Scotland has some of the best health service data in the world. Few other countries have information which combines high quality data, consistency, national coverage and the ability to link data to allow patient based analysis and follow up. The Information Services Division (ISD) is a division of National Services Scotland, part of NHS Scotland. ISD provides health information, health intelligence, statistical services and advice that support the NHS in progressing quality improvement in health and care and facilitates robust planning and decision making.
What's New in ISD?
Scottish antimicrobial use and resistance in humans in 2015
Health Protection Scotland and Information Services Division are today publishing a report on antibiotic use and resistance in Scotland during 2015.
This latest report shows that while work by the Scottish Antimicrobial Prescribing Group to improve the quality of antibiotic prescribing is proving successful, continued efforts are required to further reduce unnecessary antibiotic use. The report is intended to support NHS Boards, hospitals and primary care in their long-term planning of antimicrobial prescribing. In particular, this report should be of use to antimicrobial management teams, infection prevention and control teams and microbiologists.
Scottish antimicrobial use and resistance in humans in 2015
[30 August 2016]
Suicide in Scotland – Understanding the risks and informing preventative action
Two reports published today make a major contribution to the continuing efforts to prevent suicide in Scotland. These reports from the Information Services Division and the Scottish Public Health Observatory help Scotland’s policymakers, mental health services, local authorities and voluntary organisations to target people and places at higher risk of suicide and identify where future prevention action should be focused.
The report from the Scottish Suicide Information Database presents a profile of 4,464 suicide deaths in Scotland between 2009 and 2014. The Scottish Public Health Observatory report describes the epidemiology of suicide in Scotland in 2015 and trends in the suicide rate in recent years.
NHS Performs - Latest update
NHS Performs has been updated to include information on:
- Emergency Department activity for the week ending 16 October 2016
- Numbers of hospital wards closed with confirmed or presumed Norovirus infections on 17 October 2016
NHS Performs is a website which brings together a range of information on how hospitals and NHS Boards within NHSScotland are performing. It aims to provide this information in an easy to access, clear and understandable way.
[25 October 2016]
- More than two thirds (69%) of P1 children had no obvious decay experience in their primary teeth in 2016. This is a large improvement since ISD started recording this information in 2003 (45%).
- The average number of P1 childrenís teeth affected by obvious decay experience in 2016 is 1.21. This is less than half of the average number of teeth affected in 2003 (2.76).
- Inequalities remain, with only 55% of P1 children having no obvious decay experience in the most deprived areas compared with 82% in the least deprived areas.
- Note no obvious decay experience means there are no obvious decayed, missing or filled teeth.
- A total of 8,146 take-home naloxone kits were issued in Scotland in 2015/16, an increase of 10% on the previous year.
- For Scotland as a whole, supply of kits more than doubled, from 52 kits per 1,000 problem drug users in 2011/12 to 132 per 1,000 in 2015/16.
- In 2015/16, 7,214 kits were issued in the community (an 11% increase on the previous year) and 932 kits were issued by prisons upon release (a 6% increase).
- The percentage of kits distributed as a repeat supply increased each year from 12% in 2011/12 to 38% in 2015/16. In 2015/16, 748 repeat kit supplies were made because the previous kit was reported as having been used to treat an opioid overdose.
- In 2015, of all opioid-related deaths, 4.7% occurred among people who had been released from prison in the previous four weeks. This was significantly lower than the 9.8% observed before the programme, though the figures should be treated with caution because of the relatively small number of opioid-related deaths within four weeks of prison release.
- The percentage of all opioid-related deaths that occurred among people who had been discharged from hospital in the previous four weeks showed no consistent trend, changing from 9.7% before the programme (2006-10) to 10.3% in 2015.
Between 2006 and 2016:
- The overall number of care home places available decreased by 4% (from 43,311 to 41,461) and the number of adults in care homes decreased by 3% (from 37,885 to 36,621).
- The number of long stay residents aged 85 or over increased by 12% (15,759 to 17,579) while those under 85 decreased by 18% (20,958 to 17,159).
- The number of adult residents with dementia increased by 30% (15,303 to 19,905).
- The number of short-stay and respite residents increased by 61% (1,168 to 1,883).
- The number of registered care home places in the private sector increased by 7% (29,619 to 31,583), while those in the public sector decreased by 28% (6,216 to 4,502) and those in the voluntary sector also decreased by 28% (7,476 to 5,376).
- In 2015/16 there were almost 35,000 alcohol-related inpatient hospital admissions in Scotland. Over this period around 23,400 Scottish residents had at least one admission to hospital with an alcohol-related condition, of whom around 11,400 had not been admitted in the previous 10 years or were admitted for the first time.
