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The specific information requested is not available centrally. The national dataset for the eight key diagnostic tests is based on aggregate level returns from each board. Median or longest waits cannot be derived from the information in aggregate return.

The Scottish Orthopaedic Service Development Group decided that a further audit of the management of hip fracture care across Scotland should be undertaken for the period December 2012 to March 2013 and was published on 30 August 2013. The audit report can be accessed at:

http://www.qihub.scot.nhs.uk/media/517649/audit%20of%20care%20pathways%20for%20hip%20fracture%20patients%20in%20scotland.pdf

This audit looked at the key interventions of the patient journey from emergency department to discharge from acute orthopaedic unit and on the standard of clinical care. This national audit of hip fracture was the most comprehensive undertaken. The reports shows that 92% of patients who were considered medically fit for theatre underwent surgery within 48 hours of admission. It is anticipated that another audit will be undertaken during 2015-16.

The Scottish Government expect NHS boards to be monitoring performance against this waiting time standard locally to ensure continuing delivery.

NHS Forth Valley has advised that they have just recently recruited four new consultant gastroenterologist. These consultants will take up appointments during the next six months. Meantime to reduce the waiting time for patients they are being offered appointments at the Golden Jubilee National Hospital or in the private sector.

Information on the number of stays for hip fracture and the rate of stays for hip fracture per 10,000 population for patients aged over 65 is presented in the following two tables.

Table 1: Number of hospital stays for all ages with a diagnosis of hip fracture by patient's health board of residence for the years 2008-09 to 2012-13.

Source: SMR01, ISD Scotland

Table 2: Rate of hospital stays with a diagnosis of hip fracture per 10,000 population for patients aged over 65 by patient's health board of residence for the years 2008-09 to 2012-13:

Sources: SMR01, ISD Scotland; National Records of Scotland mid-year population estimates

Following a fragility (low trauma) fracture, clinical guidelines recommend fracture risk assessment is undertaken and, where indicated, treatment to reduce risk is offered. All mainland NHS boards have a system in place to case-find and provide risk assessment and intervention. In the majority of boards, a fracture liaison service is the preferred system, although there is local variation in how the services operate.

Patients at risk of osteoporosis should be treated according to current clinical guidelines.

The Scottish Intercollegiate Guidelines Network (SIGN) is updating its guideline on the management of Osteoporosis to incorporate the significant advances in the management of this condition, including the arrival of new treatments. The revised SIGN guideline is expected to be published this summer. Current SIGN guidelines can be found at:

http://sign.ac.uk/guidelines/fulltext/71/index.html

The National Institute for Health and Clinical Excellence published guidance (CG146) in August 2012 on assessing the risk of fragility fracture in osteoporosis:

http://pathways.nice.org.uk/pathways/osteoporosis

Where patients are identified, through a fracture liaison service or alternative local arrangement, as requiring a bone density assessment, such an assessment will be offered.

NHS Fife have advised that they have recently recruited five new locum radiologists with three having started with a further two due to start in the next few weeks. The board have also been undertaking additional sessions to reduce the waits for patients. These actions are aimed at delivering the six weeks waiting times standards for radiological tests in Fife as quickly as possible.

NHS National Services Scotland’s Information Technology Division is currently working with the NHS and other partners to enable clinicians to complete Medical Certificates of Cause of Death electronically.

It is expected that this functionality will be available to General Practitioners from spring 2015, and rolled out to other parts of the NHS incrementally thereafter.

The Scottish Government has no plans to introduce a HEAT target for drug treatment to monitor the extent to which patients are completing treatment.

The Scottish Government’s focus going forward is to ensure people receive high quality treatment and support services. In order to support this we are developing a quality improvement framework, to be delivered through Alcohol and Drug Partnerships, as part of the third phase of delivery of The Road to Recovery and as our response to the Opioid Replacement Therapies report published in August 2013.