91.5% of operations go ahead as planned in NHS Scotland and 15% more per capita are cancelled ‘at last minute’ in NHS England

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NHS Scotland cancelled only 522 out of 30 535 or 1.7% of operations because of lack of capacity in October 2018 despite a 6.45 increase in demand from patients.

986 or 3.2% were cancelled by the patients themselves and 957 or 3.1% were cancelled by the hospital for clinical reasons ie in the interests of the patient.

https://www.isdscotland.org/Health-Topics/Waiting-Times/Publications/2018-12-04/2018-12-04-Cancellations-Summary.pdf?87746828795

Just out of interest:

During the quarter ending 30th September 2018, 18,460 operations were cancelled at the last minute for non-clinical reasons by NHS providers in England.

https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2018/11/Cancelled-Operations-Stats-PN-Q2-2018-19.pdf

So, if we divide the above 18 460 by three to get a reasonable monthly figure, 6 153 patients had their operations cancelled in NHS England. England has ten times the population of Scotland so all things being equal you might expect Scotland to have had 615 such cancellations yet there were only 522. The NHS England rate of operation cancellation is 15% higher.

Footnote: It’s not clear how many of the Scottish cancellations were ‘at the last minute’.

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NHS Scotland’s waiting time targets abused again by BBC Scotland?

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Nearly all of the NHS Scotland targets are for treatment within a period of time for between 90% and 95% of patients. Anything below that is described as a failure to meet the targets and is the trigger for ministerial apologies, opposition attacks and miserable patient interviews, but I think I’ve noticed something interesting and vulnerable in these reports.

I haven’t done the research. I’ve just got an emerging wee thesis. The typical waiting time for removal of wee theses in 18 weeks. Here it is:

Reporting Scotland tell us about every failed target on the day it is released by ISD. They always tell you that the target was failed and that it has now been failed for whatever period of time it has been failed.  They sometimes tell you what the actual target percentage is but not always. They rarely if ever tell you what the actual percentage seen on time was.

I’ve noticed this pattern recently and will be watching from now on to see if it repeats to suggest a propaganda tactic. I’ll have a look back at some earlier reports for evidence too. Why? Well, is it possible that the omission of the actual performance percentage and of the target percentage is because both, when presented that way, seem very high and may trigger an unpredictable response in many viewers?

Targets are almost always 90% or 95%. Performance commonly ranges from around 70% to over 90%.

Now, imagine your base assumptions about whether or not a percentage score is good or not derives mainly from your own experience in educational assessments, in school or in college or at university, or in some craft or professional programme. Isn’t 70% really pretty good, an A? In all my time on the way to a BA Hons (2.1), even as a mature student, I only once reached 82% and commonly scored in the 65% to 75% range. Isn’t 70% for most of us, evidence of greatness and 95% evidence of freakish unworldliness?

So, is there a danger that viewers will think performance by NHS Scotland is actually pretty damn good across the board and that the targets are a bit OTT?

There is evidence that in Scotland and in the UK ,we have come to treat what should be longer term aspirational targets as opposed to everyday minimal targets.

A bit of context from an international study in 2014, is illuminating:

‘Most countries are following the UK 4-hour target as it is recognised that there is a benefit to adding in a time constraint. Victoria and Ontario [Canada] both have set the achievement target lower, at 75% and 90% respectively, compared to 95% in England [and Scotland]. Moreover, neither system actually meets their target, and especially in Victoria there are few consequences to this. In Stockholm [Sweden] the county monitors performance on the 4-hour target but this is not nationally mandated.’

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/382847/Annex_5_AandE.pdf

 

 

 

 

 

Does British Nationalism drive more to dangerous alcohol consumption levels?

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BBC Scotland’s Reevel Alderson has revealed:

‘Scots top UK drink death rates but numbers are falling’

However, it seems that another negative Scottish stereotype is about to fade as related statistics fall below those of the rest of the former UK. We’ve seen murder, knife-related crime, domestic abuse, racial abuse, youth crime and stillbirth, plummet in the years since the first SNP Government came to power just over 10 years ago. We’ve also seen the reduced impact of UK Government attacks on the poor and vulnerable, here, due to Scottish Government actions. While the causes are no doubt multifactorial, with increased home-based media usage and reduced environmental lead levels credited by some researchers, policy-makers must always share in the credit for, especially, the established effects of reduced inequalities on crime and health.

One of the more stubborn indicators was always going to be damaging alcohol consumption, but we see in Reevel’s revelations, here, a strong indication that alcohol-related deaths are in the process of falling below the levels in the rest of the former UK.

