Questions and answers

Question reference: S3W-24140

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 20 May 2009
Current Status: Answered by Nicola Sturgeon on 1 June 2009

To ask the Scottish Executive, further to the answer to question S3W-23008 by Nicola Sturgeon on 11 May 2009, to what it attributes the increase, in the last year, in the number of patients discharged from NHS hospitals as a result of death who had a diagnosis of malnutrition and what steps are being taken to reduce such cases.

NHS Scotland is now required to screen all patients on admission to hospital for the risk of undernutrition. As a result, it is likely that there has been an increase in the recording of malnutrition as a contributory cause of death on death certificates. In addition, improvements in the completeness of coding (the numbers of diagnoses that are recorded) may also artificially increase the number of recorded cases of malnutrition on hospital discharge records.

The figures published in answer to S3W-23008 show all deaths where malnutrition is the principle, or contributory, cause of death. The following table details the number of deaths directly attributable to malnutrition. The numbers of deaths in hospital directly attributable to malnutrition have remained relatively stable.

Number of Patients Who Died in Hospital and Had a Principle Diagnosis of Malnutrition Year Ending 31 March 1998-2008

	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008
All Scotland	4	8	9	8	11	8	12	12	8	4	7

The Scottish Government is taking forward a comprehensive programme to improve and enhance the nutritional care of patients in hospital backed by £1.5 million of new investment:

Screening all patients on admission to hospital for the risk of undernutrition and putting in place a care plan to meet the needs of those with, or at risk of, malnutrition.

Introducing Food in Hospitals, the National Catering and Nutrition Specification for Food and Fluid provision in Scotland, 2008, which assists NHS boards to deliver a healthy balanced diet to all patients.

Providing £1.08 million to support nutrition champions in NHS boards for a period of two years to support the NHS board in the delivery of the Food, Fluid and Nutrition agenda.

Senior charge nurses playing an important role in ensuring these patients are given care and support to improve and maintain their nutrition where appropriate.

Protected meal times also ensure that patients are not interrupted unnecessarily and also allows nursing staff more time to spend with patients who need assistance to eat and drink.

This work links directly with the development of Clinical Quality Indicators, one of which is for food, fluid and nutrition, currently being implemented across NHS Scotland.

Question reference: S3W-24141

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 20 May 2009
Current Status: Answered by Nicola Sturgeon on 1 June 2009

To ask the Scottish Executive, further to the answer to question S3W-23008 by Nicola Sturgeon on 11 May 2009, to what it attributes the number of patients discharged from NHS hospitals with a diagnosis of malnutrition and what steps are being taken to reduce such cases.

Question reference: S3W-24145

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 20 May 2009
Current Status: Answered by Nicola Sturgeon on 1 June 2009

To ask the Scottish Executive how much hospital food was wasted in the NHS expressed (a) in cash terms and (b) as a proportion of total expenditure on meals in the last 12 months, broken down by NHS board and also by hospital.

Question reference: S3W-24148

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 20 May 2009
Current Status: Answered by Nicola Sturgeon on 1 June 2009

To ask the Scottish Executive which NHS hospitals prepare patient meals onsite and which distribute meals prepared elsewhere.

Question reference: S3W-23008

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 15 April 2009
Current Status: Answered by Nicola Sturgeon on 11 May 2009

To ask the Scottish Executivehow many patients were (a) diagnosed with and (b) found to have died from malnutrition while in the care of (i) the NHS and (ii) a local authority run care home in each year since 1997, broken down by NHS board and local authority respectively.

Centrally held information can provide details for patients where malnutrition is identified on their hospital or death records. These figures may represent an undercount of the true number of cases because malnutrition as an underlying reason for admission to hospital or cause of death may not always be recorded or coded by coding staff.

The definition of malnutrition employed in this analysis includes diagnoses of nutritional deficiencies (e.g. vitamin A, thiamine and calcium deficiencies), nutritional anaemias and malnutrition related diabetes mellitus.

The tables present the number of patients discharged from acute hospitals in Scotland with a diagnosis of malnutrition (table 1) and the number of patients discharged as a result of the patient''s death from acute hospitals in Scotland with a diagnosis of malnutrition (table 2).

Information on the number of people who have died from malnutrition while in the care of a local authority run care home is not available from central statistical sources and so is not presented.

