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?
Analysis of NHS information on surgery for stress urinary incontinence and pelvic organ prolapse in Scotland
In 2014, the Scottish Government set up the Independent Review of Transvaginal Mesh Implants ('the Review'). The Review was asked to examine the safety of mesh surgery for stress urinary incontinence and pelvic organ prolapse. Information Services Division was asked to help the Review by examining routine NHS information collected on patients treated for these conditions. Our report Analysis of NHS information on surgery for stress urinary incontinence and pelvic organ prolapse in Scotland gives a summary of the analysis that was carried out and what was found.
[16 October 2015]
NHS Performs - Latest update
NHS Performs has been updated to include information on:
- Emergency Department activity for the week ending 15 November 2015
- Numbers of hospital wards closed with confirmed or presumed Norovirus infections on 16 November 2015
- Number of Delayed Discharges for October 2015
- Hospital waiting times (Outpatient; Inpatient and Day Case; Referral To Treatment; Diagnostics) for July to September 2015
NHS Performs is a new website which brings together a range of information on how hospitals and NHS Boards within NHSScotland are performing. It aims provide this information in an easy to access, clear and understandable way.
[24 November 2015]
- Mothers are getting older: There has been a steady increase in births to mothers in the over 30 age groups since 1975/76. In the most deprived areas mothers most commonly start a family at around 22 years old, in contrast to those in less deprived areas where the most common age for a first birth is 31.
- Caesarean section: In singleton births, elective* caesarean section rates have increased steadily since 1975/76 (from 4.7% to 13.4%). Emergency caesarean section rates have also seen a general increase since 1975/76 (from 3.9% to 16.5%)
[*An elective caesarean section refers to a caesarean section planned in advance and in most cases will have been recommended for clinical reasons such as breech, multiple births or previous caesarean section. It may also be the case that the woman will have chosen this method of delivery for non-clinical reasons.]
- Body Mass Index: Of the 53,222 women delivering in 2014/15, 25,891 (48.6%) were overweight or obese. For those with known BMI, overweight and obese women were less likely to have a vaginal delivery and more likely to have a caesarean section delivery than underweight or healthy weight women.
- Smoking: The percentage of mothers smoking during pregnancy and after delivery continues to fall. In 2014/15 the percentage of women known to be current smokers at the time of antenatal booking was 17.3%.
- Antenatal booking: In 2014/15 over 80% of women from each Scotland level deprivation quintile booked for their antenatal care before 12 weeks of pregnancy.
- Premature and low birthweight babies: The percentage of babies born prematurely (before 37 weeks) or with a low birthweight has decreased slightly over the last 10 years. In 2014/15, 7.3% of babies were born prematurely compared to 8.2% in 2005/06 and 6.2% had a low birthweight in 2014/15 compared to 7.6% in 2005/06.
- Total NHS Board operating costs increased by 3.4% to £10.8bn in cash terms, not adjusting for inflation, compared to 2013/14. In real terms, once inflation has been taken into account, total operating costs increased by 2.0% compared to 2013/14.
- Almost half of the total operating costs (47.8% or £5.2bn) were accounted for by hospital and community sector staff.
- Expenditure within the hospital sector was £6.1bn, an increase of 3.4% in cash terms compared to 2013/14 (2.0% in real terms).The hospital sector accounts for the largest part of expenditure (56.9%).
- Within the community sector, £1.8bn was spent, a cash terms increase of 4.9% compared to 2013/14 (3.4% in real terms). The community sector contains the smaller hospitals which serve their local communities, as well as community services delivered outside hospitals.
- Family health sector expenditure, which includes the cost of running local GP practices as well as local pharmacy, dental and ophthalmic services, amounted to just under £2.5bn in 2014/15 – a cash terms increase of 2.6% (1.2% in real terms) compared to 2013/14.
- Over 4,200 children and young people started treatment at CAMH services in Scotland, 73.0% were seen within 18 weeks. Half started their treatment within nine weeks. The trend in patients seen has been relatively stable over the last year.
- During the quarter ending September 2015, out of the 13 Boards (NHS Orkney were unable to submit data) the 18 week standard was met by five Boards (NHS Ayrshire & Arran, NHS Dumfries & Galloway, NHS Greater Glasgow & Clyde, NHS Highland and NHS Western Isles).
- Across Scotland, 14.5% of patients referred to CAMH services did not attend their first appointment. These patients may still be on the waiting list.
