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I have asked John Ewing, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

Prevalence of smoking within prisons is recorded as part of the prisoner survey. In 2008, prevalence was 79% overall; in 2009, the figure was 76%. The next survey takes place later this year.

Stop smoking services are available for prisoners. Since 2006 over 1,500 prisoners have made quit attempts, with a success rate similar to community rates.

The following table shows information on the number of bariatric surgery procedures undertaken, where a main diagnosis of obesity has been recorded, by NHS board of residence in the financial year 2009-10.

NHS Board of Residence	2009-10
Ayrshire and Arran	33
Borders	1
Dumfries and Galloway	-
Fife	4
Forth Valley	1
Grampian	15
Greater Glasgow and Clyde	34
Highland	12
Lanarkshire	23
Lothian	35
Orkney Islands	1
Shetland Islands	1
Tayside	-
Western Isles	-
Scotland	160

Source: ISD Scotland (SMR01).

 

For patients discharged in the year ending 31 March 2010, there were 51 acute occupied bed days in NHS Forth Valley connected to the diagnosis of assault by a sharp object.

The Scottish Patients at Risk of Readmission and Admission (SPARRA) tool is used to estimate the future risk of unscheduled inpatient admission of someone who has experienced at least one such admission in the preceding three years.

The following table shows the number of people who have experienced at least one unscheduled admission in the three years prior to October 2010, broken down by Scottish Index of Multiple Deprivation decile (SIMD: 2009). For each SIMD decile, the table also shows the number and percentage of these individuals whose risk of admission was estimated to be high, which is defined as a SPARRA risk score of 50% or more.

SPARRA Patients by Deprivation Category

Current SIMD: 2009	October 2010
	SPARRA Cohort	High Risk*
			%
1 (Most Deprived)	96,068	8,339	8.7
2	88,805	6,689	7.5
3	84,924	6,242	7.4
4	79,331	5,541	7.0
5	74,220	4,634	6.2
6	90,408	6,847	7.6
7	67,700	3,359	5.0
8	64,174	2,913	4.5
9	59,231	2,369	4.0
10 (Least Deprived)	51,800	1,982	3.8
Total	756,661	48,915	6.5

Source: ISD Scotland.

Ref: IR2011-00220.

The Scottish Patients at Risk of Readmission and Admission (SPARRA) tool is used to support NHS board and Community Health Partnership healthcare teams in providing proactive, planned and co-ordinated care for patients with frequently changing or complex needs.

The Scottish Government''s Long Term Conditions Collaborative is supporting NHS boards to provide appropriate interventions for people who are at most risk of unscheduled admission or readmission. These may include a period of care management by a member of the extended primary and community care team, and the development and sharing of an anticipatory care plan.

The information requested is not routinely available.

The Scottish Patients at Risk of Readmission and Admission (SPARRA) tool is used to estimate the future risk of unscheduled inpatient admission of someone who has experienced at least one such admission in the preceding three years.

The following table shows the number of people meeting this criterion in each NHS board at the start of both financial years. The table also shows the number and percentage of these individuals whose risk of admission was estimated to be high, which is defined as a SPARRA risk score of 50% or more.

SPARRA Patients by NHS Board

	April 2009			April 2010
NHS Board	SPARRA Cohort	High Risk*		SPARRA Cohort	High Risk*
			%			%
Ayrshire and Arran	62,088	4,683	7.5	63,639	4,308	6.8
Borders	18,116	1,257	6.9	18,345	1,268	6.9
Dumfries and Galloway	20,300	1,373	6.8	21,064	1,606	7.6
Fife	49,843	2,813	5.6	50,792	3,215	6.3
Forth Valley	40,406	2,390	5.9	40,749	2,650	6.5
Grampian	71,119	3,639	5.1	72,739	3,973	5.5
Greater Glasgow and Clyde	183,723	13,697	7.5	186,872	13,525	7.2
Highland	44,537	2,708	6.1	45,465	2,741	6.0
Lanarkshire	85,086	5,165	6.1	87,238	5,674	6.5
Lothian	104,030	6,490	6.2	104,233	6,538	6.3
Orkney Islands	2,525	193	7.6	2,545	166	6.5
Shetland Islands	2,916	98	3.4	2,823	90	3.2
Tayside	57,981	2,475	4.3	60,635	3,270	5.4
Western Isles	3,887	257	6.6	3,908	219	5.6
Total	746,557	47,238	6.3	761,047	49,243	6.5

Source: ISD Scotland.

Ref: IR2011-00218.

The tools used to assess the cohort identified by the Scottish Patients at Risk of Readmission or Admission (SPARRA) tool would be determined by the number and nature of the conditions of each individual, as well as their social, family and carer context.

The Scottish Government''s Long Term Conditions Collaborative (LTCC) has also worked with teams from NHS boards and their local authority and third sector partners to agree and develop practical guidance on the approach to integrated care management and anticipatory care planning.

In partnership with the Releasing Time to Care initiative, further work is being undertaken to build capability in community teams to apply these approaches. The Scottish Government''s Long Term Conditions Unit and the LTCC are also working with ehealth colleagues on developing the Key Information Summary to support electronic sharing of anticipatory care plans across teams and settings.

The smoking ban has undoubtedly reduced exposure to second-hand smoke among children in Scotland, because of greater awareness among their parents about the risks of second-hand smoke. The Scottish Government has not undertaken any formal assessment of the effects on children of passive smoking in cars to date. However, this specific topic is to be considered by the Research and Evaluation sub-group of the Scottish Ministerial Working Group on Tobacco Control which has been set up to identify gaps in research knowledge in relation to tobacco control.

NHS Health Scotland on behalf of the Scottish Government will shortly be publishing guidance which will support and encourage a move towards smoke-free environments within mental health settings at a pace which suits the services'' particular needs and circumstances.

The guidance offers a step-by-step approach to support the process of engagement with all concerned, including staff and patients who are most directly affected and which will ultimately lead to a reduction in smoking.

NHS Health Scotland will undertake a one-off exercise which will provide a snapshot of the status of establishments at the time of the introduction of the guidance. Measures will also be put in place to review progress over time.