Chamber and committees

I refer the member to the answer to question S3W-26881, on 17 September 2009. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

It is not possible from centrally held information to identify how many people have been treated for (a) drug and (b) alcohol addiction.

However, from the Scottish Drug Misuse Database (SDMD) it is possible to supply information on the number of people entering treatment at drugs services. Table 1 shows the number of new patients/clients entering treatment for drug misuse by NHS board of treatment in each of the last five years. 2007-08 is the most recent year for which information is currently available.

Data on the number of people entering alcohol services for treatment is not held centrally. However, the Scottish Alcohol Needs Assessment research report estimated that, across Scotland in 2006-07, approximately 17,000 people accessed alcohol treatment services. In addition, from acute hospital discharges it is possible to provide the number of people discharged from general acute hospitals with a diagnosis of alcohol dependence. Table 2 shows the numbers of patients discharged from general acute hospitals with a diagnosis of alcohol dependence by NHS board of treatment in each of the last five years. 2007-08 is the most recent year for which information is currently available.

Table 1: New Individual Patients/Clients¹ Reported to the Scottish Drugs Misuse Database by NHS Board of Treatment²: 2003-04 to 2007-08^3,4

	2003-04	2004-05	2005-06	2006-07	2007-08
Scotland	12,238	13,714	12,977	12,421	12,562
Ayrshire and Arran	1,295	1,293	1,232	1,141	834
Borders	192	238	282	189	257
Dumfries and Galloway	202	192	269	322	204
Fife	982	1,004	1,168	1,289	1,843
Forth Valley	402	375	511	570	528
Grampian	1,146	992	962	879	1,049
Greater Glasgow	4,275	3,994	3,819	3,409	3,085
Highland	700	1,154	638	828	502
Lanarkshire	586	1,760	1,013	741	846
Lothian	2,048	2,245	2,212	2,072	2,126
Orkney	14	11	*	*	*
Shetland	27	17	41	52	42
Tayside	525	545	908	913	1,273
Western Isles	*	20	17	22	27
Unknown	-	-	*	61	*

Source: ISD Scotland (SMR25 Interim Database), Ref: 2009-02077, Date Extracted: 7 September 2009.

Notes:

- (Zero).

* Indicates values that have been suppressed due to the potential risk of disclosure.

1. New patient/client is any person who, at the time of presenting, is not currently in contact with a service that provides specialist assessment of a client''s drug misuse care needs.

2. Individuals are included once within each NHS board area but may appear in the figures for more than one health board. Therefore the sum of local area data may not equal the Scotland figure.

3. From April 2006 the new SMR25a form was introduced. Changes to the data collection mean that figures are not directly comparable with those published from the SMR24 form i.e. prior to April 2006.

4. General Practitioner data has not been included in this analysis.

Table 2: General acute hospital¹ inpatients with a diagnosis of alcohol dependence^2,3 by NHS Health Board of Treatment^4,5: 2003-04 to 2007-08:

	2003-04	2004-05	2005-06	2006-07	2007-08
Scotland	2,870	3,320	3,443	3,494	3,467
Ayrshire and Arran	210	322	291	307	263
Borders	49	52	47	54	45
Dumfries and Galloway	38	53	50	48	58
Fife	139	183	187	214	151
Forth Valley	102	135	144	153	171
Grampian	338	442	346	337	364
Greater Glasgow	931	890	954	901	951
Highland	223	207	226	254	266
Lanarkshire	78	146	188	154	154
Lothian	441	522	582	682	618
Orkney	39	47	44	47	54
Shetland	14	*	12	11	12
Tayside	219	205	231	185	232
Western Isles	66	116	153	154	128
Outside Scotland	*	*	*	9	16

Source: ISD Scotland (SMR01), Ref: 2009-02077, Date Extracted: 7^th September 2009.

Notes:

* Indicates values that have been suppressed due to the potential risk of disclosure.

1. Excludes mental illness hospitals, psychiatric units and maternity hospitals. Transfer cases have also been excluded.

2. Caution is necessary when interpreting these figures. The recording of alcohol dependence may vary from hospital to hospital. Where alcohol dependence is suspected but unconfirmed it may not be recorded by the hospital.

