Talking-up Scotland

They’ll probably just deny it all again. Why do I bother? In the hope I piss them off having to reply and having to address me as ‘Professor’.

A World Health Organization safety checklist to encourage teamwork and communication during operations has been associated with a 37% reduction in the death rate after operations, with a notably dramatic fall since 2007/8. Dr Atul Gawande, who introduced the checklist and co-authored the above study, published in the British Journal of Surgery, said:

‘Scotland’s health system is to be congratulated for a multi-year effort that has produced some of the largest population-wide reductions in surgical deaths ever documented.’

However, it is likely that other factors will have been influential in this achievement including new improved technologies and management of the SNHS at Scottish government level. The report’s conclusion acknowledges this:

‘The WHO Surgical Safety Checklist has been implemented widely since its launch in 2008. It was introduced in Scotland as part of the Scottish Patient Safety Programme (SPSP) between 2008 and 2010 and is now integral to surgical practice. Its influence on outcomes, when analysed at a population level, remains unclear.’

The probable role of the Scottish Government, as suggested by the Nuffield Trust, in helping to enable this achievement is discussed below the frankly amazing results:

This is an astonishing trend, unique I think, in improving health outcomes with a more than halving of the mortality rates after surgery, in the space of only 10 years, and after a period of flat or worsening results under Labour.

In some ways even more impressive, the percentage of patients having to return for further surgery has fallen to almost zero! This comes after a period, under Labour, of worsening outcomes.

https://onlinelibrary.wiley.com/doi/full/10.1002/bjs.11151

The Scottish NHS and the Scottish Government

Extracts from the Nuffield Trust in 2017:

Scotland has a unique system of improving the quality of health care. It focuses on engaging the altruistic professional motivations of frontline staff to do better and building their skills to improve. Success is defined based on specific measurements of safety and effectiveness that make sense to clinicians.

Scotland’s smaller size as a country supports a more personalised, less formal approach than in England. The Scottish NHS has also benefited from a continuous focus on quality improvement over many years. It uses a consistent, coherent method where better ways of working are tested on a small scale, quickly changed, and then rolled out. Unlike in the rest of the UK, this is overseen by a single organisation that both monitors the quality of care and also helps staff to improve it.

There is much for the other countries of the UK to learn from this. While comparing performance is very difficult, Scotland has had particular success in some priority areas like reducing the numbers of stillbirths. Scotland’s system provides possible alternatives for an English system with a tendency towards too many short-term, top-down initiatives that often fail to reach the front line. It also provides one possible model for a Northern Irish NHS yet to have a pervasive commitment to quality improvement, and a Welsh system described as needing better ways to hold health boards to account while supporting them in improving care. Scotland has a longer history of drives towards making different parts of the health and social care system work together. It has used legislation to get these efforts underway while recognising that ultimately local relationships are the deciding factor. There is much for England and Wales to learn from this.

Research Report, July 2017, Learning from Scotland’s NHS at: https://www.nuffieldtrust.org.uk/files/2017-07/learning-from-scotland-s-nhs-final.pdf

 

 

 Here’s the 14^th paragraph in the iNews report today. Our other NoMedia had the same information:

Well down and far away from cursory readers and headline limiters:

‘Over the 18-month period, Police Scotland dealt with 3,425,123 emergency and non-emergency calls, meaning that the notable incidents equated to fewer than 0.006 per cent.’

They all opened with ‘in the public interest of course’, this:

‘Police Scotland call handlers and control rooms made almost 200 serious mistakes in the space of 18 months, including dozens of cases where officers were sent to the wrong address. The national force recorded 182 “notable incidents” between August 2017 and December last year, according to figures published following a Freedom of Information request.’

Liam Kerr, MSP, said: “This research sets out scores of cases which, frankly, should never have happened”.

