Chamber and committees

Systems and associated networks are designed to be resilient. In the event that there is systems failure NHS boards have business continuity plans and local service continuity plans in place which will be invoked if necessary. This applies to all IT systems including those which deal with electronic patient records. The NHS Scotland Security Policy states that boards will undertake a survey of their information systems and data and make an assessment of the likely security risks, including an evaluation of the likely impact and occurrence of any threats that may disrupt services. Boards then introduce measures to mitigate these risks. These include, but are not limited to, processes such as virus checking, regular patching of operating systems software and the provision of back-up systems.

The tools used to assess the cohort identified by the Scottish Patients at Risk of Readmission or Admission (SPARRA) tool would be determined by the number and nature of the conditions of each individual, as well as their social, family and carer context.

The Scottish Government''s Long Term Conditions Collaborative (LTCC) has also worked with teams from NHS boards and their local authority and third sector partners to agree and develop practical guidance on the approach to integrated care management and anticipatory care planning.

In partnership with the Releasing Time to Care initiative, further work is being undertaken to build capability in community teams to apply these approaches. The Scottish Government''s Long Term Conditions Unit and the LTCC are also working with ehealth colleagues on developing the Key Information Summary to support electronic sharing of anticipatory care plans across teams and settings.

The Scottish Government wrote to NHS boards in March 2008 providing guidance on information sharing between NHS Scotland and the police at:

www.sehd.scot.nhs.uk/details.asp?PublicationID=2529.

The guidance sets out how NHS boards and police forces should work together to develop a consistent approach to the sharing of information to promote the prevention and detection of crime, while respecting and safeguarding the interests of patients and the public in the confidentiality of personal health information. The guidance, which remains extant, applies to all NHS settings and to all types of crime.

Additionally, a number of injury surveillance projects are in operation across Scotland. These involve accident and emergency departments sharing anonymised data with the police on injuries caused by assault. The data is used to improve analysis and understanding of patterns of crime to inform decisions on the deployment of local resources aiming to reduce violence. The Scottish Government will consider the evidence emerging from these projects before deciding whether to provide more specific guidance to NHSScotland.

The overall response rate to the 2009-10 GP patient experience survey was 38%. As expected this was lower than the response rate in 2008-09 because the survey was designed to sample more patients from practices that had lower response rates in 2008-09. This improved the accuracy of results for practices with lower response rates. The number of responses that could be used in the calculation of the Quality and Outcomes Framework (QOF) patient experience of access indicators PE7 and PE8 was less than the number of questionnaires that were returned. This was mainly because people had not tried to access the practice in the way specified.

The results for each of the QOF indicators were derived from combinations of three questions. Therefore, the valid responses for an indicator depended on the sequence of questions being answered, and not just a response rate to a particular question “ which would be higher. For example, those who missed out a question or ticked more than one option in a question were excluded from the analysis for that indicator. The observed valid response rates (as % of the total number sent out) are shown in the following tables.

2009-10	(a) Mean	(b) Median	(c) Standard Deviation
PE7 (48 Hour Access)	25%	25%	5%
PE8 (Advance Access)	20%	21%	5%

The results from 2008-09 are shown below for comparison:

2008-09	(a) Mean	(b) Median	(c) Standard Deviation
PE7 (48 Hour Access)	37%	37%	8%
PE8 (Advance Access)	23%	24%	6%

 

The Scottish Patients at Risk of Readmission and Admission (SPARRA) tool is used to estimate the future risk of unscheduled inpatient admission of someone who has experienced at least one such admission in the preceding three years.

The following table shows the number of people who have experienced at least one unscheduled admission in the three years prior to October 2010, broken down by Scottish Index of Multiple Deprivation decile (SIMD: 2009). For each SIMD decile, the table also shows the number and percentage of these individuals whose risk of admission was estimated to be high, which is defined as a SPARRA risk score of 50% or more.