3. Diseases are recorded using the World Health Organization''s International Classification of Diseases 10th Revision (ICD10). Alcohol dependence: F10.2. Up to six diagnoses are recorded. All six diagnoses have been used to identify alcohol dependence.

4. Figures in the table only relate to those individuals who are treated as inpatients. They do not include individuals managed as outpatients or individuals attending accident and emergency who are not subsequently admitted.

5. The same patient may have been admitted multiple times within the year (for example, if a patient has been admitted six times in the year this counts as five repeat admissions).

The Scottish Government allocates funding to NHS boards for drug treatment and rehabilitation services and for alcohol treatment and support services. Tables 1 and 2 provide the funding allocations from the Scottish Government to NHS boards for each of the last five years.

These tables do not provide the complete picture of NHS spend on drug treatment and rehabilitation or alcohol treatment and support services; NHS boards and other local partners are able to supplement these funds to tackle problem drug and alcohol misuse use, in order to meet the needs of the local population.

Local authorities hold data on the amount that they spend on treating adults with addictions and substance misuse problems, this includes both drug and alcohol services. Table 3 provides the net revenue expenditure on adults with addictions and substance misuse problems by local authority for each of the last five years for which data is available; these figures are not yet available for 2008-09 or 2009-10.

Information on how much is spent by local authorities and NHS boards specifically on social care, rehabilitation and specialist medical treatment for drug and alcohol addictions is not held centrally; it is for local authorities and NHS boards to commission services to meet the needs of the local population.

Table 1: Health Board allocations for Drug Treatment and Rehabilitation

NHS Board	2005-06	2006-7	2007-8	2008-9	2009-10
	£0	£0	£0	£0	£0
Argyll and Clyde *	2,226	2,226	N/A	N/A	N/A
Ayrshire and Arran	1,155	1,155	1,155	1,198	1,360
Borders	189	189	189	196	222
Dumfries and Galloway	482	482	482	500	568
Fife	1,378	1,378	1,378	1,430	1,623
Forth Valley	828	828	828	859	975
Grampian	2,202	2,202	2,202	2,285	2,593
Greater Glasgow and Clyde	6,392	6,392	8,114	8,422	9,559
Highland	489	489	993	1,031	1,170
Lanarkshire	1,591	1,591	1,591	1,651	1,874
Lothian	4,645	4,645	4,645	4,821	5,472
Orkney	54	54	54	56	64
Shetland	72	72	72	75	85
Tayside	1,965	1,965	1,965	2,039	2,314
Western Isles	101	101	101	105	119
Scotland	23,769	23,769	23,769	24,668	27,998

Note: *Argyll and Clyde Health Board was split between Greater Glasgow and Clyde and Highland Health Boards in 2007.

Table 2: Health Board Allocations for Alcohol Treatment and Support Services

NHS Board	2005-06	2006-07	2007-08	2008-09	2009-10
	£0	£0	£0	£0	£0
Argyll and Clyde *	915	915	N/A	N/A	N/A
Ayrshire and Arran	706	706	722	1,775	2,491
Borders	280	280	286	701	984
Dumfries and Galloway	359	359	367	898	1,225
Fife	659	659	674	1,637	2,472
Forth Valley	488	488	499	1,275	1,902
Grampian	699	699	715	2,014	2,805
Greater Glasgow and Clyde	2,190	2,190	2,965	6,325	9,059
Highland	466	466	689	1,496	2,268
Lanarkshire	814	814	833	2,456	3,435
Lothian	1,107	1,107	1,132	3,401	5,311
Orkney	221	221	226	333	417
Shetland	221	221	226	345	434
Tayside	556	556	569	1,817	2,700
Western Isles	221	221	226	391	498
Scotland	9,902	9,902	10,130	24,865	36,000

Note: *Argyll and Clyde Health Board was split between Greater Glasgow and Clyde and Highland Health Boards in 2007.

