Questions and answers

Question reference: S3W-14129

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Thursday, 12 June 2008
Current Status: Answered by Shona Robison on 23 June 2008

To ask the Scottish Executive what funding will be allocated to support the Choose Life programme in 2009-10 and 2010-11.

Following Spending Review 2007, £1.2 million is allocated to national Choose Life activity for each of 2009-10 and 2010-11.

In line with the concordat between government and COSLA, funding for local suicide prevention activity will be drawn from the overall funding provided to local authorities, and will be determined by local need. Total funding to local government for 2008-11 is £34.7 billion; split £11.1 billion/£11.6 billion/£12 billion.

Question reference: S3W-13713

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 13 June 2008

To ask the Scottish Executive whether patients who did not attend for a scheduled appointment but reported subsequently, after presenting reasonable grounds for original non-attendance, have had their waiting time clock stopped, reset to zero or were removed from the list completely and sent back to the GP for a new referral.

The information requested is not available centrally.

Published national guidance on the management of waiting lists states that if a patient does not attend on the agreed date then the patient would be recorded as a “Did Not Attend” and their waiting time clock re-set to zero. The health care professional responsible for treating the patient can decide whether to refer the patient back to the care of their GP or to offer another appointment. However, hospitals have the discretion based on the individual patient’s circumstance to offer the patient a new appointment quickly.

The guidance also makes clear that the patient and the patient’s GP should be informed if a decision is made to return a patient to the care of their GP. The GP can of course re-refer the patient.

Question reference: S3W-13711

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 13 June 2008

To ask the Scottish Executive how many patients appealed against the decision to remove them from waiting lists for reasons listed in WT28 codes 37, 38, 40 and 41.

Information on appeals against decisions to remove patients from waiting lists is not collected centrally. We are not aware of any appeals that have been made or indeed any complaints received. There are a number of safeguards that protect the interests of patients in relation to their position on hospital waiting lists.

I have made clear that patients will be able to ask, at any time, to see the waiting time information held by their local NHS board about them and if necessary to have that information corrected. The Independent Advice and Support Service are also available to support patients or their representatives in making representation to NHS boards about any aspects of hospital care including their removal from a waiting list.

The NHS in Scotland already has a well established formal complaints procedure in place. Information on the number of complaints made and the issues raised, including waiting times, is published annually. It will not be possible to separate complaints relating to the operation of New Ways from complaints about other aspects of waiting times.

The New Ways guidance sets out the rule around the removal of patients from the waiting list and it makes clear that the GP and the patients must be informed. We would normally expect that the reasons for removal from a waiting list are discussed and agreed between the clinician and the patient. Where patients are returned to the care of their GP they can of course be re-referred once they are available for hospital care.

Question reference: S3O-03756

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Thursday, 12 June 2008
Current Status: Answered by John Swinney on 12 June 2008

To ask the Scottish Executive what discussions it has had with local authorities on determining the specifics of efficiency savings.

Question reference: S3W-13708

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 12 June 2008

To ask the Scottish Executive how many of the 20,931 out-patients and the 2,452 in-patients that were removed from the New Ways waiting list in the first quarter of 2008 were removed for each of the reasons under WT28 codes 20, 21, 37, 38, 40, 41, 42 and 43.

The information requested is shown in the following tables. The information provided is a breakdown of 20,931 out-patients and 2,452 in-patients and day cases and only relates to patients who were returned to the care of their GP and the reasons.

Information relating to Code 43 - inappropriate addition to list - was not presented in the New Ways statistics published on 27 May 2008, but was included in the total number of removals from the waiting list. The number of patients removed from the waiting list under Code 43 for the quarter ending 31 March 2008, was 18,608 for new out-patients and 4,703 for in-patients and day cases.

There are data quality issues around the statistics relating to reasons why patients have been removed from waiting lists. Consequently the data provided is provisional and is expected to change when the next set of statistics is published at the end of August 2008. Details of the quality issues can be found at:

http://www.isdscotland.org/isd/5573.html

NHSScotland: Number Of New Out-Patients Removed From Waiting List, and Recorded Under Reason for Removal Codes: Quarter Ending 31 March 2008^P

Removal Reason	Removal Reason Description	Quarter Ending 31 March 2008^P
Code 20	Referred back to GP – Social unavailability¹	2,387
Code 21	Referred back to GP – Medical unavailability¹	99
Code 37	Referred back to GP – Could not attend²	3,156
Code 38	Referred back to GP – Did not attend	11,867
Code 40	Referred back to GP – Refused ‘reasonable offer’	49
Code 41	Referred back to GP – No response to offer	1,960
Code 42	Referred back to GP – Inappropriate referral	1,413

^PProvisional: It is known that the accuracy of recording of these codes has varied by NHS board and these figures should be used with caution.

Source: Waiting Times Data Warehouse, ISD Scotland.

Notes:

1. No end date known for period of unavailability. Unless clinically inappropriate the patient is returned to GP care.

2. Patient asked to reschedule appointment on three or more occasions. Unless clinically inappropriate the patient is returned to GP care.

