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• Across Scotland, an estimated 59.5% of patients who had a heart attack, coronary artery bypass graft (CABG) or angioplasty were referred for cardiac rehabilitation (figure 1). This represents 67.4% of heart attack patients, 53.0% of patients undergoing CABG and 29.1% of patients undergoing angioplasty procedures.
• Patients have been allocated to a single initiating event within a hierarchical order: heart attack, CABG, angioplasty, valve surgery, heart failure, unstable angina then other events. This may contribute to the apparent low percentage of patients undergoing angioplasty reported to have been referred for cardiac rehabilitation. Audit data shows that 39.6% of patients with a type of heart attack known as a non-ST elevation myocardial infarction (NSTEMI) also had a linked angioplasty intervention.
• In NHS Boards, the percentage of patients referred to cardiac rehabilitation after any heart attack, CABG or angioplasty ranged from 35.6% in NHS Grampian to 97.6% in NHS Dumfries & Galloway.

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View Cardiac Rehabilitation in Scotland on the topic publications page

• In March 2013, 90.6% of patient journeys for which an 18 Weeks Referral To Treatment (18 Weeks RTT) waiting time could be measured were reported as being within 18 weeks. The figures for January and February 2013 were 90.5% and 90.4%, respectively.


• In March 2013, a total of 106,966 patient journeys eligible under the 18 Weeks RTT target were identified. The waiting time could be measured for 98,302 of these patients (91.9%). It was not possible to calculate the waiting time fully for 8,664 patients. NHS Boards are in the process of fully implementing upgrades to their systems to improve the data collection.


• This target was due to be delivered from 31 December 2011. This target should be delivered for 90% of patients, allowing for example, the small proportion of cases where it is not clinically appropriate for the patient to be seen and treated within 18 weeks and also to take account of any exceptional increase in demand for secondary care services.

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View Waiting Times - 18 Weeks Referral to treatment on the topic publications page

Inpatients and Day cases from 01 October 2012 including Treatment Time Guarantee:

• During the quarter ending 31 March 2013, 98.7% of inpatients and day cases were seen within the Treatment Time Guarantee of 12 weeks (84 days).


• The first date at which a patient could breach the 12 weeks guarantee was on 24 December 2012.


• As at 31 March 2013, 52,722 patients were on the inpatient and day case waiting list, of which 9,046 were recorded as unavailable.

Inpatient and Day cases prior to 01 October 2012:

• The cohort of inpatient and day case admissions added to the waiting list prior to 01 October 2012 is decreasing rapidly as patients are treated.


• As at 31 March 2013, 1,517 patients remained on the inpatient and day case waiting list, of which 763 were recorded as unavailable.

New Outpatients:

• At 31 March 2013, 97.5% of new outpatients (all sources of referral) had been waiting 12 weeks or less for an appointment. This compares to a figure of 97.3% at 31 December 2012. This statistic is used by NHS Boards from 31 March 2010 to measure performance against Scottish Government waiting times standards for new outpatients.


• During quarter ending 31 March 2013, 93.9% of new outpatients seen (all sources of referral) had waited less than 12 weeks. This compares to a figure of 94.8% at 31 December 2012.

'Whole Patient Journey' – Cardiac and Cataract

• This cohort of patients includes those added to inpatient or day case waiting list prior to 01 October 2012 and as a result are decreasing rapidly as these patients are treated.


• Of 3,570 patients waiting for cataract assessment as at 31 March 2013, 91.4% were waiting equal to or less than the local target.

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View Waiting Times - Stage of Treatment on the topic publications page

• During the quarter ending March 2013, approximately 26 000 patients were seen by an audiology specialist following either referral to audiology assessment (first contact) or a one-stop clinic.


• Approximately half of patients seen by an audiology specialist between January and March 2013 had their assessment (first contact) appointment within 5 weeks of being referred and 87.3% within 12 weeks.


• Approximately half of patients were fitted with a hearing aid within 5 weeks of their assessment appointment and 95.5% within 12 weeks.


• For those sites which report on one-stop clinics, 83.3% of patients attended and were treated within 18 weeks (within 126 days) of their referral to that service.

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View Waiting Times - Audiology on the topic publications page

At 31 March 2013:

• Approximately 46 000 patients were waiting for one of eight key diagnostic tests in NHS Scotland.


• 96.2% of patients waiting for a key diagnostic test were waiting no longer than six weeks.

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View Waiting Times - Diagnostics on the topic publications page

• Waiting times information for CAMH services is still in development. NHS Boards are working with ISD and the Scottish Government to improve the consistency and completeness of the information. The target is due for delivery from March 2013.


• To report on CAMHS waiting times, NHS Boards have had to develop, for the first time, systems to report on CAMHS waiting times.
  
• During the quarter ending March 2013, 3,971 children and young people started treatment at CAMH services in Scotland.
  
• The initial estimates from data at an early stage of development indicate that around 96% of people were seen within 26 weeks.



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View Child and Adolescent Mental Health Services (CAMHS) Waiting Times on the topic publications page

• The total number of staff in post (excluding GPs & GDs) as at 31st March 2013 is 133,205.3 compared with 132,541.5 (WTE) as at 31st December 2012.  This is an increase of 0.5% (663.8).  The corresponding headcount as at 31st March 2013 is 156,535, compared with 155,781 (headcount) as at 31st December 2012.  This is an increase of 0.5% (754).  The change in the total number of staff (excluding GPs & GDs) between 31st March 2012 and 31st March 2013 is an increase of 2,033.2 WTE (1.6%) or 2,169 headcount (1.4%).


• The number of nursing and midwifery staff in post as at 31st March 2013 is 57,036.6 (WTE), compared to 56,608.5 as at 31st December 2012.  This is an increase of 0.8% (428.2).  The corresponding headcount as at 31st March 2013 is 66,068 compared to 65,610 as at 31st December 2012, an increase of 0.7% (458).  The change in the number of nursing and midwifery staff between 31st March 2012 and 31st March 2013 is an increase of 569.3 WTE (1.0%) or 394 headcount (0.6%).


• The use (in hours) of agency nursing and midwifery staff has increased in the year 2012/13 by 14.0% in comparison to 2011/12. The cost of employing these staff has increased by 62.2% (£2.5 million)


• Nursing and midwifery bank use (in hours) increased in the year 2012/13 by 13.1% in comparison to 2011/12.  The cost of employing these staff has increased by 15.1% (£13.7m).


