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?
ISD are delighted to be taking part in #DataFest17 this week. It is a festival of data innovation hosted across Scotland from 20th-24 March 2017. Find out more at http://www.datafest.global/
[20 March 2017]
Stress Urinary Incontinence and Pelvic Organ Prolapse
A study looking at patient outcomes after vaginal mesh surgery for stress urinary incontinence and pelvic organ prolapse has been published in The Lancet. The study was led by ISD in conjunction with doctors and academics from across Scotland.
Further information on the study
[28 March 2017]
NHS Performs - Latest update
NHS Performs has been updated to include information on:
- Emergency Department activity for the week ending 19 March 2017
- Numbers of hospital wards closed with confirmed or presumed Norovirus infections on 20 March 2017
- Cancer Waiting Times October - December 2016
- Hospital Beds October - December 2016
NHS Performs is a website which brings together a range of information on how hospitals and NHS Boards within NHSScotland are performing. It aims to provide this information in an easy to access, clear and understandable way.
[28 March 2017]
- There were around 2.8 million emergency and urgent care patient journeys across Scotland in the year ending March 2016. This equates to around 5 million separate contacts with NHS 24, OOH Primary Care, SAS, A&E and Emergency Inpatient services.
- Three quarters of the activity for NHS 24, OOH Primary Care, SAS and A&E took place in the out of hours period. The out of hours period is defined as 6pm to 8 am, Monday to Friday and all day Saturday and Sunday.
- Children under five accounted for around one in ten of all contacts with all emergency and urgent care services.
- Around twice as many contacts were made to emergency and urgent care services by individuals living in Scotland’s most deprived areas compared to the least deprived.
- Females in age groups 15 through to 30 were twice as likely to contact NHS 24 and OOH Primary Care services as males.
- In the year ending March 2016, the most common patient journey involved self referrals to A&E with no subsequent contact with emergency/urgent care services within 24 hours (27%).
- Around a quarter of patient journeys starting in the OOH period involved a single contact with NHS 24 followed by a contact with OOH Primary Care. A further one in five journeys involved a single contact with either NHS 24 or OOH Primary Care.
The 62 Day Standard is that 95% of patients urgently referred with a suspicion of cancer will wait a maximum of 62 days from referral to first cancer treatment
- 87.5% of patients started treatment within the 62 day standard, compared to 87.1% in the previous quarter.
- The 62 day standard was met by five NHS Boards (NHS Borders, NHS Dumfries & Galloway, NHS Lanarkshire, NHS Orkney and NHS Shetland).
The 31 Day Standard is that 95% of all patients will wait no more than 31 days from decision to treat to first cancer treatment
- 94.1% of patients started treatment within the 31 day standard, a slight decrease from 94.3% in the previous quarter.
- The 31 day standard was met by 11 of 15 NHS Boards.
- The quarterly trend over the past two years shows a high proportion of people receiving early access for their first drug or alcohol treatment. Of the 10,322 people who started their first treatment in the most recent quarter, 95.0% waited three weeks or less. More than half (55.3%) started their first treatment within one week of referral.
- For the 6,259 people seeking alcohol treatment, 95.2% waited three weeks or less.
- For the 4,063 people seeking drug treatment, 94.6% waited three weeks or less.
- There has been little change in the waiting times performance of both drug and alcohol treatment in the last 2 years.
- All NHS Boards, except NHS Borders, NHS Highland and NHS Lothian met the Scottish Government’s standard.
- At the end of this quarter, 2,370 people were waiting to start their first drug or alcohol treatment, of which 190 (8.0%) had been waiting more than six weeks. This is an increase from the same quarter last year when 143 (5.8%) people were waiting more than six weeks.
- In prisons, 1,136 people started their first drug or alcohol treatment between October-December 2016, with 96.8% waiting three weeks or less and 75.3% waiting one week or less.
- There were 1,366 people diagnosed with Upper GI cancer in Scotland during 2015.
- The target for the mortality rate 30 days following surgery is to be below 10%. Overall in Scotland, in each of the three years this was achieved. In 2015, for example, the percentage of patients who died within 30 days of surgery was 1.3% for gastric cancer and 3.4% for oesophageal cancer.
- For patients diagnosed in Scotland between 2012 and 2014, the estimated three year survival rate for patients aged 15-44 with oesophageal cancer is 29%. As with many other types of cancer, including gastric cancer, survival rates decrease sharply with increasing age.