NHSScotland: Number Of In-Patients and Day Cases Removed from Waiting List, and Recorded Under Reason for Removal Codes: Quarter Ending 31 March 2008^P

Removal Reason	Removal Reason Description	Quarter Ending 31 March 2008^P
Code 20	Referred back to GP – Social unavailability¹	341
Code 21	Referred back to GP – Medical unavailability¹	179
Code 37	Referred back to GP – Could not attend²	120
Code 38	Referred back to GP – Did not attend	1,338
Code 40	Referred back to GP – Refused ‘reasonable offer’	205
Code 41	Referred back to GP – No response to offer	55
Code 42	Referred back to GP – Inappropriate referral	214

^PProvisional: It is known that the accuracy of recording of these codes has varied by NHS board and these figures should be used with caution.

Source: Waiting Times Data Warehouse, ISD Scotland.

Notes:

1. No end date known for period of unavailability. Unless clinically inappropriate the patient is returned to GP care.

2. Patient asked to reschedule appointment on three or more occasions. Unless clinically inappropriate the patient is returned to GP care.

Question reference: S3W-13710

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 10 June 2008

To ask the Scottish Executive what codes are applied to a patient being removed from waiting lists where the referral is not from a GP.

The information requested, for new out-patients is provided in the following table. Information for in-patients, day cases and return out-patients is not centrally available.

NHSScotland: New Out-patients Removed from Waiting List Where the Patient was Not Referred by a General Medical Practitioner or General Dental Practitioner. Codes Used During Quarter Ending 31 March 2008

Removal Reason	Removal Reason Description
10	Attended/admitted
20	Referred back to GP - Social unavailability
21	Referred back to GP - Medical unavailability
37	Referred back to GP - Could not attend
38	Referred back to GP - Did not attend
40	Referred back to GP - Refused “reasonable offer”
41	Referred back to GP - No response to offer
42	Referred back to GP - Inappropriate referral
43	Inappropriate addition to list
50	Transferred within NHS Board area to another specialty
51	Transferred within NHS Board area to another hospital
59	Transferred to another NHS Board area
80	Treatment no longer required
90	Died

Source: Waiting Times Data Warehouse, ISD Scotland.

Question reference: S3W-13716

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 10 June 2008

To ask the Scottish Executive, further to the answer to the first supplementary to question S3O-2738 by Nicola Sturgeon on 20 March 2008 (Official Report c. 7216), what steps have been taken by itself or individual NHS boards to monitor and evaluate the patient experience of the New Ways waiting times system.

The overall aim of the “Better Together” programme is to gather information on the patient experience, which will be used to drive forward service improvements. In the first few years the programme will focus on In-patients, commencing in autumn 2008. This may include general information on patient experience of waiting times. Details are still being developed and have yet to be finalised.

I have already asked ISD Scotland for a New Ways data quality assurance project to be undertaken. I understand this may include an evaluation of the patient experience based on a random sample of patients from each NHS board. The project is currently being designed and is due to report by October 2008.

As you will also be aware, the Auditor General for Scotland will also be undertaking a review of how the NHS applies the new system of defining and measuring waiting times.

Question reference: S3W-13715

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 10 June 2008

To ask the Scottish Executive whether a patient, in responding to the offer of an appointment under New Ways waiting times system and stating a “social reason” for unavailability, is able to have the clock stopped up to a date defined by that patient.

Question reference: S3W-13717

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 10 June 2008

To ask the Scottish Executive what the detailed breakdown was of the 12,868 out-patients and 8,130 in-patients deleted from waiting lists on the grounds of “treatment no longer required”.

The information requested is not collected centrally.

The decision to remove a patient from a waiting list can only be made by the healthcare professional responsible for that patient’s treatment. A patient will not be removed from a waiting list if it is clinically inappropriate to do so.

Information on numbers of patients removed from waiting lists during the quarter ended 31 March 2008, by NHS board, is published on ISD Scotland’s Acute Hospital Care website. This can be accessed at http://www.isdscotland.org/isd/3454.html.

Question reference: S3W-13709

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 30 May 2008
Current Status: Answered by Nicola Sturgeon on 10 June 2008

To ask the Scottish Executive how many of the 8,301 out-patients and the 2,914 in-patients that were removed from the New Ways waiting list in the first quarter of 2008 were transferred to another (a) speciality and (b) NHS board.

The information requested is shown in the following tables.

There are some data quality issues around the statistics relating to reasons why patients have been removed from waiting lists. Consequently, the data provided is provisional and is expected to change when the next set of statistics is published at the end of August 2008. Details of the quality issues can be found at http://www.isdscotland.org/isd/5573.html.

NHSScotland: Number of New Out-Patients Removed from Waiting List and Either Transferred to Another Specialty or Transferred to Another NHS Board. Quarter Ending 31 March 2008^P

Removal Reason	Removal Reason Description	Quarter Ending 31 March 2008^P
Code 50	Transferred within NHS Board area to another specialty	5,692
Code 59	Transferred to another NHS Board area	680

^PProvisional. It is known that the accuracy of recording of these codes has varied by NHS boards and these figures should be used with caution.

Source: Waiting Times Data Warehouse, ISD Scotland.

NHSScotland: Number Of In-Patients and Day Cases Removed from Waiting List and Either Transferred to Another Specialty or Transferred to Another NHS Board. Quarter Ending 31 March 2008^P

Removal Reason	Removal Reason Description	Quarter Ending 31 March 2008^P
Code 50	Transferred within NHS Board area to another specialty	129
Code 59	Transferred to another NHS Board area	1,622

^PProvisional. It is known that the accuracy of recording of these codes has varied by NHS boards and these figures should be used with caution.

Source: Waiting Times Data Warehouse, ISD Scotland.

Chamber and committees