It Should Be Noted That Whilst the Majority of the Annual Data for the Year Ending March

Known Issues with National Data Affecting the Acute Hospital Activity and NHS Beds Publication

Revised 19 June 2013

It should be noted that whilst the majority of the annual data for the years ending March 2011 and March 2013 is available in the publication, there will still be some information which remains affected by the implementation of the new TrakCare patient management system (PMS). ISD has clearly identified statistics which are affected by the ongoing data issues.

Up to December 2012, SMR01 data (relating to acute and general hospital discharges) is now estimated to be almost 100%. For quarter ending March 2013, 77% of SMR01 data was complete.

The main issues are detailed below with further details of these issues available on the ISD data monitoring web page.

TrakCare Issues

The Tayside inpatient/daycase procedure data which was incomplete from April 2011 onward within the 26 June 2012 publication has now been rectified. There are no outstanding procedure recording issues for Tayside relating to the 2011/12 financial year. The issue occurred due to a Patient Management System data extraction bug. This issue also affected procedure recording in Orkney and Western Isles for the periods January to October 2011 and July to October 2011 respectively. The issue remains for these two NHS Boards but will have little effect on National data.

For locations where longstanding data estimation has been employed but where there is no corresponding SMR data returned, we have removed the estimates concerned. There are a number of locations across Scotland included in the ISD(S)1 estimates that have stopped submitting SMR data since the last complete ISD(S)1 submission. This may be due to the suspension of use or closure of the beds concerned. .

Completeness

Due to the ongoing issues relating to the supply of complete and comprehensive outpatient procedure data from a number of NHS Boards all counts of outpatient procedures should be treated with caution; completeness varies greatly by NHS Board. The reduction in the total number of main procedures shown between 2010/11 and 2011/12 in the Inpatient, Day case and Outpatient procedures table is primarily due to missing outpatient procedures for NHS Ayrshire & Arran. Further details can be found within the relevant Operation and Procedure tables.

Emergency admissions and bed day data for HEAT targets relating to patients aged 65 and over and patients aged 75 and over for NHS Scotland and NHS Grampian for 2010/11 should be treated as provisional in the sense that a known, small number of records remain outstanding. Revisions to this data are expected to be minimal with NHS Grampian data predicted to be over 99% complete at the time of publication. As such, data for the concluded HEAT target relating to patients aged 65 and over are considered fit for purpose and will not be published in future releases.

Emergency admissions data for patients of all ages for 2011/12 have been provided and are provisional; admissions may increase by around 1% while bed days may increase by around 2% in future publications.

Non-NHS Provider

The completeness of Non-NHS Provider data varies from year to year. Data completeness is not known prior to 2008/9. Since then, data completeness has been improving and data for 2010/11 are likely to be the most complete (it has been estimated that around 95% of data for surgical specialties have been received for 2010/11). 2011/12 data is currently being assessed but a similar level of completeness is anticipated. It should be noted that any increases in the level of Non-NHS Provider activity are possibly the result of improved data completeness rather than a real increase in the level of activity. Individual NHS Boards will have more reliable local information on the number of NHS patients who have been treated in non-NHS locations. Non-NHS Provider figures relate to patients treated in non- NHS locations such as private hospitals, hospices, nursing homes, care homes, etc.

NHS Dumfries & Galloway Geriatric Long Stay

In 2007, Dumfries and Galloway re-classified beds in community hospitals for general use rather than being for the dedicated use of geriatric specialties. As a result of this change, admissions to these beds are now included in the analysis whereas previously they would have been excluded. This has resulted in a noticeable increase in the number of emergency (non-routine) admissions and bed days since 2007.

Lothian Emergency Day case Misclassification

ISD Scotland and NHS Lothian have been working closely to resolve some SMR01 data issues for certain Lothian hospitals, relating to PAS system changes. As part of this work NHS Lothian has amended and re-submitted SMR01 data and ISD has performed additional data analyses to amend the majority of the affected records.