- Immunisation uptake rates for children in Scotland remained high in 2016.
- Uptake rates by 12 months of age for complete primary courses of immunisation against diphtheria, tetanus, pertussis (whooping cough), polio and Hib (the five-in-one vaccine), MenC and PCV were above 96%.
- Although vaccine uptake by 12 months was high in the most deprived areas, the rates were slightly lower in these areas compared to the least deprived areas.
- The national target is for 95% uptake of one dose of the MMR vaccine by five years of age, with a supplementary measure at 24 months. In 2016, annual uptake of one dose of MMR vaccine by 24 months of age decreased slightly to 94.9%. Uptake of one dose by five years of age was 96.8%. Uptake rates of one dose of MMR by five years have remained above the 95% target since 2009.
- Quarterly uptake of the MenB vaccine by 12 months of age has increased from 94.5% to 95.8%. This was the second full quarter where data were available.
- There were 1,029,730 total outpatient attendances in the quarter ending December 2016, a slight decrease on the quarter ending December 2015 (1,091,724), with an 11.4% increase in the last five years.
- Of the total outpatient attendances, there were 356,257 new attendances and 673,473 follow-up attendances.
- Less than one in ten patients did not attend their first outpatient appointment, which is a slight reduction compared to the same quarter in 2015.
Inpatient and day case discharges
- In total there were 401,412 acute inpatient, day case episodes of care and transfers recorded in the quarter ending December 2016. This is a decrease of 3.2 % from 414,592 in quarter ending December 2015.
- Driven by changes in recording practices and service redesign to the emergency care services in some NHS Boards the number of transfers have increased by 1.3% to 104,518 episodes compared to the quarter ending December 2015.
- There were on average 15,495 available staffed beds for all acute specialties in December 2016. This is a decrease of 0.7% since the quarter ending December 2015.
Compared to financial year 2014-2015:
- In 2015/16, the total cost of General Dental Services and Public Dental Services in Scotland increased by 1.8% to £402.1m.
- Total payments made to dentists increased by 3.0% to £349.5m.
- Costs of dental registration fees for both children and adults increased by 2.1% and 4.3% respectively. This is due to fee increases and to higher numbers of patients registered.
- The total cost of treatment fees increased by 1.0% to £125.8m. However, this is due to a feescale increase of 1.6%; numbers of treatments provided continue to decrease year on year.
- Due to changes in superannuation contribution rated for NHS employers there was a further increase in costs to NHS Boards.
- At 31 March 2016, 17.6% of the population of Scotland (946,804 people) were registered for MAS.
- The service dispensed over 2.1 million items with a total value of £5.1 million, similar to the previous two years. This accounted for 2.2% of all items dispensed by community pharmacies in Scotland.
- The most common drug dispensed was paracetamol, which accounted for 21.5% of items.
- By 31 March 2016 every community pharmacy in Scotland had patients registered for the service. Registrations increased by 3.6% between 2014/15 and 2015/16.
During the week ending 19 March 2017:
- There were 26,086 attendances at Emergency Departments across Scotland.
- 92.9% of people attending Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 151 (0.6%) spent more than 8 hours in an Emergency Department.
- 26 patients (0.1%) spent more than 12 hours in an Emergency Department.
The information from this publication is included in NHS Performs.
The Information Services Division has released data up to 31 December 2016 in the Child and Adolescent Mental Health Service (CAMHS) Benchmarking Toolkit.The CAMHS benchmarking toolkit aims to support the implementation of the Child and Adolescent Mental Health policy using national data benchmarking of CAMH services across Scotland. The toolkit contains information on waiting times for CAMHS, workforce statistics, inpatient admissions and inpatient bed days.
- Over half (54.0%) of the 73,907 patients who had a first clinical appointment with an AHP MSK service were seen within 4 weeks. This is an increase compared to quarter ending 30 September 2016 when 52.5% of patients were seen within 4 weeks.
- Nine out of ten patients were seen within 18 weeks.
- 86,913 people were referred to AHP MSK services compared to 96,775 for the quarter ending 30 September 2016.
- In the quarter ending 31 December 2016, 8.1% adults did not attend their out-patient appointment for AHP MSK services.
During the week ending 12 March 2017:
- There were 26,087 attendances at Emergency Departments across Scotland.
