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The overall response rate to the 2009-10 GP patient experience survey was 38%. As expected this was lower than the response rate in 2008-09 because the survey was designed to sample more patients from practices that had lower response rates in 2008-09. This improved the accuracy of results for practices with lower response rates. The number of responses that could be used in the calculation of the Quality and Outcomes Framework (QOF) patient experience of access indicators PE7 and PE8 was less than the number of questionnaires that were returned. This was mainly because people had not tried to access the practice in the way specified.

The results for each of the QOF indicators were derived from combinations of three questions. Therefore, the valid responses for an indicator depended on the sequence of questions being answered, and not just a response rate to a particular question “ which would be higher. For example, those who missed out a question or ticked more than one option in a question were excluded from the analysis for that indicator. The observed valid response rates (as % of the total number sent out) are shown in the following tables.

2009-10	(a) Mean	(b) Median	(c) Standard Deviation
PE7 (48 Hour Access)	25%	25%	5%
PE8 (Advance Access)	20%	21%	5%

The results from 2008-09 are shown below for comparison:

2008-09	(a) Mean	(b) Median	(c) Standard Deviation
PE7 (48 Hour Access)	37%	37%	8%
PE8 (Advance Access)	23%	24%	6%

 

One of the NHS boards signed up to the TrakCare patient management system have the records aggregated at one site. The model being adopted by NHS boards implementing the TrakCare system is one that replaces any disparate electronic patient administrative records with a single integrated design within each board. In parallel, boards have improvement work underway in connection with their paper records. In part this work aims to aggregate paper records in single or fewer sites, whichever is practicable given geography. Longer term work, given the scale of the task, involves digitising (scanning) paper records based on unique Community Health Index number so as to make them available with the patient at whichever point of care.

Health Protection Scotland monitors and publishes ward closures due to norovirus outbreaks via point prevalence Management Information. Norovirus point prevalence reporting commenced on 7 January 2008.

This weekly point prevalence data relates to the number of wards closed at any time on a Monday. This provides an indicator (in as close to real-time as is possible) of the impact norovirus is having on NHSScotland but is not incidence data and can therefore miss some outbreaks, i.e. if an outbreak started on a Tuesday and was over by the Sunday it would not be recorded on the prevalence data.

Ward closures occurring on a Monday that are still ongoing the following Monday will be counted twice even though they relate to a single outbreak.

It is not possible to aggregate the provided data into an annual total of ward closures. Weekly point prevalence data for 2008 to 2011 is available from the Scottish Parliament Information Centre (Bib. number 52416).

Future weekly data for 2011 will be available at:

http://www.hps.scot.nhs.uk/haiic/ic/noroviruspointprev.aspx

There are no mandatory national surveillance systems for hospital-acquired infections outbreaks occurring in hospitals in NHSScotland. Therefore, it is not possible at a national level to identify ward closures due to hospital-acquired infections or other reasons over the time period requested. NHS board level data would need to be requested from boards.

Systems and associated networks are designed to be resilient. In the event that there is systems failure NHS boards have business continuity plans and local service continuity plans in place which will be invoked if necessary. This applies to all IT systems including those which deal with electronic patient records. The NHS Scotland Security Policy states that boards will undertake a survey of their information systems and data and make an assessment of the likely security risks, including an evaluation of the likely impact and occurrence of any threats that may disrupt services. Boards then introduce measures to mitigate these risks. These include, but are not limited to, processes such as virus checking, regular patching of operating systems software and the provision of back-up systems.

The Scottish Government wrote to NHS boards in March 2008 providing guidance on information sharing between NHS Scotland and the police at:

www.sehd.scot.nhs.uk/details.asp?PublicationID=2529.

The guidance sets out how NHS boards and police forces should work together to develop a consistent approach to the sharing of information to promote the prevention and detection of crime, while respecting and safeguarding the interests of patients and the public in the confidentiality of personal health information. The guidance, which remains extant, applies to all NHS settings and to all types of crime.

Additionally, a number of injury surveillance projects are in operation across Scotland. These involve accident and emergency departments sharing anonymised data with the police on injuries caused by assault. The data is used to improve analysis and understanding of patterns of crime to inform decisions on the deployment of local resources aiming to reduce violence. The Scottish Government will consider the evidence emerging from these projects before deciding whether to provide more specific guidance to NHSScotland.

