Chamber and committees

The Emergency Medicine Research Group, Edinburgh (EMERGE), in partnership with the Scottish Ambulance Service (SAS), has been undertaking research to improve the quality of pre-hospital resuscitation delivered by SAS personnel.

I understand that the service is keen to work with the EMERGE group to consider how the learning points and training issues arising from this research can be taken forward across the country.

The Scottish Government''s consultation on Blue Badge reform has been running since 12 July 2010 and will close on 8 October 2010. The consultation was issued to over 300 stakeholders and organisations and is available on the Scottish Government''s website. We have had a good number of responses so far, the majority of which have been from Blue Badge holders.

The following table shows the number of hospital stays where cardiac arrest is recorded as the main, or secondary diagnosis, in any episode within the hospital stay, combined with the number of out-of-hospital registered deaths where cardiac arrest is recorded as the underlying or a contributing cause of death, and the estimated number and percentage of patients discharged alive at the end of an acute continuous inpatient hospital stay. Data are shown for Scotland over the past 10 years. No comparable data are available centrally for other European countries.

Year Ending 31 March	Number of Cardiac Arrests	Number of Cardiac Arrest Patients Admitted to Hospital	Estimated Number of Cardiac Arrest Survivors Discharged Alive from Hospital	Estimated % of Cardiac Arrests Discharged Alive from Hospital
2001	2,802	1,812	442	15.8%
2002	2,557	1,687	413	16.2%
2003	2,637	1,728	401	15.2%
2004	2,353	1,532	362	15.4%
2005	2,328	1,556	360	15.5%
2006	2,128	1,394	356	16.7%
2007	2,004	1,232	331	16.5%
2008	1,974	1,307	361	18.3%
2009	1,744	1,151	335	19.2%
2010P	1,652	1,117	349	21.1%

^PProvisional

Source: ISD Scotland.

Deaths occurring in the community, in the ambulance or on arrival in the accident and emergency department and recorded as myocardial infarction may have been from a cardiac arrest. It is important to note that data on out-of-hospital deaths from cardiac arrest are probably under estimates and hence the survival rates are likely to be overestimates.

Notes:

1. The basic unit of analysis for these figures is the number of cardiac arrests recorded either in a continuous stay (CIS) in hospital or on a death registration. Probability matching methods have been used to link together death registrations from the General Register Office for Scotland (GROS) and individual SMR01 hospital episodes for each patient, thereby creating linked patient histories. Within these patient histories, SMR01 episodes are grouped according to whether they form part of a continuous spell of treatment (whether or not this involves transfer between hospitals or even NHS Boards).

2. All discharges (hospital stays) with a main or secondary diagnosis of cardiac arrest in addition to all deaths where cardiac arrest is recorded as the underlying or one of 10 secondary causes of death are included in the analysis. Death registrations corresponding to linked hospital discharges are excluded. The discharge code from the last SMR01 episode within the CIS determines whether the patient was discharged from the continuous stay alive or dead.

3. These statistics are based on the linked data set of SMR01 (Scottish Morbidity Record 01) and death records held by ISD Scotland. SMR01 collects information on inpatient and day case discharges from non-obstetric and non-psychiatric hospitals in Scotland. The linkage and use of the death records is by permission of the General Register Office for Scotland (GROS).

4. Up to six diagnoses (one main and five secondary) may be recorded on an SMR01 record. Up to 10 causes of death (underlying and secondary) may be recorded on the GROS death registration. All diagnoses position on any SMR01 record of a hospital stay and all causes of death have been used to identify cardiac arrest admissions or out of hospital deaths. Cardiac arrest has been defined using ICD10 code I46.

5. There will be some cases of myocardial infarction (MI) where a cardiac arrest occurred during the hospital stay but was not mentioned on the discharge summary.

The following table shows the number of hospital stays where cardiac arrest is recorded as the main, or secondary diagnosis, in any episode within the hospital stay combined with the number of out-of-hospital registered deaths, where cardiac arrest is recorded as the underlying or a contributing cause of death, and the estimated number and percentage of patients discharged alive at the end of an acute continuous inpatient hospital stay. Data are shown for Scotland in the latest year ending 31 March 2010^P.

Scotland for Year Ending 31 March	Number of Cardiac Arrests	Number of Cardiac Arrest Patients Admitted to Hospital	Estimated Number of Cardiac Arrest Survivors Discharged Alive from Hospital	Estimated % of Cardiac Arrests Discharged Alive from Hospital
2010P	1,652	1,117	349	21.1%

^PProvisional.