Table 3: Local Authorities'' Net Revenue Expenditure on Adults with Addictions and Substance Misuse Problems

Local Authority	2003-04 £0	2004-05 £0	2005-06 £0	2006-07 £0	2007-08 £0
Aberdeen City	2,364	2,518	2,647	2,736	2,517
Aberdeenshire	769	1,178	1,200	1,197	1,441
Angus	219	235	248	250	313
Argyll and Bute	176	195	170	84	241
Clackmannanshire	67	67	54	145	153
Dumfries and Galloway	406	440	466	431	459
Dundee City	275	252	285	280	276
East Ayrshire	231	169	139	163	163
East Dunbartonshire	352	239	139	244	270
East Lothian	198	207	285	289	7
East Renfrewshire	487	285	135	249	110
Edinburgh, City of	1,674	1,698	1,777	1,986	1,710
Eilean Siar	101	106	114	53	92
Falkirk	276	453	334	231	129
Fife	559	848	1,087	844	816
Glasgow City	7,521	7,624	8,570	7,937	9,250
Highland	777	778	766	737	1,007
Inverclyde	706	629	663	592	638
Midlothian	100	369	344	351	14
Moray	133	156	147	206	206
North Ayrshire	703	841	1,236	1,177	1,028
North Lanarkshire	1,044	877	1,068	1,368	2,239
Orkney Islands	91	37	30	10	13
Perth and Kinross	454	414	466	377	450
Renfrewshire	900	765	753	674	1,289
Scottish Borders	205	163	194	194	184
Shetland Islands	48	65	106	181	303
South Ayrshire	199	221	238	367	270
South Lanarkshire	832	640	700	660	735
Stirling	244	333	345	512	416
West Dunbartonshire	319	729	725	839	830
West Lothian	311	381	429	416	306
Scotland	22,741	23,912	25,860	25,780	27,875

Source: Local Financial Returns (LFR 3 - Social Work) 2003-04 to 2007-08.

Note: 1. All figures are Net Revenue Expenditure

Data on the prevalence of drug addiction are not held centrally. However, estimates of the prevalence of problem drug misuse (those misusing opiates and benzodiazepines) are contained in the study Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland. Estimates for 2003 can be found at:

http://www.drugmisuse.isdscotland.org/publications/local/prevreport2004.pdf.

Estimates are given by local authority area in table 3 on page 16 and by NHS board in table 10 on page 29. In both cases figures relate to those aged between 15 and 54.

Estimates relating to 2006 will be published by ISD Scotland on 6 October 2009 on the Drug Misuse Information Scotland website at http://www.drugmisuse.isdscotland.org/.

It is not possible from centrally held data to identify all activity undertaken as same-day care.

However, figures for outpatients and day-cases are routinely published by the Information Services Division (ISD) of NHS Scotland at the following address http:--www.isdscotland.org-isd-4066.html.

The Excel file Annual and quarterly summary information by NHS board of Treatment.xls provides trend information over the past 10 years.

The BADS¹ (the British Association of Day Surgery) directory is a list of procedures that are appropriate for a day surgery setting. The table below gives the number of these procedures carried out in a day surgery setting (as day-cases, first and return outpatients, and inpatients with a length of stay of 0 days) by NHS board, for each of the past five years. The table also shows annual percentage changes of the total number of BADS¹ procedures carried out on the same day.

Please note it is known that there is a degree of under-recording of procedures carried out in an outpatient setting on the SMR00 national return, and hence the outpatient figures represent an under-count of the true volume of BADS activity. ISD are currently working with NHS boards to address this.

Note: 1. The British Association of Day Surgery (BADS) was founded in 1989 to encourage the expansion of day surgery. As part of this, BADS has published a directory of surgical procedures. This directory contains aspirational goals for day surgery (including outpatient surgery). The BADS directory of procedures provides a focus for clinicians and managers involved in the planning and provision of short stay elective surgery as well as a list of procedures that are appropriate for a day surgery setting. Further information about BADS can be found here: http://www.daysurgeryuk.org/bads/joomla/.