Reevel reveals:

  • Scotland is the only country in the UK to have seen a significant reduction in alcohol-related deaths this century.
  • The number has fallen by 21% since 2001.
  • In Northern Ireland it rose by 40% over the same period.
  • The Scottish figure for 2017 was 1,120, almost 300 fewer than the peak year of 2006.
  • The UK death toll has risen in recent years and is now similar to those in 2008 where it was at the highest recorded.
  • The Scottish government introduced a minimum unit price (MUP) for alcohol in May 2018. The policy, which increased the price of some cheap, strong drinks was welcomed by alcohol campaigners.

https://www.bbc.co.uk/news/uk-scotland-46441009

Britain’s four distinct governments offer us the opportunity to form an initial hypothesis linking political ideology to excessive alcohol consumption. That it is soaring under that most British Nationalist of parties, the DUP in Norther Ireland, rising under the Loyal Labour Party in Wales and also rising under New UKIP (formerly the Conservative and Unionist Party) in England, yet falling fast under the Europhile and politically progressive SNP in Scotland, it is hard to avoid the notion that rightist British Nationalism may be driving part of the population to escapist solutions. Is golf, I wonder, also falling in popularity in Scotland?

However, It’s important that we don’t revel in Reevel’s revealing statistics, yet.

Scottish NHS workforce continues to grow strongly

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There are several newsworthy items here which I feel sure Reporting Scotland will want to cover, as to fail to do so would be, as their own Graham Stewart put it so eloquently, ‘suppression of information.’

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So:

  • 12 000 or 10% more NHS staff since SNP came to power
  • 168 more consultants, up 3.2% in one year
  • Consultant vacancy rates fall to lowest since 2016
  • More than 10 000 student nurses and midwives in training
  • Student numbers up 6.3% in one year
  • 670 new Advanced Nurse Practitioners up 4.45 in one year
  • 78 more paramedics up 5.6% in one year

 

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2018-12-04/2018-12-04-Workforce-Summary.pdf?42817324400

 

 

 

 

25% increase in number of nurses to work with young people needing mental health services

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Yesterday, Reporting Scotland announced:

Almost one third of young people who need access to mental health services are waiting longer than they should’ and ‘There was a slight improvement.’

The actual figure reported was 69% seen within 18 weeks, up from 67.5% in the previous quarter so the headline could have been:

‘Almost 70% of young people who need access to mental health services are seen on time’

Why is a 2% gap ‘almost one third’ and a 1.5% increase only ‘a slight improvement?’ Is this a manifestation of an agenda, even a subconscious one?

Though we hear precisely the 90% target figure, we do not hear of the ‘almost 70%’. To exclude only that detail, along with the choice of ‘almost’ and of ‘slight’ can only suggest a clear agenda. Is there a danger for them that the average viewer might think ‘70%, not bad, eh? I dreamed of 70%. An A?’

The report from ISD, yesterday has several optimistic signs ignored by Reporting Scotland:

  • Half of patients seen within only 12 weeks
  • Four boards hit the 90% target
  • 7% more nurses in one year
  • 4% more nurses since new minister appointed
  • Below average staff vacancies

https://www.isdscotland.org/Health-Topics/Mental-Health/Publications/2018-12-04/2018-12-04-CAMHS-Summary.pdf?199526549

Choice of language to maximise negativity and the selective omission of facts not conducive to a narrative of failure, indicates a clear political agenda to undermine SNP Government.

BBC Scotland’s Disclosure Series is not investigative journalism. Is it even journalism?

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As the BBC Wales investigative journalists exposed a violent white supremacist gang located in a small village, BBC Scotland’s ‘Disclosure Series’ team were visiting some sad people who had experience of living on an NHS Scotland waiting list. However, the choice of topic is only the first reservation we need have, the nature of the reporting itself is, as will be illustrated, somewhat remote from any idea of investigative journalism but also, lacked many of the features of journalism in its most basic sense.

Perhaps, the team’s previous experience attempting to investigate the unethical transport of young calves to Spain (The Dark Side of Dairy! Bournville?) which resulted in them both using film of Hungarian calves being shipped onto Romanian ferries instead of Scottish calves being shipped onto Northern Ireland ferries (ref below) and, laughably, following the wrong lorry all the way to Spain, has caused them to try to play safe this time. Their other two ‘investigations’ in the series have gone for malpractice by one NHS surgeon and child abuse in one care home. Now why didn’t they fancy Dark Money, the DUP and the Scottish Tories? Might somebody get punched? To be fair, this report does not mistakenly feature any Tibetan folk suffering because of long waiting lists for treatment there.

The second of the two questions in the title above, is answered using these six tests (like Labour!):

Did Disclosure: Life on the NHS List:

  1. help me understand what it feels like to wait longer than I should have to for treatment?
  2. include examples of people who had been treated by NHS Scotland within the target times?
  3. inform me how common it is to wait longer than the target times?
  4. inform me of reasons why target times are not being met such as increased demand?
  5. explain any problems with interpreting waiting time statistics?
  6. give a balanced account based on all of the above?

