Chamber and committees

The information requested isdetailed in the following table:

Nhsscotland In-Patient/DayCase Discharges for People Seen Within Eight Weeks (Angiography) or 18 Weeks(Angioplasty and Coronary Artery Bypass Grafts) in Absolute Numbers and as aPercentage of all Patients Receiving those Treatments*^†

Discharged During Quarter End	Angiography‡		Angioplasty		Coronary Artery Bypass Graft
	Number wait ≤ 8 weeks	% wait ≤ 8 weeks	Number wait  ≤ 18 weeks	% wait  ≤ 18 weeks	Number wait  ≤ 18 weeks	% wait  ≤ 18 weeks
March 2000	1,328	68.7	287	86.7	338	57.4
June 2000	1,508	75.9	358	95.5	382	70.2
September 2000	1,303	68.8	392	95.6	404	65.0
December 2000	1,338	71.1	317	93.8	360	65.0
March 2001	1,358	67.4	340	94.2	386	72.4
June 2001	1,266	70.8	322	86.1	399	78.5
September 2001	1,127	63.1	334	88.8	421	78.4
December 2001	1,202	69.0	371	94.2	435	82.4
March 2002	1,359	65.2	363	89.6	392	76.4
June 2002	1,416	72.1	415	87.0	345	82.1
September 2002	1,297	67.6	352	83.2	436	74.2
December 2002	1,322	70.5	343	81.5	376	64.5
March 2003	1,396	63.3	387	83.4	397	71.3
June 2003	1,356	65.2	415	84.7	385	76.2
September 2003	1,417	65.3	405	89.0	421	81.8
December 2003	1,443	70.4	403	84.7	381	79.5
March 2004	1,479	67.4	420	84.0	375	75.8
June 2004	1,234	59.5	461	85.2	357	74.5
September 2004	1,255	55.0	560	90.0	437	87.2
December 2004	1,615	62.5	507	97.3	446	91.2
March 2005	1,877	82.5	540	95.9	424	91.4
June 2005P	1,966	88.2	617	95.2	358	91.6
September 2005P	1,744	89.0	572	97.6	292	91.0
December 2005P	1,440	91.8	474	98.8	219	88.7

Source: ISD SMR01.

^PProvisional – source data are incomplete for laterquarters of 2005

Notes:

*Based on routine admissionsfrom the waiting list for inpatient/day case treatment in acute specialties.

†Includes cases where anAvailability Status Code (ASC) applied.

‡Data for residents of NHSFife and NHS Forth Valley undergoing angiography are excluded due to technicalreasons affecting the capture of waiting times information for these patients.

The table includes patients towhom an Availability Status Code (ASC) applied. ASCs describe certain prescribedcircumstances when it may not be possible to meet a waiting time standard (for examplewhen a patient refuses a reasonable offer of admission or is medically unfit forsurgery).

Thespecific information requested is not available. The recording of Availability StatusCodes on in-patient and day case discharge data is not mandatory. It is not thereforepossible to identify from the available data whether those patients who waited oversix months before treatment held an Availability Status Code.

Census data, provided by NHSboards to ISD Scotland and published each quarter, shows number of patients waitingover specified periods as at the census date. This census data does identify allpatients with an Availability Status Code and it is therefore possible to reporton the number of patients with a guarantee and an Availability Status Code waitingover specified periods on that census date.

As I announced in December 2004,the Availability Status Code system is being abolished and from the end of 2007we will have a clearer, more transparent system that is fairer to patients.

The Executive fully supports the continuing modernisation of audiology services. We are currently commissioning an external clinical audit and a financial audit to monitor progress.

Ring-fenced funding for audiology will be provided to NHS boards for the next two years. It will then be the responsibility of NHS boards to meet the needs of the audiology service from within their general allocation.

Regional Planning Groups (RPGs)are aware of the need to support and monitor regional Managed Clinical Networksonce their pump‑priming funding comes to an end. This will be re-iteratedin the new Health Department Letter on Managed Clinical Networks mentioned in Deliveringfor Health.

The Executive also provides fundingto Epilepsy Scotland in recognition of its work with clinicians and the RegionalPlanning Groups in promoting MCNs as an effective way of providing services forpeople with epilepsy.

I refer the member to thequestion S2W-23700 answered on 9 March 2006. All answers to written parliamentaryquestions are available on the Parliament's website, the search facility forwhich can be found at: http://www.scottish.parliament.uk/webapp/wa.search.

The figure was calculated fromthe total number of patients who were admitted to hospital from the in-patient/daycase waiting list and who were discharged between  1 October 2005 and 31 December 2005. Ofthis total, 90.5% experienced a wait of  six months or less between being addedto the waiting list and being admitted to hospital. The calculation was based onSMR01 (in-patient and day case discharge summaries from non-obstetric, non-psychiatricspecialties) data records submitted by hospitals and available for analysis forthe quarter ending December 2005.