Analysis of BADS¹ procedures carried out in a same-day care setting² over financial years 2003-04 “ 2008-09³, by NHS Board of Treatment

Health Board of Treatment	Financial Year	Day Cases	Inpatients (with a 0 Day Stay)	Outpatients	Total Same-Day BADS Procedures	% Increase in BADS
Scotland	2003-04	83,902	5,893	35,483	125,278	-
	2004-05	88,224	6,321	38,942	133,487	6.6%
	2005-06	97,401	7,004	37,955	142,360	6.6%
	2006-07	101,921	7,867	39,517	149,305	4.9%
	2007-08	103,894	7,873	37,526	149,293	0.0%
	2008-09	110,978	8,927	38,104	158,009	5.8%
Ayrshire and Arran	2003-04	5,809	386	3,965	10,160	-
	2004-05	6,095	461	3,518	10,074	-0.8%
	2005-06	6,360	505	4,393	11,258	11.8%
	2006-07	6,681	707	4,826	12,214	8.5%
	2007-08	7,157	603	4,453	12,213	0.0%
	2008-09	8,117	603	4,448	13,168	7.8%
Borders	2003-04	1,805	128	870	2,803	-
	2004-05	1,799	111	1,090	3,000	7.0%
	2005-06	2,041	115	2,006	4,162	38.7%
	2006-07	2,015	136	2,143	4,294	3.2%
	2007-08	2,055	132	2,269	4,456	3.8%
	2008-09	2,098	149	2,511	4,758	6.8%
Dumfries and Galloway	2003-04	2,769	146	2,339	5,254	-
	2004-05	2,740	213	3,175	6,128	16.6%
	2005-06	4,408	141	1,311	5,860	-4.4%
	2006-07	4,676	128	1,219	6,023	2.8%
	2007-08	5,076	265	1,200	6,541	8.6%
	2008-09	5,843	129	593	6,565	0.4%
Fife	2003-04	5,180	267	7,303	12,750	-
	2004-05	5,184	427	7,653	13,264	4.0%
	2005-06	5,719	369	7,805	13,893	4.7%
	2006-07	6,017	419	7,945	14,381	3.5%
	2007-08	5,847	441	7,097	13,385	-6.9%
	2008-09	5,693	403	7,882	13,978	4.4%
Forth Valley	2003-04	6,030	252	833	7,115	-
	2004-05	5,896	316	833	7,045	-1.0%
	2005-06	5,494	422	606	6,522	-7.4%
	2006-07	6,710	385	1,029	8,124	24.6%
	2007-08	5,344	238	2,323	7,905	-2.7%
	2008-09	4,853	596	3,311	8,760	10.8%
Golden Jubilee Hospital	2003-04	859	64	323	1,246	-
	2004-05	1,582	52	32	1,666	33.7%
	2005-06	2,917	229	0	3,146	88.8%
	2006-07	3,876	408	0	4,284	36.2%
	2007-08	4,096	0	0	4,096	-4.4%
	2008-09	2,687	10	0	2,697	-34.2%
Grampian	2003-04	4,424	272	6,498	11,194	-
	2004-05	4,586	376	7,267	12,229	9.2%
	2005-06	5,375	493	8,148	14,016	14.6%
	2006-07	6,706	542	8,870	16,118	15.0%
	2007-08	6,791	584	7,468	14,843	-7.9%
	2008-09	9,438	707	6,680	16,825	13.4%

Notes:

2. Includes day cases, first and return outpatients and inpatients with a length of stay of 0 days (as there are cases of Inpatients with a length of stay of 0 days).

