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The question relating to the spend on drugs used in the treatment of obesity-related conditions cannot be answered from data held centrally.

The current edition of the British National Formulary states that ‘obesity is associated with many health problems including cardiovascular disease, diabetes mellitus, gallstones and osteoarthritis’. However, this is not the sole cause of these other conditions. Therefore the percentage of the NHS Drugs spend in the community on obesity-related conditions cannot be accurately measured. What can be measured is the spend and percentage of the primary care drugs bill which has been spent on medicines used in the treatment of obesity.

The spend on drugs used in the treatment of obesity as a proportion of the total drug spend in Scotland is shown in the following table for each of the last five financial years. Spend is represented by the paid gross ingredient cost (GIC).

Source: ISD Scotland Prescribing Information System (PIS).

Note:

1.Relates to items dispensed in the community.

All ministerial engagements are proactively published on the Scottish Government Website.

This information is not available in the format requested. Estimates for age groups (a) 2-4 year olds, (b) 5-15 year olds and (c) adults aged 16+ are provided in the following tables from the Scottish Health Survey.

Prevalence of overweight and obesity among males in Scotland, 2008-11

Source: Scottish Health Survey

1. Overweight adults with BMI greater than 25 and less than 30. Overweight children with BMI between the 85^th and 95^th percentile of the reference population.

2. Obese adults with BMI greater than 30. Obese children with BMI greater than the 95^th percentile of the reference population.

Prevalence of overweight and obesity among females in Scotland, 2008-11

Source: Scottish Health Survey

1. Overweight adults with BMI greater than 25 and less than 30. Overweight children with BMI between the 85^th and 95^th percentile of the reference population.

2. Obese adults with BMI greater than 30. Obese children with BMI greater than the 95^th percentile of the reference population.

The information requested is given in the following table. These are the numbers of deaths, registered in Scotland in the latest five years for which final figures are currently available, for which the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code for Obesity (E66) was recorded for either the underlying cause of death or for one of the factors which contributed to the death, due to obesity or an equivalent term having been mentioned on the death certificate.

Deaths in Scotland for which Obesity (ICD-10 code E66) was mentioned on the death certificate: 2007-11

There are no renewable targets in the Climate Change (Scotland) Act 2009.

Organising appointments and scheduling admissions to hospital is an operational matter for NHS boards. It has always been common practice to slightly overbook outpatient clinics to take account of the small number of patients who may not turn up on the day. This ensures that the most efficient use of clinical resources and ensure that all patients are seen as swiftly as possible.

As independent contractors, GP practice partners are responsible for designing their own practice appointment systems to meet their service obligations. They are also responsible for ensuring that their reception staff are fully trained in prioritising appointment requests and making such bookings appropriately in accordance with practice procedures.

Effective Patient Booking for NHS Scotland was issued by the Scottish Government in August 2012. This guidance promotes and identifies how NHS Boards should apply the principles of effective patient focussed booking practice consistently to offer appointment choice for patients throughout Scotland.

In addition, further guidance has also been provided to boards in the attached link:

www.sehd.scot.nhs.uk/mels/CEL2012_33.pdf. which sets out some of the other key principles of patient choice including such areas as suitable alternative providers and reasonable offers of appointments.

Under local arrangements for interpreting services NHS boards will agree a minimum fee to be paid to the interpreter in the event that the patient does not attend.

Access to orphan medicines has been a key focus of the Health and Sport Committee and the New Medicines Review. The Scottish Government will carefully consider any recommendations for improvement to the existing arrangements from the New Medicines Review and the Health and Sport Committee.

In the Scottish Medicines Consortium (SMC) assessment process, the benefits of treatment (measured in Quality Adjusted Life Years (QALYs) will have been estimated from all patients in the clinical trial(s). These patients often cover a wide age range. When the single “cost per QALY” that informs the decision is arrived at, this will have been summed up to reflect the average across patients of all ages and thus is not specific to only one age group. This approach mitigates against any discrimination on the basis of age.

The cost per QALY is a factor in SMC decision making but the Committee will also consider the views of clinical experts and patient interest groups and SMC modifiers can be applied if appropriate.