions for children and 1 in 11 for adults in Scotland in 2013/2014.
- There were 54,673 emergency admissions to hospital in Scotland for unintentional injuries in 2013/2014. This is approximately an increase of 2% on the previous year.
- There were 1,664 deaths in Scotland in 2013 due to unintentional injury, 13 in children under the age of 15 and 1,651 in adults aged 15 years and over.
- There were 33,390 emergency admissions to hospital due to falls in Scotland in 2013/14. This represents 61% of the total number of emergency admissions to hospital due to unintentional injuries.
- Children and adults in the most deprived areas are more likely than children and adults in the least deprived areas to have an emergency admission to hospital for an unintentional injury.
- 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.