• Across all specialties, the number of Hospital, Community and Public Health Services (HCHS) medical and dental staff in post as at 31st March 2013 is 11,925.9 (WTE), compared to 12,003.3 as at 31st December 2012.  This is a decrease of 0.6% (77.4).  The corresponding headcount as at 31st March 2013 is 13,331 compared to 13,420 as at 31st December 2012, a decrease of 0.7% (89).  The change in the number of HCHS staff between 31st March 2012 and 31st March 2013 is an increase of 91.2 WTE (0.8%) or 113 headcount (0.9%).


• The number of HCHS consultant staff in post as at 31st March 2013 is 4,531.6 (WTE), compared to 4,494.3 as at 31st December 2012.  This is an increase of 0.8% (37.3). The corresponding headcount number as at 31st March 2013 is 4,827 compared to 4,785 as at 31st December 2012, an increase of 0.9% (42).  The change in the number of HCHS consultants between 31st March 2012 and 31st March 2013 is an increase of 103.9 WTE (2.3%) or 101 headcount (2.1%).


• The number of allied health profession (AHP) staff in post as at 31st March 2013 is 9,583.4 (WTE) compared to 9,511.8 as at 31st December 2012. This is an increase of 0.8% (71.5 WTE). The corresponding headcount number as at 31st March 2013 is 11,583 compared to 11,503 as at 31st December 2012, an increase of 0.7% (80).  The change in the number of AHP staff between 31st March 2012 and 31st March 2013 is an increase of 155.2 WTE (1.6%) or 193 headcount (1.7%).


• The number of administrative services staff in post as at 31st March 2013 is 24,381.9 (WTE) compared to 24,222.2 as at 31st December 2012.  This is an increase of 0.7% (159.6 WTE). The corresponding headcount number as at 31st March 2013 is 28,385 compared to 28,227 as at 31st December 2012, an increase of 0.6% (158).  The change in the number of administrative services staff between 31st March 2012 and 31st March 2013 is an increase of 84.1 WTE (0.3%) or 3 headcount (0.01%).


• NHS Highland and The Highland Council are working towards developing an integrated model for health and social care and will result in staff transferring between both organisations.  For data as at 31st March 2013, 1,449 (headcount) and 1,099.9 (WTE) Highland Council staff are included within the overall table.


• The sickness absence rate for NHS Scotland for the year April 2012 – March 2013 is 4.80%, which is an increase from 4.63% in the previous year.

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View Workforce - comprising Staff in Post, Staff Turnover, Vacancies on the topic publications page

• Data show that a headcount of 1081 clinical staff (921.7 wte) were working in CAMHS in Scotland as at 31st  March 2013; this is an increase of 2.6 % in staff in post wte since 31st December 2012 (2.5% for headcount). From 31st March 2012 it is an increase of 6.1% wte (5.6% headcount).


• Nationally, this represents a staffing level of 17.5 wte clinical workers per 100,000 of the population of Scotland.
• NHSScotland CAMHS vary in the age of population served. In some areas services are provided up to age 16 only; while others offer services up to 18 years. This has significant implications for workforce requirements. See Table 2 in the full publication report for details.
• From 1st April 2012 NHS Dumfries & Galloway CAMHS substance misuse mental health workers (headcount =5) sit within a separate subteam; Child and Adolescent substance service, CAS.
• From 1st April 2012, as part of the new Highland Lead Agency structure, CAMHS Primary Mental Health Workers are Highland Council employees, not NHS Scotland.
• From March 2013 a joint decision has been reached between CAMHS and Combined Child Health Services that 5 Health Psychologists who were previously managed within NHS Grampian CAMHS are now to be managed by NHS Grampian Combined Child Health services. They will therefore not now appear on the CAMHS database.
• As at 31st March 2013, an additional 34.5 wte posts throughout NHS Scotland CAMHS were between being advertised and being filled. A further 22.1 wte posts were approved for recruitment but not yet advertised.

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View Child and Adolescent Mental Health Services (CAMHS) in NHS Scotland: Characteristics of the workforce supply on the topic publications page

• In total there were 808 (683.1 wte) Clinical & Other Applied Psychologists employed in NHSScotland as at 31st March 2013.  This is an increase of 4.8% headcount (+37hc), and an increase of 5.2% wte (+33.7 wte) from 31st March 2012.


• This total of 808 (683.1 wte) equates to 746 (629.2 wte) Clinical Psychologists plus 62 (53.9 wte) Other Applied Psychologists. This represents a national staffing level of 1 wte Applied Psychologist per 7,692 of the general population of Scotland.


• Psychology services increasingly employ a skill-mix of staff.   Graduates of the MSc in Psychological Therapies in Primary Care (56.1wte), Graduates of the MSc in the Applied Psychology of Children and Young People (27.5 wte), assistant psychologists (73.6 wte), cognitive behavioural therapists (36.8 wte), counsellors (30.2 wte), other therapists (10.2 wte), and other clinical staff (14.2 wte), were employed in NHSScotland psychology services as at 31st March 2013.

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View Workforce Planning for Psychology Services in NHS Scotland - Characteristics of the Workforce within psychology services 2013 on the topic publications page

• Total A&E attendances have increased from 1.60 million in 2008/09 to 1.65 million in 2012/13


• During the quarter ending 31 March 2013, the proportion of new and unplanned attendances at all A&E services across Scotland that were seen and discharged within 4 hours was:  89.7% January, 91.9% February and 91.9% March.


• In March 2013 four NHS Boards achieved the waiting time standard of 98% of patients admitted, transferred or discharged from A&E within 4 hours.


• In the 12 months to March 2013, the average Emergency Department attendance rate was 2,153 per 100,000 population. The HEAT target for March 2014 is to reduce this figure to 2,095 per 100,000 population.

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View Emergency Department Activity & Waiting Times on the topic publications page

General Hospital Discharges:

• The overall rate of discharge with a diagnosis of drug misuse has increased over the last 5 years from 111 per 100,000 population in 2007/08 to 125 per 100,000 population in 2011/12. For the latest year (from 2010/11 to 2011/12) the discharge rate increased from 123 to 125 per 100,000 population.


