Questions and answers

Question reference: S3W-39323

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive whether it will confirm that, in comparing the draft budget for 2011-12 with that for 2010-11, £95 million less is budgeted for the NHS boards and Special Health Boards.

Within the 2011-12 draft budget document, the revenue budget for NHS boards and Special Health Boards will increase by £223.5 million compared to 2010-11. The 2010-11 position has been restated to reflect transfers in respect of the removal of the cost of capital (following revised HM Treasury guidance), transfer of funding in respect of Adult Support and Protection Act to local government and other corporate transfers.

Figures in the 2010-11 Draft Budget and the 2011-12 Draft Budget are not directly comparable due to the reasons stated above and therefore a more valid comparison is to use the prior year figure included in the current budget.

Question reference: S3W-39317

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive for what reason there is no target to tackle NHS staff sickness absence in the draft budget for 2011-12.

The draft budget includes a priority to support NHSScotland to achieve productivity and efficiency gains without compromising quality through the implementation of the new efficiency and productivity plan.

The Local Delivery Plan Guidance 2011-12 sets out the agreed HEAT targets and standards for NHSScotland at:

http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/17273/LDPGuidancePDF201112.

These HEAT targets and standards support the budgetary process.

NHS boards'' local delivery plan for 2011-12 will include the HEAT national standard to achieve a sickness absence rate of 4% from 31 March 2009.

The Scottish Government published its refreshed NHSScotland Efficiency and Productivity Framework in February 2011. This has set out the full range of actions that the Scottish Government will undertake to support NHS boards.

Performance against the sickness absence standard is published by ISD at http://www.isdscotland.org/isd/5380.html#Sickness_absence and considered at NHS boards'' annual reviews.

Question reference: S3W-39319

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive for what reason there is no accident and emergency waiting time target in the draft budget for 2011-12.

The target for 98% of patients to wait less than four hours from arrival to admission, discharge or transfer for accident and emergency treatment was effectively delivered in December 2007. The proportion of patients dealt with within four hours increasing from 84 per cent in April 2006 to 98 per cent in December 2007. The latest annual performance for 2009/10 was 97.4%.

The Local Delivery Plan Guidance 2011-12 sets out the agreed HEAT targets and standards for NHSScotland at:

http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/17273/LDPGuidancePDF201112.

These HEAT targets and standards support the budgetary process.

NHS boards'' local delivery plan for 2011-12 will include the HEAT national standard that 98% of patients will wait less than 4 hours from arrival to admission, discharge or transfer for accident and emergency treatment.

Performance against this standard is published by ISD at http://www.isdscotland.org/isd/4024.html and considered at the NHS boards'' annual reviews.

Question reference: S3W-39328

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive whether, in the draft budget for 2011-12 for health and sport, the workforce budget line has decreased by 17.2% and the nursing budget line by 7% compared with the draft budget for 2010-11.

Figures in the 2010-11 Draft Budget and the 2011-12 Draft Budget are not directly comparable.

The 2010-11 position has been restated to reflect transfers in respect of the removal of the cost of capital (following revised HM Treasury guidance), transfer of funding in respect of Adult Support and Protection Act to local government and other corporate transfers, therefore a more valid comparison is to use the prior year figure included in the current budget.

2011-12 Draft Budget	2010-11	2011-12	Increase
	£ million	£ million
Workforce	25.9	28.5	+10.0%
Nursing	150.1	150.4	+0.2%

Question reference: S3W-39314

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive for what reason it has reduced, in the draft budget for 2011-12, the increase planned for eHealth for 2010-11.

The 2010-11 budget includes one-off planned expenditure which reflected a phased profile of expenditure over the three year period covered by the 2007 Spending Review. In the 2011-12 Draft Budget the one-off planned expenditure has been removed from the restated 2010-11 position.

The 2011-12 settlement has been agreed by the eHealth Strategy Board. The investment budget is sufficient to meet the agreed strategic priorities over 2011-14.

Question reference: S3W-39326

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive whether it will confirm that, when comparing the draft budgets for 2011-12 and 2010-11 for health and sport, spending plans for education and training are reduced at a proportionally higher rate under the workforce line than the nursing line.

Figures in the 2010-11 Draft Budget and the 2011-12 Draft Budget are not directly comparable.

The 2010-11 position has been restated to reflect transfers in respect of the removal of the cost of capital (following revised HM Treasury guidance), transfer of funding in respect of Adult Support and Protection Act to local government and other corporate transfers, therefore a more valid comparison is to use the prior year figure included in the current budget.

2011-12 Draft Budget	2010-11	2011-12	Increase
	£ million	£ million
Workforce	25.9	28.5	+10.0%
Nursing	150.1	150.4	+0.2%

Question reference: S3W-39316

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive for what reason only four HEAT targets in the 2011-12 draft budget correlate with the Scottish Government’s performance indicators.

The Local Delivery Plan Guidance 2011-12 sets out the HEAT targets (http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/17273/LDPGuidancePDF201112).

HEAT targets are designed to support delivery of the National Performance Framework. The following table set out the national indicators that are supported by HEAT targets.

