Question 1 a) What is the Annual net expenditure on the NHS from 1997/98 to 2007/08 in Scotland? b) Per head of population
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2 NHS SPENDING - SCOTLAND Question 1 a) What is the Annual net expenditure on the NHS from 1997/98 to 2007/08 in Scotland? b) Per head of population Question 2 a) Annual real (GDP deflated) increase in net expenditure on the NHS from 1997/98 to 2007/08 in Scotland. b) per head of population Answers for Questions 1 & 2 NHS Scotland Performance 1997 and 2006 comparisons Indicator Year ending 31 March 1997 (unless stated) 1. Inpatient/Day Case Waiting Year ending 31 March 2006 (unless stated) Inpatient/Day case waiting list 82,667 69,359 (patients without an ASC) (as at 30 June 2006) Inpatients/Day cases waiting over 9 3,001 0 months (without an ASC) (as at 30 June 2006) Inpatients/Day cases waiting over 6 10,903 0 months (without an ASC) (as at 30 June 2006) Inpatients/Day cases waiting over 18 20,567 4,027 weeks (without an ASC) (as at 30 June 2006) Median Inpatient/Day case wait Outpatient Waiting Outpatients waiting over 6 months n/a 0 (without an ASC) (as at 30 June 2006) Outpatients waiting over 18 weeks n/a 11,319 (without an ASC) (as at 30 June 2006) Median Outpatient wait Heart Procedures Waiting Angiography patients waiting over 8 weeks Coronary Revascularisation patients waiting over 18 weeks 4. Activity Inpatient/Day case discharges (acute specialties) Day cases as a percentage of elective activity (acute specialties) Number of 1 st outpatient appointments (all specialties exc. A&E) 98 (at 31 March 2003) 61 (at 31 March 2003) 2 (as at 30 June 2006) 0 (as at 30 June 2006) 1,170,450 1,262, % 65.6% 1,344,849 1,362,871 Accident & Emergency attendances 1,501,696 1,499,538
3 Nurse-Led Clinics new attendances, acute specialties Nurse-Led Clinics total attendances, acute specialties Nurse-Led Clinics new attendances, non-acute specialties Nurse-Led Clinics total attendances, non-acute specialties Allied Health Professional clinics new attendances Allied Health Professional clinics total attendances n/a 90,813 n/a 552,289 n/a 72,718 (ye 31 March 2005) n/a 535,591 (ye 31 March 2005) n/a 1,325,074 n/a 5,298,348 Indicator Year ending 31 March 1997 (unless stated) 5. Beds Average Available Staffed Beds (all specialties) Year ending 31 March 2006 (unless stated) 39,668 28, Operations Number of Principal Operations 681, ,062 Number of Angiographies 10,495 12,733 Number of Angioplasties 1,526 5,437 Number of Cataract operations 16,517 26,091 Number of Hip Replacements 4,562 6,249 Number of Knee Replacements 2,597 5, Delayed Discharges Delayed Discharges - total 3,021 (at 30 September 2000) Delayed Discharges over 6 weeks 1,944 (at 30 September 2000) 8. Workforce WTE HCHS medical & dental staff 7,905.4 (at 30 September 1997) WTE HCHS medical & dental consultants (including Directors of Public Health) Headcount HCHS medical & dental consultants (including Directors of Public Health) WTE HCHS medical & dental doctors in training 2,770.6 (at 30 September 1997) 2,955 (at 30 September 1997) 4,047.3 (at 30 September 1997) Doctors in training 4,113.9 (30 th Sept 1999) General Medical Service 3,832.3 (30 th Sept 1999) WTE nursing & midwifery staff 51,479.0 (at 30 September 1997) WTE registered nursing & midwifery staff 35,244.9 (at 30 September 1997) 1,243 (at July 2006) 627 (at July 2006) 9,787.4 (at 30 September 2005) 3,582.4 (at 30 June 2006) 3,813 (at 30 June 2006) 5,120.8 (at 30 September 2005) 5,120.8 (at 30 September 2005) 4,073.8 (at 30 September 2005) 56, ,834.0 (at 30 September 2005)
4 Indicator Year ending 31 March 1997 (unless stated) Headcount registered nursing & 41,414 midwifery staff (at 30 September 1997) Number of student nurses in training 6,612 (at 31 October 1997) WTE qualified allied health 5,420.3 (at 30 September 1997) professionals Headcount qualified allied health 6,515 professionals (at 30 September 1997) WTE administrative & clerical staff 18,825.1 (at 30 September 1997) Year ending 31 March 2006 (unless stated) 46,594 (at 30 September 2005) 9,726 (at 31 October 2005) 7, ,686 (at 30 September 2005) 24,598.7 (at 30 September 2005) 9. Public Health Coronary Heart Disease deaths per 100,000 population for people aged under 75 