- 92.2% of people attending Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 147 (0.6%) spent more than 8 hours in an Emergency Department.
- 21 patients (0.1%) spent more than 12 hours in an Emergency Department.
The information from this publication is included in NHS Performs.
Discharges for mental health conditions in all hospital wards
- Mental health discharges have reached over 39,000 for the first time since 1998/99.
- For the first time, in 2015/16 mental health discharges from non-psychiatric specialties were higher than those in psychiatric specialties.
- Since 1997/98 there has been an increase of over 5,000 people discharged with symptoms of ‘delirium’ from 225 in 1997/98 to 5,631 in 2015/16 this may be explained in part due to an aging population and better data recording.
- Discharges for ‘mental and behavioural disorders due to psychoactive substance use’ have almost doubled (from 5,334 in 1997/98 to 10,298 in 2015/16).
- In 2015/16, people living in the most deprived areas were around four times more likely to experience psychiatric inpatient care than people living in the least deprived areas.
Patients treated in the Learning Disability specialty
- Discharges from the Learning Disability specialty fell sharply from around 4,700 to around 1,700, between 1997/98 and 2005/06, but have started to level out in more recent years.
- People in the most deprived areas were more than four times as likely to experience an episode of inpatient care in the Learning Disability specialty, than those living in the least deprived areas.
The data extract is presented as downloadable text (.csv) file and covers practice level prescribing for the month of December 2016. A dashboard will also available to enable preview the data without downloading the large file. The data extract will also feed into existing dashboards which present historical data already published elsewhere on the ISD website (in the February 2017 Summary stats dashboard).
- Twelve out of fourteen NHS Boards conduct pain clinics and submit data for patients seen based on the 18 weeks RTT Standard.
- As at 31 December 2016, there were 4,771 referrals to a pain clinic, a decrease from 5,235 referrals in the previous quarter. Out of these, 4,172 referrals were accepted.
- Six of the twelve NHS Boards saw over nine out of ten patients within 18 weeks. NHS Dumfries & Galloway, NHS Fife, NHS Lanarkshire, NHS Lothian, & NHS Shetland saw all their patients within 18 weeks.
- The other six NHS Boards did not meet the standard.
- 12.4% of patients did not attend their appointment and did not notify the hospital.
Pain Psychology Clinics
Ten NHS Boards provide this service.
- Among the six Boards which submit data for patients seen based on the 18 weeks RTT Standard, 91.7% of the 252 patients seen this quarter were treated within 18 weeks. This figure has seen little change over the past 5 quarters.
During the week ending 5 March 2017:
- There were 25,589 attendances at Emergency Departments across Scotland.
- 90.7% of people attending Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 301 (1.2%) spent more than 8 hours in an Emergency Department.
- 63 patients (0.2%) spent more than 12 hours in an Emergency Department.
The information from this publication is included in NHS Performs.
- Unintentional injuries accounted for approximately 1 in 10 emergency hospital admissions for adults and 1 in 8 for children in 2015/16.
- Those from the most deprived areas were more likely than those from the least deprived areas to have an unintentional injury.
- 84% of unintentional injuries in those aged 65 and over were due to falls.
- Assaults have decreased: there were 2,413 emergency admissions to hospital resulting from assault in 2015/16, a decrease of almost 55% over the past ten years.
- Emergency hospital admissions for unintentional injuries have increased by 2% over the past ten years: in 2015/16 there were 55,547 compared to 54,393 in 2006/07.
- In 2015 there were 1,892 deaths in Scotland due to unintentional injury; 18 in children under the age of 15 and 1,874 in those aged 15 and over.
Key Performance Indicator results year ending 31 March 2016
- Uptake of the screening programme was high with 84% of men in Scotland tested before age 66 and 3 months, well above the essential target of 70%. All NHS Boards achieved an uptake rate of 80% or higher.
- Uptake of screening was lower in the most deprived areas. The essential target of 70% uptake was met in all deprivation quintiles.
- 72% of men referred to vascular specialist services for assessment were seen within two weeks, slightly below the essential target of 75%.
- 28% of the men assessed by vascular specialist services as appropriate for aneurysm repair surgery were operated on by a vascular specialist within eight weeks. This was substantially below the essential target of 60%.
- Since the programme began in June 2012, the 30-day mortality rate following planned open aneurysm repair surgery was 2.5% and following Endovascular Aneurysm Repair (EVAR) was 0%. These met the essential and desirable targets.
