Questions and answers

Question reference: S2W-26365

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 30 May 2006
Current Status: Answered by Lewis Macdonald on 13 June 2006

To ask the Scottish Executive what assessment it has made of the role of multidisciplinary teams in the treatment of inflammatory arthritis.

The Executive acknowledges thatmanaging inflammatory arthritis through a multidisciplinary team, which would includenurses and therapists, would provide the best outcome for the patient and theircarers, by addressing various aspects of health and social care: treatment, rehabilitation(including vocational rehabilitation), prevention of complications and other illnesses,and the promotion of health and well-being.

Question reference: S2W-26429

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 31 May 2006
Current Status: Answered by Andy Kerr on 12 June 2006

To ask the Scottish Executive whether the recommendations in the 2000 report by Dr Richard Simpson on influenza vaccination have been implemented.

Question reference: S2W-26332

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 25 May 2006
Current Status: Answered by Andy Kerr on 9 June 2006

To ask the Scottish Executive how many in-patients with a guaranteed waiting time have waited for over six months to be treated in each quarter in each of the last five years.

The majority of patients whorequire in-patient and day case treatment are treated quickly. Nearly 53% of thepatients treated in NHSScotland hospitals receive immediate treatment and neverjoin a waiting list. Of those who do wait over 40% are admitted within one monthand over 70% within three months.

The Executive has been steadilyreducing the maximum waiting time for those patients who wait longer. The nationalmaximum waiting time was reduced from 12 months to nine months on 31 December 2003 andto six months on 31 December 2005. This will be further reduced to 18 weeks from the endof 2007. On 31 March 2006, no NHSScotland patient with a guarantee had waited morethan six months for in-patient and day case treatment.

NHSScotland is making good progresstowards meeting the next key target of a maximum wait of 18 weeks by the end of2007. At that point, a new approach to defining and measuring waiting will alsobe introduced to replace availability status codes (ASCs), which have the effectat present of excluding patients from waiting times guarantees where, for example,they are medically unfit for treatment, where they have asked for their treatmentto be postponed, or where their treatment is highly specialised or of low clinicalpriority. The new approach will be fairer, more consistent and more transparent.

Retrospective analyses of waiting times forhospital treatment compiled from SMR01 returns are based on data that does not recordwhether patients have had an ASC applied. The information requested is providedin the following table and itincludes the waiting times of patients who have been exempted from the guaranteefor the reasons given above and therefore overstates true waiting times. It is notpossible to estimate the extent of the overstatement. The SMR3 waiting times censusdata, which excludes patients with ASCs, is used for target compliance purposes,and the table provided also includes SMR3 data for NHSScotland from the censusesundertaken in each quarter since 30 June 2001.

NHSScotland: Number of Patientswho had Waited More Than Six Months* and the Percentage Treated Within Six Months*from Being Placed on the Waiting List to Admission for In-Patient or Day Case Treatmentin Each Quarter Since 30 June 2001

Quarter Ending	Waiting Time Commitment	Number Of Patients Who Waited More Than 6 Months*
30 June 2001	12 months	6,246
30 September 2001	12 months	6,787
31 December 2001	12 months	6,588
31 March 2002	12 months	6,838
30 June 2002	12 months	6,516
30 September 2002	12 months	6,849
31 December 2002	12 months	7,716
31 March 2002	12 months	8,068
30 June 2003	12 months	7,149
30 September 2003	12 months	7,299
31 December 2003	9 months	7,703
31 March 2004	9 months	7,746
30 June 2004	9 months	6,837
30 September 2004	9 months	6,979
31 December 2004	9 months	7,522
31 March 2005	9 months	7,400
30 June 2005	9 months	6,026
30 September 2005^P	9 months	4,896
31 December 2005^P	6 months	4,851
31 March 2006^P	6 months	2,516

Source: ISD SMR01

^PProvisional.

*Includes patients with an AvailabilityStatus Code. Consequently, true waiting times are likely to be overstated becauseof periods of medical unavailability, etc.

