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?
As a first step in the development of NHS Performs, the latest available published information for a range of hospital and NHS Board indicators is being made available by ISD. The initial indicators are:
- A&E attendances and waiting times(4, 8 and 12 hours) weekly and monthly data;
- Weekly information on wards closed as a result of Norovirus infections;
- Hospital Standardised Mortality Ratios(HSMRs) by quarter;
- Healthcare Associated Infection(HAI)rates by quarter.
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. It is aimed at improving access to and assist understanding of the large volume of NHS statistical information currently published.
[19 May 2015]
Child & Adolescent Mental Health Benchmarking Release
Our Mental Health Benchmarking tools have been designed to support staff drive continuous improvement in the provision of mental health services in Scotland.
The latest CAMHS Benchmarking Toolkit (for data up to December 2014) contains information on the Child and Adolescent Mental Health Services (CAMHS) waiting times and workforce statistics.
[28 April 2015]
Cancer Waiting Times Publication Consultation
ISD are undertaking a consultation on the format, content and timeliness of the Cancer Waiting Times publication. The consultation will be open until 5 p.m. on Friday 15 May 2015.
Cancer Waiting Times - Consultation [114Kb] [13 April 2015]
- The HSMR for Scotland has decreased by 16.1% between October-December 2007 and October-December 2014.
- The aim of the Scottish Patient Safety Program (SPSP) is to reduce hospital mortality by 20% by December 2015.
- Seven hospitals have already shown a reduction in excess of 20%: Balfour Hospital, Crosshouse Hospital, Forth Valley Royal Hospital, Ninewells Hospital, Southern General Hospital, Victoria/Queen Margaret Hospital, Wishaw General Hospital
- Since October-December 2007, there has been a reduction in HSMR in 30 of the 31 hospitals participating in the SPSP.
- There were 4,766 people diagnosed with Lung Cancer in NHSScotland during April 2013 to March 2014, of which 980 were diagnosed in NOSCAN, 2,612 in WoSCAN and 1,174 in SCAN.
- Overall performance against the 12 Lung cancer QPIs is generally good across all NHS Boards; however no individual NHS Board met all 12 QPI targets. This confirms that the QPIs are aspirational and designed to improve cancer care and performance, which supports the drive for continuous quality improvement and development.
- The 30 day mortality rate following treatment for lung cancer was generally low across Scotland with the exception of those patients receiving palliative chemotherapy where the mortality rate was almost 14% within 30 days.
- Participation in clinical trials across the three regions was very low (<3%). It is recognised that participation in clinical trials is fundamental in improving outcomes for patients so this is a challenging area for improvement.
During the month ending 31 March 2015:
- There were 137,572 attendances at A&E services across Scotland.
- 92.2% of attendances at A&E services were seen and subsequently admitted, transferred or discharged within 4 hours.
- 1058 (0.8%) patients spent more than 8 hours in the department
- 114 (0.1%) patients spent more than 12 hours in the department.
- 27% of attendances led to an admission to hospital.
The total number of attendances in the last 12 months (1 April 2014 to 31 March 2015), and the same period in the previous 2 years were:
- 2015: 1,639,991
- 2014: 1,621,775
- 2013: 1,618,724
The percentage seen and subsequently admitted, transferred or discharged within four hours in the last 12 months (1 April 2014 to 31 March 2015), and the same period in the previous 2 years were:
- 2015: 91.9%
- 2014: 93.9%
- 2013: 93.6%
- During the financial year 2013/14, around 1 in 370 of the Scottish population was discharged from a psychiatric hospital in Scotland at least once. At 31 March 2014, nearly 3,500 people were resident in psychiatric hospitals.
- Some measures of mental health inpatient care activity increased between 1983/84 and 1997/98 (see figure below). Between 1997/98 and 2013/14, however, the annual numbers of admissions, discharges, stays and patients all fell by around a third, while hospital residents on 31 March fell by over half. These patterns reflect the shift in recent years in the care of people with mental health problems away from inpatient treatment towards various forms of care in the community.
- The more deprived an area, the higher its rate of psychiatric inpatient discharges. In 2013/14, the rate in the most deprived fifth of the population was over three times that of the least deprived (649 compared with 197 per 100,000 population respectively).
- ‘Accessible rural’ and ‘remote rural’ areas had lower discharge rates than more urban areas.
- Approximately half of all discharges from mental health hospitals were female. In 2013/14, schizophrenia and conditions related to drug and alcohol misuse accounted for a higher proportion of hospital discharges for male patients compared with female patients, whilst females had higher proportions of hospital discharges for mood (affective) disorders and personality disorders compared to males. Dementia accounted for a similar percentage of diagnoses in each gender (around 11%).