Source: ISD Scotland.

Deaths occurring in the community, in the ambulance or on arrival in the emergency department and recorded as myocardial infarction may have been from a cardiac arrest. It is important to note that data on out-of-hospital deaths from cardiac arrest are probably underestimates and hence the survival rates are likely to be overestimates.

Notes:

1. The basic unit of analysis for these figures is the number of cardiac arrests recorded either in a continuous stay (CIS) in hospital or on a death registration. Probability matching methods have been used to link together death registrations from the General Register Office for Scotland (GROS) and individual SMR01 hospital episodes for each patient, thereby creating linked patient histories. Within these patient histories, SMR01 episodes are grouped according to whether they form part of a continuous spell of treatment (whether or not this involves transfer between hospitals or even NHS boards).

2. All discharges (hospital stays) with a main or secondary diagnosis of cardiac arrest in addition to all deaths where cardiac arrest is recorded as the underlying or one of 10 secondary causes of death are included in the analysis. Death registrations corresponding to linked hospital discharges are excluded. The discharge code from the last SMR01 episode within the CIS determines whether the patient was discharged from the continuous stay alive or dead.

3. These statistics are based on the linked data set of SMR01 (Scottish Morbidity Record 01) and death records held by ISD Scotland. SMR01 collects information on inpatient and day case discharges from non-obstetric and non-psychiatric hospitals in Scotland. The linkage and use of the death records is by permission of the General Register Office for Scotland (GROS).

4. Up to six diagnoses (one main and five secondary) may be recorded on an SMR01 record. Up to 10 causes of death (underlying and secondary) may be recorded on the GROS death registration. All diagnoses position on any SMR01 record of a hospital stay and all causes of death have been used to identify cardiac arrest admissions or out of hospital deaths. Cardiac arrest has been defined using ICD10 code I46.

5. There will be some cases of myocardial infarction (MI) where a cardiac arrest occurred during the hospital stay but was not mentioned on the discharge summary.

Heart disease, and the treatment of heart attack, remains a clinical priority for NHS Scotland and we want people to have access to the best possible treatment at the earliest possible opportunity, including potentially life-saving defibrillators.

Making further reductions in the number of deaths from heart attack is an important theme of the Scottish Government''s Better Heart Disease and Stroke Care Action plan, published in June 2009. The action plan includes an action which places responsibility on NHS boards to look at introducing defibrillators in public places and our National Advisory Committee on heart disease will monitor the progress that is being made.

We also want to ensure that the best equipment is in place for patients and we are providing £7.5 million of funding to provide cutting-edge defibrillators in Scotland''s ambulance fleet. We believe this investment in the most up-to-date technology will improve heart attack survival rates and save lives.

The Scottish Ambulance Service recognises the importance of reaching people who have had a cardiac arrest quickly and treating them effectively. It therefore has two local delivery plan (LDP) targets related to cardiac arrest:

Between 12-20% of eligible cardiac arrest patients with Return of Spontaneous Circulation on arrival at hospital, and

Reach 80% of cardiac arrest patients within eight minutes (mainland Scotland).

The cardiac Managed Clinical Networks, working with their NHS boards are conducting an assessment of Public Access Defibrillator provision in their area, drawing on information from a mapping exercise conducted by the British Heart Foundation. Their progress will be monitored by the National Advisory Group for Heart Disease.

In June, the Scottish Ambulance Service (SAS) announced that it would install defibrillators on all of its ambulances this year. This state-of-the-art technology will replace existing defibrillators in a £7.5 million initiative funded by the Scottish Government.

The Blue Badge scheme has been running since 1971, originally known as the Orange Badge scheme. The Scottish Government is currently undertaking a wide ranging consultation on the scheme to ensure that it remains fit for purpose in the 21st Century. No decisions on any possible alterations to the scheme will be considered until the consultation period has ended on 8 October 2010 and the responses analysed.

Whether a time limit should be placed on parking on double and single yellow lines is one of the areas under consideration as part of the current Blue Badge reform consultation. The Scottish Government''s decision on this will fully take into consideration the responses that are received to the consultation and the important road safety purpose which these road markings serve.

The information requested is not centrally available.

The information requested is not held centrally.