Includes information on patientsadmitted from the deferred waiting list until its abolition on 1 April 2003.

NHSScotland: Number of Patientson The Waiting List with a Guarantee Who Had Waited More Than Six Months forIn-Patient or Day Case Treatment on Each Quarterly Census Date Since 30 June 2001

Census Date	Waiting Time Commitment	Number Of Patients Who Were Waiting More Than 6 Months
30 June 2001	12 months	11,607
30 September 2001	12 months	12,223
31 December 2001	12 months	12,781
31 March 2002	12 months	10,882
30 June 2002	12 months	12,336
30 September 2002	12 months	12,381
31 December 2002	12 months	11,535
31 March 2002	12 months	8,959
30 June 2003	12 months	9,972
30 September 2003	12 months	10,538
31 December 2003	9 months	8,507
31 March 2004	9 months	5,727
30 June 2004	9 months	6,161
30 September 2004	9 months	7,512
31 December 2004	9 months	6,005
31 March 2005	9 months	1,596
30 June 2005	9 months	1,118
30 September 2005	9 months	1,249
31 December 2005	6 months	2
31 March 2006	6 months	0

Source: ISD SMR3.

Question reference: S2W-26406

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 31 May 2006
Current Status: Answered by Andy Kerr on 8 June 2006

To ask the Scottish Executive whether the correct procedures were followed in the sale of land in August 2004 by NHS Grampian to property development company, Camvo 37; whether the land was advertised for sale, and what the reasons were for the selling price of £2.

The Scottish Executive HealthDepartment annually monitors property transaction reports prepared by each NHS board’sinternal auditor and in this transaction the report confirms that the correctprocedures were followed by NHS Grampian.

The property was notadvertised for sale given the decision to sell for a health-related purpose.This is one of a number of instances where NHS bodies can sell off-market whichare collectively referred to as priority interests.

Where a transaction isdeemed appropriate to proceed on an off-market basis for a health-relatedpurpose to a non-NHSScotland body the sale price is determined by aprofessional valuer. In this instance the sale price was recommended by theDistrict Valuer who took into account the health-related nature of thetransaction, that the houses were in poor condition and required expenditure toupgrade before they were fit for occupation by people with learningdisabilities and that no grant assistance was available.

Question reference: S2W-26430

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 31 May 2006
Current Status: Answered by Andy Kerr on 8 June 2006

To ask the Scottish Executive which of the recommendations specific to pandemics in the 2000 report by Dr Richard Simpson on influenza vaccination have been implemented and whether the recommendations contributed to the formation of the influenza pandemic contingency plans for Scotland.

The Scottish Executiveresponded to the recommendations in the 2000 report by Dr Richard Simpson in December 2000. A copy of thatresponse can be found at:http://www.scottish.parliament.uk/business/committees/historic/health/papers-01/hep01-01.pdf.

The most recent version of the UK Influenza Contingency Plan was issued in October 2005. This is aconstantly developing area of work and the plan reflects the most up to datethinking and advice.

Question reference: S2W-26302

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 25 May 2006
Current Status: Answered by Andy Kerr on 7 June 2006

To ask the Scottish Executive whether local NHS boards are free to adopt guidance that differs from National Institute for Health and Clinical Excellence guidance which has been endorsed by NHS Quality Improvement Scotland.

Question reference: S2W-26305

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 25 May 2006
Current Status: Answered by Andy Kerr on 7 June 2006

To ask the Scottish Executive what measures it has put in place to improve implementation by NHS Scotland of the National Institute for Health and Clinical Excellence technology appraisal guidance, Acute coronary syndromes - clopidogrel (No. 80).

Question reference: S2W-26303

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 25 May 2006
Current Status: Answered by Andy Kerr on 7 June 2006

To ask the Scottish Executive whether it will clarify which guidance takes precedence in the event that there are differences between guidance produced by the Scottish Intercollegiate Guidelines Network and that of the National Institute for Health and Clinical Excellence endorsed by NHS Quality Improvement Scotland.

