Information Services Division

The 62 Day Standard states that 95% of patients urgently referred with a suspicion of cancer will wait a maximum of 62 days from referral to first cancer treatment

• 82.7% of patients started treatment within the 62 day standard, compared to 81.4% in the previous quarter and 87.1% for quarter ending December 2017.
• The 62 day standard was met by one NHS Board: NHS Lanarkshire.

The 31 Day Standard states that 95% of all patients will wait no more than 31 days from decision to treat to first cancer treatment

• 94.9% of patients started treatment within the 31 day standard, compared to 95.2% in the previous quarter and 94.6% for quarter ending December 2017.
• The 31 day standard was met by nine NHS Boards: NHS Ayrshire & Arran, NHS Borders, NHS Dumfries & Galloway, NHS Fife, Golden Jubilee National Hospital, NHS Lanarkshire, NHS Lothian, NHS Shetland, and NHS Western Isles.

The quarterly trend over the past three years shows little change in performance. Of the 10,550 people who started their first treatment in the most recent quarter, 93.9% waited three weeks or less.

• For the 6,105 people seeking alcohol treatment, 94.4% waited three weeks or less.
• For the 4,445 people seeking drug treatment, 93.1% waited three weeks or less.

Ten NHS Boards met the Local Delivery Plan standard. Three NHS Boards did not meet the standard: NHS Grampian, NHS Highland and NHS Lothian. NHS Shetland’s data was excluded – please see the data quality section in the main report for more detail.

At the end of this quarter, 2,547 people were waiting to start their first drug or alcohol treatment, of which 364 (14.3%) had been waiting more than six weeks. This is an increase from the same quarter last year when 236 (9.4%) people were waiting more than six weeks.

In prisons, 910 people started their first drug or alcohol treatment between October-December 2018 with 97.8% waiting three weeks or less.

• Apart from rotavirus vaccine, over 95% of children had received each routine immunisation by the time they were 12 months in Scotland in 2018.
• Uptake of the complete two dose course of rotavirus vaccine by 12 months of age was 92.8% in 2018, a decrease from 93.4% in 2017.
• The national target is for 95% uptake of one dose of the MMR vaccine by five years of age; this has been met since 2009 and in 2018 the figure was 96.6%.
• MMR vaccine is first offered at 12 to 13 months of age. In Scotland uptake was 94.2% by 24 months of age with variation shown across the NHS Boards in the map.
• By 24 months of age, 94.6% of children had received the Hib/MenC booster vaccine and 94.7% had received the Pneumococcal Conjugate Vaccine (PCV) booster.
• Uptake of the MenB booster vaccine by 24 months is reported for the first time this year and was 93.7%.
• Children from the more deprived areas were less likely to take up the vaccines than children in the less deprived areas.
• Across the reporting ages of 12 months, 24 months, five years and six years, there are a total of 17 measures of vaccine uptake. There were small decreases in the uptake rates for 14 of the 17 measures in 2018, compared with the previous year. Uptake rates fell by between 0.2 and 1.1 percentage points.

Colorectal Cancer incidence

• In 2016 there was a 1.6-fold variation in the incidence rate of colorectal cancer across NHS Boards, ranging from 60.3 to 94.0 per 100,000 population, adjusted for age and sex. The corresponding figure for Scotland as a whole was 73.9.

Colorectal Cancer mortality

• In 2017 there was a 2.3-fold variation in the mortality rate of colorectal cancer across NHS Boards, ranging from 25.1 to 56.8 per 100,000 population, adjusted for age and sex. The corresponding figure for Scotland as a whole was 33.9.

Colonoscopy

• In 2017 there was a 2.5-fold variation in the rate of colonoscopy procedures across NHS Boards, ranging from 769.2 to 1891.8 per 100,000 population, adjusted for age and sex. The corresponding figure for Scotland as a whole was 1245.3.

Uptake of Bowel Screening

• The bowel cancer screening uptake rate across NHS Boards in 2017, ranged from 51.6% to 66.5% and the corresponding Scotland figure was 56.0%. The Scottish Bowel Screening Programme target is 60%.

• 44.7% of the 82,942 patients who had a first clinical appointment with an AHP MSK service were seen within 4 weeks for quarter ending 31 December 2018. (National Target : the maximum wait for AHP MSK Services from referral to first clinical out-patient appointment is 4 weeks for 90% of patients)
• There were 106,255 referrals to AHP MSK services in this quarter.
• At 31 December 2018, 34.2% of the 64,771 patients waiting for a first clinical appointment with an AHP MSK service had been waiting 4 weeks or less.

Based on the available data for the financial year ending March 2018:

• The total (net) expenditure for general psychiatry services for 2017/18 was just over £967 million for NHS Scotland. This is an increase of around 3% from £937 million in 2016/17.
• The gross ingredient cost for medicines in Mental Health per head of population increased from £15.17 in 2016/17 to £19.66 in 2017/18.
• In 2017/18 the average length of stay for mental health care in Scotland was 83.3 days. This represents an increase from 70.9 days in 2016/17 which was partly due to a number of long-term patients being discharged in 2017/18.