SPARRA Patients by Deprivation Category

Current SIMD: 2009	October 2010
	SPARRA Cohort	High Risk*
			%
1 (Most Deprived)	96,068	8,339	8.7
2	88,805	6,689	7.5
3	84,924	6,242	7.4
4	79,331	5,541	7.0
5	74,220	4,634	6.2
6	90,408	6,847	7.6
7	67,700	3,359	5.0
8	64,174	2,913	4.5
9	59,231	2,369	4.0
10 (Least Deprived)	51,800	1,982	3.8
Total	756,661	48,915	6.5

Source: ISD Scotland.

Ref: IR2011-00220.

The Scottish Patients at Risk of Readmission and Admission (SPARRA) tool is used to estimate the future risk of unscheduled inpatient admission of someone who has experienced at least one such admission in the preceding three years.

The following table shows the number of people meeting this criterion in each NHS board at the start of both financial years. The table also shows the number and percentage of these individuals whose risk of admission was estimated to be high, which is defined as a SPARRA risk score of 50% or more.

SPARRA Patients by NHS Board

	April 2009			April 2010
NHS Board	SPARRA Cohort	High Risk*		SPARRA Cohort	High Risk*
			%			%
Ayrshire and Arran	62,088	4,683	7.5	63,639	4,308	6.8
Borders	18,116	1,257	6.9	18,345	1,268	6.9
Dumfries and Galloway	20,300	1,373	6.8	21,064	1,606	7.6
Fife	49,843	2,813	5.6	50,792	3,215	6.3
Forth Valley	40,406	2,390	5.9	40,749	2,650	6.5
Grampian	71,119	3,639	5.1	72,739	3,973	5.5
Greater Glasgow and Clyde	183,723	13,697	7.5	186,872	13,525	7.2
Highland	44,537	2,708	6.1	45,465	2,741	6.0
Lanarkshire	85,086	5,165	6.1	87,238	5,674	6.5
Lothian	104,030	6,490	6.2	104,233	6,538	6.3
Orkney Islands	2,525	193	7.6	2,545	166	6.5
Shetland Islands	2,916	98	3.4	2,823	90	3.2
Tayside	57,981	2,475	4.3	60,635	3,270	5.4
Western Isles	3,887	257	6.6	3,908	219	5.6
Total	746,557	47,238	6.3	761,047	49,243	6.5

Source: ISD Scotland.

Ref: IR2011-00218.

The Scottish Medicines Consortium (SMC) assesses newly licensed medicines or treatments for clinical and cost-effectiveness and issues advice to NHSScotland.

SMC decisions are made by a panel of experts from different fields including clinicians (medical and pharmacy), public partners, health economists, NHS board Chief Executives and the Association of the British Pharmaceutical Industry.

The SMC does not undertake formal collaboration with any other health technology bodies, either in undertaking assessments or in sharing or developing methodology.

The SMC operates independently from the Scottish Government. Further information about the membership and role of the SMC can be found on their website at www.scottishmedicines.org.uk.

The information requested is not routinely available.

There are two adult medium secure units in Scotland, the Orchard Clinic, Edinburgh and Rowanbank, Glasgow. The Memorandum of Procedure on Restricted Patients defines an abscond as An abscond will have taken place when a restricted patient is absent without authority from a ward, work placement, open supervision (i.e. supervision which does not require the use of physical restraints nor continued oversight), or exceeds his or her authorised suspension of detention, or makes away from an escort. An abscond may be for a brief period of time or for longer.

There have been a small number of absconds from these units as follows:

2007: Two from the Orchard Clinic, 2008: One each from the Orchard Clinic and Rowanbank, 2009: One from the Orchard Clinic, 2010: Two from the Orchard Clinic.

The Memorandum of Procedure on Restricted Patients defines an escape as An escape will have taken place when a restricted patient breaches a physical barrier, for example, breaks out of a locked ward.

No people have escaped from either the Orchard Clinic or Rowanbank in the years 2007, 2008, 2009 or 2010.

The smoking ban has undoubtedly reduced exposure to second-hand smoke among children in Scotland, because of greater awareness among their parents about the risks of second-hand smoke. The Scottish Government has not undertaken any formal assessment of the effects on children of passive smoking in cars to date. However, this specific topic is to be considered by the Research and Evaluation sub-group of the Scottish Ministerial Working Group on Tobacco Control which has been set up to identify gaps in research knowledge in relation to tobacco control.