- 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 Scottish Government has set a standard for the NHS in Scotland to deliver a maximum wait of 18 weeks from a patient’s referral to treatment for Psychological Therapies from December 2014. The standard should be delivered for at least 90% of patients.
- 13.030 people started treatment for Psychological Therapies in Scotland, an increase of 466 (3.7%) over the previous quarter.
- Five NHS Boards met the standard of treating 90% of patients referred within 18 weeks - these were NHS Greater Glasgow & Clyde, NHS Highland, NHS Lanarkshire, NHS Shetland and NHS Tayside.
- Half of the patients started their treatment within 7 weeks, more than 4 out of 5 (81%) being seen within 18 weeks.
- Improving access to services for older people is a key element of the mental health strategy. Over 700 people aged 65 and over started treatment for Psychological Therapies in this quarter and 9 out of 10 (90%) were seen within 18 weeks.
During the quarter ending September 2015:
- 332 eligible patients were screened at an IVF centre in Scotland. This compares to 343 in the quarter ending June 2015.
- 100% of eligible patients were screened for IVF treatment within 365 days (12 months).
- 90.3% of patients waiting for a key Diagnostic test at 30 September 2015 had been waiting less than six weeks. This compares to 89.3% at 30 June 2015 and 91.0% at 30 September 2014.
- 86.1% of patients waiting for a New Outpatient appointment at 30 September 2015 had been waiting 12 weeks or less. This compares to 89.8% at 30 June 2015 and 93.2% at 30 September 2014.
- 87.2% of patients were seen within the 18 week Referral to Treatment standard during month ending 30 September 2015. This compares to 88.3% seen during month ending 30 June 2015 and 89.4% during month ending 30 September 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 978.7 WTE (1134 headcount) as at 30 September 2015.
- The total clinical staff WTE within CAMHS has increased by 28% since 2009.
- The headcount has remained relatively stable over the past year. At 30 September 2015 there were 1134 clinical staff (978.7 WTE). Nationally, this represents a staffing level of 18.3 WTE clinical workers per 100,000 of the population of Scotland.
- An additional 47.4WTE posts throughout NHS Scotland were being advertised. A further 6.3 WTE posts were approved for recruitment but not yet advertised.
- The total number of clinical staff employed in Psychology Services continues to rise annually, with 1049.0 WTE (1257 headcount) including 743.8 WTE (901 headcount) Clinical and Other Applied Psychologists in post at 30 September 2015.
- This total of 743.8 WTE (901 headcount) equates to 686.0 WTE (834 headcount) Clinical Psychologists plus 57.8 WTE (67 headcount) Other Applied Psychologists.
- This represents a substantial increase in Clinical and Other Applied Psychologists employed in Psychology Services workforce over the last 12 years, from 371.0 WTE (426 headcount) in 2003.
- This represents a staffing level of 13.9 WTE Applied Psychologists per 100,000 of the population of Scotland.
- The total of 1049.0 WTE also includes Graduates of the MSc in Psychological Therapies in Primary Care (67.2 WTE), Graduates of the MSc in the Applied Psychology of Children and Young People (40.4 WTE), Cognitive Behavioural Therapists (56.3 WTE), Counsellors (24.8 WTE), other therapists (15.2 WTE), and other clinical staff (27.9 WTE).
- An additional 73.7 WTE posts were in the process of being advertised at 30 September 2015. A further 7.8 WTE posts were approved for recruitment but not yet advertised.
Hospital Bed Days associated with delays in discharge in September 2015
- In September 2015, there were 48,091 days spent in hospital associated with delays in discharge. This is an 8% decrease on the same period last year.
- Nationally, 70% of these bed days are occupied by patients aged 75 and over.
Patients ready for discharge as at October 2015 census
- 1,280 patients were delayed at the October 2015 census. This is a 7% decrease on October 2014. Over a quarter of these delays (340) are for patients with specific complex care needs.
- At the census point, there were 551 patients who were delayed over two weeks. Although this is a 6% reduction on the corresponding period a year ago, this number has been rising since April 2015.
- The main reasons for these delays were: 39% (216) awaiting place availability in a care home; 36% (198) waiting to go home; 11% (60) awaiting a community care assessment
During the week ending 15 November 2015:
- There were 24,198 attendances at Emergency Departments across Scotland.
- 94.4% of attendances at Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 97 (0.4%) patients spent more than 8 hours in an Emergency Department.
- 22 patients (0.1%) spent more than 12 hours in an Emergency Department.
