Chamber and committees

The funding provided for Choose Life each year since May 2007 is as follows:

	2007- 08	2008- 09	2009-10	2010-11
National	£962,000	£920,000	£964,000	£813,619
Local	£3.198 million*	**	**	**

Notes:

*£3.198 million was allocated by Scottish Government to local authorities for suicide prevention action, with associated guidance on priorities for the use of funds.

**Under the concordat between the Scottish Government and COSLA, funding for local suicide prevention action in 2008-11 is wrapped up in general allocations to local authorities. It is for local authorities to determine, on the basis of local circumstances and needs, how to prioritise this funding.

Funding provided for the Choose Life programme in 2010-11 is less than that provided in 2009-10, due to Choose Life now being situated within NHS Health Scotland and having access to their internal resources to help support Choose Life programme objectives. Choose Life now have the practical and professional support of the larger organisation, as well as drawing on their knowledge, expertise and development skills at no extra cost. Effectively the programme objectives are being supported at the same level at a reduced cost to the Scottish Government.

Other Scottish Government funding is also provided to support a range of actions on improving mental health and wellbeing, such as the development of a Confidential Suicide Register for Scotland aimed at improving future knowledge on suicide prevention, and other programmes of work designed to tackle depression and anxiety.

The number of calls (a) received and (b) answered by Breathing Space, in each month since January 2010 is as follows:

Month	Received	Answered
January 2010	6,246	5,804
February 2010	5,364	4,903
March 2010	6,413	5,854
April 2010	5,881	5,541
May 2010	6,102	5,690
June 2010	5,398	4,890
July 2010	6,354	5,885
August 2010	6,523	6,066

Note: It is normal to expect a level of abandoned calls in any contact centre and this can vary depending on the nature of the business.

The average number of calls received and answered in 2006-07 to 2010-11 is as follows:

Year	Received	Answered
2006-07	2,984	2,869
2007-08	3,486	3,329
2008-09	4,357	4,186
2009-10	4,541	4,257
2010-11	6,052	5,614

 

The figures show a consistent and significant rise in calls received since 2006.

No. Waiting an hour for a call to be answered by Breathing Space is exceptional. For example, the average time for a call to be answered since January 2010 is 21 seconds.

Heart disease, and the treatment of heart attack, remains a clinical priority for NHS Scotland and we want people to have access to the best possible treatment at the earliest possible opportunity, including potentially life-saving defibrillators.

Making further reductions in the number of deaths from heart attack is an important theme of the Scottish Government''s Better Heart Disease and Stroke Care Action plan, published in June 2009. The action plan includes an action which places responsibility on NHS boards to look at introducing defibrillators in public places and our National Advisory Committee on heart disease will monitor the progress that is being made.

We also want to ensure that the best equipment is in place for patients and we are providing £7.5 million of funding to provide cutting-edge defibrillators in Scotland''s ambulance fleet. We believe this investment in the most up-to-date technology will improve heart attack survival rates and save lives.

The Scottish Ambulance Service recognises the importance of reaching people who have had a cardiac arrest quickly and treating them effectively. It therefore has two local delivery plan (LDP) targets related to cardiac arrest:

Between 12-20% of eligible cardiac arrest patients with Return of Spontaneous Circulation on arrival at hospital, and

Reach 80% of cardiac arrest patients within eight minutes (mainland Scotland).

The longest recorded time to answer a call by Breathing Space was 1 hour 13 seconds at 14:00 hrs on 31 July 2010.

This delay was exceptional and due to the combination of increased call demand, and reduced staff availability because of staff turnover.

All reasonable steps are taken to answer calls, including supervisors answering the calls, to try to avoid callers waiting longer than necessary.

The average time for a call to be answered since January 2010 is 21 seconds.

The cardiac Managed Clinical Networks, working with their NHS boards are conducting an assessment of Public Access Defibrillator provision in their area, drawing on information from a mapping exercise conducted by the British Heart Foundation. Their progress will be monitored by the National Advisory Group for Heart Disease.

In June, the Scottish Ambulance Service (SAS) announced that it would install defibrillators on all of its ambulances this year. This state-of-the-art technology will replace existing defibrillators in a £7.5 million initiative funded by the Scottish Government.

The following table shows the number of hospital stays where cardiac arrest is recorded as the main, or secondary diagnosis, in any episode within the hospital stay combined with the number of out-of-hospital registered deaths, where cardiac arrest is recorded as the underlying or a contributing cause of death, and the estimated number and percentage of patients discharged alive at the end of an acute continuous inpatient hospital stay. Data are shown for Scotland in the latest year ending 31 March 2010^P.

Scotland for Year Ending 31 March	Number of Cardiac Arrests	Number of Cardiac Arrest Patients Admitted to Hospital	Estimated Number of Cardiac Arrest Survivors Discharged Alive from Hospital	Estimated % of Cardiac Arrests Discharged Alive from Hospital
2010P	1,652	1,117	349	21.1%

^PProvisional.

Source: ISD Scotland.

Deaths occurring in the community, in the ambulance or on arrival in the emergency department and recorded as myocardial infarction may have been from a cardiac arrest. It is important to note that data on out-of-hospital deaths from cardiac arrest are probably underestimates and hence the survival rates are likely to be overestimates.