• The rise is entirely due to increases in the older age groups (particularly 35 years and over). In the younger age groups the discharge rates dropped; by 24% for 15-19 year olds; by 23% for 20-24 year olds; and by 15% for 25-29 year olds.


• Opioids were involved in 71% of discharges, which is an increase from 67% in 2007/08.Cannabinoids increased from 7% to 10% and sedatives/hypnotics from 3% to 5%, whereas cocaine dropped from 8% to 5%, other stimulants from 6% to 3% and multiple/other drugs from 15% to 12%. Note that more than one drug can be recorded within a hospital stay.

Psychiatric Hospital Discharges:

• The rate of psychiatric hospital discharges with a diagnosis of drug misuse has remained fairly steady for the last five years (2006/07 to 2010/11) at around 29-31 discharges per 100,000 population.

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View Drug-related Hospital Statistics Scotland 2011/12 on the topic publications page

• In 2011/12, there were 689 alcohol-related discharges per 100,000 population from a general acute hospital in Scotland (38,724 discharges in total). This is a 1% decrease in rates compared to the previous year (2010/11), when there were 697 alcohol-related discharges per 100,000 population (38,920 discharges).


• Over the last five years, there has been a 13% decrease in alcohol-related discharge rate from a general acute hospital in Scotland; from 788 discharges per 100,000 population in 2007/08 to 689 discharges per 100,000 population in 2011/12


• The largest decrease was in those aged under 20 years age. For people aged 35-39 and 40-44 year olds the rate increased slightly from 2010/11 to the latest year, although since 2007/08 their rates have dropped as well.


• In all five years, the rate of alcohol-related general acute hospital discharges was approximately seven times greater for patients living in the most deprived areas compared to those living in the least deprived areas (see Fig 1).

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View Alcohol-related Hospital Statistics Scotland 2011/12 on the topic publications page

• In Scotland for the two year period, 2010 and 2011, the percentage of people diagnosed with the earliest stage (stage 1) of breast, colorectal and lung cancer (combined) was 23.0%.


• The equivalent National figures for the individual cancers are: breast 38.2%, colorectal 17.2% and lung 13.1%.


• The two cancers with the highest percentage of stage 1 cancers (breast and colorectal) have national screening programmes in place.


• The variation in the percentage of stage 1 cancers diagnosed may reflect, at least in part, variation in the percentage of not known stage both at cancer type and Health Board level. The national percentage of not known stage for the three cancers combined is 9.1%.


• The equivalent figures for the percentage of not known stage in the individual cancers are: breast 6.6%, colorectal 14.6% and lung 6.9%.

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View Detect Cancer Early Baseline on the topic publications page

• The level of the Scottish population (all ages) registered with an NHS GDS dentist was 81.8% as at 31st March 2013, up from 79.8% as at 30th September 2012.
• Within the 6-12 and 13-17 age groups, over 99% of the population was registered with an NHS GDS dentist.
• Among mainland NHS boards, Greater Glasgow & Clyde had the highest level of children registered (89.9%) and Ayrshire & Arran the highest level of adults registered (85.9%).
• Grampian had the lowest registration rates for children (79%), adults (59.4%) and the total population (63.3%).
• Nationally, the rate of participation in NHS General Dental Services among registered patients over the last 2 years was 86.6% for children and 75.4% for adults (down from 87.5% and 77.1% respectively, as at 30th September 2012).
• Participation rates were lowest in the 18-24 age group (69.3%) and highest in the 0-2 age group (98.1%).
• Participation rates for children were highest in Borders (91.9%) and lowest in Shetland (83.5%); rates for adults were also highest in Borders (85.5%) and lowest in Orkney (67.4%).

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View Dental Statistics - Registration and Participation on the topic publications page

• There were 116,198 quit attempts made with the help of NHS smoking cessation services in Scotland in 2012.  This compares with 112,812 quit attempts in 2011 (revised 2011 figure), an increase of 3,386 (3.0%).  The number of quit attempts made in NHS cessation services in Scotland in 2012 was the highest annual figure since the national monitoring began, in 2006.


• An estimated 11.0% of the adult smoking population made a quit attempt with an NHS smoking cessation service in 2012.  Three quarters (75.2%) of these quit attempts were made in pharmacy services.


• Females accounted for 57.3% of quit attempts made and males 42.7%.  The highest proportion of quit attempts was in the 45-59 years age group (29.9%).  Over one third of quit attempts (37.2%) were made by people living in the 20% 'most deprived' areas of Scotland.  In 2012, there were 2,985 quit attempts made by pregnant women, an increase of 229 (8.3%) on the 2011 figure of 2,756 (revised 2011 figure).


• One month after the quit date, 38.1% of individuals had quit (self-reported 'not smoked, even a puff, in the last two weeks'), 17.4% were still smoking and 44.5% were 'lost to follow-up'/unknown smoking status.  This compares with a one month quit rate of 37.6% in 2011 (revised 2011 figure).


• There were a total of 44,261 one month self-reported quits in 2012, an increase of 1,811 (4.3%) on the 42,450 one month self-reported quits in 2011 (revised 2011 figure).


• Three months after the quit date the percentage quit rate was 12.4% (based on client self-reported 'smoked up to five cigarettes since one month follow-up' and on quit attempts during the first nine months of the year).  This compares with a three month quit rate of 15.6% for the same time period in 2011 (revised 2011 figure).  There was an increase in the percentage of cases 'lost to follow-up/unknown' from 2011 to 2012.


• Based on the 2011 calendar year, quit rates at one, three and 12 months were 37.6%, 15.8% and 5.5% respectively.  Note: the denominator for the percentages remains total quit attempts in 2011.  The cumulative percentages of cases 'lost to follow-up'/smoking status unknown at one, three and 12 months were 44.7%, 61.3% and 68.9%.

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View NHS Smoking Cessation Service Statistics (Scotland) 1st January to 31st December 2012 on the topic publications page

125,410 bed days were occupied by delayed discharge patients in NHS Scotland during the quarter January to March 2013.

At the April 2013 census, 44 patients were delayed over 4 weeks. This compares with 174 at the January 2013 census and 108 at the April 2012 census.

