A range of support services will be provided in partnership by NHS boards, local authorities and the third sector to meet the needs of families and carers of people living with an eating disorders, in line with statutory obligations and Scottish Government policy.

Examples include the provision of evidence based family therapy through NHS Scotland; the Scottish Government’s funding of national carer organisations providing accessible services to support carers and young carers; Scottish Government provision of nearly £34 million over 2008-16 for NHS board carer information strategies; and work being undertaken by NHS 24 to redesign and improve the provision of information to people cared for, and people caring for others including unpaid and young carers through the Carers Information Scotland service.

The information is not collected centrally. All NHS boards work in partnership to provide appropriate care, services and support to those living with an eating disorder on the basis of comprehensive, multi-disciplinary needs assessment.

Information on psychiatric inpatient 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 treated in the same or different NHS board areas⁵ from the one in which they reside, 2005-06 to 2013-14.

1. Patients are counted in every category they satisfy, so may be included in multiple rows for each year.

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. 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.

6. ‘Non-resident or unknown’ contains all patients for which information on council area is not available on SMR04, which includes patients living outside of Scotland and patients with no fixed abode.

Source: SMR04 (psychiatric inpatient and day case database)

https://isdscotland.scot.nhs.uk/Health-Topics/Mental-Health/Publications/2015-05-12/2015-05-12-MHIC-Report.pdf?65449160338

The information is not held centrally. All NHS boards work in partnership to provide appropriate care, services and support in a range of settings to those living with an eating disorder on the basis of comprehensive, multi-disciplinary needs assessment.

The majority of people with an eating disorder will be treated in the community by specialist eating disorder or community mental health teams. A small number may need specialist psychiatric or acute inpatient care which can be provided through the two specialist NHS inpatient eating disorder units serving the north and south east of Scotland, or in general or adolescent psychiatry in mental health hospitals, and as appropriate in acute care.

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.

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.

The Scottish Government is committed to improving the lives of people with learning disabilities, their families and carers through the implementation of The keys to life in Scotland. The focus of the keys to life strategy is to reduce the significant health and social inequalities faced by people who have learning disabilities. Specifically the strategy aims to reduce the significant health inequalities and early mortality of the population.

People with learning disabilities are supported by a wide range of multi disciplinary health and social care professionals in the community.

In addition to the full service of primary care offering treatments there are also further levels of specialist care such as community dentistry for those who require a more protected environment. Other specialist services include a range of clinical provisions from the community learning disability specialist teams which provide nursing, speech and language therapy, psychology, psychological therapies, psychiatry, occupational and physiotherapy services.

Other initiatives aim to address new challenges facing learning disability services such as dementia services as the learning disability population is now mainly older than previously experienced by health and social care services.