Atthe time of the publication for the period in question, hospitals had submitted55,072 SMR01 discharge records, of which 49,850 (90.5%) had recorded a wait of six months or less for admission. Additional records received later will be includedin future routine analyses and updates of the website. The figures for the quarterended 31 December 2005 are therefore provisional, as the web pages make clear.

Theinformation includes patients with an Availability Status Codes (ASC) – whichrecords circumstances where the waiting time guarantee does not apply (for example,where the patient had asked to postpone their admission at some point after theywere added to the waiting list, where at some point they were medically unfit fora planned procedure, or where they had failed to attend for their treatment). Therecorded waiting times of patients with an ASC are therefore likely to overstatethe period of time for which they were waiting and available for treatment. Patientswith an ASC are excluded from the Executive’s in-patient and day case waiting timeguarantee. The recording of ASCs on the SMR01 database is not mandatory and consistencyof recording will vary across NHSScotland. ASCs cannot, therefore, be excluded fromanalyses of in-patient/day case waiting times.

The SMR01 returns for the quarterended 31 December 2005 do not record the number of patients who, on that date,were waiting more than six months for admission. A separate census of patients waitingat the quarter end date is taken and published. This is referred to as thein-patient/day case waiting list census and the relevant dataset is referred toas SMR3. SMR3 returns calculate waiting times from the date the patient was addedto the waiting list to the census date. The SMR3 census for 31 December 2005 showedthat, of patients who were still waiting at that date and who were covered by thein-patient and day case waiting times guarantee (that is, patients who did not haveASCs), two Were waiting more than six months.

The figure quoted was calculatedfrom SMR00 (out-patient return) data records provided by all NHS boards in respectof patients who attended for new out-patient appointments at NHS clinics taken orled by consultants in acute specialties between 1 October 2005 and 31 December 2005.These returns allow calculation of the waiting time experienced by these patients.It is calculated as the time elapsed between the date each patient’s referral letterfrom a general medical or dental practitioner was received at the hospital and thedate of their out-patient appointment. The records of patients who have an AvailabilityStatus Codes (ASC) are not included in the calculation. ASCs record circumstances where theout-patient waiting time target does not apply (because, for example, the patientasks to delay an appointment, fails to attend and is offered another appointment,or refuses a reasonable offer of an appointment). At the time of the publicationfor the quarter in question, Boards had submitted 190,632SMR00 returns for new out-patient attendances in acute specialties where the patientdid not have an ASC. Of these 171,294 (or 89.9%) recorded a wait of 26 weeks orless.

AdditionalSMR00 records relating to the quarter ended 31 December submitted by boards afterthe closure of the file for the publication of statistics on  23 February 2006 willbe included in future routine analyses and updates of the website. The figures publishedon 23 February are therefore provisional (as the web pages make clear).

TheSMR00 returns for the quarter ended 31 December 2005 do not record the number of patients who, on that date, were waiting morethan 26 weeks for a new out-patient appointment. A separate census of patients waitingat the quarter end date is taken and published. This is referred to as theout-patient waiting list (OPWL) census. The OPWL census allows calculation of waitingtimes from receipt of referral letter at the hospital to the census date. The OPWLcensus for 31 December 2005 showed that, of patients who were waiting at that dateand who were covered by the out-patient waiting times target (that is, patientswho did not have ASCs), two were waiting more than 26 weeks. These cases were theresult of administrative errors. They were seen at out-patient clinics as soon asthe errors were discovered.

The NHS in Scotland and InformationServices Division of NHS National Services Scotland (ISD Scotland) have checkingsystems in place to try to eliminate recording errors from waiting times data. Howeverit is possible that a small proportion of data recording errors are made and includedin the statistics, including errors relating to the calculation of waiting times.

The specific information requestedis not readily available from central statistical returns. It is not currently possibleto calculate the length of time that in-patients/day cases waited between GP referraland admission to hospital. However, information is available on the length of timethat in-patients/day cases waited between the date they were placed on the waitinglist and their date of admission.

Table1 shows the number and percentage of in-patients/day cases admitted within six months,from date placed on the waiting list to date of admission, for the last five financialyears, broken down by quarter of discharge. The total number of in-patient/day casedischarges in the period is also shown. All figures refer only to in-patients/daycases routinely admitted from home from the waiting list.

Thefigures in the table include patients with an Availability Status Codes (ASC)– which records circumstances where the waiting time guarantee does not apply (forexample, where the patient is medically unfit for a planned procedure). The recordingof ASCs on the source database is not mandatory and consistency of recording willvary across NHSScotland. ASCs cannot, therefore, be excluded from analyses ofin-patient/day case waiting times.

