Chamber and committees

The Scottish Executive is committed to reducing waiting at every stage of the patient's journey through the NHS and to ensuring that journey is as swift and responsive as possible. The current national maximum waiting time for in-patient and day case treatment, including orthopaedic surgery, will be reduced from 12 months to nine months in 2003. The National Waiting Times Unit expects NHS boards to be targeting lengthy waits for diagnosis and treatment. The unit is currently assessing NHS boards' Local Health Plans to determine how best to distribute additional funding to tackle waiting in 2002-03. It may fund specific initiatives to reduce delays for orthopaedic surgery, depending on the capacity in each NHS board area.

On 31 December 2001, 3,243 patients in NHS Greater Glasgow were awaiting hospital admission for orthopaedic surgery.

In the year ending 30 September 2001, the median waiting time for a hip replacement operation in NHS Greater Glasgow was 218 days.

The median waiting times for hip replacement surgery, in the year ended 30 September 2001, by NHS board of residence, are given in the following table:NHSScotland: Median Waiting Times For Hip Replacement Surgery, By NHS Board of Residence: Year Ending 30 September 2001.

NHS Board	30 September 2001Median Wait (Days)
Argyll and Clyde	182
Ayrshire and Arran	138
Borders	173
Dumfries and Galloway	202
Fife	184
Forth Valley	218
Grampian	109
Greater Glasgow	218
Highland	112
Lanarkshire	133
Lothian	207
Orkney	45
Shetland	147
Tayside	127
Western Isles	56
Scotland	158

Source: ISD, Scotland.

It is a matter for individual NHS boards and trusts to assess and provide for local needs and to determine the staffing levels required for effective delivery of service outcomes. Trusts must be able to adapt staffing arrangements to suit the changing pattern of local circumstances, and be judged by outcomes rather than inputs.The number of higher specialist training posts available in Scotland is regularly adjusted, to meet the projected number of new consultants needed to meet known and anticipated turnover and local service developments. Sixteen doctors training in Scotland are expected to achieve a Certificate of Completion of Specialist Training in Orthopaedic Surgery in 2002, allowing them to apply for consultant positions. In March 2001 the specialist registrar establishment for orthopaedic surgery was increased from 50 to 58, a rise of 16%. We will consider whether additional training posts for orthopaedic surgery should be part of the targeted increase of 375 junior doctors, which was announced on 2 April 2001, for the period to 2004. The targeting will take account of the review of medical workforce planning which is currently under way.

I refer the member to the answer given to question S1W-22823.

In answer to this question and also to questions S1W-22824, S1W-22826 and S1W-22827 I would advise that, in response to concerns about access to audiology services and quality of treatment, Good Practice Guidance on Adult Hearing and Fitting Services was issued to NHSScotland in March 2001. The Executive has commissioned a wide-ranging review of audiology services, which is due to report in the autumn. The review group report will provide costs and recommendations to NHSScotland on how to address any shortfalls identified in the service provided. The review will also report on progress on implementation of the Good Practice Guide.The Good Practice Guidance recommends that all patients should be reviewed at least every three years as part of a process of continuing care. It also recommended that digital aids should be supplied whenever clinical judgement indicates that they would provide benefit to the patient involved that would not be provided by other types of hearing aid.Digital hearing aids are included within the wide range of hearing aids available on the central contract for NHSScotland.

I refer the member to the answer given to question S1W-22823.

It is for NHS boards and trusts to assess and provide for local needs and to determine staff numbers and the design of teams required for effective delivery of service outcomes. The number of higher specialist training posts available in Scotland is regularly adjusted to meet the projected number of new consultants needed to meet known and anticipated turnover and local service developments.To help inform local decisions in this area, the Executive has initiated a wide-ranging review of audiology services, which is expected to report in autumn 2002. The review group will report initial recommendations on staffing, training and skill-mix by the end of March 2002.

I refer the member to the answer given to question S1W-22823.