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Monitoring care & treatment

Quarterly statistics - first and second quarters, 2007

These provisional statistics were collected by the Commission for the periods 1 January to 31 March, and 1 April to 30 June 2007. Scroll down the page for detailed reports.

Summary

Emergency and short-term detention

The number of new civil orders granted by quarter has stabilised over the latest two quarters (Figure 1). The Code of Practice, which supports good practice under the Act, makes it clear that the preferred route for a person into compulsory treatment is through the use of a short-term detention certificate. This route provides better safeguards for the patient.

The total number of detention episodes, initiated through emergency and short-term detentions, is lower in the two quarters from January to June 2007 compared with the previous two quarters (Table 57a). In all four quarters reported below, approximately half the people subject to emergency detention were admitted directly from the community, while the rest were informal inpatients (Table 58). People on short-term detentions coming directly from the community accounted for 21 and 26% (respectively) of all cases in the last two quarters. These patterns have not changed significantly between quarters.

For Scotland as a whole, just under half of all emergency detention certificates were granted out of hours, and with MHO consent, in both quarters (Tables 79 and 80). Just under one third of EDCs in Scotland did not have MHO consent. Tables 79 and 80 show variations between health board areas.

Community-based compulsory treatment orders (CCTOs)

The number of quarterly variations of CTOs from hospital to community-based orders has fallen slightly, while numbers of new community-based CTOs appear to be stable by quarter (Table 2). The rate of increase of people subject to CTOs based in the community is slowing, compared with previous census dates (Table 64). The number of people subject to community CTOs, who are temporarily recalled to hospital, has increased since the first quarterly report. Relating these recall figures to the prevalence of community CTOs (see Table 64), it is clear that the proportion of people on CCTOs who are recalled has increased, from 7% in July to September 2006 to 11% in April to June 2007. This may reflect increasing awareness of these measures.

Detentions by local authority and health board areas

In most areas, the numbers of orders have fluctuated over the period covered in this report. Rates of detention per 100,000 population vary considerably between health boards. Excluding island areas, emergency detention rates vary from 16 (NHS Borders) to 60 (NHS Dumfries & Galloway). Short-term detention rates vary from 40 (NHS Borders) to 79 (NHS Greater Glasgow and Clyde). The rates of short-term orders granted range from 28 per 100,000 population in North Lanarkshire, to 103 in Glasgow City (excluding the island authorities). The range of rates has remained fairly consistent since January to March 2006 (see previous quarterly report).

Young People

The number of admissions of under 18s to non-specialist facilities reported to us has dropped in the last two quarters (Figure 2). The total for the January to March 2007 quarter is 45 cases; the total for the April to June quarter is 31. We think any such admissions to hospitals across Scotland are undesirable. We want to see health boards fulfil their duty to provide appropriate services for all young people requiring admission for psychiatric treatment.

The Commission plans to visit all individuals admitted under the age of 16, and 16-17 year olds who have been detained in accommodation which is not age-appropriate. See HDL 2005 (55) (.pdf) advising health boards of duties in relation to this monitoring.

Advance Statements

The Commission has recognised that it is a priority to monitor this aspect of the Act, but, as advance statements have been little used, the number of over-rides doesn't tell us much about patient wishes being upheld. The number of times advance statements are overridden is fairly consistent by quarter (around 12). We think the potential of advance statements hasn't been fully realised by practitioners and service users and we would like to see practice develop in this area. We will be examining the different types of over-rides in more detail this year.

Point prevalence information

This is information about people subject to compulsion on a particular census date (5th October 2006). The most noticeable feature is that the number of people subject to community-based CTOs is higher than previous census dates. A total of 2,445 people were subject to compulsion on the census date. Of these, 873 (36%) were women. The 'orders granted' reports for October to December (Tables 4 and 5) show that 53% of all new compulsory powers reported in the most recent quarter involved women. This suggests that women are less likely to remain as detained patients. Their orders are more likely to be revoked or allowed to lapse. The age distribution differs between men and women who are detained. For example, there are more men in the 25-34 age band by proportion than women; and more women in the 65-84 age band than men. Detention rates by health board area vary by order type. Excluding island health boards, community-based CTOs range from 1.3-8.8 per 100,000 population; hospital-based CTOs range from 14.0-33.9 per 100K.

Adults with Incapacity Act activity

The total number of applications for welfare guardianship made in the first and second quarters of 2007 is 310 and 288 respectively. The Commission was notified of 290 welfare guardianship orders granted during the first quarter, and 225 granted during the second quarter. In the next report we will report on trends over four quarters. For Scotland as a whole, the number of local authority and private applications is quite similar (Tables 70 and 71). For some local authorities, however, the two rates differ significantly. 52 and 55% of applications were made by relatives or carers in these two quarters, respectively (see Table 73). This proportion has increased from 40% in the previous quarter. In 22 and 24% of all orders granted, an interim order was sought (Table 72). 39 and 43% of all orders included welfare and financial powers, as opposed to welfare powers alone (Table 74). For three consecutive quarterly periods, 61% of all orders granted related to women, 77 and 79% of whom were over 65 years old.

74 and 77% of orders were granted for an indefinite duration. A range of powers were granted falling into 12 categories (Table 78). In 98 and 99% of orders granted, the power to determine care and accommodation (or where adult should reside) was included.

Criminal Proceedings

This is the first time we have reported on this activity by court area (Table 57). The numbers of criminal proceedings granted is too small to demonstrate quarterly trends (Table 1).

Ethnic Monitoring

The proportion of returns of ethnic minority monitoring forms is not yet sufficient for reporting purposes. We continue to be concerned that we are not able to report on this.

Detailed statistics

Note: Population figures provided by General Register of Scotland, revised estimates, as at June 2006. We cannot be absolutely certain that the quarterly figures notified to the Commission, and consequently reported by our IT system, are correct at date of publication. We will be working with the range of agencies responsible for supplying us with information to verify our statistics over the year. Please see our Annual Reports for finalised figures.

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