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Information on and methods of calculating emergency readmission rates has been under consideration by a sub-group of the NHSScotland Clinical Resource and Audit Group (CRAG). A report containing data on emergency re-admissions at all ages will be provided as part of the next Clinical Outcome Indicators Report, scheduled for publication on 16 July 2002. I will write to you thereafter with an age-related analysis of the data.

The Expert Group on Financial and Other Support has considered evidence from wide ranging sources including information on the approach to medical compensation in the Republic of Ireland for patients who contracted hepatitis C from contaminated blood supplies. The group will submit their preliminary report to me by the end of July 2002 and it will be made public following discussion with the Health and Community Care Committee. A list of the evidence considered by the group will be included in the preliminary report.

An estimated 2,095 nursing students in Scotland are expected to complete their studies in the year to October 2002.The information is not available in the form requested. Nursing education is delivered by 11 higher education institutions in Scotland. On completion of their studies, students may take up a post in any NHS board area.

Tables 1 and 2 show the percentage changes to the target allocations within the Arbuthnott formula (updated in November 2001) for Hospital and Community Health Services (HCHS) (table 1) and GP Prescribing (table 2). Columns 1, 2 and 3 indicate the three component elements of the overall changes:1. The change in the population share by health board.2. The change in the age/sex structure of the health board's population.3. The change in morbidity and life circumstance (MLC) i.e. deprivation.There has been no update of the remoteness adjustment in 2001.GP Prescribing (table 2) has been separated from HCHS (table 1) because GP Prescribing uses a different population base. The population base for HCHS is the mid-year estimate (MYE) by Health Board of Residence. For GP Prescribing, the relevant population base is the Community Health Index (CHI) "deflated" for GP list size inflation. GP Prescribing is also based on the Health Board of Management, not the Health Board of Residence (background note - point 3).Table 1. Hospital and Community Health Services (HCHS)

	1	2	3	=1+2+3
Health Board	Change in MYE Pop. Share	Change in age/sex adjustment	Change in deprivation adjustment	Change in overall Arbuthnott HCHS share
Argyll and Clyde	-0.7%	0.3%	1.1%	0.7%
Ayrshire and Arran	-0.4%	0.5%	0.9%	1.0%
Borders	0.7%	0.7%	1.3%	2.8%
Dumfries and Galloway	-0.9%	1.4%	0.4%	0.9%
Fife	0.5%	0.4%	-0.1%	0.8%
Forth Valley	0.9%	0.0%	0.5%	1.5%
Grampian	-0.2%	0.8%	0.9%	1.4%
Greater Glasgow	-0.6%	-1.5%	-0.7%	-2.9%
Highland	0.2%	0.7%	-0.4%	0.6%
Lanarkshire	0.3%	0.6%	-0.3%	0.6%
Lothian	1.4%	-0.6%	-0.5%	0.2%
Orkney	-0.3%	0.0%	0.4%	-0.1%
Shetland	-1.9%	0.7%	-0.1%	-1.4%
Tayside	-1.0%	0.8%	0.1%	-0.2%
Western Isles	-2.6%	0.7%	0.1%	-1.8%

Table 2. GP Prescribing

	1	2	3	=1+2+3
Health Board	Change in HBMgt Pop. Share	Change in age/sex adjustment	Change in deprivation adjustment	Change in overall Arbuthnott Prescribing share
Argyll and Clyde	-1.7%	1.1%	0.9%	0.3%
Ayrshire and Arran	-0.4%	1.2%	0.6%	1.4%
Borders	0.8%	1.5%	1.1%	3.4%
Dumfries and Galloway	-0.6%	2.7%	0.4%	2.4%
Fife	0.5%	0.4%	-0.1%	0.7%
Forth Valley	1.3%	-0.2%	0.3%	1.4%
Grampian	-1.3%	0.8%	0.7%	0.2%
Greater Glasgow	0.2%	-1.8%	-0.6%	-2.3%
Highland	0.2%	1.5%	-0.3%	1.3%
Lanarkshire	0.7%	0.1%	-0.3%	0.5%
Lothian	1.7%	-1.9%	-0.2%	-0.5%
Orkney	-1.4%	2.4%	0.4%	1.3%
Shetland	-2.5%	0.9%	0.0%	-1.6%
Tayside	-1.6%	1.5%	0.0%	-0.1%
Western Isles	-3.4%	3.1%	0.0%	-0.4%

Note:HBMgt = health board management.

All consultant nurse/midwife submissions are vetted by a central evaluation panel co-ordinated by the Scottish Executive Health Department. Prior to doing so each proposal must be supported by the local Unified Health Board. In their submission each trust/NHS board must demonstrate the local need for the post, explaining how this fits with the rest of the organisation and the key policy documents influencing the development of this proposal. Each submission must also include the arrangements for audit and the outcome measures that will be used to evaluate the impact of the post.

