ISD Scotland

Customer Newsletter

February 2010

STI Surveillance Forum

Each year the sexual health team at ISD organises and hosts the STI surveillance system (STISS) forum. The event is designed to give staff working in clinical coding and data entry, and clinical staff, the opportunity to hear about exciting ongoing work in sexual health. Many of the sexual health information outputs from ISD rely on data entered into STISS and the event reminds staff of the value and uses of their efforts.

The seventh annual STISS forum was held on 10 December 2009 in Edinburgh. The event was chaired by ISD's Jim Chalmers who also took attendees through the highlights of the 2009 Scotland's Sexual Health Report (SSHI) report. Andy Winter delivered an update on the National Sexual Health System (NaSH) before attendees broke off into smaller groups to discuss their experiences and thoughts on using NaSH on a day to day basis. The morning session also featured Felicity Naughton from the Scottish Government (on secondment from ISD), who spoke about the recently published HIV Action Plan, and Eunice Sinyemu from HIV Scotland who gave an insight into issues facing those from African and Ethnic minorities living with HIV.

In the afternoon Zareena Rafiq from ISD explained how the Data Augmentation for Sexual Health (DASH) project uses a mystery shopper methodology to assess patients’ experience of accessing Genito-Urinary Medicine (GUM) services in Scotland, and Dr Catherine Mercer from the University of London presented her work on the National Surveys of Sexual Attitudes and Lifestyles. The final workshop of the day was from Jennifer Lawson and Eleanor Parris from the Sexability programme run by the Family Planning Association. The programme offers free courses to young people aged 11-18. These involve interactive workshops, on sex and relationships.

The sexual health team would like to thank all the speakers who presented on the day and all the attendees who participated in the event. If you are interested in attending future STISS forums please contact the Zareena, DASH project manager, by email zareena.rafiq@nhs.net.

SBR could populate Scottish Immunisation Recall System

The Scottish Birth Record (SBR) is a web-based system that captures data securely over the NHS Network. The system aims to collect nationally-consistent data on every birth in Scotland. This is either by direct data entry to the clinical module of the SBR system (in Highland, Islands, Borders, Forth Valley and Dumfries and Galloway - and parts of Greater Glasgow & Clyde), or via import from local maternity information systems. The data is then reviewed by clinical coders, in a coding module of the system, prior to submission to ISD, where it is analysed and made available for local and national management and planning. An interface from SBR allows allocation of Community Health Index (CHI) for newborn babies.

In December the SBR team met with the National User Group for the Scottish Immunisation Recall System (SIRS) to propose an enhanced link between SBR and the Child Health Systems Programme (CHSP) — of which SIRS is part. SBR currently records and stores a small amount of newborn screening information. The screening information forms part of a report which can be printed from the SBR and given to Child Health Departments for them to enter manually onto SIRS. The intention is to create an interface to replace this computer-paper-computer flow and automatically update SIRS with screening data on newborns.

This Month’s Publications

Alcohol-related Hospital Statistics

  • The number of alcohol-related discharges from general acute hospitals in Scotland decreased from 43,045 discharges in 2007/08 to 41,922 discharges in 2008/09.
  • Over the period 2004/05 to 2008/09 the number of alcohol-related discharges from general acute hospitals increased by 9%.
  • In 2008/09 the rate of alcohol-related discharges from general acute hospitals was 6.8 times greater in the most deprived than least deprived group.
  • Harmful use was recorded in 13,964 discharges from general acute hospitals in Scotland during 2008/09.
  • The number of alcohol-related discharges from psychiatric hospitals in Scotland between 2003/04 and 2007/08 decreased by 15%.

Chronic liver disease (ScotPHO website)

  • From 1993 to 2003, there was a sharp increase in chronic liver disease (CLD) mortality rates in both men and women.
  • The highest rise in CLD mortality rates was seen in the 30-39 age groups, with an almost five fold increase since 1984.
  • In the last twenty years there has been a four fold increase in CLD hospital discharge rates in men and threefold increase in discharge rates among women.
  • Among women the largest increase in CLD hospital discharge rates was in the 25-29 age group; with a 7 fold increase between 1984-88 and 2004-2008.
  • Men living in the most deprived areas are 11 times more likely to die from CLD and women six times more likely than those living in the least deprived areas.
  • The CLD mortality rate in Scotland has been increasing steadily over the last 30 yrs in contrast to the majority of European countries where CLD death rates have been decreasing.

