ISD Scotland

Customer Newsletter

August 2010

ISD Consultant Awarded International Research Prize

David Conway, Consultant in Public Health Dentistry was awarded the Hatton Senior Clinical Research prize at the International Association for Dental Research (IADR) meeting in Barcelona in July. The prize was awarded for David’s presentation entitled "Socioeconomic Risk Factors Associated with Upper Aerodigestive Tract Cancer", part of his work on inequalities within the Alcohol-related cancers and genetic susceptibility in Europe (ARCAGE) study.

Assessment of ISD Statistical Publications

Following on from the successful UK Statistics Authority (UKSA) assessments of ISD's Cancer, Cancer Screening and Workforce statistics, the assessment of ISD's Waiting Times statistics has now been published on the UKSA website (see report 55).

The UKSA confirm that 'Waiting Times and Waiting Lists' statistics continues to be designated with the ‘National Statistics’ kite mark. At the request of ISD, 'A&E Waiting Times' and 'Diagnostic Tests and Investigations Waiting Times' where also assessed. We are delighted that the UKSA also confirm that, subject to a small number of requirements, these previously development statistics have now been designated as ‘National Statistics’.

This demonstrates that the statistics meet the standards set out in the UKSA’s 'Code of Practice for Official Statistics'. The National Statistics kite mark is an assurance that statistics are produced and explained to a high standard and serve the public good.

We feel that this positive assessment is due in part to close working between ISD's Waiting Times Programme and the users of statistics in NHS Boards, Scottish Government and elsewhere in the service.

You can get more information about waiting times statistics from the Waiting Times Programme webpages.

You can get more information about ISD and Official Statistics from the ISD website.

Lean in ISD

Since March of this year, ISD have been engaged in a programme of process improvement using Lean.  The first two areas looked at were the SMR01 dataset and Practice Team Information.  For both areas, the processes were extensively mapped, inefficiencies identified and solutions proposed.  During a “rapid improvement” week held in June, both teams then developed the proposed solutions, implemented them and have since been measuring the changes to ensure that they have been sustained.

As a result of eliminating delays and improving process efficiencies, the teams have freed up a significant amount of time and have used this to start on new work for the Scottish Ambulance Service and NHS Tayside. Their new processes will also improve our service to customers by provision of more timely data and Information Requests, application of best practice and hence a more consistent approach across ISD and design of more fit-for-purpose reports.

In addition to these projects, several other projects are currently ongoing in ISD involving the following areas:

  • Prescribing
  • System Watch
  • Clinical Trial Standard Operating Procedure Review
  • Workforce and Resources
  • Warehouse Analysis

A further update as to the benefits of these ongoing projects will be given in the next newsletter.  As we develop our Lean capability and experience, we would aim to extend participation in our improvement projects to include our customers and hence, improve still further the positive impact of any changes we make, on you.

For further information on the Lean project in ISD contact Fiona Murphy on fiona.murphy1@nhs.net.

Maternity and Neonatal Information

Linking administrative health records held within ISD has evolved over the years primarily due to advances in technology and the enthusiasm people have for turning data into intelligence. As part of this evolution ISD has created permanently 'linked' dynamic datasets. One of these datasets is known as the Maternity and Neonatal linked dataset and holds information from 1975 to the present.

All records on the maternity and neonatal file are linked via the mother record, with each year's SMR02 (Obstetric) records progressively linked to the existing SMR02 records on the database. This creates a file with each mother's maternity records grouped together. SMR11 (neonatal information up to 2002), SBR (Scottish Birth Record, from 2003), SSBID (Scottish Stillbirth and Infant Death Survey), GRO Birth and Stillbirth registration records are then linked to the SMR02 records, which provides the baby information for each pregnancy in the group.