In January 2008, the Scottish Government set up an integrated programme to improve and enhance the nutritional care of people in hospitals. This programme has resulted in a toolkit and educational framework which includes a malnutrition assessment and nutritional pathway, along with a national nutrition and catering specification. The Scottish Government has also funded a programme to improve nutrition in care homes.

Table 1: Number of Patients Discharged from Hospital with a Diagnosis of Malnutrition in NHS Scotland, by NHS Board of Residence; Year Ending 31 March 1998-2008

	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008
All Scotland	1,805	1,842	1,828	1,668	1,624	1,786	1,791	1,884	1,999	1,946	1,884
Ayrshire and Arran	109	109	145	135	130	168	128	117	121	117	127
Borders	43	53	39	29	45	40	60	34	34	55	59
Dumfries and Galloway	88	104	119	105	93	101	95	95	102	76	122
Fife	45	48	75	77	98	105	112	128	131	130	157
Forth Valley	60	56	80	83	92	94	57	65	54	47	30
Grampian	65	68	69	68	54	52	82	95	97	107	120
Greater Glasgow and Clyde	596	636	515	465	398	443	451	526	521	536	434
Highland	71	70	88	78	90	96	90	106	142	134	120
Lanarkshire	271	294	290	274	189	209	175	160	157	198	174
Lothian	311	247	227	201	310	344	410	435	534	443	443
Orkney Islands	5	2	3	1	2	4	5	5	8	6	8
Shetland Islands	5	2	7	5	3	3	5	6	6	7	8
Tayside	129	132	161	139	115	117	118	106	87	78	76
Western Isles	7	21	10	8	5	10	3	6	5	12	6

Source: Information Services Division (ISD) Database SMR01.

Table 2: Number of Patients Discharged from Hospital Due to Death with Diagnosis of Malnutrition in NHS Scotland, by NHS Board of Residence; Year Ending 31 March 1998-2008

	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008
All Scotland	51	84	85	86	93	96	93	106	110	91	110
Ayrshire and Arran	1	10	9	7	11	6	8	10	10	11	7
Borders	2	1	3	1	1	1	3	3	3	2	3
Dumfries and Galloway	-	5	2	4	6	5	6	5	4	3	3
Fife	4	4	8	8	13	11	10	10	10	4	17
Forth Valley	2	10	6	9	10	8	7	5	4	4	5
Grampian	1	4	5	6	3	5	2	3	9	7	11
Greater Glasgow and Clyde	16	12	22	23	19	27	24	28	32	18	24
Highland	5	6	7	3	4	6	4	4	6	8	5
Lanarkshire	4	9	4	6	1	7	4	6	8	7	12
Lothian	12	12	11	10	13	12	19	23	17	20	17
Tayside	4	9	8	8	12	6	6	8	7	7	5
Island Boards	-	2	-	1	-	2	-	1	-	-	1

Source: ISD Database SMR01.

Question reference: S3W-22288

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 24 March 2009
Current Status: Answered by John Swinney on 29 April 2009

To ask the Scottish Executive how much each local authority spends on (a) wages and salaries and (b) external contractors, expressed (i) in cash terms and (ii) as a proportion of the total local authority expenditure.

The information on wages and salaries for 2007-08 is in the following table. Local authorities'' expenditure on external contractors is not held centrally.

Local Authorities'' Employee Costs 2007-08

	Employee Costs (£000)	Employee costs as a % of gross expenditure
Scotland	6,846,523	43.9%
Aberdeen City	266,945	45.1%
Aberdeenshire	288,288	47.3%
Angus	133,701	44.2%
Argyll and Bute	122,426	39.8%
Clackmannanshire	64,062	44.6%
Dumfries and Galloway	168,922	39.6%
Dundee City	234,429	49.4%
East Ayrshire	164,975	48.6%
East Dunbartonshire	127,468	47.9%
East Lothian	110,423	44.4%
East Renfrewshire	120,681	49.2%
Edinburgh, City of	563,474	41.2%
Eilean Siar	63,383	45.8%
Falkirk	193,749	46.9%
Fife	471,181	48.1%
Glasgow City	809,287	33.1%
Highland	330,943	47.9%
Inverclyde	128,187	45.5%
Midlothian	108,481	47.4%
Moray	111,813	46.6%
North Ayrshire	173,106	43.1%
North Lanarkshire	422,468	46.6%
Orkney Islands	43,294	43.3%
Perth and Kinross	165,855	45.7%
Renfrewshire	234,816	46.6%
Scottish Borders	147,336	47.3%
Shetland Islands	80,524	54.7%
South Ayrshire	149,339	47.6%
South Lanarkshire	370,535	44.6%
Stirling	117,594	47.1%
West Dunbartonshire	149,772	48.7%
West Lothian	209,063	48.7%

