Chamber and committees

Meningococcal B (Men B) vaccination was introduced from 1 September 2015 for infants due to receive their primary immunisations starting at two months of age on or after 1 September 2015 (i.e. those babies born on or after 1 July 2015). The vaccine is offered alongside other routine immunisations at two and four months of age, with a booster dose at 12-13 months. A limited one-off catch-up programme was also delivered targeting infants born in May and June 2015 receiving other routine immunisations.

Table 1 shows the number of infants born from 1 May to 31 July 2015 who received the Men B vaccine by six months of age through the national programme. Information on Men B vaccine given out-with the routine childhood immunisation schedule or in a private hospital/clinic is not held centrally.

Table 1: Number of infants born 1 May to 31 July 2015 receiving Men B vaccine by six months of age by NHS Board of Residence

Source: Scottish Immunisation and Recall System 15 February 2016

Data are provisional.

1. NHS boards based on the boundaries as at 1 April 2014.

2. The figures presented relate to infants receiving one or more doses of the Men B vaccine by six months of age. Infants born in May 2015 would have been offered one dose of vaccine, infants born from June 2015 would have been offered two doses of vaccine.

The national source of A&E information is the Information Services Division (ISD) A&E data mart. Within the A&E data mart the facility exists to record attendances at A&E due to self harm and other psychiatric conditions. However, the fields which can be used to identify self harm and other psychiatric conditions are all optional for completion by NHS boards and the level of recording is not sufficient for accurate national reporting of attendances due to self harm and other psychiatric conditions. ISD has an on-going programme of data quality assurance to improve the quality of data collected.

Patients are considered to attend A&E rather than admitted to A&E. The national source of A&E information is the Information Services Division (ISD) A&E data mart. Within the A&E data mart the facility exists to record attendances at A&E due to self harm and other psychiatric conditions. However, the fields which can be used to identify self harm and other psychiatric conditions are all optional for completion by NHS boards and the level of recording is not sufficient for accurate national reporting of attendances due to self harm and other psychiatric conditions. ISD has an on-going programme of data quality assurance to improve the quality of data collected.

Information on the vacancy rate of all applied psychologists being advertised within psychology services in each NHSScotland health board is provided from September 2011 to December 2015 in Table 1.

Information on vacancy rates of (b) liaison psychologists and (c) consultant psychologists in each NHSScotland health board in each of the last five years is not held centrally.

The Scottish Government has announced an additional £150 million for mental health services over the next five years. As part of this funding, £4.8 million will be awarded to Healthcare Improvement Scotland to establish a ‘Mental Health Access Improvement Support Team’ who will provide a comprehensive package of support to work in partnership with boards to improve access to mental health services.

The total number of clinical staff employed in psychology services across NHSScotland has increased by 24.5 per cent since March 2011. Any fluctuation in vacancies is linked to our efforts to increase capacity by recruiting even more staff.

Table 1: Whole time equivalent of psychologist vacancies being advertised within psychology services by NHS board as at September 2011 to December 2015.

Source NHS Education for Scotland Information Services Division (ISD) Psychology Workforce Database.

Further information on the psychology workforce is published by ISD Scotland and can be found at the following link:

http://www.isdscotland.org/Health-Topics/Workforce/Psychology/.

Information on the vacancy rate for psychologists in A&E departments, broken down by NHS Scotland health board, is not centrally held.

The Scottish Government has announced an additional £150 million for mental health services over the next five years. As part of this funding, £4.8 million will be awarded to Healthcare Improvement Scotland to establish a ‘Mental Health Access Improvement Support Team’ who will provide a comprehensive package of support to work in partnership with boards to improve access to mental health services.

The total number of clinical staff employed in psychology services across NHS Scotland has increased by 24.5 per cent since March 2011. Any fluctuation in vacancies is linked to our efforts to increase capacity by recruiting even more staff.

Further information on the psychology workforce is published by Information Service Division Scotland and can be found at the following link:

http://www.isdscotland.org/Health-Topics/Workforce/Psychology/.