This linked dataset provides a wealth of information relating to pregnancy, delivery and the baby's first few months of life. It is analysed for research, epidemiology, clinical audit and improvement of care for expectant mothers and babies. Research topics vary greatly: from examining the risk associated with induction of labour at different gestations, to pregnancy outcomes and maternal cardiovascular risk. Work from the programme has resulted in a number of recent publications, including:

Risk of Skin Cancer after Phototherapy for Neonatal Jaundice: Retrospective Cohort Study. David H Brewster, Janet S Tucker, Michael Fleming, Carole Morris, Diane L Stockton, David J Lloyd, Sohinee Bhattacharya & James WT Chalmers. Archives of Disease in Childhood, June 2010

Time of birth and risk of neonatal death at term: retrospective cohort study. Dharmintra Pasupathy, Angela M Wood, Jill P Pell, Michael Fleming, and Gordon C S Smith. BMJ July 2010;

The Effect of Changing Patterns of Obstetric Care in Scotland (1980–2004) on Rates of Preterm Birth. Norman JE, Morris C, Chalmers J.PLoS Med (2009).

Child Health

The National Managed Clinical Network (NMCN) for Children with Exceptional Healthcare Needs (CEN) is funded by the Scottish Government as part of the National Delivery Plan to develop and improve the care of children with highly complex needs, e.g. a range of physical disabilities and requirements for ongoing feeding and/or respiratory support.

Members of the Child Health team have been working with Dr Pat Jackson, Lead Clinician for the NMCN CEN, to produce baseline statistics on the characteristics (e.g. demographics, household composition, diagnosis, support services in place) of children who meet the ‘exceptional healthcare needs’ criteria, from data held on the Support Needs System. These statistics will be updated on an annual basis and will be used to inform services planning for this group of children and to monitor the impact of the NMCN CEN.

Review of Information on Dependency and Care Needs

Since 1995 ISD have been collecting data to measure the dependency and care needs of older people in continuing care hospital facilities via the Scottish Health Resource Utilisation Groups (SHRUGs) data collection system.

The data was collected on an ongoing annual basis by trained ISD interviewers who visited facilities throughout Scotland and the data published annually in the Older Peoples Statistical Report (pdf). 

However, the numbers of patients in this target group have diminished over the years, largely because of the policy drive towards more care delivered in community settings. In view of this, and as part of ISDs ongoing process of rationalising and modernising its information collection processes, ISD are currently undertaking a consultation of users to determine the customer, use, benefit and value of measuring the dependency & care needs of older people in long stay care. If the outcome of the consultation indicates a continued requirement for this type of information ISD will explore the most efficient and effective way of collecting the data.

While the consultation is ongoing ISD have currently no immediate plans to undertake further SHRUGs interviews.

If you would like more information about the consultation please contact margaret.quinn@nhs.net

Information Governance – Annual Conference

The Annual Conference of the NHS Scotland Information Governance Programme takes place on 8 September 2010 at the Holiday Inn,Corstorphine Road, Edinburgh. The Conference,  entitled Challenging Myths - Managing Risks, will feature a range of workshops covering topics such as:

  • Managing Risks;
  • Carrying Out an Audit
  • Return on Investment
  • Professionalism in Information Governance

For further information or to request a booking form please email to nss.infogov@nhs.net.

Recent Publications

Cancer Survival in Scotland

  • Survival from cancer has, in general, increased between the periods of 1983-1987 and 2003-2007: 18 percentage points increase in males and almost 15 percentage points in females when looking at all cancers combined
  • Taking all cancers combined, five year relative survival in the period 2003-2007 is estimated as 46% for males and 54% for females.
  • The largest absolute increases in survival are found in breast, prostate and colorectal cancers, malignant melanoma of the skin and in lymphomas and leukaemias.
  • There is variability (random variation) in the numbers of events observed by location and over time.  The smaller the group of patients at risk of dying, the greater the variability in actual deaths seen when measured over fixed periods of time.
  • Inaccurate recording of information in hospital records, or errors in the coding of information, for example the main diagnosis, can lead to the over- or under-estimation of the number of deaths which would be expected for a hospital.  ISD seeks to avoid this by undertaking regular surveys of data quality in all NHS Boards and provides training in clinical coding

