The National Health Service in Scotland Quarterly Bulletin
No. 7: April 1998 to March 1999

Introduction

The purpose of the National Health Service in Scotland (NHSiS) is to promote good health, to diagnose and treat those who are ill and to provide health care for those with continuing needs - free at the time of use, in partnership with people and with other organisations, and within the resources that the country makes available.

This bulletin presents information on the performance of the NHSiS in 1998-99 against key objectives. From 1 July this will be the responsibility of the new Scottish Executive. It includes information on hospital and general practitioner services together with summaries of new developments, and should be of interest both to the public and to NHS staff.

Each edition of this bulletin includes quarterly updates on the volume of patient activity and waiting times, together with selected topics of interest covering different aspects of the Health Service. It is intended to provide the reader with a flavour of topical issues in Health.

Key Points this Quarter

• Around £4.8 billion was spent by the NHS in Scotland in 1998-99 (or £938 gross expenditure per head of population). This was an increase of 5.0% (£230 million) in cash terms over the previous year.
• The number of whole time equivalent clinical staff (medical and dental staff, nurses and professions allied to medicine) employed within the NHSiS has increased by 4.5% since 1988.
• The mortality rate from coronary heart disease for persons aged less than 75 years old fell by 38% between 1986 and 1997.
• The mortality rate from cancer among people aged less than 75 years old fell by 10% between 1986 and 1997, with most of this reduction occurring in the period since 1993.
• In the fourth quarter of 1998-99 the 95% immunisation target for children aged two years old was met in all programmes except measles, mumps and rubella (MMR) - where uptake now seems to have stabilised at 92.0% compared with a general trend for reduction in the last few years.
• On average, people in Scotland consult their GP about 3 times per annum - with the very young and the very old having the highest rates of attendance.
• Between the ages of 15 and 64 female rates of attendance are considerably higher than those of males. Outside of these age groups attendance rates between the sexes are much more evenly balanced.
• In 1998-99 there was a reported increase of 1.6% (18,934) in the number of acute inpatient and day case episodes compared with the same period last year. This is much lower than the increases of 3% to 5% seen in recent years.
• In 1998-99 there was an increase of 4.9% in patients treated as day cases compared with the previous year. This is lower than the growth of around 10% we have seen in recent years.
• In the last ten years the percentage of cases treated as day cases in acute specialties has increased from 28.7% to 58.6%.
• Health Boards have shown large changes in service provision in 1998-99 for those with learning disabilities. The provisional outturn for the year shows an increase of £10.6m in resource transfer to Local Authorities, increases in community contacts and a 14.9% reduction in the number of occupied beds.
• The service provision for those with mental health needs in 1998-99 required an increase of £6.7m in resource transfer to Local Authorities. In addition a further £4.4m has been required for hospital and community services in this area compared with 1997-98.
• As at 31 March 1999 there were 70,227 inpatients and day cases on the waiting list for treatment. This represents a reduction of 10.6% (8,299) compared with the position as at 31 December 1998, and is over fourteen thousand below the March 1999 target of 84,649.
• In 1998-99 just over four fifths (80.4%) of patients were treated within 3 months of being placed on the waiting list.
• The Patient's Charter guarantees treatment for inpatient's and day cases within 12 months. There has been a considerable reduction in the number of breaches of the 12 month guarantee in recent years. As at 31 March 1999, three patients with a guarantee were waiting longer than 12 months for treatment.
• In the fourth quarter of 1998-99 63.8% of new outpatients referred by their GP or dentist received an appointment within the 9 week target. This compares with 69.1% in the fourth quarter of 1997-98.
• In quarter 3 of 1998-99 there were 1,684 complaints received by Trusts. Of these 70.4% were dealt with within the 20 working day target. There has been a downward trend in the number of complaints made to Trusts: from around 2,000 per quarter at the start of the new procedure to around 1,800 in recent quarters.