Since 1 February 2010 the Scottish Resilience Development Service has delivered multi-agency training events for strategic and tactical managers in responder organisations across Scotland on the following dates:

Month	Course Dates
February 2010	3
March 2010	30
April 2010	21 and 27
May 2010	6 x 2, 24 and 25
June 2010	7, 8, 10, 15 and 30
July 2010	1, 5, 21 and 29
August 2010	6, 9, 13, 19 x 2, 24 and 25
September 2010	1, 13, 14, 20, 29 and 30
October 2010	22
November 2010	4, 5, 10 x 2,11, 16, 17, 23 and 25
December 2010	9 and 15
January 2011	14, 19, 20, 26 and 27

These training events provide attendees with the skills required to respond to emergencies irrespective of the cause but scenarios based around severe weather and flooding are included in the training material.

The Scottish Medicines Consortium (SMC) assesses newly licensed medicines or treatments for clinical and cost-effectiveness and issues advice to NHSScotland.

SMC decisions are made by a panel of experts from different fields including clinicians (medical and pharmacy), public partners, health economists, NHS board Chief Executives and the Association of the British Pharmaceutical Industry.

The SMC does not undertake formal collaboration with any other health technology bodies, either in undertaking assessments or in sharing or developing methodology.

The SMC operates independently from the Scottish Government. Further information about the membership and role of the SMC can be found on their website at www.scottishmedicines.org.uk.

The information is not centrally available. However, published information showing whole time equivalent of school nurses by NHS board at 30 September 2007 to 2010 is available at :

www.isdscotland.org/isd/servlet/FileBuffer?namedFile=Nursing_and_midwifery%202010.xls&pContentDispositionType=attachment.

Table 1 shows the number of practices for which total Quality and Outcomes Framework (QOF) payments for 2009-10 (a) increased by 1% or more, (b) changed by less than 1% and (c) decreased by 1% or more relative to 2008-09. No practice received exactly the same QOF payment in both years. The table is based on data for 1,003 Scottish general practices that were open in both years and for which detailed comparable payments data are held centrally. For context, in each of these years the total number of GP practices in Scotland was around 1,015.

Table 2 shows the number of practices for which QOF payments associated specifically with the GP patient experience survey for 2009-10 (indicators PE7 and PE8) (a) increased by 1% or more, (b) changed by less than 1% and (c) decreased by 1% or more relative to 2008-09. In 78% of practices the part of their QOF payment that related directly to the GP patient survey results was higher in 2009-10 than it was for 2008-09.

Overall changes in payments made to practices for the 2009-10 year relative to 2008-09 were the product of a number of changes made to the QOF indicator set, the rules used to calculate payments for indicators, and the baseline number of pounds available for each QOF point achieved, as well as variations in practice QOF achievements from year to year.

The results of the GP patient experience survey 2009/10 are published at:

http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/GPPatientExperienceSurvey

The results of the GP patient access survey 2008/09 are published at:

http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/Survey

Detailed information on QOF achievements for Scottish general practices is published annually at www.isdscotland.org/qof.

Table 1. Change to Total QOF Payments Between 2008-09 and 2009-10 ^1,2

NHS Board	Number of Practices1	(a) Increased by 1% or More	(b) Changed by Less Than 1%	(c) Decreased by 1% or More
Ayrshire and Arran	59	46	6	7
Borders	25	16	3	6
Dumfries and Galloway	35	23	4	8
Fife	57	38	5	14
Forth Valley	56	26	12	18
Grampian	84	28	9	47
Greater Glasgow and Clyde	267	128	28	111
Highland	102	54	10	38
Lanarkshire	98	48	15	35
Lothian	116	29	22	65
Orkney	13	4	0	9
Shetland	10	4	0	6
Tayside	69	33	15	21
Western Isles	12	11	0	1
Scotland	1,003	488	129	386

Table 2. Change to QOF Payments Directly Relating to the GP patient survey (Indicators PE7 and PE8) between 2008-09 and 2009-10 ^1,2

NHS Board	Number of Practices1	(a) Increased by 1% or More	(b) Changed by Less Than 1%	(c) Decreased by 1% or More
Ayrshire and Arran	59	47	8	3
Borders	25	19	5	1
Dumfries and Galloway	35	30	5	0
Fife	57	48	7	2
Forth Valley	56	41	8	4
Grampian	84	72	5	5
Greater Glasgow and Clyde	267	207	36	23
Highland	102	67	21	14
Lanarkshire	98	77	9	10
Lothian	116	100	9	7
Orkney	13	7	3	3
Shetland	10	7	2	1
Tayside	69	55	8	5
Western Isles	12	5	5	2
Scotland	1,003	782	131	80

Notes

1. Based on data for 1,003 Scottish general practices that were open in both years and for which detailed comparable payments data are held centrally. In each of these years the total number of GP practices in Scotland was around 1,015.

2. These figures do not reflect any local or national adjustments that may have been made to practice payments after QOF achievement data for each year were published at www.isdscotland.org/qof.

There are currently no plans to establish a national managed clinical network for the treatment of severe and complex obesity.