NHS Forth Valley Service Restructure

‘Falkirk and District Royal Infirmary became Falkirk Community Hospital in August 2010, after which it specialised in providing Care of Elderly and Rehab inpatient facilities. The new Forth Valley Royal Hospital opened at this time, with inpatient units for a minority of specialties; a further change occurred in July 2011 when acute inpatient services at Stirling Royal Infirmary also migrated to the new Forth Valley Royal Hospital. From July 2011 Stirling Royal Infirmary became Stirling Community Hospital.’

From quarter ending December 2012, Forth Valley started to submit SMR01 data for Clinical Assessment Units. This resulted in an increase in activity compared to previous quarters. NHS Borders GP other than Obstetric beds have been reclassified as Geriatric Long Stay (GLS) beds. This has led to a decrease in GP in other than Obstetrics bed figures and an increase in GLS beds. The net effect is an apparent decrease in bed numbers for acute specialties.

NHS Greater Glasgow & Clyde Service Restructure

The movement in activity may be attributed to service redesign and realignment of services throughout NHS GG&C, such as the opening of the Ambulatory Care Hospitals at Stobhill Hospital & Victoria Infirmary.

New Glasgow CHP

The Community Health Partnership (CHP) configuration of Glasgow City local authority changed with effect from 22 March 2011. The previous five Community Health & Care Partnerships (CHCPs) have been replaced by one CHP. The new CHP is called ‘Glasgow City CHP’.

The change affects the following CHPs:

S03000016 East Glasgow Community Health & Care Partnership S03000019 North Glasgow Community Health & Care Partnership S03000021 South East Glasgow Community Health & Care Partnership S03000022 South West Glasgow Community Health & Care Partnership S03000024 West Glasgow Community Health & Care Partnership

NHS Western Isles beds data submission

NHS Western Isles until recently had not submitted beds data since December 2010. All subsequent data had been estimated on the basis of the last data submitted. The newly submitted data covering quarters March 2012 onwards suggests a 23% higher bed complement than previously published. ISD are currently assessing the quality of this data.

Beds Data Quality Assurance Exercise – March 2013

Due to ongoing ISD(S)1 data submission problems and high level of data estimation employed for a number of health boards, ISD have asked boards to provide additional quality assurance of Average Available Beds figures for the quarters ending December 2011 and December 2012 by comparing the high-level publication figures with their own local records.

At Scotland level, ISD figures differ by less than 2% from those derived locally by NHS boards. Table 1, below, gives further detailed comparison at NHS board level. Where significant differences lie, ISD will be following up with the boards concerned to fully understand where these arise, ensure consistency in measurement methodology and specialty classification, and to take steps for improving data submissions in future. Comparisons at lower levels down to individual specialty will likely result in greater percentage variation between ISD and local figures due to the complexity of measuring average available beds and the progressively smaller numbers involved.

ISD are embarking upon a programme of work to review the ISD(S)1 data collection generally which aims to improve the data quality and coverage and will include improving beds information as a key deliverable. Intersystems have now released the TrackCare extract to boards for local testing and implementation.

Table 1 - Average Available Staffed Beds - Comparison of ISD central figures with locally derived board figures.

Mar 12 Mar 13 NHS Board All Specialties All Specialties ISD Board ISD Board Scotland 24,161 23,634 23,819 23,549 Ayrshire & Arran 1,711 1,653 1,711 1,556 Borders 468 * 462 443 Dumfries & Galloway 719 712 684 690 Fife 1,470 1,353 1,367 1,369 Forth Valley 1,022 1,012 1,047 1,034 Golden Jubilee National Hospital1 175 * 177 * Grampian1 2,365 * 2,365 * Greater Glasgow & Clyde 6,764 6,529 6,548 6,584 Highland 1,208 1,198 1,188 1,187 Lanarkshire 2,357 2,259 2,331 2,226 Lothian1 3,701 * 3,725 * Orkney1 53 * 54 * Shetland 68 * 65 63 Tayside 1,943 1,948 1,978 1,949 Western Isles 135 140 115 127

Notes: 1 - shaded cells indicate ISD figures differ by 5% or more from local figures

* - Golden Jubilee National Hospital, NHS Grampian, NHS Lothian and NHS Orkney indicated they are content that ISD figures are an accurate relection of their average available beds and did not provide local figures.