- In 2015/16 the rate of alcohol-related inpatient stays are similar to the previous year, reducing by under 2%. Overall, there has been a steady decline in alcohol-related hospital stays since 2008/09 both in general acute hospitals and in psychiatric hospitals.
- In recent years, there has been an increase in hospital admissions for alcoholic liver disease and alcohol withdrawal state during a period where overall alcohol-related admissions have been decreasing.
- In recent years, there has been an increase in the number of people having multiple alcohol-related admissions within a year. This may be contributing to the slowing of the overall decreasing trend in alcohol-related admissions.
- There continues to be an inequality gap for alcohol-related admissions between those living in the most and least deprived parts of Scotland.
- Over the last ten years, the overall age-adjusted cancer mortality rate has fallen by 11%. Although the rate of deaths due to cancer has decreased over this period, the actual number of deaths due to cancer has not. This largely reflects an increase in older age groups within the population and the fact that cancer is a relatively common disease among the elderly.
- The age-adjusted cancer mortality rate has fallen by 14% for males and 6% for females.
- Lung cancer is the most common cause of death from cancer in Scotland. The number of deaths are more than double that of colorectal cancer, the next most common cause of death from cancer.
- Significant patterns exist when examining incidence and mortality rates by deprivation in Scotland. For all cancers combined, the most deprived areas have incidence rates that are almost a third higher than the least deprived areas. Mortality rates are almost two-thirds higher in the most deprived compared with the least deprived areas.
- There is considerable variation in trends for different types of cancer. For example, the rate of female deaths due to breast cancer has decreased by 21% over the last ten years. For males, the mortality rate due to stomach cancer has decreased by 36% over the last ten years. The mortality rate for cancer of the liver has increased by 46% for males and 69% for females over the same time.
- Across Scotland, almost half of babies born in 2015/16 (49.3%) were being breastfed at their Health Visitor first visit (around 10 days of age).
- The proportion of babies being breastfed at their first visit has increased slightly over the last 10 years. This reflects an increase in the proportion receiving mixed breast and formula feeding, and a slight decrease in the proportion receiving breastfeeding only (exclusive breastfeeding).
- Breastfeeding rates decline as babies get older. Across Scotland, 38.9% of babies born in 2015/16 were being breastfed at their 6-8 week review.
- Breastfeeding rates are lower in more deprived areas and among younger mothers.
- Breastfeeding rates vary across Scotland. This may reflect differences in factors such as deprivation and local services.
During the week ending 16 October 2016:
- There were 24,852 attendances at Emergency Departments across Scotland.
- 94.6% of people attending Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 68 patients (0.3%) spent more than 8 hours in an Emergency Department.
- 9 patients (< 0.1%) spent more than 12 hours in an Emergency Department.
The information from this publication is included in NHS Performs.
During the week ending 09 October 2016:
- There were 26,390 attendances at Emergency Departments across Scotland.
- 92.6% of people attending Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 130 patients (0.5%) spent more than 8 hours in an Emergency Department.
- 22 patients (< 0.1%) spent more than 12 hours in an Emergency Department.
The information from this publication is included in NHS Performs.
- On 31 December 2015 4,919 individuals were receiving RRT in Scotland. 2773 (56%) of these had a functioning kidney transplant.
- 619 new patients started RRT in 2015, 11.5 per 100 000 population.
- The graph below shows trends in survival of patients starting RRT 2006-2015.
- 246 patients received a kidney transplant in Scotland in 2015. 77 of these were from living donors and 50 of those transplants were pre-emptive meaning they were performed before the patient had required any other form of RRT.
- The chart below (see summary) shows the percentage of patients receiving RRT on 31 December from 1991-2015 by type of treatment and age group. Transplant is the most frequent treatment method of receiving RRT for those aged <65 whereas hospital haemodialysis is for those aged ≥65.
- Patients have a lower risk of infection if haemodialysis is received through an arteriovenous (AV) fistula. 73% of haemodialysis patients in Scotland in May 2016 were receiving dialysis via an AV fistula compared with 72% in May 2015. There are significant differences between units. The Renal Associationís guideline is 85%.
- A total of 20 out of 32 hospitals with an Emergency Department submitted data to STAG in 2014-2015, reporting on 6034 patients, of which 1313 (22%) are classified as having major trauma.
- Men make up the majority of major trauma patients (71%) compared to women (29%). The most common cause for men suffering major trauma is moving vehicle accidents, whilst for women is low falls under two meters.
- 25% of major trauma patients are transferred to another hospital, primarily for Neurosurgical care.
- 22% of patients suffering major trauma died in hospital between 2014 and 2015.
- The Royal Hospital for Children Glasgow treated 83 patients from June 2015 to June 2016 who met the STAG inclusion criteria. 20 patients were classified as having major trauma (24%), and more boys than girls were seen with an almost 3:1 ratio.