At the April 2013 census there were 24 patients delayed for over 6 weeks. This compares with 57 at the January 2013 census and 13 at the April 2012 census. 208 patients were delayed over 2 weeks.

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View Delayed Discharges in NHS Scotland - figures from April 2013 census on the topic publications page

• HSMR at Scotland-level has decreased by 11.8% between October to December 2007 and October to December 2012.
• Twenty eight (90%) of the thirty one hospitals participating in the SPSP have shown a reduction in HSMR since October-December 2007 (end of the baseline period); eight of those had a reduction in excess of 15%.
• Rolling annual HSMR shows that there was a sustained reduction in hospital mortality between 2009 and 2011; the level thereafter has remained relatively constant.

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View Hospital Standardised Mortality Ratios - Quarterly Statistics on the topic publications page

• For the past four years there has been a fall in the number and rate of abortions with 12,447 in 2012 compared to 13,904 in 2008 (representing rates of 12.0 per 1000 women aged 15-44 in 2012, and 13.3 in 2008). This fall is a change to the overall pattern of increase since the implementation of the 1967 Abortion Act, although small dips for short periods have been observed before. Birth rates also peaked in 2008, but whereas there has been a 9.5% fall in abortion rates between 2008 and 2012, there has only been a 5.2% fall in live birth rates over this period (NRS Preliminary Annual Figures: http://www.gro-scotland.gov.uk/files2/stats/births-marriages-deaths-preliminary/bdve-2012-preliminary-tablep1b.xls).


• The fall in abortion rates between the peak of 2008 and 2012 has been greatest in younger women, with a reduction of 27.5% in those aged 16 to 19.
  
  Although there has been a recent marked reduction in abortions in younger women, the rate of terminations in 2012 is still highest in this group, at 17.8 per 1000 aged 16-19 and 21.1 per 1000 in those aged 20-24. Lower rates are seen in the older age groups: women aged 25-29 (15.5 per 1000); aged 30-34 (11.2 per 1000); aged 35-39 (6.8 per 1000) and in women aged 40 and over (2.5 per 1000).


• The proportion of early terminations has been rising steadily in recent years, with 69.8% of all terminations performed at less than 9 weeks in 2012, compared to 62.2% in 2009. There has also been a sustained increase in the use of medical methods compared to surgical terminations.


• In 2012, the rate of abortions continues to show a clear link with the level of deprivation. In areas of high deprivation the rate is 16.1 per 1000, nearly double the rate of 8.6 per 1000 for the least deprived areas of Scotland.


• Approaching a third (30.7%) of the 12,447 women having a termination in 2012 had a previous termination. The proportion of women having had a previous termination varies across mainland NHS boards from 26.9% in the NHS Fife to 36.8% in NHS Tayside. The Island boards (Orkney, Shetland and Western Isles) recorded the lowest proportion at 20.6%.


• In 2012, the vast majority (11,761; 94.5%) of terminations were carried out under Ground C. There were 159 terminations carried out under Ground E ...substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped of which 30 were for Down’s syndrome, 15 for anencephaly, 13 for musculoskeletal conditions and 12 for other chromosomal conditions.

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View Abortion Statistics, 2012 on the topic publications page

• In school year 2011/12 a total of 52,139 valid height and weight measurements were recorded for children in Primary 1 in Scotland. This is approximately 92% of children in Primary 1. This is the first year that data are available for all council areas in Scotland.

Based on epidemiological thresholds used for population monitoring purposes:

• In 2011/12, 76.9% of children in Primary 1 were classified as healthy weight, a marginal increase on the 2010/11 figure of 76.7%.


• The BMI distribution of children in Primary 1 has remained broadly similar over the period 2000/01 to 2011/12 with around 21% to 23% of children (one in five) at risk of overweight and obesity combined and around 1.5% at risk of underweight. In 2011/12, 21.9% of children in Primary 1 were at risk of overweight and obesity combined and 1.2% at risk of underweight.

Based on clinical thresholds for assessing children:

• In 2011/12, 84.6% of children in Primary 1 in Scotland were classified as healthy weight, a marginal decrease on the 2010/11 figure of 84.7%.


• The BMI distribution of children in Primary 1 has remained broadly similar over the period 2000/01 to 2011/12 with around 14% to 16% of children overweight, obese and severely obese combined and around 0.5% underweight.  In 2011/12, 14.9% of children were classified as overweight, obese and severely obese combined and 0.4% underweight.

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View Primary 1 Body Mass Index (BMI) statistics for school year 2011/12 on the topic publications page

• In the five year period, 2007-2011, half of the deaths in Scotland from cancer occurred in NHS hospitals (38,157 out of 76,510).  A quarter of deaths from cancer were at home (19,457), while 18% were in hospices (13,894).


• The overall pattern described above has also been consistent over the 10 year period 2002-2011, with only a small decrease in the percentage of deaths occurring in hospital and a small increase in the percentage of deaths occurring at home.

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View Place of Death from Cancer 2011 on the topic publications page

NHSBSP Performance Standards, at 31st March 2012:

• Looking at three year performance standard attendance figures, uptake has dropped slightly from 74.9% in 2008-11 to 74.5% in 2009-12.


• Greater Glasgow and Clyde were the only NHS Board not to meet the minimum performance attendance standard of >70% of women invited during the previous three years.  The attendance rate for Greater Glasgow and Clyde was 70.8% in 2008-11 but dropped slightly to 69.8% in 2009-12.


• In 2011-12, all but one of the NHS Breast Screening Programme Minimum Performance Standards and all but 3 of the 13 targets were met.

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View Scottish Breast Screening Programme Statistics 2011/12 on the topic publications page

• In 2011, there were 438 cases identified as eligible for inclusion in the NDRDD cohort (an increase from 365 in 2010).


• Over three quarters (78.3%) were male, over half (53.4%) lived in the most deprived areas in Scotland and the 35-44 years age group accounted for the highest proportion of deaths (38.1%).


• Over two fifths (44.5%) of the cohort, where known, were a parent or parental figure.


• Where known, nearly two thirds (63%) had a history of drug injecting and over three quarters (77.4%) had a medical condition recorded in the 6 months prior to death.


• Where known, almost two thirds of individuals (64.5%) had been in contact with a drug treatment service at some point in their lives.


• Where known, in the 6 months prior to death, one third (34.3%) had been released from police custody and almost a fifth (18.1%) had been released from prison.