The regulations were laid on Tuesday 23 February 2016 following extensive consultation and stakeholder engagement: www.gov.scot/Topics/marine/Salmon-Trout-Coarse/fishreform.

Information that is provided in the following tables shows the number of emergency readmissions within seven days of the original admission, for each calendar year from 2010 to September 2015, broken down by NHS board of residence and surgical and medical specialty groupings.

a)

i) The number of continuous inpatient stays for medical specialties by calendar year and NHS board of residence.

Source: SMR01, Information Services Division (ISD) Scotland

¹Only covers January to September 2015.

The number of emergency readmission continuous inpatient stays within seven days for medical specialties by calendar year and NHS board of residence.

Source: SMR01, ISD Scotland

¹Only covers January to September 2015.

ii) The number of continuous inpatient stays for surgical specialties by calendar year and NHS board of residence.

Source: SMR01, ISD Scotland

¹Only covers January to September 2015.

The number of emergency readmission continuous inpatient stays within seven days for surgical specialties by calendar year and NHS board of residence.

Source: SMR01, ISD Scotland

¹Only covers January to September 2015.

b)

i) The percentage of medical admissions which were followed by a readmission with seven days by calendar year and NHS board of residence.

Source: SMR01, ISD Scotland

¹Only covers January to September 2015.

ii) The percentage of surgical admissions which were followed by a readmission with seven days by calendar year and NHS board of residence.

Source: SMR01, ISD Scotland

¹Only covers January to September 2015.

Note: All discharges (defined as a continuous stay in hospital) which meet the selection criteria were included in the analysis. Each discharge was compared with the next admission to hospital for the same patient. If this subsequent admission occurred within seven days of the date of discharge for the previous hospital stay and was coded as an emergency admission, it was selected as a relevant readmission. Cases were excluded from the analysis if the patient died within seven days of discharge. The figures include readmissions within seven days whether or not the readmission was related to the previous hospital stay.

The Scottish Government considers hospital standardised readmission rates every three months, on both a national and a hospital basis. The measures are rates of surgical readmissions within seven days, rates of surgical readmissions with 28 days, rates of medical readmissions within seven days and rates of medical readmissions within 28 days. These measures have been standardised by age, sex and deprivation (Scottish Index of Multiple Deprivation 2009).

Where a specific hospital has a significantly higher than expected standardised rate of readmission (compared to other hospitals) the corresponding NHS board is asked to investigate so as to gain assurance about the quality of care being delivered and to learn any lessons for improvement. For the same reasons the Scottish Government also invites all NHS boards to continuously review their latest information on readmissions.

The definitions for statistically high are based on standardised rates that are three standard deviations from the average; standardised rates that are two standard deviations from the average on consecutive occasions; and how many of the four standardised readmission rate measures meet these criteria on each occasion. It should also be noted that the methodology has changed over time as the data under consideration moved from annual to quarterly time periods.

In 2011-12, the Scottish Government wrote to NHS Highland regarding surgical and medical hospital standardised readmission rates at Belford Hospital which had significantly higher than expected levels (greater than three standard deviations from the Scottish average). The board concluded that this was due to errors in the clinical coding of patients and not the quality of care being provided (with planned admissions incorrectly recorded as readmissions).

In December 2013, the Scottish Government wrote to NHS Borders regarding surgical hospital standardised readmission rates at Borders General Hospital (greater than two standard deviations from the Scottish average on consecutive occasions for two of the four measures). The board concluded that the case reviews carried out in NHS Borders did not highlight an increase in the genuine rate of readmission, and that the apparent high levels were due to errors in the coding of certain patients.

The Scottish Health Protection Network’s Sexual Health and Blood Borne Viruses Group already comprises a range of groups looking at delivery of the framework in Scotland, including our work on hepatitis C. These groups include clinical experts, public health experts, patient representatives, and third sector organisations in addition to the Scottish Government. The groups look at all of the issues relevant to elimination including prevention, diagnoses, testing and treatment. In addition, the treatment and therapies sub-group has been established by the government specifically to consider how to make best use of emerging therapies for hepatitis C, and this group is keeping under review treatment targets and the evolving treatment landscape.