- The screening programme in Scotland met or exceeded the essential target in 10 of the 12 performance indicators.
Screening tests and results to 31 March 2016
- Since the programme began over 87,500 of men eligible for screening have been tested and over 1,300 (1.5%) men had an aneurysm detected. In addition, over 4,000 men self-referred into the programme and were tested.
As at 31 December 2016:
- The number of staff employed by NHSScotland continues to increase gradually. The headcount of 162,302 staff represents a rise of 0.5% over the last year. Adjusting for part time working, the WTE has risen by 0.7% to 139,262.0. Over the last 10 years the WTE has risen by 9.6%.
- There were 5,170.3 WTE medical and dental consultants in post, an increase of 1.7% (88.2 WTE) since December 2015 and a reported 42.6% (1,545.7 WTE) since September 2006. Over the last 10 years the greatest percentage increases were reported in emergency medicine (185.1%) and paediatric specialties (84.0%), while medical specialties account for the greatest increase in number (448.6 WTE).
- 6.8% (377.0 WTE) of consultant posts were vacant. This compares to 6.0% at 31 December 2015 and 7.0% at 30 September 2016. Of these vacancies, 180.9 WTE were vacant for more than six months, an increase of 34.0 WTE since 31 December 2015 but a slight decrease of 2.6 WTE since 30 September 2016.
- There were 59,709.1 WTE nursing and midwifery staff in post, an increase of 0.7% (421.7 WTE) from December 2015. Over the last 10 years, the overall WTE has increased by 5.2% and the proportion of qualified staff has increased from 72.2% to 73.5%.
- 4.1% (2,525.5 WTE) of nursing and midwifery posts were vacant. This compares to 3.6% at 31 December 2015 and 4.3% at 30 September 2016. Of these vacancies, 736.5 WTE were vacant for 3 months or more, an increase of 185.4 WTE since 31 December 2015 but a decrease of 88.1 WTE since 30 September 2016.
- At 31 December 2016, 1,080.3 WTE (1,305 headcount) clinical staff were in post within psychology services in NHSScotland. This is an increase of around 165% since data collection began in 2001. However there has been little change to the size of this workforce over the last two years.
- Clinical psychologists still remain the largest staff group within this workforce with 716.5 WTE in post at this census compared to 311.0 WTE at 30 September 2001 – an increase of 57% However, there has also been little change to the size of this group over the last two years.
- Since quarterly data collection began in September 2011, the WTE of posts reported as vacant has remained relatively stable (see Figure 7). At 31 December 2016, 69.7 WTE posts were in the process of being advertised, equating to a 6.1% vacancy rate.
- Since this data collection began in 2006, there has been a 49.1% increase in the CAMHS workforce from 653.7 WTE (741 headcount) to 974.7 WTE (1,141 headcount) as at 31 December 2016. WTE and headcount have remained stable since March 2015.
- Nationally, there is an average staffing level of 18.1 WTE clinical workers per 100,000 of the population of Scotland at 31 December 2016. An additional 100.3 WTE clinical workers in post would be required to reach the overall target of 20 WTE clinical workers per 100,000 of the total population, a target set by the Scottish Government in 2005/06 that was to be achieved by the end 2016.
- At 31 December 2016, 26.0 WTE (2.6%) posts were vacant and in the process of being advertised. Including these posts, the CAMHS workforce would be 1,000.7 WTE, equivalent to a staffing level of 18.6 WTE clinical workers per 100,000 of Scotland’s population.
- 11,234 people started treatment for Psychological Therapies in Scotland which is an increase from the previous quarter (11,164) and a decrease from quarter ending December 2015 (13,161).
- Just under eight out of ten (77.5%) patients were seen within 18 weeks which compares with 79.6% in the previous quarter and 83.5% for the quarter ending December 2015.
- Two NHS Boards met the standard of treating 90% of patients referred within 18 weeks - these were NHS Lanarkshire and NHS Western Isles. Data completeness for NHS Greater Glasgow and Clyde and NHS Highland are below 50% due to IT system changes; no conclusions can be drawn from their data. Revised figures will be published on completion of IT changes, therefore, Scotland figures will change.
- 580 people aged 65 and over started treatment for Psychological Therapies in this quarter and 87.9% were seen within 18 weeks which is a decrease from the previous quarter (617) and quarter ending December 2015 (704).