• This year's report includes data on drugs 'present' in the body and drugs 'implicated' in the death.  The presence of a drug in the toxicology of the deceased individual does not necessarily mean that the drug was implicated in (contributed to) the death.


• In the vast majority of cases (97%) more than one drug was present in the toxicology and in 68.9% more than one drug was implicated in the death.


• In relation to drugs present, the proportion of deaths with heroin/morphine and alcohol has decreased over the period 2009-2011, while the proportion of deaths with methadone, diazepam and anti-depressants has increased over this period.


• In 2011, diazepam was the drug most frequently found to be present in the body at death (81.4%) and methadone was the drug most frequently implicated in the death (53.4%).


• The majority of individuals (150, 60.7%) with methadone found in their toxicology were not in receipt of a methadone prescription at the time of death.


• Where known, almost three quarters (73.8%) of individuals in the 2011 NDRDD cohort were not currently in receipt of a prescribed substitute drug.

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View The National Drug Related Deaths Database (Scotland) report 2011 on the topic publications page

• Over the last ten years, age-standardised incidence rates of cancer in Scotland have fallen by 3% in males but increased by 9% in females.


• Cancer incidence rates and trends in incidence rates show considerable variation between different types of cancer.


• Actual numbers of cases of cancer have risen over the last decade. This is likely to be largely due to an ageing population.


• Two in five people in Scotland will be diagnosed with some form of cancer during their lifetime. This includes cancers that will have no detrimental impact on life expectancy, such as indolent prostate tumours.


• It is estimated that there are 165,000 individuals who have been diagnosed with cancer over the last 20 years in Scotland and who are still alive. This is approximately 3% of the population of Scotland.

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View Cancer Incidence 2011 on the topic publications page

• In 2011/12, 11,380 individuals received a specialist assessment of their drug use care needs, which equates to a rate of 230 per 100,000 of the Scottish population. This compares with a rate of 238 (11,696) reported in 2010/11.
• Of those reporting illicit drug use in the last month (7,875 individuals), 55% reported using heroin. This compares to 63% in 2010/11.
• Of those under the age of 25 who reported illicit drug use in the last month, 34% reported using heroin. This is a drop from 44% reported in 2010/11.
• Twenty-two per cent of all individuals (for whom information is available) reported that they had injected in the month prior to their initial assessment. Forty-seven per cent reported that they had never injected.
• Seven per cent of individuals reported that they had shared needles/syringes in the previous month.
• Of those individuals who had injected drugs in the past: 81% reported that they had been tested for Hepatitis B; 82% for Hepatitis C and 80% for HIV, prior to their initial assessment.
• Sixty-two per cent of individuals reported that a year or more had elapsed between the onset of problem drug use and their initial assessment. This is consistent with previous years.

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• Diet and nutrition
  In 2010/11, 15% of adults living in the most deprived SIMD quintile reported that they met the recommended daily intake of five or more portions of fruit and vegetables, compared with 28% in the least deprived quintile. Among children aged 2-15, 7% of boys in the most deprived SIMD quintile met the recommendation, compared with 17% in the least deprived quintile. For girls, 12% met the recommendation in both the least and most deprived quintiles. The proportion of children consuming no daily fruit and vegetables was greatest in the most deprived quintile (16%) and lowest in the least deprived quintile (5%).
• Tobacco use
  There is a strong gradient in smoking rates across SIMD quintiles. In 2011, smoking rates increased from 12% in the least deprived quintile to 38% in the most deprived quintile.
• Deaths
  Within Scotland, the highest all-cause age/sex standardised mortality rates are generally found in the west of the country (e.g. Greater Glasgow & Clyde and Lanarkshire NHS Boards). In 2011 the lowest rate (for residents of Orkney NHS Board) was almost 25% lower than for Greater Glasgow & Clyde. There is a strong deprivation pattern, and the rate for persons living in the least deprived SIMD decile (424 deaths per 100,000 population) was less than half the rate for the most deprived decile (1,014 deaths per 100,000 population).
  Over the period 2009-2011, the most common underlying cause of death for all ages was acute myocardial infarction (8.4% of all deaths), followed by malignant neoplasm of the bronchus and lung (7.7%) and chronic ischaemic heart disease (6.1%).
• Allergic conditions
  In 2011/12, more people consulted their GP for asthma, eczema and nasal allergies than for any other allergic conditions. Allergic reactions to stings and allergies to food were important but uncommon reasons for consulting. Asthma accounted for around 80% of hospital admissions for allergic conditions.
• Diabetes
  In 2011/12, over 4,000 people were admitted to hospital in Scotland because of diabetes, and diabetes contributed to over 66,000 admissions. In 2011/12, there were over 2,200 admissions with diabetic ketoacidosis, a serious complication of diabetes. Diabetes was identified as a contributing factor to over 4,400 deaths in Scotland in 2011.

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• During the period September to November 2012, around 21,000 women consulted their GP with breast symptoms such as lumps, pain and infection. This is an estimate based on a sample of GP practices, so the exact figure could be anywhere in the range 18,300 to 23,700. During the same period in 2011, the number of women consulting with these symptoms was around 13,900 (range 12,300 to 15,500).
• Many more women consulted their GP during the period September to November 2012 than during previous quarters or the same period in 2011. This corresponds with the timing of the Breast Cancer Awareness campaign.
• Consultations for breast symptoms such as lumps, pain and infection reached a peak in October 2012. During this month these symptoms accounted for around 0.56% of all consultations, compared to 0.35% in October 2011.

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• The level of the Scottish population (all ages) registered with an NHS GDS dentist was 79.8%, up from 78.0 % at 31st March 2012.
• Among mainland NHS boards, Dumfries & Galloway and Greater Glasgow & Clyde had the highest level of children registered (89.2%), while Ayrshire & Arran had the highest level of adults registered (83.9%); Ayrshire & Arran also had the highest level of total population registered (84.9%).
• Among mainland NHS boards, Grampian had the lowest level of children (77.1%), adults (56.0%) and total population (60.2%) registered.
• Nationally, the rate of participation in NHS General Dental Services among registered patients over the last 2 years was 87.5% for children, 77.1% for adults and 79.3% for all registered patients; these results are very similar to those of March 2012 (87.4%, 77.4% and 79.6% respectively).
• Participation rates for children were highest in Borders (92.5%) and lowest in Shetland (85.6%), while rates for adults were highest in Borders (86.4%) and lowest in Orkney (69.5%); rates for all registered patients were highest in Borders (87.9%) and lowest in Western Isles (74.4%).