- Over the last ten years, the overall age-standardised cancer (excluding non-melanoma skin cancers) mortality rate has fallen by 11%. Although the rate of death due to cancer has decreased over this period, the actual number of deaths due to cancer has not. 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.
- Over the last ten years, the cancer mortality rate has fallen by 15% for males and 6% for females.
- Lung cancer is the most common cause of death from cancer in Scotland. The number of deaths are more than double that of colorectal cancer, the next most common cause of death from cancer.
- Significant patterns exist when examining incidence and mortality rates by deprivation in Scotland. For all cancers combined, the most deprived areas have incidence rates that are almost a third higher than the least deprived areas. Mortality rates are over two-thirds higher in the most deprived compared with the least deprived areas.
- There is also considerable variation in trends for different types of cancer. For example, the rate of female deaths due to breast cancer has decreased by 20% over the last ten years. For males, the mortality rate due to stomach cancer has decreased by 36% over the last ten years. The mortality rate for cancer of the liver has increased by over 40% for both males and females.
- HPV immunisation uptake rates in Scotland remain high and exceed 80%.
- In 2014/15, 11 of the 14 NHS Boards in Scotland offered girls in S1 one dose of HPV vaccine and uptake by the end of the school year was high at 89.0%.
- In 2014/15, all NHS Boards in Scotland offered girls in S2 the first dose of HPV vaccine and uptake by the end of the school year was high at 91.4%. In seven Boards and part of Fife (West Fife) girls in S2 were also offered the second dose of vaccine during the school year. Uptake of the second dose by the end of the school year was 82.7%.
- For girls who were in S2 in school year 2013/14 (S3 in 2014/15), one year later data shows uptake rates increased to 88.8% for all three doses, 92.5% for two doses and 94.4% for one dose by the end of school year 2014/15.
- The Defined Daily Doses per 10,000 Population per Day (a proxy for patient rates) for alcohol dependency drugs increased from 7.1 in 2005/06 to 9.1 in 2008/09 but has remained relatively stable since. This is in line with the number of patients being dispensed at least one drug for alcohol dependence, which has remained broadly steady over the last six years. In 2014/15 a total of 9,395 patients were prescribed drugs for alcohol dependency.
- Over the last six years treatment with drugs for alcohol dependence has been most common in patients between 45 and 49 years of age. In 2014/15, 72% of patients dispensed drugs for alcohol dependence were aged between 35 and 59. Treatment in younger age groups has generally slightly decreased and in older age groups slightly increased. In 2014/15, 62% of those dispensed drugs for alcohol dependence were male.
- Treatment with drugs for alcohol dependence is much more common in the more deprived areas. In 2014/15, patients living in the most deprived areas were five times more likely to be treated for alcohol dependence compared to the least deprived.
- The HSMR for Scotland has decreased by 15.7% between October-December 2007 and April – June 2015.
- Eight hospitals have shown a reduction in excess of 20%: Balfour Hospital; Crosshouse Hospital; Forth Valley Royal Hospital; Monklands District General Hospital; Ninewells Hospital; Royal Alexandra/Vale of Leven Hospital; Victoria/Queen Margaret Hospital and Wishaw General Hospital.
- Since October-December 2007, there has been a reduction in HSMR in 27 of the 29 hospitals participating in the Scottish Patient Safety Programme (SPSP).
- The Queen Elizabeth University Hospital opened to patients in April 2015, since then services from the Southern General, Victoria Infirmary and Western Infirmary/ Gartnavel have transferred to this new hospital, reducing the number of SPSP hospitals from 31 to 29.
During the week ending 8 November 2015:
- There were 25,302 attendances at Emergency Departments across Scotland.
- 94.4% of attendances at Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 81 (0.3%) patients spent more than 8 hours in an Emergency Department.
- 16 patients (0.1%) spent more than 12 hours in an Emergency Department.
- In 2014 there were 357 patients who received ECT, relating to 434 episodes of treatment.
- The most common diagnosis of patients receiving ECT was depression in the context of both major depressive disorder and its various manifestations.
- The most common indication remains resistance to antidepressant medication (56%). For one in ten patients ECT was administered as an emergency life saving treatment. The majority of treatments involved those patients deemed to have capacity to give informed consent (65%).
- 75% of patients who completed an episode of ECT showed significant improvement.
- 72% of patients with capacity displayed significant improvement following treatment, compared with 82% of the patients who lacked capacity, reflecting the more severe nature of the illness in the latter group at the outset.
- The most frequently recorded side effect remains headache (25%).
- There were a total of 9 critical incidents reported (0.2% of all treatments).