Cancer deaths per 100,000 population for people aged under 75 Stroke deaths per 100,000 population for people aged under 75 Teenage pregnancies rate per 1,000 population for females aged years Flu vaccination uptake aged over 65 years Adult smoking aged 16 years and over (ye 31 December 1997) (ye 31 December 1997) 32.4 (ye 31 December 1997) 65.9% (ye 31 March 2001) 30.4% (1999 Scottish Household Survey) 67.5 (ye 31 December 2005) (ye 31 December 2005) 20.6 (ye 31 December 2005) (ye 31 March 2004) 77.8% 26.2% (2005 Scottish Household Survey) 10. Prescribing Total number of prescriptions 55.0m 77.3m Indicator Year ending 31 March 1997 (unless stated) Year ending 31 March 2006 (unless stated) 11. Finance NHS Spending 4,237m (cash) 8,191m (resource) (ye 31 March 2005) Question 3. Of the extra money available each year, what has it been spent on? How much of the extra funds available each year has been spent on wages, capital expenditure, drugs, clinical negligence, compensation new staff etc? (Please can we have as detailed a breakdown as possible) We are unable to answer this as the extra budget isn't separated out, but added to the total sum given to health boards on an annual basis.
5 Question 4 a and b a) How many hospitals have opened? How many hospitals have closed? What has been the net gain/loss of hospitals? b) How many new hospitals are standing empty? How many old/existing (not new) hospitals are standing empty? NHS Hospital openings in Scotland since 01/01/ NHS hospital closures in Scotland since 01/01/ Notes : a. This data is sourced from the ISD Location Code Directory which is maintained according to information received from NHS Boards. Changes to the activity status of NHS locations are therefore recorded on notification from the Boards. Question 5 a) How many more operations have been carried out each year? b) How many more patients have been seen each year in hospitals? Is it possible to have a break down of this? See the tables in Answer 1 & 2 5 c) How many more hospital doctors have been employed each year (head count and whole time equivalent)?
6 HCHS medical and dental staff by specialty NHSScotland Workforce Statistics WTE 2006 Headcount 2006 WTE 2005 Headcount 2005 WTE 2004 Headcount 2004 WTE 2003 Headcount 2003 All staff All staff All staff All staff All staff All staff All staff All staff All Specialties All Medical Specialties Hospital Medical Specialties Emergency Medicine Anaesthetics Clinical Laboratory Specialties Chemical pathology Clinical genetics Haematology Histopathology Immunology Medical microbiology & Virology Medical Specialties Audiological medicine Dermatology General medicine (group) Cardiology Paediatric cardiology Clinical pharmacology & therapeutics Infectious diseases Endocrinology & diabetes Gastroenterology General (acute) medicine Renal medicine Respiratory medicine Rheumatology
7 Genito - urinary medicine Geriatrics Homoeopathy Intensive Care Medicine Medical oncology Medical ophthalmology 3 3 Neurology Paediatrics Palliative medicine Clinical oncology Rehabilitation medicine Clinical Neuro-Physiology Obstetrics & Gynaecology Occupational Medicine Psychiatric Specialties Child & adolescent psychiatry Forensic psychiatry General psychiatry Psychiatry of learning disability Old age psychiatry Psychotherapy Radiology Clinical radiology Nuclear medicine Surgical Specialties Cardiothoracic surgery ENT surgery General surgery Neurosurgery Ophthalmology Oral & Maxillofacial Surgery Trauma & Orthopaedic surgery Paediatric surgery Plastic surgery
8 Urology Public Health Medicine Community Medical Specialties Breast screening service Community child health Community psychiatry Family planning Well woman service General Practice All Dental Specialties Hospital Dental Specialties Oral medicine Oral surgery Orthodontics Paediatric dentistry Restorative dentistry Dental & Maxillofacial Radiology Oral Microbiology Oral Pathology Fixed & Removable Prosthodontics Surgical Dentistry Community Dental Specialties Community Dentistry Dental Public Health