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Rates of stillbirths and deaths:

• Stillbirth rate 5.1 per 1000 births
• Neonatal death rate 2.7 per 1000 live births
• Perinatal mortality rate 6.9 per 1000 births
• Post-neonatal deaths 1.3 per 1000 live births
• Infant mortality rate 4.0 per 1000 live births

All rates are lower than in most recent years. The perinatal mortality rate in 2011 was the same as 2010’s record low rate.

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• Information on Allied Health Professionals working in mental health has been included in the toolkit for the first time.
• The total expenditure for adult mental health services was £877m in 2011/12, an increase of 1.1% since 2010/11, and is equivalent to £167 for every person in Scotland.
• The average length of stay for adult mental health specialties in Scotland decreased from 80.5 days in 2010/11 to 65.2 days in 2011/12 (excluding NHS Ayrshire & Arran). The median length of stay remained at 16 days, unchanged for the last 4 years.
• There was a small increase in the number of people on compulsory treatment orders in Scotland from 2,066 in 2010/11 to 2,181 in 2011/12.
• In 2011/12 the number of mental health officers in Scotland equates to 635 whole time equivalents (WTE); a decrease of approximately 7.5% from 2010/11.
• The mortality rate for persons in contact with the mental health service in Scotland (excluding NHS Ayrshire & Arran) is 2.8 times higher than the mortality rate for the general population when standardised by age and sex.

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View Adult Mental Health Benchmarking Toolkit 2011/12 on the topic publications page

In the period October – December 2012:

• Across Scotland, 95.8% of patients started treatment within 62 days of urgent referral with suspicion of cancer, an increase from 94.0% during the period July - September 2012.
• 98.1% of patients started treatment within 31 days of decision to treat, regardless of the route of referral, which is an increase from 97.6% in the period July - September 2012.
• 99.8% of the patients that were urgently referred with a suspicion of cancer from the breast screening programme were seen within 62 days of referral. Amongst patients that were urgently referred from the cervical screening programme, 94.4% were seen within the standard of 62 days, while of patients urgently referred from the colorectal screening programme, 91.8% were seen within 62 days.

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• In October - December 2012, of the 10,875 people who started their first drug and/or alcohol treatment, 92.1% had waited 3 weeks or less, compared to 91.5% in the previous quarter.
• 92.0% of the 7,043 people who started alcohol treatment between October and December 2012 had waited 3 weeks or less, compared to 92.1% in the previous quarter.
• 92.2% of the 3,832 people who attended an appointment for drug treatment waited 3 weeks or less, compared to 90.4% in the previous quarter.
• Of the 2,583 people who were still waiting to start drug or alcohol treatment, 108 people, or 4.2%, had waited more than 6 weeks at the end of December 2012, compared to 84 people, or 2.3% in the previous quarter.

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• There were around 370,000 acute inpatient and day case discharges in the quarter ending December 2012. This is an increase of around 2.4% from the same quarter of the previous year
• The total number of outpatient attendances in the quarter ending December 2012 was around 1,171,500. This is an increase of around 1.8% on the quarter ending December 2011.
• The number of available staffed beds in acute specialties was recorded as 16,085 in the quarter ending December 2012. This is a reduction of 1.6% from 16,340 beds in December 2011.
• The rate of emergency bed days per 1,000 patients aged 75 and over reduced by 7.2% from 5,393 in 2009/10 to a 5,003 in 2011/12.

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• The gross total payments to Scottish dispensing contractors decreased from £1,178 million in 2011 to £1,126 million in 2012.
• The net ingredient cost (NIC) paid to dispensing contractors for drug reimbursement has decreased, from £972 million in 2011 to £919 million in 2012. However, the cost for remuneration of services shows an increase of £1.8 million (0.9%) from £205.7 million in 2011 to £207.5 million in 2012.
• The gross ingredient cost (GIC) paid to dispensing contractors in 2012 in respect of dispensing was £965.7 million. This is a decrease of £46.8 million (4.6%) when compared to 2011.
• The number of prescription items for 2012 was 96.6 million. This is an increase of 2.8 million (3.0%) compared to 2011. The number of prescription items for 2011 was 93.8 million. This was an increase of 2.8 million (3.1%) compared to 2010.

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View Prescribing Statistics - Dispenser Remuneration on the topic publications page

In Scotland immunisation uptake rates for children aged up to six years remain high and stable.

• At Scotland level, annual uptake rates by 24 months of age for primary courses of immunisation against diphtheria, tetanus, pertussis, polio & Hib (DTP/Pol/Hib), MenC and PCV remain high and stable at around 96% to 98%. Uptake rates have exceeded the 95% target for the last decade.


• Annual uptake of the first dose of MMR vaccine by 24 months of age reached 95.0% for the first time (the previous annual figure was 94.0%). Uptake rates by 24 months of age have continued to be above 90% since calendar year 2006. Annual uptake of the first dose of MMR by five years of age is 96.9% (the previous annual figure was 96.4%). MMR uptake rates by five years have remained above the 95% target since calendar year 2009.


• Uptake of the PCV booster vaccine by 24 months of age increased to 95.4% in 2012 (94.1% in 2011). This is the first time uptake of the PCV booster has reached and exceeded 95% since its introduction to the routine immunisation schedule in September 2006

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View Childhood Immunisation Statistics, quarter and year ending December 2012 on the topic publications page

• In 2011, the use of systemic antibacterials in primary care (items/1000 population/day) was 3.4% higher than in 2010, corresponding to an increase of 162 000 prescription items. However there was a continued reduction in the use of broad spectrum antibacterials associated with Clostridium difficile infection (CDI); cephalosporins 23.8%; combination penicillins (mainly co-amoxiclav) 17.7% and fluoroquinolones 10.8%.


• Overall, 32% of the Scottish population had at least one antibacterial item dispensed in
  2011; 8.2% had =3 items and 2.2% had =6 items dispensed. The use of antibacterials increased in all age groups from 2010 to 2011 with the greatest increase in the age groups 0-4 years (4.1%), 5-14 years (5.7%) and =80 years (5.2%).


