Chamber and committees

In the years from 2007 to 2011, inclusive, no such deaths were registered anywhere in Scotland.

Statistics of deaths in other parts of the United Kingdom are produced by the Office for National Statistics (England and Wales) and the Northern Ireland Statistics and Research Agency. Both organisations make a range of published tables available on their web sites, and both have enquiry points which can be approached for breakdowns that are more detailed than their standard published figures.

The information requested is not held centrally.

The recently published Health Care Needs Assessment (HCNA) on Rheumatoid Arthritis was conducted by the Scottish Public Health Network at the request of Scottish Government. The HCNA outlines current RA service provision across Scotland and makes a number of recommendations that aim to assist NHS Boards to plan and develop services for people living with RA and support them to become more person centred, safe and effective.

The report highlights the role of the multidisciplinary team (MDT) in the management of RA in both the early and chronic disease stages and provides a recommendation for NHS boards that all patients should have access to assessment by a full MDT. The report notes that most rheumatology departments in Scotland now have at least some elements of a multidisciplinary team.

It is for NHS boards to plan and provide services in accordance with national and local priorities, in line with the health needs of their resident populations. NHS boards will need to consider how they will take the recommendations in the HCNA forward.

Figures for hospital stays for rheumatoid arthritis are shown in table 1 and for “juvenile arthritis” in table 2.

Table 1 - Number of Rheumatoid Arthritis Hospital Stays by Financial Years 2007-08 to 2011-12, by Gender and Age Group, based on ICD10 Codes M05 and M06

Source: ISD Scotland SMR01.

^PProvisional - Due to the implementation of new Patient Management Systems by some NHS boards there is known data incompleteness for NHS Grampian in the most recent year. Figures may increase in future revisions.

Table 2 - Number of “Juvenile Arthritis” Hospital Stays by Financial Years 2007-08 to 2011-12, by Gender and Age Group, based on ICD10 Codes M08 Excluding M08.1

Source: ISD Scotland SMR01.

^PProvisional - Due to the implementation of new Patient Management Systems by some NHS boards there is known data incompleteness for NHS Grampian in the most recent year. Figures may increase in future revisions.

Note that the terms used in the World Health Organization International Classification of Diseases (ICD) to code hospital diagnosis do not fully reflect current clinical terminology for arthritis starting in early life. The term “Juvenile Rheumatoid Arthritis” has been replaced in clinical practice by “Juvenile Inflammatory Arthropathy” although no exact code is available for the latter term. Because of these terminological issues the figures provided in table 2 should be treated with caution.

The information requested on how many rheumatology Clinical Nurse Specialists work in NHSScotland is published on the NHS Information Service Division’s website:

http://www.isdscotland.org/Health-Topics/Workforce/Publications/2011-11-29/Clinical_Nurse_Specialist_S2011.xls?92532856.

It is for each NHS board to decide how best to meet the needs of their population. This includes how best to utilise funding, facilities and staff, while taking account of national and local priorities, to meet local needs. This of course applies to how many rheumatology clinical nurse specialists the NHS boards employ in 2013.

The information requested is available from the Scottish Parliament Information Centre (Bib. number 54426). The table covers all deaths, registered in Scotland, for which the underlying cause was classified as adult rheumatoid arthritis.

The figures in the table do not include deaths for which the underlying cause was classified as juvenile rheumatoid arthritis (which is recognised as a separate clinical condition, clearly distinct from adult rheumatoid arthritis). One such death was registered in those five years: a female, aged over 40, in Dumfries and Galloway, in 2009.

It is important to note that the number of deaths for which the underlying cause was classified as rheumatoid arthritis is believed to underestimate substantially the true number of deaths which result from rheumatoid arthritis. This underestimation arises because having rheumatoid arthritis substantially increases the risk of cardiovascular disease and infection. However, when people die from those causes, rheumatoid arthritis may not be mentioned on their death certificates (for example, because the doctors who certify their deaths may be unaware that they had rheumatoid arthritis). As a result, it is not possible to provide comprehensive figures of the total number of deaths to which rheumatoid arthritis may have contributed.

The Scottish Centre for Healthy Working Lives is funded to provide advice to employers to promote health, safety and wellbeing in the workplace. The Centre is able to advise employers on the measures they can take to support employees with a range of health conditions or disabilities including arthritis.

The number (headcount) of Clinical Nurse Specialists within the specialty of Rheumatology as at 30 September 2011 is detailed in the following table:

NHS boards have not received a reduction in funding from the Scottish Government.

GPs receive updates and training on advances in dealing with fertility problems through medical journals, evidence based update courses provided by the Royal College of General Practitioners, and British Medical Journal learning courses. NHS boards provide GPs with information on what services are provided locally, based on national criteria developed by the Expert Advisory Group on Infertility Services in Scotland (EAGISS) in 2000, and the recommendations of the 2007 review.

The National Infertility Group will make recommendations to Ministers, including an update on eligibility criteria, by the end of December 2012.

Guidance for NHS boards, replacing A National Service Framework for The Care of Infertile Couples in Scotland, will be produced in due course.

This information is not collected centrally in Scotland.