Question reference: S2W-26304

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 25 May 2006
Current Status: Answered by Andy Kerr on 7 June 2006

To ask the Scottish Executive what assessment has been made of the performance of NHS Scotland in the implementation of the National Institute for Health and Clinical Excellence technology appraisal guidance, Acute coronary syndromes - clopidogrel (No. 80).

No specific assessment hasbeen made.

Coronary heart disease is a clinicalpriority for NHSScotland. NHS boards are expected to implement therecommendations of National Institute for Health and Clinical Excellencetechnology appraisals when they have been endorsed by NHS Quality ImprovementScotland. Where a recommended treatment is not being made available, this willbe pursued pro-actively with the NHS boards concerned.

Question reference: S2W-25914

Asked by: Nanette Milne, MSP for North East Scotland, Scottish Conservative and Unionist Party
Date lodged: Friday, 12 May 2006
Current Status: Answered by Andy Kerr on 25 May 2006

To ask the Scottish Executive how many hospital patients have venous thrombosis; what percentage of patients receive appropriate prevention treatment, and what action is being taken to educate hospital staff on the extent of venous thromboembolism.

It is not possible, from centrallyheld hospital discharge records, to identify explicitly patients who acquired venousthrombosis whilst in hospital. The figures given in the table describe the numberof patients in Scotland discharged from hospital with a main or secondary conditionof venous thrombosis. These figures will include people who acquire venous thrombosisin hospital but may also include patients admitted with venous thrombosis.

AcuteHospital (Non-Obstetric, Non-Psychiatric) In-Patient/Day Case Discharges with anyDiagnosis of Venous Thrombosis (Years Ending 31 March 2001 to 2005)

2001	7,047
2002	6,869
2003	6,886
2004	6,421
2005	6,069

Source: ISD. The data relateto the following International Classification of Diseases 10th revision (ICD10)codes:

GO8.X: Intracranial and intraspinalphlebitis and thrombophlebitis.

126: Pulmonary Embolism.

163.6: Cereb infarct due cerebralvenous thrombosi, nonpyogenic.

167.6: Nonpyogenic thrombosisof intracranial venous system.

180: Phlebitis and thrombophlebitis.

181: Portal vein thrombosis.

182.2: Embolism and thrombosisof vena cava.

182.3: Embolism and thrombosisof renal vein.

182.8: Embolism and thrombosisof other specified veins.

182.9: Embolism and thrombosisof unspecified vein.

K75.1: Phlebitis of portal vein.

O22.2: Superficial thrombophlebitisin pregnancy.

O22.3: Deep phlebothrombosisin pregnancy.

O22.5: Cerebral venous thrombosisin pregnancy.

O87.0: Superficial thrombophlebitisin the puerperium.

O87.1: Deep phlebothrombosisin the puerperium.

O87.3: Cerebral venous thrombosisin the puerperium.

Data on the percentage of patientsreceiving appropriate prevention treatment is not held centrally. The Scottish Surveillanceof HAI Programme (SSHAIP), a national audit of surgical site infection, does, however,include data on the number of orthopaedic patients receiving prophylaxis for venousthromboembolism (VTE), in accordance with SIGN Guideline 62. The SSHAIP data showthat 91% of such patients receive prophylaxis. This can be regarded as indicativeof coverage in orthopaedic patients in general, a group particularly at risk ofVTE.

In addition, maternity unitsin Scotland are working to local protocols for VTE, covering bothprophylaxis and treatment, based on guidelines from the Royal College of Obstetricsand Gynaecology and SIGN Guideline 62.

NHS Quality Improvement Scotlandintends to carry out an exercise taking stock of all the initiatives in place inNHSScotland across different clinical specialties aimed at preventing VTE. The resultswill help to determine how best to raise awareness amongst hospital staff.

Chamber and committees