Since 2004 NHS 24 has undertaken regular six-monthly patient surveys involving 1,200 randomly selected patients. Respondents are asked a short series of questions about their experience of the service and the return rate is between 25% and 30%. The overall satisfaction rating has been between 86% and 90%.

In addition, in August 2007, Audit Scotland published its report Primary Care out-of-hours services which showed that satisfaction amongst users of NHS 24 and out-of-hours services is high, with 85% of those surveyed indicating that overall they were satisfied with the service they received.

It is estimated that up to one percent of the overall NHS budget could be lost to fraud each year.

NHS boards report identified losses that are recorded on their losses register as part of the annual accounts process in a standard template. Fraud losses are not reported separately but alongside losses from theft, arson and wilful damage. We believe that these reports do not provide a full picture of actual losses sustained by the NHS in Scotland since they relate only to losses incurred and identified. Audit Scotland and NHSScotland Counter Fraud Services also collect information on fraud losses but these do not agree, mainly due to timing and reporting differences. We plan to introduce enhanced reporting by NHS boards of identified/attempted frauds during this financial year.

Free personal and nursing care was introduced in Scotland through the Community Care and Health (Scotland) Act 2002. Local authorities provide personal care services at home, without charge, to people aged 65 and over, or make payments for personal and nursing care to care homes for self funding residents assessed by their local authority as requiring that care. Local authority funded residents also receive personal care without charge.

Information on the number of people who have applied for free personal care is not available. Table 1 provides information on the number of clients aged 65 and over who are receiving free personal care services at home in each year since 2002-03, broken down by local authority. Table 2 provides information on the number of long stay residents aged 65 and over who are receiving free personal care in care homes in each year since 2002-03, broken down by local authority.

Table 1 “ Number of Clients Aged 65+ who are Receiving Free Personal Care Services at Home (2002-03 to 2006-07)

Local Authority	2002-03	2003-04	2004-05	2005-06	2006-07
Aberdeen City	1,470	1,470	1,510	1,590	1,760
Aberdeenshire	1,050	1,210	1,320	1,570	1,810
Angus	720	770	800	800	790
Argyll and Bute	390	480	430	340	440
Clackmannanshire	250	360	370	440	480
Dumfries and Galloway	1,380	1,380	1,380	1,380	1,380
Dundee City	650	780	800	1,250	1,200
East Ayrshire	510	870	1,030	1,100	1,250
East Dunbartonshire	400	600	710	780	830
East Lothian	710	710	740	860	880
East Renfrewshire	480	540	610	710	750
Edinburgh, City of	1,450	1,970	2,310	2,450	2,650
Eilean Siar	320	420	410	450	450
Falkirk	980	1,040	1,190	1,190	1,200
Fife	2,790	3,200	3,290	3,290	3,420
Glasgow city	3,140	4,020	5,260	6,340	4,810
Highland	1,110	1,400	1,600	1,840	1,780
Inverclyde	820	840	920	930	1,050
Midlothian	220	290	320	520	520
Moray	610	680	590	660	760
North Ayrshire	660	830	960	980	1,000
North Lanarkshire	1,330	1,670	2,010	2,900	2,270
Orkney Islands	150	180	190	190	180
Perth and Kinross	320	700	950	1,030	1,010
Renfrewshire	630	770	820	960	1,010
Scottish Borders	710	880	1,040	1,110	1,040
Shetland Islands	170	190	190	170	180
South Ayrshire	1,100	1,130	1,190	1,230	1,330
South Lanarkshire	890	1,100	1,310	1,790	2,160
Stirling	360	420	430	460	450
West Dunbartonshire	430	680	590	980	1,010
West Lothian	1,140	1,310	1,070	960	970
Scotland	27,340	32,870	36,300	41,240	40,810

Source: Quarterly Key Monitoring Survey, Scottish Government.

Note: All figures are rounded to the nearest ten and are yearly averages.

The 2002-03 figures are thought to be an undercount. Many local authorities could not provide figures straight away as systems were being put in place, so early figures were estimated.

Table 2: The Number of Long-Stay Residents Aged 65+ who are in Care Homes and are Receiving Free Personal Care (2002-03 “ 2006-07)

Local Authority	2002-03	2003-04	2004-05	2005-06	2006-07
Aberdeen City	1,670	1,670	1,640	1,630	1,630
Aberdeenshire	1,510	1,460	1,450	1,450	1,390
Angus	730	740	760	710	720
Argyll and Bute	660	630	620	720	720
Clackmannanshire	250	250	250	260	260
Dumfries and Galloway	820	860	820	780	800
Dundee City	830	850	910	850	820
East Ayrshire	720	730	700	710	690
East Dunbartonshire	500	520	530	530	540
East Lothian	550	570	580	570	570
East Renfrewshire	500	450	420	400	330
Edinburgh, City of	2,950	3,030	3,060	3,040	3,010
Eilean Siar	200	190	190	190	190
Falkirk	650	660	700	720	740
Fife	1,960	2,000	2,030	2,060	2,020
Glasgow city	5,030	4,760	4,570	4,530	4,530
Highland	1,500	1,420	1,400	1,440	1,350
Inverclyde	640	620	610	580	540
Midlothian	520	520	490	470	470
Moray	460	430	540	590	550
North Ayrshire	870	860	850	850	830
North Lanarkshire	1,620	1,550	1,480	1,410	1,490
Orkney Islands	90	90	80	100	100
Perth and Kinross	1,170	1,190	1,170	1,140	1,070
Renfrewshire	960	980	1,040	1,040	1,070
Scottish Borders	750	750	750	750	740
Shetland Islands	110	110	110	110	110
South Ayrshire	760	760	780	820	820
South Lanarkshire	1,600	1,630	1,700	1,670	1,660
Stirling	550	560	540	550	520
West Dunbartonshire	520	500	550	570	510
West Lothian	590	590	580	580	600
Scotland	32,250	31,890	31,890	31,810	31,390

Source: Quarterly Key Monitoring Survey, Scottish Government.