3. Years ending 31 March.

Health Board of Treatment	Financial Year	Day cases	Inpatients (with a 0 day stay)	Outpatients	Total same-day BADS Procedures	% Increase in BADS
Greater Glasgow and Clyde	2003-04	23,556	2,185	5,462	31,203	-
	2004-05	25,160	1,942	5,044	32,146	3.0%
	2005-06	28,062	2,243	4,536	34,841	8.4%
	2006-07	28,542	2,401	4,514	35,457	1.8%
	2007-08	29,711	2,682	4,588	36,981	4.3%
	2008-09	31,021	3,026	4,765	38,812	5.0%
Highland	2003-04	3,825	168	1,744	5,737	-
	2004-05	4,420	194	1,939	6,553	14.2%
	2005-06	4,902	211	1,997	7,110	8.5%
	2006-07	5,095	230	1,542	6,867	-3.4%
	2007-08	5,629	234	1,385	7,248	5.5%
	2008-09	6,245	310	1,953	8,508	17.4%
Lanarkshire	2003-04	8,916	651	2,040	11,607	-
	2004-05	8,282	554	3,358	12,194	5.1%
	2005-06	8,693	513	3,368	12,574	3.1%
	2006-07	9,894	577	1,046	11,517	-8.4%
	2007-08	9,400	530	1,184	11,114	-3.5%
	2008-09	11,555	630	1,484	13,669	23.0%
Lothian	2003-04	14,016	814	1,770	16,600	-
	2004-05	15,174	1,033	2,174	18,381	10.7%
	2005-06	15,387	1,207	718	17,312	-5.8%
	2006-07	13,298	1,258	4,042	18,598	7.4%
	2007-08	14,143	1,466	4,097	19,706	6.0%
	2008-09	14,504	1,618	3,836	19,958	1.3%
Orkney	2003-04	293	4	31	328	-
	2004-05	344	3	22	369	12.5%
	2005-06	460	7	7	474	28.5%
	2006-07	510	11	0	521	9.9%
	2007-08	502	11	0	513	-1.5%
	2008-09	494	16	0	510	-0.6%
Shetland	2003-04	286	22	78	386	-
	2004-05	509	7	85	601	55.7%
	2005-06	542	18	62	622	3.5%
	2006-07	514	38	32	584	-6.1%
	2007-08	512	29	117	658	12.7%
	2008-09	537	37	80	654	-0.6%
Tayside	2003-04	5,657	515	2,227	8,399	-
	2004-05	5,991	610	2,751	9,352	11.3%
	2005-06	6,552	506	2,998	10,056	7.5%
	2006-07	6,875	589	2,309	9,773	-2.8%
	2007-08	7,070	623	1,345	9,038	-7.5%
	2008-09	7,241	648	469	8,358	-7.5%
Western Isles	2003-04	477	19	0	496	-
	2004-05	462	22	1	485	-2.2%
	2005-06	489	25	0	514	6.0%
	2006-07	512	38	0	550	7.0%
	2007-08	561	35	0	596	8.4%
	2008-09	652	45	92	789	32.4%

Sources: SMR00 (Scottish outpatient records) and SMR01 (Scottish Inpatient and Day case records).

Notes:

a. Note that the submission of return outpatient records in SMR00 is not mandatory.

b. From April 2003 the national reporting of surgical activity in an outpatient setting has been required and ISD has been working with NHS boards to develop full compliance nationally. At this stage only a proportion of NHS boards have achieved extensive coverage and further work will be necessary by most boards before a complete account of all outpatient surgical activity can be made.

c. The information was extracted from the SMR00 and SMR01 data sets maintained by ISD Scotland. Note that SMR00 relates to all specialties excluding accident and emergency and genito urinary medicine.

d. The BADS surgical procedures do not include any non-surgical care or treatment (for example, renal dialysis or chemotherapy) that may be carried out in a day-case setting.

I refer the member to the answer to the question S3W-26679 on 17 September 2009. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

Information on the number of patients receiving social care and rehabilitation services is not held centrally. However, information is available on the number of interventions offered for community based support and rehabilitation. Note that this may be an overestimate of the number receiving treatment because not all those offered an appointment may enter treatment. The number of interventions offered is available from the Drug Treatment Waiting Times Framework from April 2005 only. Information is collected by Alcohol and Drug Action Teams (ADATs) and submitted to ISD every quarter. For this reason it cannot be broken down by local authority area; however, it can be aggregated to NHS health board level.

The following tables show the number of interventions offered where the appointment is scheduled for the quarter shown. Information on community based support/ rehabilitation is shown in table 1 and information on residential detoxification/ rehabilitation is shown in table 2.

Note that the quality and completeness of data varies between health boards and between quarters and caution is recommended when interpreting these figures.

Table 1: Number of interventions offered¹ for community based support/ rehabilitation² by health board^4,5, where the appointment was scheduled for the quarter ending with the date shown.