9 5 d) How many more hospital consultants have been employed each year (head count and whole time equivalent)? Whole time equivalent at 30th September Whole time equivalent at: Sep-05 Dec-05 Mar-06 Jun-06 Sep-06 All Specialties 2, , ,770.62,818.82, ,982.03,090.63,194.83,283.83, , ,544.03,565.63, ,627.9 All Medical Specialties 2, , ,699.22,744.02, ,903.23,010.73,112.73,205.53, , ,465.83,486.03, ,547.4 Hospital Medical Specialties 2, , ,563.02,609.02, ,764.12,872.32,965.53,065.43, , ,317.53,333.23, ,395.7 Emergency Medicine Anaesthetics Clinical Laboratory Specialties Chemical pathology Clinical genetics Haematology Histopathology Immunology Medical microbiology & Virology Medical Specialties Audiological medicine Dermatology General medicine (group) Cardiology Paediatric cardiology Clinical pharmacology & therapeutics Infectious diseases Endocrinology & diabetes
10 Gastroenterology General (acute) medicine Renal medicine Respiratory medicine Rheumatology Genito - urinary medicine Geriatrics Homoeopathy Intensive Care Medicine Medical oncology Medical ophthalmology Neurology Paediatrics Palliative medicine Clinical oncology Rehabilitation medicine Clinical Neuro-Physiology Obstetrics & Gynaecology Occupational Medicine Psychiatric Specialties Child & adolescent psychiatry Forensic psychiatry General psychiatry Psychiatry of learning disability Old age psychiatry Psychotherapy Radiology Clinical radiology
11 Nuclear medicine Surgical Specialties Cardiothoracic surgery ENT surgery General surgery Neurosurgery Ophthalmology Oral & Maxillofacial Surgery Trauma & Orthopaedic surgery Paediatric surgery Plastic surgery Urology Public Health Medicine Community Medical Specialties Breast screening service Community child health Community psychiatry Family planning Well woman service General Practice All Dental Specialties Hospital Dental Specialties Oral medicine Oral surgery Orthodontics Paediatric dentistry Restorative dentistry
12 Dental & Maxillofacial Radiology Oral Microbiology Oral Pathology Fixed & Removable Prosthodontics Surgical Dentistry Community Dental Specialties Community Dentistry Dental Public Health Headcount 4 at 30th September Headcount at: Sep-05 Dec-05 Mar-06 Jun-06 Sep-06 All Specialties 2,699 2,807 2,955 3,007 3,138 3,195 3,306 3,411 3,511 3,591 3,719 3,771 3,793 3,813 3,853 All Medical Specialties 2,612 2,722 2,871 2,919 3,042 3,101 3,212 3,314 3,415 3,497 3,630 3,676 3,697 3,714 3,757 Hospital Medical Specialties 2,473 2,575 2,719 2,769 2,883 2,940 3,052 3,143 3,253 3,322 3,455 3,503 3,516 3,534 3,576 Emergency Medicine Anaesthetics Clinical Laboratory Specialties Chemical pathology Clinical genetics Haematology Histopathology Immunology Medical microbiology & Virology Medical Specialties
13 Audiological medicine Dermatology General medicine (group) Cardiology Paediatric cardiology Clinical pharmacology & therapeutics Infectious diseases Endocrinology & diabetes Gastroenterology General (acute) medicine Renal medicine Respiratory medicine Rheumatology Genito - urinary medicine Geriatrics Homoeopathy Intensive Care Medicine Medical oncology Medical ophthalmology Neurology Paediatrics Palliative medicine Clinical oncology Rehabilitation medicine Clinical Neuro-Physiology Obstetrics & Gynaecology Occupational Medicine Psychiatric Specialties Child & adolescent psychiatry
14 Forensic psychiatry General psychiatry Psychiatry of learning disability Old age psychiatry Psychotherapy Radiology Clinical radiology Nuclear medicine Surgical Specialties Cardiothoracic surgery ENT surgery General surgery Neurosurgery Ophthalmology Oral & Maxillofacial Surgery Trauma & Orthopaedic surgery Paediatric surgery Plastic surgery Urology Public Health Medicine Community Medical Specialties Breast screening service Community child health Community psychiatry Family planning Well woman service General Practice
15 All Dental Specialties Hospital Dental Specialties Oral medicine Oral surgery Orthodontics Paediatric dentistry Restorative dentistry Dental & Maxillofacial Radiology Oral Microbiology Oral Pathology Fixed & Removable Prosthodontics Surgical Dentistry Community Dental Specialties Community Dentistry Dental Public Health From Tables which can be found at <
16 e) How many more hospital nurses have been employed each year (head count and whole time equivalent)? Tables E1 (wte) and E2 (headcount) can be found at < and gives a trend of nursing staff. Hospital nurses can be identified by adding Hospital specialties and Senior Nurse Managers.