Kerr is of course correct in his use of ‘scores’. There were ‘nine score and two’ as they used to say in the Old Testament.

https://inews.co.uk/news/scotland/errors-police-scotland-call-handlers-officers-sent-wrong-addresses/

Kerr Might have said in the voice of Spike Milligan: ’What? 99.994%? It’s not good enough! Go out and get some more.’

Thanks to another Scottish Labour parliamentary question we can see that radiography staffing vacancies are, on average, running at 5.02%. The average UK employee turnover rate is around 15%. In Higher Education it’s 11%.

https://www.e-days.co.uk/news/employee-turnover-rates-an-industry-comparison

I suspect that level would be pretty de-stabilising, in the health service, but are vacancies running at 5% not a good thing, enabling some movement to allow promotion and the appointment of newly trained staff? If there were no vacancies at all, as was the case in schools in the early 80s, we’d hear plenty complaints about that.

 

 

Thanks to this parliamentary question from Scottish Labour, we can see how few trains have been ‘stop-skipping’ in recent times.

While ‘stop-skipping’ is hugely annoying for some passengers affected by it, there can be reasonable explanations for actions which are taken in the interest of the greater good of all the passengers on the system at any one time. See this:

Skip-stop is a public transit service pattern which reduces travel times and increases capacity by not having all vehicles make all designated stops along a route.

When skip stops are used in rail transit, the transit operator designates stations as either major or minor, typically by ridership. Usually, all vehicles stop at the major stations, but only some vehicles stop at the minor ones.

In systems that have no extra track for a faster train to pass a slower train, skip-stop may be employed either during busier travel hours to reduce travel time of a particular train, or during off-peak hours to raise efficiency by not stopping on “unpopular” stations.

https://en.wikipedia.org/wiki/Skip-stop

Reporting Scotland returned tonight to their reporting on NHS Tayside’s treatment of breast cancer patients. The report contained no inaccuracies but through the sequencing of the information presented, created a causal connection not made by the Review Group report which they had supposedly based their presentation on. They said in an uninterrupted sequence:

1. There’s further criticism tonight of a decision to give breast cancer patients in Tayside lower doses of drugs during chemotherapy than they would have received elsewhere in Scotland.
2. A panel of experts has described the practice as close to being unacceptable.
3. Fourteen of the patients involved have since died.

The very strong implication here is that these fourteen patients died because of the lower doses. The Review Group report absolutely does not say that or imply it in any way. Indeed, it says quite explicitly that of the 300 plus patients involved:

‘The overall assessment of the increased risk of recurrence within the treated cohort is extremely difficult to quantify but probably of the order of 1-2%. A risk of harm of 1-2%, allows an estimate that around 1 patient per year in NHS Tayside may have suffered an adverse outcome.’

https://www.gov.scot/publications/clinical-risk-assessment-healthcare-improvement-scotland-report-clinical-management-breast-cancer-nhs-tayside-april-2019/

 So, the Review Group has made only the smallest, most hesitant connection between the treatment and perhaps a single death from the 300 plus patients treated. The BBC with its Royal Charter to inform has clearly failed to do so and, disgracefully, has contributed to an uninformed and dangerous scare story which might, in itself, damage the mental health and thus prospects of hundreds of breast cancer patients being currently treated by NHS Tayside. I’d complain, again, but I’m tired of the unprofessional, undereducated stubbornness of those working in Reporting Scotland.

 

Here’s my request:

Please provide me with the number of FOI requests made to you, over the last 10 years, by individuals representing or from these groups:

1. The Scottish Labour Party
2. The Scottish Lib Dems
3. The Scottish Conservatives
4. The SNP
5. BBC Scotland
6. The Herald newspaper
7. The Scotsman newspaper
8. STV

Here is the SPS response:

I can confirm that the authority does not hold full records of FOISA requests for 10 years prior to 18 March 2019. Our records commence in April 2013. I can also confirm that we do not record the newspaper or the broadcaster for which a journalist is working when making a request, nor do we record the political party interest of a request received from a political source on our log.