Table1: Number and Percentage of In-Patients and Day Cases Admitted within Six Months- Quarters Ending 30 June 2000 to 31 December 2005

Discharged During Quarter Ended:	Total Number of In-Patient and Day Case Discharges	In-Patients and Day Cases Admitted within 6 Months
		Number of In-Patient and Day Case Discharges	Percentage of Total In-Patient and Day Case Discharges
Jun 2000	117,046	106,394	90.9
Sep 2000	115,093	103,682	90.1
Dec 2000	117,107	105,350	90.0
Mar 2001	117,293	105,753	90.2
Jun 2001	108,406	97,475	89.9
Sep 2001	106,876	95,261	89.1
Dec 2001	108,865	97,401	89.5
Mar 2002	111,934	99,838	89.2
Jun 2002	101,561	90,893	89.5
Sep 2002	100,536	89,294	88.8
Dec 2002	102,379	89,467	87.4
Mar 2003	104,232	89,888	86.2
Jun 2003	99,460	86,255	86.7
Sep 2003	99,941	86,044	86.1
Dec 2003	102,610	86,881	84.7
Mar 2004	108,367	92,666	85.5
Jun 2004	102,975	89,898	87.3
Sep 2004	101,365	87,914	86.7
Dec 2004	102,714	88,036	85.7
Mar 2005	101,606	87,351	86.0
Jun 2005p	103,823	92,752	89.3
Sep 2005p	92,640	83,867	90.5
Dec 2005p	70,457	63,762	90.5

Source: ISD SMR01.

^PProvisional – these data may be incomplete. The figuresrelate to the number of records which were available for inclusion at the time ofthis analysis – this differs from the number of records available at the time of the Acute Hospital Care website publication. The actual number of cases seen maybe higher. Additional records received later will be included in future updatesof the percentage seen within six months figure on the website.

Centrally held informationcan provide details of general medical and dental practitioner (GP) referrals toconsultant outpatient clinics and the time elapsed to the first out-patient appointment.

The following table details the number and percentageof appointments within 26 weeks of referral* by a GP, for each quarter up to andincluding December 2005.

The information excludes patients who have an Availability Status Codes (ASC).ASCs record circumstanceswhere the outpatient waiting time target does not apply (because, for example, thepatient asks to delay an appointment, fails to attend and is offered another appointment,or refuses a reasonable offer of an appointment).

Quarter Ending	No. Seen Within 26 Weeks	% Seen Within  26 Weeks	Total Waiting Times Cases Seen
June 2000	218,970	93.7	233,620
September 2000	212,519	93.9	226,291
December 2000	220,457	92.5	238,416
March 2001	219,358	91.4	240,119
June 2001	213,416	90.8	235,043
September 2001	208,770	90.8	229,864
December 2001	213,837	89.4	239,194
March 2002	210,009	88.2	238,034
June 2002	207,336	87.9	235,780
September 2002	205,093	87.9	233,435
December 2002	207,141	86.3	240,159
March 2003	205,956	85.8	240,128
June 2003	194,599	87.2	223,210
September 2003	193,096	88.0	219,410
December 2003	195,990	87.1	225,015
March 2004	199,930	86.0	232,467
June 2004	189,651	87.3	217,241
September 2004	184,883	87.1	212,341
December 2004	193,967	83.9	231,291
March 2005	189,002	81.5	231,900
June 2005P	201,411	88.5	227,550
September 2005P	185,816	90.9	204,388
December 2005P	184,941	90.0	205,534

Source: ISD SMR00.

*Based on date referral receivedby hospital.

^PProvisional – these data may be incomplete. The figuresrelate to the number of records which were available for inclusion at the time ofthis analysis – this differs from the number of records available at the time of the Acute Hospital Care website publication. The actual number of cases seen maybe higher. Additional records received later will be included in future updatesof the percentage seen within 26 weeks figure on the website.

The number of in-patients andday cases with a guarantee is currently measured by a quarterly in-patient/day caseWaiting List Census (SMR3). The census records each patient waiting and how longthey have been waiting on the last day of March, June, September and December andwhether they have an Availability Status Code (ASC). Patients without an ASC havea guaranteed maximum wait, but patients referred to obstetric, psychiatric and longstay sectors are specifically excluded. The census information is reported by eachunified NHS board to ISD and the figures are reported on ISD’s website approximatelyseven weeks after the date of the census.

AvailabilityStatus Codes can be applied in the following circumstances:

ASC A: for patients with medical constraints that prevent admission for treatment

ASC 2: where the patient has asked to defer admission for personal reasons or refusedan offer of admission or an out-patient appointment has been rescheduled for his/herconvenience

ASC 3: in individual cases where, after discussion with the patient, the treatmenthas been judged of low medical priority

ASC 4: for highly specialised treatments identified at time of placing the patienton a waiting list

ASC 8: for patients who did not attend (DNAs)

ASC 9: in the circumstances of exceptional strain on the NHS such as a major disaster,major epidemic or outbreak of infection, or service disruption by industrial action.

Currently some 88per cent of patients with an ASC have codes A, 2 and 8 and these situations arepatient driven rather than NHS driven. I announced in December 2004 that ASCs willbe abolished by 31 December 2007 and be replaced by a fairer and more transparentsystem. From 31 December 2007, patients will be treated within 18 weeks of beingplaced on the waiting list. Any periods of unavailability for treatment for medical,social or personal will be deducted from patients’ calculated waiting time. Patientswho fail to attend or who refuse a reasonable offer of treatment may be referredback to the care of their GP.