• Antibacterial use in secondary care (hospitals) is now reported for 10 NHS boards covering 81% of the population. In 2011, the total use of systemic antibacterials in secondary care was 1.7% higher (DDD/1000/day) than in 2010. The use of broad- spectrum antibacterials associated with CDI was 0.4% higher in 2011 in hospitals; which included reductions in cephalosporins (11.2%) and fluoroquinolones (6.0%) and increases in co-amoxiclav (6.7%) and clindamycin (1.7%).


• In 2011, the number of cases of E. coli bacteraemia was 3839 which is 10% higher than in 2009. The increase does not seem to have been driven by resistant strains as resistance to key antimicrobials is decreasing; including a decreasing trend in cephalosporin resistance reaching frequencies of 8-9% in 2011, the lowest since 2008.


• The decreasing trends (and stable in some instances) in resistance to key antimicrobials among the Scottish Gram-negative organisms, including E. coli, K. pneumoniae and P. aeruginosa described in this report, should be seen in the light of Europe-wide increases in antimicrobial resistance in Gram-negatives.


• In 2011, extended spectrum beta-lactamase (ESBL) producers among E. coli (6.5%)
  and K. pneumoniae (7.0%) were at the lowest frequencies since 2008.


• Among Gram-positive organisms antimicrobial resistance trends are generally stable or decreasing. An exception is the increasing frequency of vancomycin resistance among isolates of E. faecium which reached 27.6% in 2011, above what is reported for the UK (8.9%), and only exceeded in Europe by Ireland (34.9%).


• Since 2008 there has been an 18% increase in the use of carbapenems in Scotland despite initiatives to restrict the use of this group of agents. Carbapenem resistance among Gram-negative organisms is still rare, but has now been reported from nearly all parts of Scotland. This highlights the need for measures to preserve the effectiveness of carbapenems for the future.

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View Scottish Antimicrobial Prescribing Group (SAPG) Report on Antimicrobial Use and Resistance in humans in 2011 on the topic publications page

• Unintentional injuries accounted for approximately 1 in 7 emergency hospital admissions for children and 1 in 10 for adults in Scotland in 2011/2012.


• There were 54,427 emergency admissions to hospital in Scotland for unintentional injuries in 2011/12. This is a slight decrease of approximately 1% on the previous year.


• There were 1,657 deaths in Scotland in 2011 due to unintentional injury, 16 in children under the age of 15 and 1,641 in adults aged 15 years of age and over.


• There were over 32,000 emergency admissions to hospital due to falls in Scotland in 2011/12. This represents approximately 60% of the total number of emergency admissions to hospital due to unintentional injuries.


• Children and adults in the most deprived areas are more likely than those in the least deprived areas to have an emergency admission to hospital for an unintentional injury.

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• For Scotland as a whole there has been substantial improvement in the recording of ethnic group. Over the last two years completeness of recording has increased from just under 50% to 75% for acute hospital discharges and has risen from just over 30% to 60% for new outpatients.


• Recording of ethnicity varies widely among Boards and remains relatively low in some boards: in the quarter ending September 2012 completeness of recording ranged from 23% to almost 100% for both acute inpatient and day case records.


• Ethnic group recording for some Boards may have been affected by the implementation of the new NHS Patient Management System (PMS).

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View Improving ethnic data collection for equality and diversity monitoring on the topic publications page

• In total there were 808 (682.4 wte) Clinical & Other Applied Psychologists employed in NHSScotland as at 31st December 2012.  This is an increase of 5.5% headcount (+42hc), and an increase of 6.1% wte (+39.3 wte) from 31st December 2011.


• This total of 808 (682.4 wte) equates to 745 (627.3 wte) Clinical Psychologists plus 63 (55.1 wte) Other Applied Psychologists. This represents a national staffing level of 1 wte Applied Psychologist per 7,700 of the general population of Scotland.


• Psychology services increasingly employ a skill-mix of staff.   Graduates of the MSc in Psychological Therapies in Primary Care (54.6 wte), Graduates of the MSc in the Applied Psychology of Children and Young People (22.7 wte), assistant psychologists (50 wte), cognitive behavioural therapists (38.8 wte), counsellors (30.9 wte), other therapists (10.2 wte), and other clinical staff (13.8 wte), were employed in NHSScotland psychology services as at 31st December 2012.

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View Workforce Planning for Psychology Services in NHSScotland - Characteristics of the Workforce within Psychology Services on the topic publications page

• Data show that a headcount of 1055 clinical staff (898.2 wte) were working in CAMHS in Scotland as at 31st  December 2012; this is an increase of 1.4 % in staff in post wte since 30th September 2012 (1.2% for headcount). From December 2011 it is an increase of 6.6% wte (7.2% headcount).


• Nationally, this represents a staffing level of 17.1 wte clinical workers per 100,000 of the population of Scotland.


• NHSScotland CAMHS vary in the age of population served. In some areas services are provided up to age 16 only; while others offer services up to 18 years. This has significant implications for workforce requirements. See Table 2 in the full publication report for details.


• From 1st April 2012 NHS Dumfries & Galloway CAMHS substance misuse mental health workers (headcount =5) sit within a separate subteam; Child and Adolescent substance service, CAS.


• From 1st April 2012, as part of the new Highland Lead Agency structure, CAMHS Primary Mental Health Workers are Highland Council employees, not NHS Scotland.
  
  As at 31st December 2012, an additional 52.4 wte posts throughout NHS Scotland CAMHS were between being advertised and being filled. A further 23.5 wte posts were approved for recruitment but not yet advertised.

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• Waiting times information for CAMH services is still at an early stage of development. NHS Boards are working with ISD and the Scottish Government to improve the consistency and completeness of the information. The target is due for delivery from March 2013.


• To report on CAMHS waiting times, NHS Boards have had to develop, for the first time, systems to report on CAMHS waiting times.


• During the quarter ending December 2012, almost 3,200 children and young people started treatment at CAMH services in Scotland.


• The initial estimates from data at an early stage of development indicate that around 91% of people were seen within 26 weeks.