For Scotland as a whole for the financial year ending March 2018:

• The number of paid items for dementia drugs increased from 244.1 in 2016/17 to 247.3 per 1,000 population aged 65 years and above in 2017/18.
• The average length of stay for psychiatric hospital discharges with a dementia diagnosis increased from 147.6 days in 2016/17 to 175.4 days in 2017/18.
• The proportion of dementia spells admitted to acute hospitals from private residence in Scotland that followed the Home to Hospital to Home care path shows a decrease from 61.4% in 2016/17 to 59.5% in 2017/18.

During week ending 17 March 2019:

• There were 27,081 attendances at A&E services in NHSScotland.
• 88.9% of attendances at A&E services were seen and resulted in a subsequent admission, transfer or discharge within 4 hours
• 298 patients spent more than 8 hours in an A&E department
• 71 patients spent more than 12 hours in an A&E department.

During week ending 10 March 2019:

• There were 26,750 attendances at A&E services in NHSScotland.
• 90.1% of attendances at A&E services were seen and resulted in a subsequent admission, transfer or discharge within 4 hours.
• 245 patients spent more than 8 hours in an A&E department.
• 53 patients spent more than 12 hours in an A&E department.

Pain Clinics

Twelve out of fourteen NHS Boards offer pain clinics to patients and provide data to ISD on how long patients wait to attend their first appointment based on the 18 weeks referral to treatment (RTT) Standard.

• Between 01 October 2018 and 31 December 2018, there were 5,219 new patients referred to a pain clinic. This compares with 4,985 referrals in the previous quarter.
• Of the 2,809 patients who attended (were seen) for their first appointment between 01 October 2018 and 31 December 2018, 1,988 (70.8%) attended within 18 weeks of referral. This compares with 72.4% in the previous quarter.
• Of the 4,810 patients who were still waiting for their first appointment at 31 December 2018, 714 (14.8%) had been waiting for more than 18 weeks.
• NHS Lanarkshire, NHS Lothian, NHS Orkney, NHS Shetland and NHS Western Isles saw all their patients within 18 weeks.
• 1,480 patients were removed from a waiting list for reasons other than being seen. 380 (12.3%) patients did not attend their first appointment and did not notify the hospital.

Pain Psychology Clinics

Due to the developmental nature these data should be interpreted with caution. Ten NHS Boards provide Pain Psychology Clinics, but only seven can provide data.

• There were 540 new patients referred to pain psychology clinics between 01 October 2018 and 31 December 2018.
• Of the 313 patients who attended their first appointment in this quarter, 219 (70.0%) were seen within 18 weeks.
• Of the 673 who were still waiting for their first appointment as at 31 December 2018, 137 (20.4%) had been waiting for more than 18 weeks.
• 207 patients were removed from a waiting list for reasons other than being seen. 47 (12.2%) patients did not attend their first appointment and did not notify the hospital.

Tobacco Use: Admissions attributable to smoking in those aged 35 and over (Hospital admission based on primary cause)

• In 2017, there were an estimated 51,400 smoking-attributable hospital admissions in Scotland.
• Over the last ten years (2008-2017) there has been a 21% decrease in the estimated smoking-attributable admission rates to hospital.
• In 2017, smoking was the reason for an estimated 50% of admissions for cancers that can be caused by smoking; 44% of admissions for respiratory conditions that can be caused by smoking; and 17% of circulatory conditions that can be caused by smoking.

Diabetes

• Both hospital admissions and deaths where diabetes was a contributory or primary cause have increased over the last 10 years. In 2017/18 hospital admissions associated with diabetes decreased slightly but mortality continued increasing.

Sexual Health - Termination of pregnancy

• ScotPHO have created a new page within our sexual health topic area which summarises previously published information relating to termination of pregnancy.

The Information Services Division has released Community Pharmacy activity and direct pharmaceutical care services in an open data format. This information release makes these data available in response to information requests for contractor data relating to specific Community Pharmacy services.

The Information Services Division has released NHSScotland prescribing data for December 2018 in two formats - practice level Open Data and an interactive dashboard.

During week ending 03 March 2019:

• There were 27,078 attendances at A&E services in NHSScotland.
• 90.9% of attendances at A&E services were seen and resulted in a subsequent admission, transfer or discharge within 4 hours
• 245 patients spent more than 8 hours in an A&E department
• 55 patients spent more than 12 hours in an A&E department.

• The 21 year long term trend shows variation in the total number of patients who have been admitted as an inpatient or day case for planned treatment.
• Developments in clinical practice over the years will mean that patients who were previously admitted to hospital may now be treated as an outpatient. These patients would no longer be included in these inpatient and day case long term trends.
• The chart below shows the long term trend for the percentage of patients treated within 12 weeks as an inpatient or day case.