Note: All figures are rounded to the nearest ten and are yearly averages.

These residents may be mainly funded by their local authority or may be a self-funder receiving £149 or £216 per week towards their care home fees (until 31 March 2008, £145 and £210 respectively). All of these residents receive personal care services for free.

Neither we within the Scottish Government, nor officials within NHS boards where car parking charging schemes are in place, have any evidence that staff are leaving posts at such hospitals to work at other NHSScotland locations where car parking charges have not been introduced.

It is clear that car parking spaces cannot be provided for everyone and we must strive to achieve an appropriate balance between the needs of patients, visitors and staff in the use of car parking spaces, especially where these are limited because of the constraint of a particular site. We shall continue to ensure that charges are only introduced where appropriate and necessary and that the level of charge is reasonable, with provisions in place for an appropriate allocation of staff car parking permits. Discussions and decisions on car parking policies will continue to be taken forward on a partnership approach to ensure that car parking schemes are applied consistently, fairly and transparently.

NHSScotland boards have for some time been required by the NHSScotland Environmental Management policy to co-operate with local authorities, regional transport partnerships and other stakeholders in the planning and implementation of local and regional transport strategies. By engaging in this way, we seek to ensure that through integrated transport policies NHSScotland facilities, in particular new developments, are accessible to all by public transport, as well as by other means such as walking and cycling.

Boards are also required to develop site-specific travel plans as a requirement of the Scottish Government's national transport strategy. These plans are required by the end of April 2008, although many have been in place for a number of years, and seek to comply with the Scottish Government's long-term vision, objectives, priorities and plans for travel management.

The following table shows the proportion of staff with car parking permits at those NHSScotland hospital sites where car parking charges have been introduced.

The criteria used in the allocation of staff car parking permits has always been a matter to be determined locally and the revised guidance issued in January supports this approach but emphasises that such criteria should only be developed and agreed in discussion on a staff partnership basis. Each board's area partnership forum or equivalent is likely to be the best forum for such discussions, drawing upon local expertise of the relevant services, HR managers and occupational health staff as appropriate. The criteria should take account of good employment practice, that car use may be essential to the delivery of services and personal circumstances which may justify the use of a car to travel to work, including ill health and disability and significant continuing domestic or carer commitments.

The revised guidance also requires that the criteria used in determining who should be granted a permit is applied consistently and transparently and that staff are provided with clear, accessible and widely available information on site-specific procedures for the allocation and issue of car parking permits and any concessions available.

Proportion Of Staff Within Parking Permits
Board	Hospital	% Staff with Permits
Greater Glasgow and Clyde	Southern General	17
	Gartnavel General	29
	Victoria Infirmary	8
	Western Infirmary	13
	Yorkhill	12
NHS Lothian	Western General	17.5
	Royal Infirmary	34
	Royal Hospital for Sick Children	5.5
	St John's	100¹
NHS Grampian	Foresterhill	20²
	Dr Gray's	n/a
NHS Tayside	Ninewells	20
NHS Highland	Raigmore	35³

 

Notes:

1. When traffic management arrangements were first introduced within West Lothian all staff applications for permits for St John's Hospital were granted including those from community staff and staff based outwith St John's but legitimately and regularly visiting the site. The practical effect of this is that considerably more staff than simply those based at St John's have permits “ the actual percentage of staff with permits equates to 138% of the St John's-based staff.

2. Refers to priority permits only “ staff who do not qualify for these permits are automatically entitled to a general permit available for use in public car parks.

3. All staff are entitled to a permit but no guarantee that a parking space will be available.

For those boards where car parking charges are currently in place, we shall be reviewing their current car parking schemes against the principles and criteria set out in the revised guidance. Accordingly, we have asked for reports from these boards by 30 June 2008 and once these reports have been considered we shall issue a full policy statement on the provision of car parking at NHSScotland facilities and our proposals for updating the existing guidance.

Guidance was issued on 29 March 2005 to the health boards and GPs that the NHS (General Medical Services Contracts) (Scotland) Regulations 2004 were to be amended to prevent the use of national or premium rate telephone lines. These were considered to be an unacceptable barrier to access to a service which is otherwise provided free. The amendment came into effect on 1 July 2005.

We work closely with the Scottish Public Services Ombudsman and the Scottish Health Council to ensure that the NHS complaints procedure is easy to use and effective.

We have recently commissioned the Scottish Health Council to carry out a full evaluation of the first three years of operation of the revised NHS complaints procedure.

Statistical information on complaints made under the NHS Complaints Procedure, broken down by NHS board and by financial year, is published annually and can be found at http://www.isdscotland.org/isd/4362.html.