Hospital Standardised Mortality Ratios – Quarterly Statistics

  • The data suggest that hospital mortality across Scotland is largely reducing over time.
  • No hospital had mortality which was significantly higher than predicted given the patients and conditions seen there and relative to the Oct 06 – September 07 baseline.
  • A single apparently high value of the HSMR is not sufficient evidence on which to conclude that a poor quality or unsafe service is being provided
  • There is variability (random variation) in the numbers of events observed by location and over time.  The smaller the group of patients at risk of dying, the greater the variability in actual deaths seen when measured over fixed periods of time.
  • Inaccurate recording of information in hospital records, or errors in the coding of information, for example the main diagnosis, can lead to the over- or under-estimation of the number of deaths which would be expected for a hospital.  ISD seeks to avoid this by undertaking regular surveys of data quality in all NHS Boards and provides training in clinical coding.

Births in Scottish hospitals, financial year 2008/2009

  • The number of births in Scotland is increasing
  • There was a steady increase in the proportion of births to mothers aged 30-34, from 13% in 1976 to a peak of 31% in 2002 but this has now declined slightly to 26.5% in 2009. There has also been a steady rise in the proportion of births to women aged 35-39, from 5% in 1976 to 17% in each of the last 4 years.

Waiting times and waiting lists to 30 June 2010 (monthly and quarterly data)

  • At 30 June 2010, approximately 99.9% of new outpatients (all sources of referral) had been waiting 12 weeks or less. 
  • At 30 June 2010, approximately 99.9% of inpatients and day cases were waiting less than the 12-week national standard.

Dental Statistics – Publication reports on Registrations and Fees & Treatments.

  • The percentage of the Scottish population registered with an NHS GDS dentist was 69.0% (all ages) as at 31st March 2010 and 70.1% (all ages) as at 30th June 2010. Overall, there was a 0.8 percentage point decrease from 31st December 2009 to 31st March 2010, followed by a 1.1 percentage point increase from 31st March 2010 to 30th June 2010. [These figures are based on an improved methodology which has removed deceased and duplicate patient records and allowed for reporting by patient residence postcode ].

Suicide Statistics 2009

Suicide is a leading cause of mortality among young people and Scotland’s suicide rate is higher than in other parts of the UK.

  • There were 746 deaths by suicide in Scotland in 2009 (deaths from intentional self harm and events of undetermined intent). This is a reduction on the 2008 figure, and equates to an age-sex-standardised rate for 2009 of 14.2 per 100,000 population. 
  • Based on three-year rolling averages there was a 13% fall in suicide rates between 2000-02 and 2007-09 in men and a 7% fall in women. 
    In 2009, the suicide rate for males was just under three times that for females.
  • Suicide rates generally increased with increasing deprivation, with rates in the most deprived 30% of areas of Scotlandsignificantly higher than the Scottish average. This rate remains approximately four times higher in the most deprived area compared to the least deprived area.
  • Between 2000-04 and 2005-09, the suicide rate decreased in 10 of the 14 NHS Boards and in 22 of the 32 local authorities.

Scottish Bowel Screening Programme Statistics (November 2007 to end October 2009)

Scottish Cervical Screening Programme Statistics 2009/2010

Influenza Update 2009/10

Audiology Waiting Times to 30 June 2010 (monthly and quarterly data)

A&E waiting times to 30 June 2010 (monthly and quarterly data)

Diagnostic waiting times to 30 June 2010 (monthly and quarterly data)

Genito-urinary Medicine Statistics, year ending December 2009

Delayed Discharges in NHSScotland (formerly Patients Ready for Discharge) figures from the July 2010 Census

Improving ethnic data collection for equality and diversity monitoring

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