Chamber and committees

The figures for 2000-01 and 2001-02 are not available. The percentage of requests by GPs for an ambulance within an hour which were met within the hour for 2002-05 are set out in the following table. The information is not available for the earlier two years.

Health Board Area	2002-03	2003-04	2004-05
Argyll and Clyde	72.6%	72.9%	63.3%
Ayrshire and Arran	87.5%	76.5%	67.6%
Borders	64.0%	60.0%	63.2%
Dumfries and Galloway	86.9%	75.6%	45.5%
Fife	83.8%	74.7%	53.2%
Forth Valley	81.1%	70.6%	62.5%
Grampian	87.0%	94.7%	99.1%
Greater Glasgow	51.2%	42.5%	37.4%
Highland	90.2%	95.3%	98.6%
Lanarkshire	59.2%	53.1%	45.0%
Lothian	63.0%	61.4%	55.7%
Orkney	91.2%	94.4%	98.7%
Shetland	86.8%	96.2%	100.0%
Tayside	83.4%	71.1%	63.0%
Western Isles	90.5%	95.8%	99.3%
Scotland Total	72.1%	69.3%	85.6%

 

The reduction in performance in some areas, especially those with sizeable urban conurbations, may be seen as an indicator of the progress the Scottish Ambulance Service is making towards delivery of its eight minute response time target for category A (life threatening) calls. An accident and emergency unit on its way to a GPs urgent call can be diverted to a category A emergency incident if that is the nearest available unit. This prioritisation of the category A emergency call over the GPs urgent call reflects the comparative risk of the emergency call over the GPs urgent. The balance of risk also takes account of the fact that, as a rule, GPs urgent calls will mean that the GP has been with the patient and will in many circumstances still be with the patient while the ambulance is on its way. GPs can also call for an emergency response including in circumstances where they may have already made an urgent request but where there is a change to the patient’s condition indicating the need for the call to be upgraded.

The information is not available centrally.

All practices are expected to provide to all of their patients essential and those additional services they are contracted to provide under the terms of the new General Medical Services contract. Minor injury services are defined under the contract as enhanced services and NHS boards decide whether or not there is a local need for the provision of these more specialised services. NHS boards also determine the location of such services. To prevent any erosion of services the new General Medical Services contract is underpinned by a Patient Services Guarantee which states that it is the responsibility of the NHS board to ensure continuation of the full range of services to patients under the new contract, as was available under the previous contract.

The Scottish Executive has invested in the Scottish Ambulance Service at a level designed to enable it to employ more front-line staff and deliver a more responsive service for patients. Between March 2001 and March 2004 the ambulance service employed 220 additional paramedics and technicians on accident and emergency units. Demand analysis information is continuously monitored and is used by the ambulance service to ensure that resources are deployed where they will have the maximum impact on patient care.

Pathology is included within a number of specialties which are grouped by ISD Scotland under the heading “Clinical Laboratory Specialties”.

Within this group, the number of consultants in post had increased by almost 3% between 1999 and 2004. At 30 September 2004, the vacancy rate for the consultant posts was 7.1%. This was below the average for “all specialties” in Scotland which was 7.4% at the same date.

Information on the number of vacancies by NHS board is published on the Scottish Health Statistics website under Workforce Statistics, at www.isdscotland.org/workforce.

At 30 September 2004, there were three (2.4 whole-time equivalent) NHS employed locums. These locums will not necessarily be filling vacant posts but may be covering for staff on, for example, annual or sick leave. Information on the use of agency locums is not available centrally.

The Scottish Executive Health Department, NHS Education Scotland and NHS Boards are working closely together to increase consultant capacity and hard to fill vacancies are being targeted.

The information requested about existing laboratories and plans for further developments is shown in the following table. It is for NHS boards to determine how to allocate resources to local services.