17 f) Please give us a break down of all other staff increases/decreases each year, including management (head count and whole time equivalent) All staff including GPs 1 112, , , , , , , , , , x x All staff excluding GPs 109, , , , , , , , , , , % 1.7% Change Average annual change All medical staff including GPs 10, , , , , , , , , , x x All medical staff excluding GPs 7, , , , , , , , , , , % 3.0% All dentists 2, , , , , , , , , , , % 2.1% HCHS medical and dental staff 7, , , , , , , , , , , % 3.0% Consultant 2, , , , , , , , , , , % 3.3% Doctors in training 3, , , , , , , , , , , % 3.1% Other medical and dental staff 1, , , , , , , , , , , % 1.3% General medical service 1 3, , , , , , , , , , x x Performer 3, , , , , , , , , , x x Performer registrar x x Performer salaried x x Performer retainee x x General dental service 2,3 1, , , , , , , , , , , % 2.7% General dental practitioner 2 1, , , , , , , , , , , % 2.5% Vocational dental practitioner % 6.0% Assistant dental practitioner % 0.8% Nursing and midwifery staff 51, , , , , , , , , , , % 0.9% Registered 35, , , , , , , , , , , % 1.5% Nurses 32, , , , , , , , , , , % 1.7% Midwives 3, , , , , , , , , , , % -1.1%
18 Non-registered 16, , , , , , , , , , , % -0.5% Therapeutic, Healthcare Science, Technical, Pharmacy and Ambulance Staff 15, , , , , , , , , , , % 3.6% Therapeutic Staff 6, , , , , , , , , , , % 4.2% Qualified 5, , , , , , , , , , , % 4.0% In training % 10.1% Assistant , , , , , , , , , , % 4.6% Healthcare Science Staff 2, , , , , , , , , , , % 1.9% Qualified 2, , , , , , , , , , , % 1.3% In training % 7.1% Unqualified % 4.1% Technical staff 2, , , , , , , , , , , % 4.4% Qualified 1, , , , , , , , , , , % 3.6% In training % 4.8% Unqualified % 9.1% Pharmacy Staff 1, , , , , , , , , , , % 6.0% Qualified , , , , , , , % 5.2% In training % 2.7% Unqualified % 13.4% Ambulance staff 2, , , , , , , , , , Administrative and estates staff 32, , , , , , , , , , , % 1.6% Administrative, Clerical and Senior Management 4 19, , , , , , , , , , , % 2.8% Works % -1.9% Trades 5 1, , , , , , , , , , , % -1.6% Ancillary 5 11, , , , , , , , , , , % -0.4% Tables A1 (whole time equivalent) and A2 (headcount) can be found on the workforce web pages ( < give an overall summary of the NHS workforce in Scotland
19 Question 6 a) Please provide the number of NHS prescriptions issued and cashed each year. What has been the cost of this to the NHS each year? There is currently no record of the actual number of prescriptions written. Whether they are dispensed or not is down to the patient. Data does exist for prescriptions dispensed by community pharmacists and the following link will provide the requested information. Prescriptions dispensed Millions by community pharmacists and appliance suppliers by dispensing doctors stock orders Total per person on general practitioners lists Number Cost of total prescriptions dispensed million Net ingredient cost Dispensing fees, transitional payments, professional allowance, oncosts, etc. 5, Total (gross) less Charges paid by patients Total (Exchequer cost) Average cost per prescription dispensed (per prescripti on) Net ingredient cost Dispensing fees, professional allowance, oncosts, etc Total (gross) less Charges paid by patients Total (Exchequer cost)
20 6 b) Please provide the number of prescribed drugs which have been returned and destroyed (per year). What has been the cost of these returned and destroyed drugs (per year)? How much has "waste medicine" cost the NHS? The data to answer these questions is not collected. Data will exist at individual health board level on the volume of drugs collected for destruction from pharmacies and the cost of that destruction, not all of which will be unavoidable wastage. Question 7. How much NHS money each year has been spent in the independent sector (in s and % increase each year)? from 1997/98 to latest data available? Independent Sector Funding The allocations from the Scottish Executive to NHS Boards to purchase additional capacity in the independent sector