- Some improvements (see chart) in achieving STAG Quality Indicators (QI) are noted from 2013 to 2015.
- Hypertension (high blood pressure) was the most prevalent condition in the clinical indicator group (13.9%). This figure is similar to previous years.
- The Osteoporosis (brittle and fragile bones) indicator had the largest increase in achievement for a clinical indicator between 2014/15 and 2015/16. This increased from 87.3% to 92.3%, a difference of 5%.
The data extract is presented as downloadable text (.csv) file and covers practice level prescribing for the month of July 2016. A dashboard will also available to enable preview the data without downloading the large file. The data extract will also feed into existing dashboards which present historical data already published elsewhere on the ISD website (in the September 2016 Summary Stats dashboard).
- In August 2016, 45,551 days were spent in hospital by people delayed in their discharge.
- There were 1,472 people delayed at the August 2016 census.
- 70% of people experiencing a delay were aged 75+.
- 320 (22%) of these delays were for people with specific complex care needs.
- Of the remaining 1,152 people delayed at the census:
- 374 (32%) were awaiting place availability in a care home
- 359 (31%) were awaiting completion of arrangements for social care support (e.g. carer) in order to live in their own home
- 151 (13%) were awaiting completion of a post hospital social care assessment.
During the week ending 02 October 2016:
- There were 26,072 attendances at Emergency Departments across Scotland.
- 93.9% of people attending Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours.
- 112 patients (0.4%) spent more than 8 hours in an Emergency Department.
- 19 patients (< 0.1%) spent more than 12 hours in an Emergency Department.
The information from this publication is included in NHS Performs
Quit attempts in 2015/16
- The number of quit attempts made with the help of NHS smoking cessation services fell for the fourth consecutive year to 64,736. This represents a 5% year-on-year decrease from 2014/15 compared to a 28% year-on-year fall between 2013/14 and 2014/15. The rise in the use of electronic cigarettes to help quitting may have contributed to these changes.
- Of the estimated 932,000 adult smokers in Scotland around 7% made a quit attempt with an NHS smoking cessation service.
- There were 2,291 quit attempts made by pregnant women, a 19% decrease compared with 2014/15.
Success of quit attempts in 2015/16
- NHSScotland met its smoking cessation standard, with nine of the fourteen NHS Boards meeting their individual standards.
- One month after quit dates, 37% (23,990) reported that they were still not smoking. This figure fell to 22% (13,965) by three months.
- Of the 23,990 self-reported one month quits, 65% (15,685) were confirmed on carbon monoxide (CO) testing, implying a true quit rate of 24%.
Smoking cessation services and treatments in 2015/16
- Although only 30% of quit attempts were supported by specialist services (non-pharmacy) , there were much higher quit rates (48% and 33% at one and three months compared to 33% and 17% for pharmacy services).
- At Scotland level there were higher quit rates for treatment with varenicline compared with nicotine replacement therapy.
- Dispensing of antipsychotics, antidepressants, drugs for ADHD and drugs for dementia has been steadily increasing over the past ten years. Dispensing of hypnotics and anxiolytics has remained stable in the past ten years although and there was a small decrease (1.6%) this year.
- There is a trend of increasing total cost for antidepressants and ADHD. This reflects increased usage. There has been a decrease in cost for hypnotics and anxiolytics, antipsychotics, and dementia drugs. This is primarily due to reductions in drug prices and drugs coming out of patent.
- Prescribing rates were higher in more deprived areas. For elderly patients dispensed dementia drugs, this pattern is less pronounced, but still evident.
- There are substantially more mental health drugs dispensed to females than males. The exception to this is ADHD drugs, where 80% of dispensing is to males.
- There is wide variation in dispensing of mental health drugs between NHS Boards (partly reflecting different populations and methods of service delivery).
- There was a 4% fall in the total number of NHSScotland complaints received in 2015/16 (21,456) compared to last year. In NHSScotland overall five complaints were made per 10,000 contacts (0.05%). Contacts include: hospital admissions; outpatient appointments; A&E attendances; visits to GP and nurses; dental and ophthalmic treatments.
- The total number of complaints received by NHSScotland hospital and community health services was 13,469, a 2% decrease.
- There were also decreases in the number of complaints received by family health services (6,742, 9% decrease) and by special boards, national and support organisations (1,245, 2% decrease).
- Response times have remained steady over the last five years. The majority of complaints were dealt with within 20 days.
- Hospital and community health services: 69%
- Family health services: 90%
- Special boards/national and support organisations: 82%
- There was a small decrease in the number of complaints being fully upheld in hospital and community health services and special boards, national and support organisations. This information is not available for family health services; it is not mandatory for these organisations to provide this data.