National Indicator	HEAT Target Demonstrating NHS Contribution to National Indicator
Increase healthy life expectancy at birth in the most deprived areas	Majority of targets
Reduce alcohol related hospital admissions by 2011	Achieve agreed number of screenings using the setting-appropriate screening tool and appropriate alcohol brief intervention, in line with SIGN 74 guidelines during 2011-12. By March 2013, 90% of clients will wait no longer than 3 weeks from referral received to appropriate drug or alcohol treatment that supports their recovery.
Reduce mortality from coronary heart disease among the under 75s in deprived areas	Achieve agreed number of inequalities targeted cardiovascular Health Checks during 2011-12. NHSScotland to deliver universal smoking cessation services to achieve at least 80,000 successful quits (at one month post quit) including 48,000 in the 40% most-deprived within-Board SIMD areas over the three years ending March 2014.
Reduce the rate of increase in the proportion of children with their Body Mass Index outwith a healthy range by 2018	Achieve agreed completion rates for child healthy weight intervention programme over the three years ending March 2014.
Reduce the percentage of the adult population who smoke to 22% by 2010	NHSScotland to deliver universal smoking cessation services to achieve at least 80,000 successful quits (at one month post quit) including 48,000 in the 40% most-deprived within-Board SIMD areas over the three years ending March 2014.
60% of school children in primary 1 will have no signs of dental disease by 2010	At least 60% of 3 and 4 year olds in each SIMD quintile to have fluoride varnishing twice a year by March 2014.
Improve public sector efficiency through the generation of 2% cash releasing efficiency savings per annum	NHS Boards to deliver a 3% efficiency saving to reinvest in frontline services.
Reduce overall ecological footprint	NHSScotland to reduce energy-based carbon emissions and to continue a reduction in energy consumption to contribute to the greenhouse gas emissions reduction targets set in the Climate Change (Scotland) Act 2009.
Achieve annual milestones for reducing inpatient or day case waiting times culminating in the delivery of an 18 week referral to treatment time from December 2011	Deliver 18 weeks referral to treatment from 31 December 2011.
Decrease the estimated number of problem drug users in Scotland by 2011	By March 2013, 90% of clients will wait no longer than 3 weeks from referral received to appropriate drug or alcohol treatment that supports their recovery.
Increase the average score of adults on the Warwick-Edinburgh Mental Wellbeing Scale by 2011	Deliver faster access to mental health services by delivering 26 weeks referral to treatment for specialist Child and Adolescent Mental Health Services (CAMHS) services from March 2013; and 18 weeks referral to treatment for Psychological Therapies from December 2014.
Reduce proportion of people aged 65 and over admitted as emergency inpatients 2 or more times in a single year	Reducing the need for emergency hospital care, NHS Boards will achieve agreed reductions in emergency inpatient bed days rates for people aged 75 and over between 2009-/10 and 2011-12 through improved partnership working between the acute, primary and community care sectors.
Increase the percentage of people aged 65 and over with high levels of care needs who are cared for at home	Reducing the need for emergency hospital care, NHS Boards will achieve agreed reductions in emergency inpatient bed days rates for people aged 75 and over between 2009-10 and 2011-12 through improved partnership working between the acute, primary and community care sectors.

Question reference: S3W-39329

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive whether it will list the eHealth strategy commitments that it plans to defer under its draft budget for 2011-12.

Question reference: S3W-39320

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive for what reason it has decided to create HEAT standards to replace HEAT targets.

HEAT targets are agreed with a wide range of stakeholders, and set out the areas where accelerated improvement is required.

NHS Boards aim to deliver the HEAT targets through sustainable improvement. Following delivery of HEAT targets, the expectation is that NHS boards will continue to deliver the improved performance and the target becomes a standard. For 2011-12, the local delivery plan guidance (see http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/17273/LDPGuidancePDF201112.) sets out eight national standards.

Provide 48 hour access or advance booking to an appropriate member of the GP Practice Team.

To respond to 75% of Category A calls within eight minutes from April 2009 onwards across mainland Scotland (Scottish Ambulance Service).

98% of patients will wait less than four hours from arrival to admission, discharge or transfer for accident and emergency treatment.

No patient will wait longer than 12 weeks from referral (all sources) to a first outpatient appointment (measured on month end Census).

No patient will wait longer than nine weeks for inpatient and day case treatment (measured on month end Census).

No people will wait more than six weeks to be discharged from hospital into a more appropriate care setting.

Maintain the number of people with a diagnosis of dementia on the Quality and Outcomes Framework (QOF) dementia register and other equivalent sources.

NHS boards to achieve a sickness absence rate of 4% from 31 March 2009.

The Scottish Government will monitor these standards, and discuss performance at NHS boards'' annual reviews. The HEAT targets which have been delivered by NHS boards, over and above the eight national standards, are standards which are monitored locally by NHS boards.

Question reference: S3W-39318

Asked by: Helen Eadie, MSP for Dunfermline East, Scottish Labour
Date lodged: Wednesday, 02 February 2011
Current Status: Answered by Nicola Sturgeon on 24 February 2011

To ask the Scottish Executive for what reason there is no emergency ambulance response rate target in the draft budget for 2011-12.

The Scottish Ambulance Service achieved the 75% category A response time target in March 2009 at which time the target became a standard. Since then we have seen year on year improvement to the full-year performance returned by the Service.

The Local Delivery Plan Guidance 2011-12 sets out the agreed HEAT targets and standards for NHSScotland at:

http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/17273/LDPGuidancePDF201112.

These HEAT targets and standards support the budgetary process.

The Scottish Ambulance Service''s Local Delivery Plan for 2011-12 will include the HEAT national standard to respond to 75% of Category A calls within 8 minutes from April 2009 onwards across mainland Scotland.

The Scottish Ambulance Service regularly reports on performance against this standard at its board meetings and in its annual report. Performance is also considered at the Scottish Ambulance Service annual review.

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