Chamber and committees

The information requested is not available centrally.

The Scottish Government continues to work with NHS Scotland to provide a high quality of care which is quick and safe. For example, last year two £100 million new hospitals were opened at Stobhill and the Victoria in Glasgow which have redesigned their services around the needs of the patient to enhance the quality of care and speed up diagnosis and treatment.

As part of the Scottish Government''s commitment to reduce waiting times, the Health Delivery Directorate''s Improvement Support Team continues to work with all NHS boards to redesign and transform services across Scotland to improve access through all stages of the patient pathway. This work aims to help all NHS boards to deliver the 18 weeks referral to treatment time target that is due to be delivered by end of December 2011.

The latest published figures for 30 June 2010 showed that patients are effectively receiving an outpatient consultation within 12 weeks, key diagnostic tests within four weeks and inpatient and day case treatment within nine weeks. This clearly shows that patients across Scotland are now experiencing shorter waits for outpatient consultations, tests and treatment.

Following evaluation of choices made by medical trainees, NHS Education for Scotland has developed a refreshed marketing strategy to attract medical trainees to remote and rural areas of Scotland.

Through year-on-year increases in resource allocations to NHS boards, the Scottish Government has maintained the financial incentives scheme available to support recruitment of GPs in remote and rural and deprived areas, where every GP taking up post is awarded a supplementary payment of £5,000. All doctors who work in the Scottish islands continue to be entitled to receive the Scottish Distant Islands Allowance.

The information requested is not held centrally.

The revised clinical guideline (Guideline 101) on the management of asthma, published on 30 June 2009 by the British Thoracic Society in conjunction with the Scottish Intercollegiate Guidelines Network (SIGN), recommends that people with asthma should be offered self-management education that focuses on individual needs, and that this should be reinforced by a written personalised action plan.

We expect clinicians in NHS Scotland to take account of the recommendations in SIGN Guidelines.

I refer the member to the answer to question S3W-36238 on 24 September 2010. 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.

The following table shows the number of hospital stays where asthma is recorded as the main diagnosis at the beginning of the hospital stay and the number of emergency readmissions for asthma within 28 days of a previous hospital stay for asthma for the last 20 years. It also shows the admission and readmission rates per 100,000 population.

Number of Hospital Stays where Asthma is Recorded as the Main Diagnosis at the Beginning of the Hospital Stay and Number of Emergency Readmissions for Asthma within 28 Days of a Previous Hospital Stay for Asthma, By Financial Year of Discharge

Year of discharge	Number of Asthma Hospital Stays	Rate per 100,000 Population	Number of Asthma Emergency Readmissions within 28 days	Rate per 100,000 Population
1990-91	9,203	181.1	751	14.8
1991-92	9,721	191.2	769	15.1
1992-93	9,173	180.4	747	14.7
1993-94	9,954	195.5	682	13.4
1994-95	8,668	169.9	694	13.6
1995-96	9,148	179.2	658	12.9
1996-97	7,839	153.9	619	12.2
1997-98	7,619	149.9	564	11.1
1998-99	7,165	141.1	504	9.9
1999-2000	7,061	139.2	417	8.2
2000-01	6,175	122.0	420	8.3
2001-02	6,135	121.1	356	7.0
2002-03	6,102	120.7	379	7.5
2003-04	6,131	121.2	389	7.7
2004-05	6,833	134.6	490	9.6
2005-06	6,219	122.1	465	9.1
2006-07	7,260	141.9	577	11.3
2007-08	6,402	124.5	481	9.4
2008-09	7,134	138.0	506	9.8
2009-10P	6,272	120.8	453	8.7

^PProvisional.

Source: ISD Scotland.

Notes:

The basic unit of analysis for these figures is a continuous stay in hospital. Probability matching methods have been used to link together individual SMR01 (Scottish Morbidity Record 01) 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).

All discharges (hospital stays) with an initial main diagnosis of asthma are included in the analysis. Each discharge is then compared with the next admission to hospital for asthma for the same patient. If this subsequent admission occurs within 28 days of the date of discharge for the previous hospital stay and is coded as an emergency admission, it is selected as a relevant readmission.

The information presented relates to the conventional approach that relies on the statistical circumstance that the distribution of the interval to emergency readmissions forms a distinct peak in the days following discharge. Readmissions fall away thereafter to approach background level of admission. This suggests that there is a strong probability that readmissions in the period following discharge are in fact related to that discharge. The period of 28 days is to some extent arbitrary, but has been widely adopted as maximising the trade off between including as many related readmissions as possible and excluding as many unrelated readmissions as possible. The figures include readmissions within 28 days whether or not the readmission was related to the previous hospital stay.

The Quality and Outcomes Framework (QOF) of the new GMS contract incentivises GPs to record the number of patients diagnosed with asthma and to put in place a system for their ongoing review. The Scottish Government is not aware of any studies examining the impact of quality improvement measures such as the QOF on admission or readmission rates for asthma in Scotland.

In addition, NHS Quality Improvement Scotland (NHS QIS) published clinical standards for asthma services for children and young people in March 2007, which provide clear advice and guidance on effective clinical practice. NHS boards'' progress towards implementing the standards was reviewed in November 2008 and the recommendations contained within the NHS QIS national overview report are being taken forward by the respiratory managed clinical networks (MCNs) which have been developed in all NHS Boards with pump priming funding from the Scottish Government. The MCNs act as the vehicles for local implementation of relevant standards and guidelines. This helps ensure consistency of care, as well as the delivery of HEAT target T6, which includes reducing hospital admissions for those with a primary diagnosis of asthma.

Self-management has a central role in NHS Scotland''s Healthcare Quality Strategy which includes three key quality ambitions: that services should be person-centred, safe and effective.