Board Area	Number of Histopathology Laboratories	Additional Comments
NHS Argyle and Clyde	1	A review of Laboratory services across NHS Argyle and Clyde has just been completed and its recommendations are under consideration.
NHS Ayrshire and Arran	1	The board is planning investment to meet anticipated demand in 2005–06.
NHS Borders	Nil	Histopathology services for the Borders are provided by NHS Lothian.
NHS Dumfries and Galloway	1	It is likely that this will remain the number for the foreseeable future.
NHS Fife	1	The Board is developing clinical links with Dundee and Aberdeen.
NHS Forth Valley	1	Workload expected to expand significantly in next 5-10 years
NHS Grampian	1	No plans to increase the number of laboratories
NHS Greater Glasgow	4	In the short-term it is intended to create a single management structure for histopathology. Over a 6-10 year timescale, it is proposed that a single large histopathology centre for Greater Glasgow be established on a common site. The board has made significant investments in all services connected to the delivery of waiting times targets. A strategy is being developed to modernise clinical laboratory provision in Greater Glasgow.
NHS Highland	1	No significant changes planned.
NHS Lanarkshire	3	Moving to two within this year by amalgamating Wishaw and Hairmyres. There may in due course be a further reduction within the next five years to a single histopathology lab.
NHS Lothian	3	The Pan-Lothian Laboratory Review is considering whether the current histopathology service could be provided centrally from the Royal Infirmary of Edinburgh.
NHS Orkney	Nil	Service will continue to be commissioned from NHS Grampian and other Boards as appropriate.
NHS Shetland	Nil	Board will continue to commission service from NHS Grampian.
NHS Tayside	1	The Board has recently invested in pathology with the appointment of an additional two pathologists.
NHS Western Isles	Nil	Board will continue to commission service from NHS Highland.

Source: NHS boards, April 2005.

The Executive is also supporting, through the regional planning groups, the development of a Managed Clinical Network in Histopathology which will be responsible for developing a framework for the introduction of new technologies and new ways of working. In particular, the network will implement the PathAlba project, a telemedicine initiative funded by the Executive, which will ensure that specialist pathology expertise is available for the benefit of patients across Scotland irrespective of geographical location.

There are no figures held for NHS boards opting not to fund the enhanced payments scheme for provision of minor injuries services through general practices in their area under the new GP contract. To underpin the new UK-wide GMS contract there is a Patient Services Guarantee to ensure that patients receive a consistent range of high quality services throughout the UK The new contract ensures that patients have access to a wide range of services delivered in primary care settings and it is the responsibility of the NHS board to provide such services as minor injury within their region if the local need requires, whilst ensuring that the Patient Service Guarantee is delivered by guaranteeing patients at least the range of services that they enjoyed under the previous contract.

The following table detailsthe end-year flexibility (EYF) levels for the Scottish Executive including its armslength bodies for each year since 1999:

Year	Executive Portfolios EYF	Arms Length Bodies EYF	% of Total Budget
1999-2000	£435 million	-	2.6%
2000-01	£718 million	-	4.0%
2001-02	£477 million	£166 million	3.2%
2002-03	£332 million	£62 million	1.9%
2003-04	£403 million	£220 million	2.5%

Notes:

1.It has not been possibleto obtain separate data for the arms length bodies EYF figures for 1999-2000 or2000-01.

2.The % of Total Budgetcalculation is based on the total level of EYF for each year (i.e. column 2 andcolumn 3 of the table).

The Scottish Executive doesnot forecast estimated levels of EYF and does not therefore have figures foreach of the next five years.

The table giving the numberof households, broken down by local authority, which were in receipt of 25% and50% discounts as at September in each of the last five years is available fromthe Parliament’s Reference Centre (Bib. number 36273). Information on the numberof households who qualify for 100% council tax benefit is not held centrally,as benefits are a reserved issue administered by the Department of Work andPensions and individual local authorities.

There is no widely accepted employment rate that corresponds to full employment. The Executive’s definition of full employment is employment opportunity for all, which is only achievable by ensuring opportunities for people in the whole of society throughout their working lives.

This is an operational matterfor NHS Greater Glasgow. Information of this kind is not held centrally.