- Over the last ten years, age-standardised incidence rates of cancer in Scotland have fallen by 4% in males but increased by 7% in females.
- For both males and females in Scotland combined, lung cancer is still the most common cancer overall, with 5,124 cases diagnosed in 2013 (17% of all cancers), compared to 4,697 cases (15%) of breast cancer and 3,812 cases of colorectal cancer (12%). The ranks of the three most common cancers are unchanged from 2012.
- Cancer incidence rates and trends in incidence rates show considerable variation between different types of cancer. For instance, the incidence rate of malignant melanoma of the skin for all people has increased by 30% over the last ten years. In contrast, the incidence rate of cancer of the oesophagus has decreased by 8% over the same period.
- Excluding non-melanoma skin cancer, the actual number of cancers diagnosed in Scotland has increased over the last 10 years from 27,095 cases in 2003 to 31,013 in 2013. This is likely to be largely due to an ageing population.
- It is estimated that two in five people in Scotland will be diagnosed with some form of cancer during their lifetime. This includes cancers that will have no detrimental impact on life expectancy, such as indolent prostate tumours.
- It is estimated that there are 176,000 people in Scotland who have been diagnosed with cancer over the last 20 years and who are still alive. This is approximately 3% of the population of Scotland.
- The 448 cases analysed in this report are largely a subset of the 526 drug-related deaths already published by National Records Scotland (NRS) in August 2014.
- As in previous years, three quarters (76%) of those who died were male and half (50%) lived in the most deprived areas of Scotland. The percentage of deaths among individuals aged 35 and over has increased from half of deaths (50%) in 2009 to two-thirds (66%) of deaths in 2013.
- Over a third (36%) of those who died, were a parent or parental figure. 273 Children lost a parent or parental figure to a drug-related death in 2013.
- In the six months prior to death, almost three quarters, (72%) of the 2013 cohort had a medical condition recorded. Almost two thirds (63%) of the cohort had a psychiatric condition recorded (higher than in any previous cohort).
- Over half (53%) had been in contact with a drug treatment service and one quarter (28%) had been admitted to hospital for an acute or psychiatric inpatient stay in the six months before death. Collectively, seven in ten individuals (71%) who died a drug-related death in 2013 had been in contact with a service (drug treatment, hospital, police or prison) which may have identified them as being at risk of drug-related death.
- Almost two-thirds (64%) of those who were known to have used drugs also had a history of intravenous (IV) drug use. Almost one third (31%) were prescribed an Opioid Replacement Therapy (ORT) drug at the time of death.
NHSBSP performance standards, at 31 March 2014:
- For the latest three-year period, the uptake rate for Scotland has fallen slightly from 73.5% in 2010-13 to 72.9% in 2011-14. The results for both periods exceed the minimum standard of >70%.
- The uptake rate for NHS Greater Glasgow and Clyde was 67.8% in 2011-14. All other NHS Boards achieved the attendance standard of >70% of women invited to a screening appointment.
- Comparing three-year combined performance figures for those women aged 53-70 years with a previous screen within 5 years of attendance, the invasive cancer detection rate has increased from 5.7 per 1,000 women screened in the period 2005-08 to 6.8 in 2011-14.
- In 2013/14, all but 1 of the 13 NHS Breast Screening Programme minimum performance standards were achieved and all but 2 of the 11 targets were met.
- Over 1,450 cases of screen detected breast cancer were diagnosed in women of all ages.
- Of these over 80% (1,255 cases) of cancers detected were invasive, of which over half were less than 15mm in size and unlikely to be detected by a physical examination.
- The total number of eye examinations has increased from 2006/07 to the highest ever recorded figure in 2013/14 (2.04 million).
- Of these 1.66 million were primary eye examinations and 374,000 were supplementary eye examinations.
- Increasing trends were seen across Scotland, for primary and supplementary eye examinations and domiciliary visits.
- Most patients were not referred for any further investigation following their eye examination (1.64 million), illustrating that 80% of all patients in 2013/14 were dealt with in a primary care setting.
- Between 2006/07 and 2013/14, the recorded numbers of patient clinical conditions (diabetes, glaucoma /hypertension or is over 40 and has a relative who suffers from glaucoma) have continued to increase.
- Of these 1.66 million were primary eye examinations and 374,000 were supplementary eye examinations.
- The number of claimants of optical vouchers remained fairly stable, increasing by 1% from 487,000 in year ending March 2013 to 494,000 in year ending March 2014.