The first question is really answered already. This programme is labelled ‘investigative series.’ Based on government waiting list statistics in the public domain and already reported repeatedly on BBC Scotland news followed up by visits to interviewees unthreatened in any way, this study could have been carried out by an S4 Media Studies group of pupils. While the previous investigation into the transport of calves might have had at least a wee bit of risk for the team, this topic is the stuff of everyday regular reporting of the kind you see across the tabloid press.

Is it then just journalism, at least of a reasonably professional quality? See this:

Did Disclosure: Life on the NHS List:

  1. help me understand what it feels like to wait longer than I should have to for treatment? The programme had several extended interviews in which more than one person cried and in which all were very upset by their experience. These were undeniably cases where delays mattered. We could hardly fail to empathise.
  2. include examples of people who had been treated by NHS Scotland within the target times? The programme’s title does not restrict the survey to only those waiting too long. ‘Life on the NHS List’ by definition should include a sample of the many thousands who were seen within the target time to discover how they felt. For around 80% of the time allocation, we watched and listened to the presenter with four individuals, two of whom sobbed as they described their pain or anxiety. The lingering of interviewer and close up camera on these faces was positively morbid and emotionally exploitative. It’s not clear how this small sample, presented in this way, informed us usefully about the experience of the thousands on waiting lists. We heard of two special cases including a smug individual who had gone to France for the treatment and somehow persuaded his local board to pay for much of it. It’s not clear how these two cases informed us usefully.
  3. inform me how common it is to wait longer than the target times? Official figures were not presented though these are available. Did the official figures where around 70% of patients are seen within the target times not satisfy the programme-makers need to sensationalise and to shock? Though the targets are higher, might many viewers, based on their experience of 70% representing considerable success in other contexts such as in exams, think 70% is OK? Instead we saw unsourced, uncontextualized and dramatically illustrated, cumulative figures designed to shock audiences.
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  1. inform of me of reasons why target times are not being met such as because of massively increased demand? There was no attempt to do so quantitatively beyond passing comments regarding ‘pressure on staff’. Such data is easily accessed.

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  1. explain any problems with interpreting waiting time statistics? These were taken at face value other than to suggest, based on conversation with one unidentified professional, that there are secret waiting lists which are even longer.
  2. give a balanced account based on all of the above? The programme was horribly unbalanced with around 90% of the time allocated to interview and observation. Interviews and observations of a handful of individuals as they offered the interviewer helpful soundbites such as Why could they not take me sooner’ and ‘You’re trying so hard to fight the condition and the pain’ and as she told us that she, in one case, while leading a dancing class, was in ‘absolute agony’ dominated. Maybe it’s my pathetic male pain threshold but if I was in absolute, absolute mind, agony, I doubt I’d be walking around talking to an interviewer. Interviews with the minister responsible were used to elicit the expected political response confirming the interviewer’s stunning insights that failure to meet targets is bad, that improvements are always needed and that the statistics don’t tell the full story of pain and anxiety. Frankly, like most viewers, I don’t need repeated endless morbidly explicit demonstrations of suffering to help me understand that there is real pain behind the statistics. I’ve been there, done that, get it. What I need are objective and fair assessments of the situation, across the country, with meaningful explanation of the problematic nature of targets in health care, an account of the recent funding reductions, of their impacts and of their origins in Westminster. Most of all, I need relevant evidence presented properly without modifications to sensationalise and to generate shock.

 

https://www.farminguk.com/News/Scotland-s-chief-veterinary-officer-slams-BBC-for-misunderstanding-farming-issues_50254.html

 

Scotland’s affordable housing supply continues to increase ahead of non-Scottish parts

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In Scottish Housing News today:

Plans to invest more than £150 million to continue the development of affordable housing across Aberdeenshire over the next five years have been agreed. The Strategic Housing Investment Plan (SHIP) outlines opportunities across the area from 2019-2024. Having been agreed by Aberdeenshire Council’s communities committee, the document has now been passed to the Scottish Government, which will provide funding for the projects. Over the course of the next five years, 2,354 homes could potentially be built across Aberdeenshire, with around 590 suitable for households with particular needs, and 73 fully accessible for wheelchair users.

http://www.scottishhousingnews.com/25106/new-aberdeenshire-plan-could-see-more-than-2350-affordable-homes-built-over-next-five-years/

As always, related posts on affordable housing:

‘Social housing: One of Scotland’s best kept secrets?’ Tell our Nomedia

92% of Scots happy with their housing!

SNP Government builds affordable/social housing at almost twice the rate of Tories in England

Scotland increasingly ‘streets ahead’ of England on affordable housing delivery

Scottish social housing more accessible and cheaper than in rest of UK

Good news on affordable housing from the Scotsman despite unnecessary quotation marks, a wee ‘despite’ and a ‘but’

Once more, an East Renfrewshire social rent housing project in Scottish Housing News forgets to credit the huge Scottish Government subsidy