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As the length of time someone has to wait for such an assessment is directly related to the person’s condition, the average waiting time would not be meaningful.

A total of six patients with a Scottish postcode have been placed on the waiting list for a heart-lung transplant since 1999. Because of the small number of patients involved, it is not possible to give the figure for each year on grounds of patient confidentiality.

It is not possible to give an average waiting time because of the small number of patients involved. The length of time a person has to wait for a transplant is dependent on a suitable donor organ becoming available.

The SKIPPER package was originally developed by ISD Scotland, in the mid 1990s, as a means of supporting NHSScotland in planning and performance management. It is based on old pre-web technology and is expensive to maintain, distribute and support. Difficulties have increased with the introduction and use of more modern operating systems (e.g. Windows 2000) where the successful installation of SKIPPER requires much more effort.

Finally, the knowledge that the system needed substantial development to reflect changes in information requirements and organisational changes in NHSScotland led ISD Scotland to conclude that it was not viable to continue to support SKIPPER.

The final release of SKIPPER was at end of May 2004. Before reaching a final decision ISD Scotland reviewed to what extent there were alternative sources to the SKIPPER screens. In some cases SKIPPER duplicated information published on the ISD Scotland website. Indeed, ISD Scotland found that the majority of SKIPPER screens had an alternative source, although not necessarily with the same level of detail. ISD is committed to continual improvement of the contents of its website and is confident that, in time, much of the useful information, previously on SKIPPER, can be made available through the web.

Information is provided by practices themselves. Any patient who has moved to a new location and wishes to join the list of a practice, or who wishes simply to change doctor, is free to apply to any local practice. A practice is required by the National Health Service (General Medical Services Contracts) (Scotland) Regulations 2004 to state the reasons for the refusal of any application. A patient whose application is made to a practice with a closed list will be informed accordingly. The procedure for the closure of a list is set out in the regulations and a practice is required to give notice to its health board prior to consideration of the proposal.

The information requested is not available centrally.

However, emergency admissions, within 28 days of discharge, can be identified and are presented in a table Emergency readmissions, within 28 days, to Scottish hospitals a copy of which has been placed in the Parliament’s Reference Centre (Bib. number 33792).

It is not possible to provide the information requested, as people are not required to register their decision to carry an organ donor card.

As there is no heart-lung transplant programme in Scotland, almost all Scottish patients receive their transplant at the Freeman Hospital in Newcastle.

A total of eight patients with a Scottish postcode have received a heart-lung transplant since 1999. Because of the small number of patients involved, it is not possible to give the numbers in each year for reasons of patient confidentiality.

The percentage of each board’s spending spent on administration costs in each of the last five years was as follows:

Board	1998-99	1999-2000	2000-01	2001-02	2002-03
Argyll and Clyde	7%	6%	6%	6%	6%
Ayrshire and Arran	6%	6%	6%	6%	6%
Borders	7%	8%	7%	8%	8%
Dumfries and Galloway	7%	7%	7%	6%	6%
Fife	6%	6%	6%	7%	6%
Forth Valley	6%	6%	5%	5%	6%
Grampian	6%	7%	7%	7%	7%
Greater Glasgow	8%	7%	8%	8%	8%
Highland	7%	7%	6%	6%	6%
Lanarkshire	7%	7%	7%	7%	6%
Lothian	8%	7%	7%	7%	7%
Orkney	6%	6%	7%	7%	4%*
Shetland	6%	5%	5%	6%	4%*
Tayside	8%	8%	9%	7%	7%
Western Isles	8%	7%	8%	8%	4%*

Notes:

The boards’ spending is taken to be the gross total revenue expenditure figures from their published Annual Accounts for each respective financial year. The amount spent on administration is taken to be management and administration costs reported in their published Annual Accounts plus management and administration expenditure incurred by trusts in their area. Trust management and administration expenses are taken from Scottish Financial Return (SFR) 5.2, which is completed by each hospital, as disclosed in answering parliamentary question (S2W-8040).

^*Due to a change in reporting requirements, the 2002-03 figures of the Island Health Boards (Orkney, Shetland and Western Isles) are not directly comparable with the preceding four years. Their 2002-03 figures shown thereforeonly include the hospital management and administration costs but not board management costs, which are not available for that year. This situation has been rectified in 2003-04.

In 2003-04 the cost of £9,882,454 for clinical negligence claims was met by theClinical Negligence and Other Risks Indemnity Scheme (CNORIS) and NHS boards.

The cost of clinical negligence claims is generally met from (CNORIS) which is a risk management scheme for NHSScotland that came into operation on 1 April 2000. The scheme was established by the Clinical Negligence and Other Risk Indemnity Scheme (CNORIS) Scotland Regulations 2000, as amended.

Membership of CNORIS is mandatory for all health bodies in Scotland. The arrangements cover both clinical and non-clinical liabilities and are funded by contributions from the members. At the outset there were two aims in establishing the scheme, firstly, to provide cost-effective claims management and financial risk pooling arrangements for all of Scotland's NHS bodies. Secondly, to encourage a rigorous and logical approach to risk management in both the clinical and non-clinical sectors of NHSScotland.

In 2003, the special health board, NHS Quality Improvement Scotland (NHS QIS) was formed and the Health Department decided that the CNORIS risk management standards, should become part of the work of NHS QIS. It was decided to combine the CNORIS standards with the former Clinical Standards Board’s generic standards to form Healthcare Governance standards. The process of establishing the new standards is on-going.

CNORIS operates as a risk pool, meeting the cost of negligence cases arising in any one year (subject to a deductible payable by the member (i.e. NHS body)). The pool operates on a pay-as-you-go basis with members' contributions for any one year based on the expected level of demand on the pool in that year. Further information on the scheme can be found at http://www.cnoris.com/.

In managing the scheme two actuarial reports are commissioned each year. The main report is undertaken in November each year and is used to assess the likely demand on the scheme and determine contribution levels for the coming year. The second report is undertaken each September and assesses the claims to be settled in the remaining six months of the year, the level at which claims have settled in comparison to the amount claimed, the likelihood of new claims and existing funds. This allows the Department to manage the level of funds held centrally and assess if the scheme can return unspent resources in-year.

The scheme actuaries assessed that the potential liability in 2003-04 was £13.68 million. The Department off-set this amount by £4 million, from a carried forward balance leaving £9.68 million to be collected for 2003-04. After the application of risk management discounts £8.49 million was collected. The amounts collected were as follows:

NHS Board	Amount Collected
Argyll and Clyde	£911,774
Ayrshire and Arran	£550,385
Borders	£177,734
Dumfries and Galloway	£289,903
Fife	£513,897
Forth Valley	£401,985
Grampian	£741,823
Greater Glasgow	£1,606,639
Highland	£332,781
Lanarkshire	£656,578
Lothian	£1,171,764
Orkney	£30,963
Shetland	£36,073
Tayside	£740,763
Western Isles	£58,096
Special Health Boards	£271,827
Total	£8,492,985

 

In 2003-04, a further £4.53m was returned to CNORIS members following the in-year review.