Information on the provision of on-site childcare facilities by NHS trusts is not held centrally, but should be available from NHS trusts locally. The Scottish Executive is committed to family friendly policies and encourages all NHSScotland employers to adopt and support appropriate childcare policies.

A detailed breakdown of the latest available information on the number of vacant medical consultant posts is shown in the following table. The table should be read in conjunction with the following notes.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. The total Specialist Registrar (SpR) establishment was increased by 100 in 2001, a rise of 9%, with many of the increases being in the specialties with the highest levels of vacancies. Additional funding for a further targeted increase of 375 junior doctors was announced on 2 April 2001, for the period to 2004. Targeting will take account of vacancy levels and also of the review of medical workforce planning which is due to report shortly.Medical Consultant Vacancies by Specialty and NHS Board Number at 30 September 2000

		Argyll & Clyde			Ayrshire & Arran	Borders	Dumfries & Galloway	Fife	Forth Valley	Grampian	Greater Glasgow	Highland	Lanarkshire	Lothian	Shetland	Tayside	Western Isles	Common Services Agency
Total Consultant Vacancies		12			11	3	6	11	12	9	26	7	24	12	2	11	2	4
Accident & Emergency Medicine				-	-	-	-	-	1	-	-	-	2	-	-	-	-	-
Anaesthetics		2			1	-	-	-	-	1	1	-	-	-	-	5	-	-
Clinical Laboratory Specialties
Blood Transfusion		-			-	-	-	-	-	-	-	-	-	-	-	-	-	2
Chemical Pathology		-			-	-	-	-	-	-	1	-	-	-	-	-	-	-
Haematology		-			1	2	1	-	-	-	-	1	-	-	-	1	-	-
Histopathology		-			2	-	-	-	-	-	4	-	2	-	-	1	-	-
Medical Microbiology & Virology				-	-	-	-	-	-	-	-	-	-	-	-	1	-	-
Medical Specialties
Dermatology		1			-	-	-	1	-	-	1	-	-	-	-	-	-	-
General Medicine (Group)		-			-	1	-	-	1	-	2	2	3	2	-	1	-	-
Geriatrics				-	1	-	-	-	-	-	-	-	1	-	-	-	-	-
Neurology		-			-	-	-	-	1	-	-	-	-	-	-	-	-	-
Paediatrics		2			-	-	-	-	-	1	-	-	-	1	-	-	-	-
Obstetrics & Gynaecology		1			-	-	-	-	-	1	1	-	-	1	-	-	-	-
Occupational Medicine		-			-	-	-	-	-	-	-	-	-	1	-	-	-	-
Psychiatric Specialties
Child & Adolescent Psychiatry				1	1	-	2	1	-	-	1	-	1	-	-	-	-	-
Forensic Psychiatry		-			-	-	-	-	1	-	-	-	-	1	-	-	-	-
General Psychiatry				3	-	-	-	-	-	-	1	2	3	4	-	-	-	-
Psychiatry of Learning Disability				-	-	-	-	-	1	-	-	-	-	-	-	-	-	-
Old Age Psychiatry		-			-	-	1	-	-	1	1	-	2	-	-	1	-	-
Psychotherapy				-	-	-	-	-	-	-	2	-	-	-	-	-	-	-
Radiology
Clinical Radiology		-			-	-	-	8	4	2	-	-	2	1	-	-	1	-
Nuclear Medicine		-			-	-	-	-	-	-	-	-	-	-	-	1	-	-
Surgical Specialties
Cardiothoracic Surgery		-			-	-	-	-	-	-	3	-	-	-	-	-	-	-
ENT Surgery				-	1	-	-	1	-	-	-	-	-	-	-	-	-	-
General Surgery		-			1	-	1	-	2	-	-	-	4	-	2	-	-	-
Ophthalmology		-			1	-	-	-	1	-	-	-	1	-	-	-	-	-
Trauma & Orthopaedic Surgery		-			-	-	1	-	-	-	4	-	3	-	-	-	1	-
Paediatric Surgery		-			-	-	-	-	-	1	-	-	-	-	-	-	-	-
Plastic Surgery				-	-	-	-	-	-	-	3	-	-	-	-	-	-	-
Urology		-			-	-	-	-	-	-	1	-	-	-	-	-	-	-
Public health medicine		1			2	-	-	-	-	2	-	1	-	-	-	-	-	2
Community Specialties
Breast Screening Service				-	-	-	-	-	-	-	-	-	-	1	-	-	-	-
Community Child Health				1	-	-	-	-	-	-	-	1	-	-	-	-	-	-

Notes:1. Data is sourced from the ISD(M)4 collection form and is the latest available.2. Information is provided on posts vacant at 30 September 2000 irrespective of when the vacancy arose.3. Includes honorary appointments.4. Only specialties and NHS boards with consultant vacancies are included.

