Chamber and committees

Licensed branded medicines are included. Primary care data is used as this is the most consistent data set available across the UK. The health departments explored with industry whether an accurate four country split of Pharmaceutical Price Regulation Scheme sales data could be obtained to inform the apportionment however not all companies are able to provide this data.

As set out in the Pharmaceutical Price Regulation Scheme agreement between the Department of Health and the Association of British Pharmaceutical Industry, payment percentages are adjusted annually. The annual payment percentages for 2016 and 2017 are not yet available.

The information requested is not collected centrally.

There are very good reasons why people are treated outside their board areas as specialist care is provided in the most appropriate environment, regardless of board boundaries. In many cases it is simpler for a patient to go to a hospital in a neighbouring board area, as it is nearer to their home. There are many other patients who start their care in their own area and are then referred to a regional centre for specialist treatment, for example to the Golden Jubilee Hospital as a national centre providing treatments such as heart transplants and cardiac bypass surgery.

Data on the specific numbers of referrals and declines is not provided to the Scottish Government. However the latest published data on the numbers of all referrals and referrals including those rejected referrals for psychological therapies and child and adolescent mental health services (CAMHS) by NHSScotland is available from the Information Services Division (ISD) reports on waiting times reports on CAMHS and psychological therapies.

These ISD reports are available online at:

CAMHS waiting times report: http://www.isdscotland.org/Health-Topics/Waiting-Times/Publications/2015-05-26/2015-05-26-CAMHS-Report.pdf

Information on psychiatric inpatients and day case discharges is recorded in Scottish morbidity record 04 (SMR04). Data on SMR04 is routinely published by financial year and 2013-14 is the latest year for which information is available.

Table 1: Number of patients¹ discharged from psychiatric hospitals in Scotland^2,3,4 who were recorded as discharged to⁵ a private residence in which they live alone, 2005-06 to 2013-14.

1. If a patient has multiple discharges in a year, each with different discharge destinations they have been counted once in each applicable row.

2. Psychiatric inpatient and day case activity is recorded in Scottish morbidity record 04 (SMR04).

3. Data from the State Hospital (Carstairs) have been excluded.

4. Data from the learning disability specialty have been excluded.

5. The “Discharge/Transfer to” field records patients discharged to various settings. This field has been used to generate these data.

6. This is identified using the “Discharge/Transfer to” field with the value “Private residence – living alone”

7. This includes the “Discharge/Transfer to” codes of “Private residence – type not known” and “Private residence – no additional detail added”.

8. The “Discharge/Transfer to” field also records patients discharged to various “temporary places of residence”. In some of these places patients may be living alone, however these have not been included in the table above. More details of the SMR04 dataset and the “Discharge/Transfer to” variable can be found in the data dictionary (http://www.ndc.scot.nhs.uk/Dictionary-A-Z/) section of the Information Services Division (ISD) website.

Source: NHS ISD SMR04 (psychiatric inpatient and day case database)

After a homelessness assessment has taken place, local authorities record the additional support needs which the household may have, including support needs for mental health problems.

The following table shows:

1. The number of cases assessed each year as homeless or threatened with homelessness.

2. The number of these cases which, in addition to being assessed as homeless or threatened with homelessness, have had a support need identified due to a household member having a mental health problem.

The extent to which mental health problems directly contributed to the episode of homelessness is not known.

Information on how many hours have been filled by A&E locum staff in each year since 2010 is not held centrally.

However, we currently have the highest medical staffing levels ever. Under this government, the number of consultant medical staff working in NHSScotland has increased by a record 37.5%. A&E has seen an unprecedented increase of 171.7% in consultant staff.

The Scottish Government is also working with doctors and nurses to design the new emergency workload planning tool to be rolled out later in 2015. This will help NHS boards ensure they have appropriate staffing levels in place to meet variable workload demands.

This investment in emergency medical staff was recognised in March 2015 by Dr Martin McKechnie, Vice President of the Royal College of Emergency Medicine Scotland, who stated: “The College welcomes the support the Scottish Government has given to increasing staffing and tackling crowding in our A&Es.” (Royal College of Emergency Medicine release, 24 March)

Funding for mental health will be drawn from the overall resources available this year for healthcare and local government with NHS boards and councils responsible for local decision making and delivery, funding is not ring-fenced.

Details on child and adolescent psychiatry expenditure by NHS board is available from the Scottish Health Service Costs Report and supporting data tables published by Information Services Division Scotland. Published annually the latest report for financial year ending March 31, 2014, (published 2 December 2014), is available online at: http://www.isdscotland.org/Publications/index.asp [ref data table R04 LSX].To support the delivery of Child and Adolescent Mental Health Services (CAMHS) the Scottish Government has invested over £16 million over last six years to increase the number of psychologists working in specialist CAMHS by over 70%, with a further £3.5 million committed this year. In addition £85 million funding for mental health was announced on 24 May 2015. This follows the £15 million over three years announced in November 2014 for the Mental Health Innovation Fund providing £100 million in total. This funding will be invested in improving mental health services and will partly be used to further improvements to child and adolescent mental health services and bring down waiting times.

Information on psychiatric inpatients and day case discharges is recorded in Scottish morbidity record 04 (SMR04). Data on SMR04 is routinely published by financial year and 2013-14 is the latest year for which information is available.

Due to the small number of patients, an NHS board breakdown is not possible for those aged 17 or under.

Table 1: The number of patients aged 18 or over¹ discharged from psychiatric hospitals in Scotland^2,3, with a main diagnosis of learning disability^4,5, 2010-11 to 2013-14, by NHS board of treatment^6,7,8.

Table 2: The number of patients aged 17 or under¹ discharged from psychiatric hospitals in Scotland^2,3, with a main diagnosis of learning disability^4,5, 2010-11 to 2013-14, Scotland total.

* Indicates values that have been suppressed due to the potential risk of disclosure.

1. Age on discharge from facility.

2. Psychiatric inpatient and day case activity is recorded in Scottish morbidity record 04 (SMR04).

3. Data from the State Hospital (Carstairs) have been excluded.

4. In order to define learning disability the following ICD-10 codes have been used – F70-F89. The SMR04 dataset has space to record a main discharge diagnosis and up to five secondary discharge diagnoses, this analysis looks at the main diagnosis position only. For SMR04 records, diagnosis is recorded on admission and discharge. For this analysis, only diagnosis on discharge has been used.

5. Some board areas record admissions for respite care as SMR04 returns whereas others do not. This is due to differences in models of service delivery.

6. Where the data was assigned to a non-NHS provider, patients were allocated to an NHS board based on the location of the facility they were treated in.

7. Orkney and Shetland are not included in the table as there are no SMR04 hospitals in these NHS boards.

8. Patients are only counted once in each year under the first NHS board in which they were discharged.