Chamber and committees

The Scottish Government is allocating £70 million from within the NHS budget to a Change Fund in 2011-12 which will enable NHS boards and partner local authorities, together with the third and independent sectors, to redesign services in support of improved care outcomes for the growing older population. The Change Fund will assist partners in achieving the HEAT target and in ensuring older people receive the best possible care whenever they need it.

Guidance issued jointly by the Scottish Government and COSLA on accessing this fund requires all partnerships, by 28 February 2011, to prepare and submit Change Plans setting down how their allocation will be used to achieve a shift in the balance of care. We will work closely with partnerships to develop these plans.

This was a development target and delivering the target has, as expected, generated valuable lessons about how to deliver most effectively. This learning has been incorporated into the guidance for boards to support delivery of the new HEAT target on Child Healthy Weight, 2011-14.

Revenue resource limit;

Capital resource limit;

Meet their cash requirement, and

Achieve their efficiency savings targets, currently set at 2% for 2010‘11.

http://www.nhshealthquality.org/nhsqis/8679.html.

This modernisation has ensured that staff receives equal pay for work of equal value; introduced standard terms and conditions, and facilitated new ways of working to take account of changing clinical practices.

More recently, the Scottish Government has made clear its intention to make sure public sector pay settlements are tightly constrained in the current financial climate and remain affordable and sustainable. This is demonstrated by our public sector pay policy that has introduced a pay freeze for all staff earning less than £21,000 per annum in 2011-12.

http://www.isdscotland.org/isd/5785.html

Decisions on how NHS boards can best allocate their resources within each board area are made by NHS boards, taking into account local and national priorities, including the ambitions set out in the Healthcare Quality Strategy. Details of the quality strategy are available at:

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

Healthy Life Expectancy (at birth)

Premature Mortality - from all causes, aged under 75 years

Mental Wellbeing - adults aged 16 years and over

Low birth weight

These are supported by indicators for:

Coronary Heart Disease (first ever hospital admission for heart attack aged under 75 years; deaths aged 45 to 74 years)

Cancer (incidence rate aged under 75 years; deaths aged 45 to 74 years)

Alcohol (first ever hospital admission aged under 75 years; deaths aged 45 to 74 years)

All-cause mortality aged 15 to 44 years (to capture large inequalities in mortality observed in this age group)

Data against these indicators are collected and published annually by the Scottish Government.

The third report was published in October 2010:

http://www.scotland.gov.uk/Publications/2010/10/25144246/0.

In terms of progress made since 2007 there is no simple answer. For some indicators, inequalities have reduced and for some they have increased. For others they have remained stable. Given the long-term nature of the health inequalities challenge, we would not expect significant changes in the indicators over the short-time period since 2007.

In addition, the National Performance Framework includes targets to increase healthy life expectancy at birth in the most deprived areas and to reduce mortality from coronary heart disease among the under 75s in deprived areas. Progress against these measures is reported through Scotland Performs:

http://www.scotland.gov.uk/About/scotPerforms.

The Ministerial Task Force reconvened earlier this year to review progress since the publication of Equally Well. The report of the review was published in June and included a recommendation to convene again in 2012 to review progress:

http://www.scotland.gov.uk/Publications/2010/06/22170625/0.

The Scottish Health Survey (SHeS), with a Scottish sample size around four times that of the GLF, is therefore the preferred population survey measure of alcohol consumption in Scotland. The SHeSUK Comparisons report, published in August 2010, compared SHeS Scottish estimates with Health Survey for England (HSE) figures. It showed that a significantly higher proportion of men and women in Scotland exceeded the sensible daily drinking guidelines and a significantly higher proportion drank twice the recommended limit (a measure of binge drinking) on at least one occasion in the previous week. Mean daily consumption on the heaviest drinking day was also considerably higher for both men and women in Scotland. Millilitres of alcohol purchased is not a robust measure of relative consumption levels across countries, as it takes no account of the strength of the alcohol purchased.

In addition, sales data published by NHS Health Scotland in July 2010 showed that per capital alcohol sales were 24% higher in Scotland in 2009 than in England and Wales. Average weekly sales per adult (aged 16 and over) in Scotland equated to 22.9 units, 4.5 units higher than in England and Wales (18.4 units). Higher alcohol sales in Scotland have been evident throughout the period covered by this data, i.e. since 2005.

The higher per capita weekly alcohol sales in Scotland are likely to, at least in part, explain the higher alcohol-related mortality rates in Scotland. In addition, SHeS data suggests people in Scotland are more likely to exceed sensible daily limits and to binge drink than their English counterparts, increasing their risk of developing acute and chronic alcohol-related health conditions.

Caution should be used in interpretation and comparison of the UK health statistics data given differences in collection methods used across the UK. Anticipated improvements in data collection from next year will provide more consistent figures and allow more accurate comparison across the UK.

The data shows that in Scotland the vast majority of the deaths recorded as being caused by mental and behavioural issues are due to dementia (2,585 out of 3,327). There is no suggestion that more people die from dementia in Scotland than in other parts of the UK and the improvements in data collection will allow more accurate comparison in future. We are committed to improving the quality of life of those with dementia, their families and carers through delivery of our National Dementia Strategy published earlier this year.