1a. Prior to the dissolution of the Argyll and Clyde Health Board and the creation of the expanded Highland and Greater Glasgow and Clyde Health Boards:

Health Board Area	30 June 2005	30 September 2005	31 December 2005	31 March 2006	30 June 2006	30 September 2006	31 December 2006	31 March 2007	30 June 2007
Scotland6	734	856	819	1010	859	860	805	1046	1325
Argyll and Clyde	101	165	135	202	150	118	189	183	200
Ayrshire and Arran	8	X	70	59	45	86	X	X	132
Borders	9	*	*	50	0	*	*	*	*
Dumfries and Galloway	50	28	26	58	61	47	31	75	100
Fife	214	152	139	203	177	197	X	234	209
Forth Valley	*	*	*	X	*	6	0	0	0
Grampian	24	16	17	21	11	31	*	26	55
Greater Glasgow	148	210	221	161	192	195	261	269	233
Highland	X	42	34	*	7	X	*	*	*
Lanarkshire	57	37	56	72	88	58	100	117	165
Lothian	105	188	107	164	104	88	180	108	118
Orkney	0	X	*	*	*	*	13	X	X
Shetland	0	0	0	0	*	*	0	0	0
Tayside	12	*	8	6	13	25	21	27	57
Western Isles	*	*	0	0	0	0	X	0	X

 

1b. Following the dissolution of the Argyll and Clyde Health Board and the creation of the expanded Highland and Greater Glasgow and Clyde Health Boards:

Health Board Area	30 September 2007	31 December 2007	31 March 2008	30 June 2008	30 September 2008	31 December 2008	31 March 2009
Scotland6	1,479	1,215	1,272	1,511	1,426	1,474	1,456
Ayrshire and Arran	125	149	161	237	162	168	208
Borders	*	*	6	*	6	*	6
Dumfries and Galloway	75	92	66	61	43	53	17
Fife	219	X	172	160	163	159	157
Forth Valley	0	0	0	0	25	6	53
Grampian	44	32	28	57	45	28	29
Greater Glasgow and Clyde	396	377	358	435	589	573	431
Highland (including Argyll and Bute)	37	63	25	51	31	42	39
Lanarkshire	194	173	183	136	164	169	163
Lothian	275	261	220	307	103	193	273
Orkney	*	X	*	*	*	X	*
Shetland	*	*	0	0	0	0	*
Tayside	94	61	49	55	80	73	63
Western Isles	*	0	*	0	*	*	13

Notes:

*Indicates values that have been suppressed due to the potential risk of disclosure.

X No data submitted for this quarter.

Table 2: Number of interventions offered¹ for residential detoxification/ rehabilitation³ by health board^4,5, where the appointment was scheduled for the quarter ending with the date shown.

2a. Prior to the dissolution of the Argyll and Clyde Health Board and the creation of the expanded Highland and Greater Glasgow and Clyde Health Boards:

Health Board Area	30 June 2005	30 September 2005	31 December 2005	31 March 2006	30 June 2006	30 September 2006	31 December 2006	31 March 2007	30 June 2007
Scotland6	213	168	375	174	185	183	157	191	235
Argyll and Clyde	*	23	27	*	*	*	6	*	8
Ayrshire and Arran	*	X	8	*	15	11	X	X	6
Borders	53	*	36	27	*	33	29	24	8
Dumfries and Galloway	0	0	0	0	0	0	0	0	0
Fife	0	0	0	0	0	0	X	0	0
Forth Valley	0	0	0	X	0	0	0	0	0
Grampian	*	11	*	12	20	13	7	17	14
Greater Glasgow	147	126	133	124	140	106	101	145	178
Highland	X	0	0	0	0	X	0	0	0
Lanarkshire	*	0	*	0	0	*	0	0	11
Lothian	0	0	165	0	0	13	14	*	10
Orkney	0	X	0	0	0	0	0	X	X
Shetland	0	0	0	0	0	0	0	0	0
Tayside	0	*	0	0	0	0	0	0	0
Western Isles	0	0	0	0	*	0	X	0	X

 

2b. Following the dissolution of the Argyll and Clyde Health Board and the creation of the expanded Highland and Greater Glasgow and Clyde Health Boards:

Health Board Area	30 September 2007	31 December 2007	31 March 2008	30 June 2008	30 September 2008	31 December 2008	31 March 2009
Scotland6	250	289	245	291	183	210	161
Ayrshire and Arran	*	*	0	6	*	*	*
Borders	8	47	51	12	9	11	50
Dumfries and Galloway	0	0	0	0	0	0	0
Fife	0	X	0	0	*	*	0
Forth Valley	0	9	32	20	0	0	0
Grampian	6	*	0	*	*	10	19
Greater Glasgow and Clyde	185	192	130	212	152	158	57
Highland (including Argyll and Bute)	*	0	0	0	0	0	*
Lanarkshire	12	6	10	9	13	10	21
Lothian	35	32	22	30	*	16	*
Orkney	0	X	0	0	0	X	0
Shetland	0	0	0	0	0	0	*
Tayside	*	0	0	0	0	0	0
Western Isles	0	0	0	0	0	0	0

Notes:

*Indicates values that have been suppressed due to the potential risk of disclosure.

X No data submitted for this quarter.

1. The number of interventions offered is approximately the same as the number of clients offered treatment. Occasionally a client may be offered more than one intervention in the same quarter, meaning that the total number of clients may be slightly smaller than the number of interventions.

2. Community based support/ rehabilitation involves interventions that have the purpose of tackling the social and psychological problems faced by the client (such as debt and benefit problems, relationship and family issues, relapse prevention, and employability and training issues), and includes structured day programmes, counselling, and group work. Clients may be in receipt of other treatment interventions in parallel with community based support and rehabilitation (e.g. substitute prescribing).

3. Residential detoxification/ rehabilitation is detoxification and/or rehabilitation that involves the client being admitted to a residential facility or hospital.

4. Data are submitted by NHS services and non-NHS services (local government and voluntary sector).

5. Alcohol and Drug Action Teams (ADATs) collect and quality assure data, and submit aggregate reports to ISD each quarter. Data quality varies across ADATs and over time.

6. The Scotland figure is an aggregate of the information provided from ADATs. It should be noted that the number of services submitting data varies significantly from area to area and within areas across the data collection period and caution is recommended when interpreting these figures. The Scotland figure includes any data that have been suppressed at the health board levels to prevent disclosure.

There is no nationally agreed rate for GPs to provide an out-of-hours and a locum service.

NHS boards are responsible for ensuring the provision of safe, sustainable and high quality health care that meets the needs of their patients. They must do so in line with strategic national priorities, ensuring they achieve the annual performance targets that are set out within their Local Delivery Plan and agreed with the Scottish Government. Decisions about the deployment of their resources are operational matters for the Scottish Ambulance Service.

Following the issue of the Refreshed Strategy for Volunteering within NHSScotland in February 2008 we expect that NHS boards (including the Scottish Ambulance Service) should be doing all they can to attract volunteers to ensure that services of benefit to patients can be maintained. We have given a commitment to keep the mileage rates payable to volunteers under review.

The Scottish Ambulance Service is committed to developing clinical services to patients. This starts from when the caller is connected to the Emergency Medical Dispatch Centre (EMDC) through the on-going enhancement of clinical triage and advice, through to the treatment at scene and onward conveyance to the most clinically appropriate secondary care centre. Specific examples of development include the development of integrated clinical pathways for primary clinical conditions such as Acute Coronary Syndromes (chest pain and heart attack) and stroke.

The use of see and treat protocols continues to develop, allowing some patients to be given treatment and information relevant to their condition and then remain at home when it is clinically safe and appropriate for them to do so. For such patients being taken to hospital is not in their best interests. The service has also produced a variety of patient leaflets for patients and carers following see and treat, where it is has been safe to treat patients at home but where additional information is of use. These cover topics such as lower than normal blood glucose levels, nosebleeds, minor wounds, seizures, asthma, fainting and panic attacks.

In some parts for the country, the service have successfully developed the role of the Community Paramedic; their role is to deliver high quality treatment and care to patients, associated duty of care to other members of the public including the provision of health advice (see and treat) and transportation to appropriate medical facilities, generally in emergency situations, using a range of paramedic skills. In addition to this they may also diagnose, discharge or refer suitable minor injury and/or acute illness patients whilst working on behalf of the ambulance service, GP out-of-hour''s service or within a minor injury clinic setting.