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• In December 2012, 90.9% of patient journeys for which an 18 Weeks Referral To Treatment (18 Weeks RTT) waiting time could be measured were reported as being within 18 weeks. The figures for October and November 2012 were 90.8% and 90.4%, respectively.


• In December 2012, a total of 98,313 patient journeys eligible under the 18 Weeks RTT target were identified. The waiting time could be measured for 90,580 of these patients (92.1%). It was not possible to calculate the waiting time fully for 7,733 patients. NHS Boards are in the process of fully implementing upgrades to their systems to improve the data collection.


• This target was due to be delivered from 31 December 2011. This target should be delivered for 90% of patients, allowing for example, the small proportion of cases where it is not clinically appropriate for the patient to be seen and treated within 18 weeks and also to take account of any exceptional increase in demand for secondary care services.

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Post 01 October 2012:

• During the quarter ending 31 December 2012, 7 of 58,070 patients seen waited beyond treatment time guarantee of 12 weeks.

Pre 01 October 2012:

• The information contained within this report on patients added to the list prior to 01 October 2012 is not directly comparable with any previous report. 


• As at 31 December 2012, the total number of new outpatients (all sources of referral) added to the list prior to 01 October 2012 still waiting to be seen is 20,007.


• During quarter ending 31 December 2012, 89.5% of new outpatients seen (all sources of referral) had waited less than 12 weeks.


• As at 31 December 2012, the total number of inpatients and day cases added to the list prior to 01 October 2012 still waiting to be seen is 5,967.


• During quarter ending 31 December 2012, 82.5% of inpatients and day cases admitted had waited less than 9 weeks.

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• During the quarter ending December 2012, approximately 26 000 patients were seen by an audiology specialist following either referral to audiology assessment (first contact) or a one-stop clinic.



• Approximately half of patients seen by an audiology specialist between October and December 2012 had their assessment (first contact) appointment within 5 weeks of being referred and 86.2% within 12 weeks.




• Approximately half of patients were fitted with a hearing aid within 5 weeks of their assessment appointment and 92.6% within 12 weeks.



• For those sites which report on one-stop clinics, 81.2% of patients attended and were treated within 18 weeks (within 126 days) of their referral to that service.

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• During the quarter ending 31 December 2012, the proportion of new and unplanned attendances at all A&E services across Scotland that were seen and discharged within 4 hours was;  94.4% October, 93.5% November and 90.3% December.


• In December 2012 four NHS Boards achieved the waiting time standard of 98% of patients admitted, transferred or discharged from A&E within 4 hours.


• In the 12 months to December 2012, the average Emergency Department attendance rate was 2,188 per 100,000 population. The HEAT target for March 2014 is to reduce this figure to 2,095 per 100,000 population.

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• Approximately 125,000 bed days were occupied by delayed discharge patients in NHS Scotland during the quarter October to December 2012.


• At the January 2013 census there were 57 patients delayed for over 6 weeks. This compares with 95 at the October 2012 census and 54 at the January 2012 census.


• At the January 2013 census, 174 patients were delayed over 4 weeks and 325 patients were delayed over 2 weeks

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• The total WTE staff in post (excluding GPs & GDs) as at 31st December 2012 is 132,541.5, compared to 131,845.2 as at 30th September 2012. This is an increase of 0.5% (696.4 WTE). The corresponding headcount as at 30th December 2012 is 155,781, compared to 155,281 as at 30th September 2012, which is an increase of 0.3% (500 headcount).


• As at 31st December 2012, total Nursing and Midwifery WTE staff in post increased by 0.6% (345.0 WTE) from 56,263.5 as at 30th September 2012, to 56,608.5. The headcount for all Scotland Nursing and Midwifery staff as at 31st December 2012 is 65,610. This is an increase of 0.4% (230 headcount) compared to 65,380 as at 30th September 2012.


• Across all specialties, the number of Hospital, Community and Public Health Services (HCHS) Medical and Dental staff in post as at 31st December 2012 is 12,003.3 (WTE), compared to 11,943.9 (WTE) as at 30th September 2012. This is a WTE increase of 0.5% (59.4). HCHS headcount increased by 0.8% (103) to 13,420 in December 2012 compared to 13,317 in September 2012.


• As at 31st December 2012, the WTE of Consultants in post is 4,494.3, compared to 4,476.2 at 30th September 2012. This is an increase of 0.4% (18.2 WTE). The corresponding headcount for Consultants in post increased by 0.5% (22 headcount) from 4,763 as at 30th September 2012 to 4,785 as at 31st December 2012.


• The WTE of Allied Health Professions (AHP) staff in post increased by 1.0 % (89.6) from 9,422.3 as at 30th September 2012 to 9,511.8 as at 31st December 2012. The headcount of AHPs as at 31st December 2012 is 11,503, which is an increase of 0.9% (108 headcount) from 11,395 as at 30th September 2012.


• The number of Administrative Services staff in post as at 31st December 2012 is 24,222.2 (WTE), compared to 24,137.1 as at 30th September 2012. This is an increase of 0.4% (85.1 WTE). Similarly, the headcount of Administrative Services staff in post increased by 0.2% (68 headcount) to 28,227 as at 31st December 2012, compared to 28,159 (headcount) as at 30th September 2012.


• Support Services staff in post as at 31st December 2012 is 13,708.1 (WTE), compared to 13,703.3 as at 30th September 2012. This is an increase of 4.8 WTE. The headcount of support services staff as at 31st December 2012 is 18,732, which is a decrease of 8 headcount from 18,740 since 30th September 2012.


• NHS Highland and The Highland Council are working towards developing an integrated model for health and social care and will result in staff transferring between both organisations. As part of the February 2013 publication, 1,433 (headcount) and 1,099.6 (WTE) Highland Council staff are included within the overall table for data at 31st December 2012.

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• HSMR at Scotland-level has decreased by 12.4% between October to December 2007 and July to September 2012.
• Twenty seven (87%) of the 31 hospitals participating in the SPSP have shown a reduction in HSMR since October to December 2007 (end of the baselineyear).
• HSMRs in Scotland are not directly comparable to similar measures adopted elsewhere in the United Kingdom.

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At 31 December 2012:

• Approximately 41 000 patients were waiting for one of eight key diagnostic tests in NHS Scotland.


• 94.1% of patients waiting for a key diagnostic test were waiting no longer than six weeks.

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