Planning Together, was published alongside our proposals for establishing a comprehensive workforce development infrastructure for NHSScotland at local, regional and national level. This whole systems approach to integrated workforce planning will provide coherent and structured arrangements for addressing the workforce aspects of all services, including the maternity services framework.An action plan will be issued to reflect the feedback gained from the Workforce Development Action Day held on 15 April and to set out a critical path for creating a robust workforce development function, which integrates workforce planning with service planning across all services in NHSScotland.In the meantime, a short-life expert group on maternity services has been convened to determine a model specification for the provision of acute maternity services. As part of its work, this group is examining the workforce needs which arise from the modernisation of maternity services, in line with the principles enshrined in A Framework for Maternity Services in Scotland.

Generally continuing professional development (CPD) is the responsibility of the trusts to support and evaluate, based on service and staff needs, for all staff including nurses and professions allied to medicine (PAMs). However, on occasion the Scottish Executive Health Department provides targeted funding for specific initiatives e.g. the £1.75 million announced for CPD as part of Facing the Future. Decisions have still to be made about how this money will be distributed and evaluated.Other targeted funding such as the Specialists Nursing Initiative, or Clinical Effectiveness funding for PAMs have been monitored to ensure effective use of resources.

The information requested is given in the following table, broken down by qualified and unqualified nursing vacancies by NHS board.Nursing vacancies^1,2 by NHS Board Whole-Time Equivalent: at 31 March 2001

	Total Vacancies	Became vacant in:			Vacancies as a percentage of establishment
		Less than 3 Months	3 Months or more	Unknown	Total	3 months or more
Qualified
Scotland	1,253.1	717.6	192.8	342.8	3.7%	0.6%
Argyll and Clyde2	146.8	60.6	75.1	11.1	6.2%	3.2%
Ayrshire and Arran	52.3	48.1	4.2	0.0	2.2%	0.2%
Borders	19.0	15.0	4.0	0.0	4.2%	0.9%
Dumfries and Galloway	2.6	2.6	0.0	0.0	0.2%	0.0%
Fife	57.0	48.8	2.2	6.0	2.8%	0.1%
Forth Valley	40.1	34.6	5.5	0.0	2.5%	0.3%
Grampian	156.3	122.0	34.3	0.0	4.6%	1.0%
Greater Glasgow2	452.4	190.5	39.6	222.2	5.6%	0.5%
Highland	36.1	25.7	10.4	0.0	2.4%	0.7%
Lanarkshire2	4.9	4.9	0.0	0.0	0.3%	0.0%
Lothian	184.1	136.5	6.2	41.5	3.5%	0.1%
Orkney	4.0	1.0	3.0	0.0	2.9%	2.1%
Shetland	7.0	7.0	0.0	0.0	7.1%	0.0%
Tayside	72.0	6.3	7.5	58.2	2.3%	0.2%
Western Isles	4.8	4.0	0.8	0.0	2.0%	0.3%
Special Health Boards	13.8	10.0	0.0	3.8	4.4%	0.0%
Unqualified
Scotland	391.5	196.6	61.4	133.5	2.5%	0.4%
Argyll and Clyde2	52.6	20.7	31.9	0.0	4.0%	2.4%
Ayrshire and Arran	18.1	18.1	0.0%	0.0	1.6%	0.0%
Borders	0.0%	0.0%	0.0%	0.0	0.0%	0.0%
Dumfries and Galloway	8.6	8.6	0.0%	0.0	1.6%	0.0%
Fife	3.8	3.3	0.5	0.0	0.5%	0.1%
Forth Valley	17.4	17.4	0.0	0.0	1.9%	0.0%
Grampian	22.1	15.5	6.6	0.0	1.5%	0.4%
Greater Glasgow2	138.1	49.6	11.4	77.1	3.8%	0.3%
Highland	5.2	4.2	1.0	0.0	0.9%	0.2%
Lanarkshire2	0.0	0.0	0.0	0.0	0.0%	0.0%
Lothian	88.7	56.7	10.0	22.0	3.7%	0.4%
Orkney	0.0	0.0	0.0	0.0	0.0%	0.0%
Shetland	2.0	2.0	0.0	0.0	4.1%	0.0%
Tayside	10.6	0.6	0.0	10.0	0.8%	0.0%
Western Isles	0.0	0.0	0.0	0.0	0.0%	0.0%
SNBTS	24.4	0.0	0.0	24.4	12.4%	0.0%
State Hospital Carstairs	0.0	0.0	0.0	0.0	0.0%	0.0%

Source: ISD(M)36, ISD Scotland.Notes:1. Excludes nurses in training.2. Lanarkshire Primary Care NHS Trust have not submitted a return and data for Lomond and Argyll Primary Care NHS Trust and North Glasgow University Hospitals NHS Trust were incomplete.3. The vacancy figures relate to posts vacant at 31 March 2001, irrespective of when the vacancy arose.4. Establishment is the sum of Staff in Post, Posts Under Review and Total Vacancies.