Source: Local Financial Returns 2007-08

Note:

1. Police and fire expenditure is apportioned to councils using the amount that the Joint Boards requisition from them.

2. Expenditure on council tax and non-domestic valuation and registration of electors is apportioned to councils using the amount that the Valuation Joint Boards requisition from them.

3. Regional Transport Partnerships expenditure is apportioned to councils by population (GROS 2007 mid-year estimates).

The relatively low percentage of employee costs as a percentage of gross expenditure for Glasgow is due to the creation of a number of Arms Length External Organisations. These were created as part of the council''s on-going programme of service reform. The greatest impact on employee costs has been in relation to the transfers of Building Services and Culture and Related Services.

Question reference: S3W-22287

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 24 March 2009
Current Status: Answered by John Swinney on 14 April 2009

To ask the Scottish Executive what the total revenue budget is for each local authority in 2009-10.

Question reference: S3W-22004

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Monday, 16 March 2009
Current Status: Answered by John Swinney on 30 March 2009

To ask the Scottish Executive what the mileage rate is for reimbursing its employees for work-related journeys made by car and, if there are differing rates, who is entitled to each rate.

A mileage allowance is payable when Scottish Government staff use their private motor vehicles for travel on official business. The use of private motor vehicles, however, should only occur when it is established that an official allocated vehicle, a hired car or public transport is either not available or practicable. The current mileage rates apply to all staff and are as follows:

Motor Vehicle Mileage	40 pence per mile
Motor Cycle Mileage	24 pence per mile
Leased Car Mileage	8 pence per mile (this does not apply to self drive hired cars or officially allocated self drive cars)
Passenger Supplement	5 pence per mile for each passenger travelling
Equipment Supplement	2 pence per mile

Question reference: S3W-22007

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Monday, 16 March 2009
Current Status: Answered by Nicola Sturgeon on 27 March 2009

To ask the Scottish Executive, further to the answers to questions S3W-20359 and S3W-21586 by Nicola Sturgeon on 23 February 2008 and 16 March 2008 respectively, for what reason it did not provide the 2008 figures in answer to the earlier question.

The information presented in the answer to question S3W-20359 was extracted from a snapshot of the national Scottish Morbidity Record (SMR) file taken during January 2009. Initial data for December 2008 had not, at that time, been submitted to the national file and therefore the Information and Statistics Division of NHS National Services Scotland (ISD) were not in a position to provide 2008 figures.

The information presented in the answer to question S3W-21586 was extracted after the February update to the national file when initial December 2008 data had become available. These 2008 data are provisional.

As stated in the questions S3W-21983 and S3W-21984, SMR01 data returns relating to the private sector are known to be significantly incomplete. In July 2008 NHS boards were asked to ensure submission of complete and accurate data. In addition the ISD data return relating to the private health care includes independent hospitals, hospices and care homes run by local authorities and charities.

I refer the member to the answer to question S3W-21983 on 27 March 2009. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

Question reference: S3W-21801

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 12 March 2009
Current Status: Answered by Michael Russell on 25 March 2009

To ask the Scottish Executive what discussions it has had with HM Government and other key stakeholders with a view to helping to reduce the number of maternal and neonatal fatalities in developing countries.

The Scottish Government is an active member of the steering group to take forward Health is Global: A UK Government Strategy and officials have participated in meetings with colleagues in the relevant UK Departments involved in the strategy. This reinforces Scotland''s commitment to tackling global health issues and meeting the Millennium Development Goals of developing countries, including that of maternal health.

More specifically, as part of our international development programme maternal and neonatal health is an area which the Government of Malawi has highlighted as a priority for Scottish Government support. We have continued our support for this important area, working with key stakeholders in Malawi and Scotland, and in January this year we announced further funding for projects which will work to reduce maternal and neonatal mortality.

Seòmar agus comataidhean