is split by financial year in the table below. This includes the commitment in Fair to All, Personal to Each (2004) of 45 million over 3 years. Independent Sector Funding Allocated to Boards 2002/3 2003/4 2004/5 2005/6 6.9m 10.3m 7.6m 12.8m NHS Boards also purchase further independent health care sector capacity in addition to this. Contracting Boards contract with independent sector providers directly, although the Executive, through the National Waiting Times Unit, has had a key role in coordinating value for money indicative prices on behalf of NHS Boards. Waiting Times The independent sector has had a role to play in the substantial progress that has been made in reducing waiting times for patients across Scotland. The latest figures show the number of patients with a guarantee who had waited more than 18 weeks for a first outpatient appointment, hospital inpatient or day case treatment are now at the lowest levels ever recorded.
21 Question 8. How much money has been spent on I.T. projects (central and local) each year from 1997/98 to latest year data available? earliest year available.. Revenue 000 Capital ,685 2, ,067 2, ,295 4, ,512 4, ,221 6, ,316 8, ,367 10, ,301 30,000 The SEHD carried out a one-off survey of local spend in 2002/03 but this proved resource-consuming and difficult mainly because of differences in definition of what constituted IM&T spend. Its best estimate of spend by NHS boards is 50 million in 2006/07. It now intends to review the recording of local financial data. Question 9. How many extra hospital beds have been made available each year from 1997/98? If possible, can we have a break down (acute, maternity etc) And Question 10. Please can we have figures of bed occupancy rates each year since 1997/98? All Specialities Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds 37,998 36,376 34,696 33,160 31,930 30,793 29,886 29,081 28,296 % Occupancy Mean Stay (Days) per Episode Throughput All ACUTE Specialities Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds 19,016 18,752 18,456 18,091 18,029 17,903 17,710 17,562 17,523 % Occupancy Mean Stay (Days) per Episode Throughput
22 All DENTAL Specialities Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds % Occupancy Mean Stay (Days) per Episode Throughput All GP other than Obstetrics Specialities Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds 1,150 1,169 1,212 1,252 1,268 1,265 1,264 1,263 1,258 % Occupancy Mean Stay (Days) per Episode Throughput All Obstetric Specialities Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds 1,354 1,267 1,220 1,182 1,120 1,099 1, % Occupancy Mean Stay (Days) per Episode Throughput Geriatrics Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds 9,272 8,629 8,167 7,638 7,398 7,231 7,074 6,780 6,468 % Occupancy Mean Stay (Days) per Episode Throughput Psychiatric Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds 9,076 8,674 8,145 7,745 7,345 7,145 6,950 6,557 6,282 % Occupancy Mean Stay (Days) per Episode Throughput
23 Radiology Specialities Indicator Financial Year Ending 31st March (p) Average Available Staffed Beds % Occupancy Mean Stay (Days) per Episode Throughput The link to the beds web page is: The link to the actual data table for trend in bed numbers and occupancy is: Question 11. How many more General Medical Practitioners have been employed each year (head count and whole time equivalent) from 1997 to latest available data? See tables for Question 5 f.) Also Tables A1 (whole time equivalent) and A2 (headcount) can be found on the workforce web pages ( < give an overall summary of the NHS workforce in Scotland including General Medical Practitioners GP headcounts and Whole Time Equivalent figures are available via ISD's workforce information pages Specifically, visit the page ervice=content.show& and select the A2 or A1 tables for headcount and WTE respectively. The tables currently show data for each year from inclusive, but updated versions to include 2006 will be published on 30th January
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