Chamber and committees

The Information and Statistics Division of the Common Services Agency do not currently have plans to compile key health indicators, using the same criteria as the Organisation for Economic Co-operation and Development.

The algorithms are a copyrighted product used under licence by NHS 24 and are not widely available. NHS 24 involved Scottish clinicians in an extensive programme of structured review and adaptation of the algorithms in 2001. NHS 24 also arranges for clinicians to view the system on which the algorithms sit as required, and will share specific examples in order to gain clinical confidence in the algorithms and the decision support system used by it. However, the algorithms on their own are not the clinical end product and they need to be used by experienced and trained nurses to provide the NHS 24 service.

The algorithms, or series of logically structured questions, were initially developed by an American clinical software company. During 2001, NHS 24 involved Scottish clinicians in an extensive programme of structured review and adaptation of the algorithms, known as the "Airth Process".The Clinical Standards Board for Scotland (CSBS) was informed of the detail of the "Airth Process" and acknowledged the process as an example of good practice. This process involved a clinical review of the algorithms by some 50 practising clinicians, including doctors, nurses, pharmacists, dentists, surgeons, accident and emergency consultants, paediatricians and other specialists, to incorporate best evidence or best practice where it existed, including reference to Scottish Intercollegiate Guidance Network guidelines. The review meetings took place in a structured manner allowing clinicians to concentrate on ensuring the algorithms were appropriately adapted to the Scottish clinical situation.NHS 24 is also implementing a quality strategy plan to demonstrate, among other things, the clinical effectiveness of its processes and is discussing with CSBS how an external review process should be put in place.

NHS 24 is a confidential service for the public. The confidentiality extends to the standard NHS interpretation of "confidentiality" and all clinical and other patient information is bound by standard NHS confidentiality regulations. All patients are asked, in every consultation, whether they consent to information being passed on to their GP or other relevant service in order for them to obtain further care. If a patient requests that the information should not be transferred, then this will be respected.However, there are clearly situations where patients or others may be at significant risk - for example, where issues of child protection arise. Under these circumstances information may require to be shared among the social, health care or police services contrary to the patient's expressed wish. These circumstances are extremely rare and NHS 24 staff are trained in order to both recognise and deal with these situations in a sensitive and professional manner.

We are aware of three trials involving the drug Arimidex (anastrozole) and Scottish patients. There may be other smaller studies involving this drug, but this information is not available centrally.Preliminary results from the largest trial, the ATAC trial (Arimidex, Tamoxifen, Alone or in Combination) have been published. (Information about this trial can be found in The Lancet dated 7 September 2002, Volume 360, pages 790-792). Patients recruited into the other two trials are still being followed up.

Funding is no longer distributed on the basis of the Scottish Health Authorities Resource Equalisation formula. The bulk of funding allocated to NHS boards is distributed using the Arbuthnott formula. In some instances, however, where specific projects are undertaken or where particular ministerial objectives are to be achieved, resources are distributed in a variety of different ways in order to achieve these objectives.

The bulk of NHS boards' unified budgets allocated in the last 12 months has been distributed using the Arbuthnott formula.

The National Review of Resource Allocation drew on a range of resources including:statistical experts in the Information and Statistics Division of the Common Services Agency who provided much of the data used in this review and were also responsible for much of the analytical work;senior managers and medical and nursing experts from the NHS who took part in the work of the Arbuthnott Committee;external researchers who were commissioned to carry out some of the research needed to support the work of the review, andstaff in the Scottish Executive Health Department who also provided substantial analytical support to this review.This was the first major review of the resource allocation formula that had been carried out for over 20 years, and it was important to ensure that the Arbuthnott Committee could draw on a wide range of advice for its work.

This information requested is not held centrally.

This information requested is not held centrally.