Notes:

1. The basic unit of analysis for these figures is the number of cardiac arrests recorded either in a continuous stay (CIS) in hospital or on a death registration. Probability matching methods have been used to link together death registrations from the General Register Office for Scotland (GROS) and individual SMR01 hospital episodes for each patient, thereby creating linked patient histories. Within these patient histories, SMR01 episodes are grouped according to whether they form part of a continuous spell of treatment (whether or not this involves transfer between hospitals or even NHS boards).

2. All discharges (hospital stays) with a main or secondary diagnosis of cardiac arrest in addition to all deaths where cardiac arrest is recorded as the underlying or one of 10 secondary causes of death are included in the analysis. Death registrations corresponding to linked hospital discharges are excluded. The discharge code from the last SMR01 episode within the CIS determines whether the patient was discharged from the continuous stay alive or dead.

3. These statistics are based on the linked data set of SMR01 (Scottish Morbidity Record 01) and death records held by ISD Scotland. SMR01 collects information on inpatient and day case discharges from non-obstetric and non-psychiatric hospitals in Scotland. The linkage and use of the death records is by permission of the General Register Office for Scotland (GROS).

4. Up to six diagnoses (one main and five secondary) may be recorded on an SMR01 record. Up to 10 causes of death (underlying and secondary) may be recorded on the GROS death registration. All diagnoses position on any SMR01 record of a hospital stay and all causes of death have been used to identify cardiac arrest admissions or out of hospital deaths. Cardiac arrest has been defined using ICD10 code I46.

5. There will be some cases of myocardial infarction (MI) where a cardiac arrest occurred during the hospital stay but was not mentioned on the discharge summary.

The Emergency Medicine Research Group, Edinburgh (EMERGE), in partnership with the Scottish Ambulance Service (SAS), has been undertaking research to improve the quality of pre-hospital resuscitation delivered by SAS personnel.

I understand that the service is keen to work with the EMERGE group to consider how the learning points and training issues arising from this research can be taken forward across the country.

The following table shows the number of hospital stays where cardiac arrest is recorded as the main, or secondary diagnosis, in any episode within the hospital stay, combined with the number of out-of-hospital registered deaths where cardiac arrest is recorded as the underlying or a contributing cause of death, and the estimated number and percentage of patients discharged alive at the end of an acute continuous inpatient hospital stay. Data are shown for Scotland over the past 10 years. No comparable data are available centrally for other European countries.

Year Ending 31 March	Number of Cardiac Arrests	Number of Cardiac Arrest Patients Admitted to Hospital	Estimated Number of Cardiac Arrest Survivors Discharged Alive from Hospital	Estimated % of Cardiac Arrests Discharged Alive from Hospital
2001	2,802	1,812	442	15.8%
2002	2,557	1,687	413	16.2%
2003	2,637	1,728	401	15.2%
2004	2,353	1,532	362	15.4%
2005	2,328	1,556	360	15.5%
2006	2,128	1,394	356	16.7%
2007	2,004	1,232	331	16.5%
2008	1,974	1,307	361	18.3%
2009	1,744	1,151	335	19.2%
2010P	1,652	1,117	349	21.1%

^PProvisional

Source: ISD Scotland.

Deaths occurring in the community, in the ambulance or on arrival in the accident and emergency department and recorded as myocardial infarction may have been from a cardiac arrest. It is important to note that data on out-of-hospital deaths from cardiac arrest are probably under estimates and hence the survival rates are likely to be overestimates.

Notes:

1. The basic unit of analysis for these figures is the number of cardiac arrests recorded either in a continuous stay (CIS) in hospital or on a death registration. Probability matching methods have been used to link together death registrations from the General Register Office for Scotland (GROS) and individual SMR01 hospital episodes for each patient, thereby creating linked patient histories. Within these patient histories, SMR01 episodes are grouped according to whether they form part of a continuous spell of treatment (whether or not this involves transfer between hospitals or even NHS Boards).

2. All discharges (hospital stays) with a main or secondary diagnosis of cardiac arrest in addition to all deaths where cardiac arrest is recorded as the underlying or one of 10 secondary causes of death are included in the analysis. Death registrations corresponding to linked hospital discharges are excluded. The discharge code from the last SMR01 episode within the CIS determines whether the patient was discharged from the continuous stay alive or dead.

3. These statistics are based on the linked data set of SMR01 (Scottish Morbidity Record 01) and death records held by ISD Scotland. SMR01 collects information on inpatient and day case discharges from non-obstetric and non-psychiatric hospitals in Scotland. The linkage and use of the death records is by permission of the General Register Office for Scotland (GROS).

4. Up to six diagnoses (one main and five secondary) may be recorded on an SMR01 record. Up to 10 causes of death (underlying and secondary) may be recorded on the GROS death registration. All diagnoses position on any SMR01 record of a hospital stay and all causes of death have been used to identify cardiac arrest admissions or out of hospital deaths. Cardiac arrest has been defined using ICD10 code I46.

5. There will be some cases of myocardial infarction (MI) where a cardiac arrest occurred during the hospital stay but was not mentioned on the discharge summary.

The Scottish Government''s consultation on Blue Badge reform has been running since 12 July 2010 and will close on 8 October 2010. The consultation was issued to over 300 stakeholders and organisations and is available on the Scottish Government''s website. We have had a good number of responses so far, the majority of which have been from Blue Badge holders.