Waiting times

  • At 31 December 2009, over 99.9% of new outpatients (GP/GDP referrals only) and over 99.9% of inpatients and day cases were waiting less than the 15-week national standard. This is the statistic used by NHS Boards from 31 December 2007 to measure performance against Scottish Government waiting times standards. The 15-week national standard came into place from 31 March 2009 having previously been set at 18-weeks.
  • At 31 December 2009, over 99.9% of new outpatients (GP/GDP referrals only) and 99.8% of inpatients and day cases were waiting less than 12 weeks. 12 weeks is the new national standard that comes into place from 31 March 2010 (for all referral sources).
  • During quarter ending 31 December 2009, over 99.9% of new outpatients seen and 99.9% of inpatients and day cases treated had waited less than 15 weeks.
  • During quarter ending 31 December 2009, approximately 99.0% of new outpatients (GP/GDP referrals only) seen and 99.2% of inpatients and day cases treated had waited less than 12 weeks.
  • 97.2 % of patients attending Accident and Emergency (A&E) departments in Scotland during the month ending 31 December 2009 were admitted, discharged or transferred within 4 hours against the national standard of 98% within 4 hours.

Cancer Waiting Times

  • 96.0% of reported urgently referred patients diagnosed with cancer in Scotland during July-September 2009 began treatment within 2 months (62 days). This is a small increase from 95.7% in the previous quarter and up from 91.6% in July-September 2007. The target set by the Scottish Government is 95%.
  • The mainland NHS Boards with the highest and lowest proportions of patients starting treatment within 62 days of urgent referral were NHS Borders (100%) and NHS Fife (94.3%) respectively.
  • The cancer types with the highest and lowest proportions of patients starting treatment within 62 days of urgent referral were cancer of the breast (97.3%) and colorectal cancers (93.4%), respectively.
  • NHSScotland met the national target to treat 95% of urgently referred cancer patients within two months for the first time in the reporting period of October to December 2008, and this has continued through all quarters until September 2009

Delayed Discharges

Improving ethnic data collection for equality and diversity monitoring

Key Clinical Indicators for Sexual Health

System Watch

The Health Service in Scotland has been subject to seasonal variation in public demand for medical services. This demand increases particularly during the winter period.

System Watch is a real time web-based system developed to assist with service planning within NHS Scotland by monitoring and predicting activity within hospitals, primary care and other relevant agencies. Data is received weekly from NHS boards, Health Protection Scotland, Scottish Ambulance Service, NHS 24 and General Register Office. Predictions are available one to three weeks ahead and are based on seasonal and weekly variation, current emergency admission activity and flu rates. Information is provided at national, NHS board and hospital levels.

The System Watch team at ISD are initiating a full review and redevelopment of the system which will include examining the process, current prediction model, information and presentation. One of our first steps will be to form a project board, and we would welcome involvement from NHS boards and other relevant organisations. If you are interested, or have any queries about the system, please email nss.isdSYSTEMWATCH@nhs.net.

Please note that System Watch is currently only available to those working in NHSScotland.

Psychological Therapies Access Target

The Scottish Government is currently scoping work around a Psychological Therapies Access target. This work is being led by the Mental Health Division and ISD are leading on the information and development side of this work. Fiona Black from ISD’s Mental Health Programme will be working collaboratively with NHS Education for Scotland (NES) and the Scottish Government to support this initiative. Plans include a Psychological Therapies Workforce Census, which will be held in May this year. The census aims to identify and capture information on the training, activity and supervision of those delivering psychological therapies.

Scoping work is ongoing in advance of the first steering group meeting on 10th March. Initial visits have been held with the Psychological Therapy Training Coordinator and Head of Psychology in a small number of Health Boards to discuss the census and a wider information review. Further meetings and communications are planned over the next few months with the remaining Health Boards and other Senior Managers/Information Leads.

For more information please contact FionaBlack@nhs.net.

Better Data on Heart Attack

The recording of Myocardial Infarction (MI) is important for many purposes, including comparisons of post MI mortality between hospitals, and service planning – e.g. planning levels of provision of cardiac rehabilitation. In the past some hospitals may have appeared to have better post MI survival rates due to the inclusion of patients with less severe heart disease in their MI data.

The introduction of more sensitive tests (i.e. troponin) has meant an increase in numbers being diagnosed as having had an MI. There is a need to distinguish between the more severe type of MI (ST elevated MI- STEMI) and the other type of MI – (non ST elevated MI -NSTEMI), as they have different treatment protocols and prognoses

ISD proposes, with the agreement of the Coronary Heart Disease (CHD) Audit & Indicators Steering Group, to introduce changes to the current coding guidelines to enable these different types of MI to be better distinguished on Scottish Morbidity Record (SMR01) data. The planned implementation date for the new codes is October 2010.

If you have any queries please contact Adam Redpath Tel 0131 275 6704 or email adam.redpath@nhs.net. Instructions and guidance will be circulated by ISD to all relevant stakeholders well in advance.

Customer Survey 2009

Results of the ISD Customer Survey 2009

ISD would like to thank all customers who took time to complete the survey and we are now working on an action plan to make best use of the feedback given. If there are any questions regarding the survey please contact Bill Dunn at w.dunn@nhs.net.

Newsletters

This month also see the release of the Scottish Public Health Observatory (ScotPHO) newsletter.

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