I can however confirm that from the time our records commence in April 2013 until the date of this request the SPS has recorded:

1. 138 requests from 56 different individuals from a political source,
2. 600 requests from 256 different journalists.

https://www.whatdotheyknow.com/request/562733/response/1347514/attach/3/HQ18331.pdf?cookie_passthrough=1

I wonder who has been making these requests? Hmmm:

Yes, it’s Lib Dem MSP Liam McArthur. This one below is from him too:

And again! No wait, it’s another Liam, Kerr, Tory:

Don’t Tories like prison overcrowding? Punish them not the victims! Here he is again:

Why is he wearing a Farrage coat? Is he planning to join Brexit or UKIP?

 

In the Scotsman today, a retired police officer tells us:

‘There’s good news on crime rates but beware the sting in the tail, writes former Deputy Chief Constable Tom Wood. The latest published crime statistics were good news – overall crime down by an impressive 16 per cent since last year and, within that big picture, further good news that violent crime had reduced with only a tiny minority of us ever falling victim. Remarkably, recorded crime has fallen by over 40 per cent in the last ten years. Now there’s an important caveat in all this of course and that’s the fact that only reported crime can be recorded and only recorded crime counts.’

BUT we already have another reliable source dealing with the above concern in The Scottish Crime and Justice Survey (SCJS) which:

• Enables the Scottish population to tell us about their experiences of, and attitudes to, a range of issues related to crime, policing and the justice system; including crime not reported to the police;
• Provides a valid and reliable measure of adults’ experience of crime, including services provided to victims of crime.

The survey, though based on a sample, is very reliable and only those differences that are statistically significant at the 95% significance level are described as differences.

As in the police reported crime statistics, people’s experience of crime is down, massively:

Both violent AND property crime are falling:

Crime has fallen by more than 400 000 incidents in 10 years:

Also, far fewer of us experience crime:

Finally, people have experienced an even greater fall in crime than in the police statistics:

‘A comparable subset of crime is used to enable comparisons to be made between recorded crime and SCJS estimates, with both sources showing 7 marked decreases over the past decade. Between 2008/09 and 2017/18, police recorded crime in the comparable subset fell by 40%, whilst the estimated number of incidents in the SCJS comparable crime group decreased by 47%.’

 

https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2019/03/scottish-crime-justice-survey-2017-18-main-findings/documents/scottish-crime-justice-survey-2017-18-main-findings/scottish-crime-justice-survey-2017-18-main-findings/govscot%3Adocument

 

The Scottish Conservatives spokesperson for Education and the Undead has accused the Scottish Government of abject failure in not creating a single ‘Zombie Academy School’ in Scotland. England has surged ahead with ‘hundreds of them.’ BBC Scotland’s fearless Disclosure team has found that there are no Academy Schools at all, never mind Zombie ones, in Scotland.

Head of BBC Scotland since the recent Zombie invasion of Pacific Quay, Jackie Bird (above), said: ‘Gnnnaaaauuushhhhgnnnnnarrrr!’ but after sniffing him thoroughly, would not eat the Conservative spokesperson.

What is a Zombie Academy School?

In the Guardian yesterday:

‘53,000 pupils in limbo after rise in ‘zombie’ academy schools. Rising numbers of pupils in England are being taught in state schools that have been left to drift for months or even years without established management, according to figures obtained by Labour. It estimated that more than 50,000 pupils are currently attending academies in England that have been unable to join a multi-academy trust or find a sponsor, leading the opposition to claim that the government’s flagship schools’ improvement policy is in tatters. The figures are an increase on the 40,000 pupils trapped in 64 similar “zombie schools” uncovered by a Guardian investigation 16 months ago, suggesting that the Department for Education (DfE) is still struggling to find willing sponsors.’

https://www.theguardian.com/education/2019/apr/15/53000-pupils-in-limbo-after-rise-in-zombie-academy-schools?CMP=share_btn_link