The person-centred quality ambition promotes mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making. This means staff should work with people to set personalised goals and signpost them to the type of support and information they need to help them live well. This includes information on self-management.

This ambition closely mirrors the principles of self management that are central to the Gaun Yersel'' self-management strategy for Scotland, developed by the Long Term Conditions Alliance Scotland. Implementation of the self-management strategy is being delivered as part of our long-term conditions action plan and is a key improvement intervention within the quality strategy.

Supporting people to understand their symptoms and to have more confidence and control in managing their conditions improves their health and wellbeing, enables earlier and more effective intervention by the right team at the right time and so supports our effective quality ambition.

Self-management also has a key role in improving safety in NHSScotland. People who have the right information and advice about their condition are far more likely to have a full understanding of treatments and interventions, to manage their medication safely, recognise flare-ups at an early stage and avoid harmful triggers and situations.

Condition specific self-management plans are already in use throughout NHS Scotland, particularly for conditions such as diabetes, asthma, chronic obstructive pulmonary disease and epilepsy. These help people understand their symptoms, provide guidance on who to turn to for further support and information, and enable them to make health choices and be properly involved in decisions about care and treatments. People living with more than one long-term condition may be better served by a generic self-management plan, which, if appropriate, may also include a personalised healthcare and support plan.

The following table shows the number of hospital stays where asthma is recorded as the main diagnosis at the beginning of the hospital stay and the number of emergency readmissions for asthma within 28 days of a previous hospital stay for asthma for year ending 31 March 2010. The table also shows the admission and readmission rates per 100,000 population.

Number of Hospital Stays where Asthma is Recorded as the Main Diagnosis at the Beginning of the Hospital Stay and Number of Emergency Readmissions for Asthma within 28 days of a Previous Hospital Stay for Asthma, Year Ending 31 March 2010^P

NHS Board of Residence	Number of Asthma Hospital Stays	Rate per 100,000 Population	Number of Asthma Emergency Readmissions within 28 days	Rate per 100,000 Population
NHS Ayrshire and Arran	520	141.6	46	12.5
NHS Borders	118	104.7	5	4.4
NHS Dumfries and Galloway	158	106.4	11	7.4
NHS Fife	417	114.8	38	10.5
NHS Forth Valley	311	106.7	33	11.3
NHS Grampian	555	101.8	44	8.1
NHS Greater Glasgow and Clyde	1,644	137.1	97	8.1
NHS Highland	403	129.8	40	12.9
NHS Lanarkshire	739	131.4	39	6.9
NHS Lothian	903	109.3	47	5.7
NHS Orkney Islands	14	70.1	-	-
NHS Shetland Islands	12	54.0	-	-
NHS Tayside	436	109.1	47	11.8
NHS Western Isles	42	160.4	6	22.9
Scotland	6,272	120.8	453	8.7

^PProvisional.

Source: ISD Scotland.

Notes:

The basic unit of analysis for these figures is a continuous stay in hospital. Probability matching methods have been used to link together individual SMR01 (Scottish Morbidity Record 01) 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).

All discharges (hospital stays) with an initial main diagnosis of asthma are included in the analysis. Each discharge is then compared with the next admission to hospital for asthma for the same patient. If this subsequent admission occurs within 28 days of the date of discharge for the previous hospital stay and is coded as an emergency admission, it is selected as a relevant readmission.

The information presented relates to the conventional approach that relies on the statistical circumstance that the distribution of the interval to emergency readmissions forms a distinct peak in the days following discharge. Readmissions fall away thereafter to approach background level of admission. This suggests that there is a strong probability that readmissions in the period following discharge are in fact related to that discharge. The period of 28 days is to some extent arbitrary, but has been widely adopted as maximising the trade off between including as many related readmissions as possible and excluding as many unrelated readmissions as possible. The figures include readmissions within 28 days whether or not the readmission was related to the previous hospital stay.

This information is not held centrally by the Scottish Government. As the independent and recognised sports governing body for football the Scottish Football Association is responsible for the development of football in Scotland and the member may wish to contact them directly for this information:

George Peat

President

The Scottish Football Association

Hampden Park

Glasgow

G42 9AY

Tel: 0141 616 6000

Email: [email protected].

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This information is not held centrally by the Scottish Government. Not all local authorities have in place sports pitch and facility strategies which outline current provision and help to determine future priority areas based on local needs and priorities. As of September 2010, 18 local authorities have pitch strategies in place with a further eight local authorities in the process of preparing them. A wide range of practical and technical advice is available to local authorities from sportscotland on the preparation of sports pitch and facility strategies and on the planning and development of facilities more generally.

The Scottish Government has invested over £17 million in quality facilities through the National and Regional Sports Facilities Strategy which will have a significant positive impact on football. These include indoor and outdoor synthetic football pitches at Aberdeen Sports Village, Toryglen Regional Football Centre, both of which are open to the public, with the Ravenscraig Sports Facility due to open soon.

In addition, sportscotland operate a Sports Facilities Fund which offers funding to eligible groups to help in the development and upgrading of facilities and since 2007 this has seen over £21 million invested in facilities throughout Scotland.

The Scottish Government has developed a programme of web based health checks for people when they reach 40 in association with NHS 24. The Life Begins at 40 pilot service was launched in Grampian in May 2010. To the first week in September, 212 people have accessed the system.

Keep Well currently delivers inequalities targeted health checks to individuals in the most deprived communities across Scotland. These are targeted at those aged
45 to 64 and individuals outwith this age range may also receive a check if they are considered to be particularly vulnerable or at risk. Around 85,000 checks have been undertaken around Scotland. A record of those checked at 40 years of age is not maintained.

Pilots to introduce universal health checks for all Scots aged 40 to 74 are due to begin in 2011.