Scottish Parliament

Response from Sir Robert Chote to Dr Sandesh Gulhane MSP – Waiting time statistics

Dear Dr Gulhane,

Thank you for your letter of 9 November asking us to investigate concerns about statistics on Accident and Emergency (A&E) waiting times in Scotland. The Scottish Government has a target that 95 per cent of people attending A&E should be seen within four hours.

Your letter refers to an article in the Scotsman, which points out that an estimated 2,000 patients who present at the Acute Assessment Unit (AAU) of Glasgow’s Queen Elizabeth University Hospital each month are excluded from Public Health Scotland’s (PHS) monthly waiting times statistics. The author suspects there may be inconsistencies in data collection here because patients presenting at an apparently similar Assessment Unit – the Medical Assessment Unit (MAU) at the Western General Hospital in Edinburgh – are included.

The monthly A&E statistics (and the Government target) cover all types of A&E site, including Emergency Departments, Minor Injury Units, and smaller community casualty sites. Virtual attendances and activity taking place in trolleyed areas of assessment units, which are often located alongside A&E departments, should also be included. Patients admitted to staffed beds in an Assessment Unit (rather than spending time on trolleys or chairs) are considered Emergency Admissions rather than A&E attendances and should be included in separate Inpatient and Day Case Statistics to which the four hour A&E access standard does not apply.

A&E statistics for the Western General Hospital include activity for both the Minor Injuries Unit and trolleyed areas of the MAU. For the Queen Elizabeth University Hospital, patients coming into trolleyed areas of the AAU via the Emergency Department should be included in the statistics. We understand from PHS that, due to limitations of the current data collection, activity in trolleyed areas of assessment units cannot be differentiated in the data. Therefore, statistics for the AAU are not reported separately but should be included as part of the overall A&E activity reported for the hospital. PHS has acknowledged this issue and is undertaking further work to assess whether or not all relevant activity in this assessment unit is being included in A&E submissions it receives.

In addition to the monthly A&E statistics, Public Health Scotland also publishes weekly waiting times statistics, which are often used by the media to report and compare hospital performance against the Scottish Government target. However, these are confined to Emergency Departments, which PHS defines as “large hospital departments which typically provide a consultant-led, 24-hour service with full resuscitation facilities and designated accommodation for the reception of emergency patients”.

The way in which services and facilities are defined in the monthly and weekly statistics is clearly very important to understand from a user perspective, especially in the context of the Government target. Background information and a glossary are available online, but the recent confusion suggests that they should be made more accessible and transparent for users. The Office for Statistics Regulation has suggested this to PHS. It has also asked PHS to communicate more clearly any caveats regarding data collection issues across various sites.

Separately, you raised a concern that initiatives adopted by individual hospitals may result in inconsistencies in the statistics. This recent Herald article claims that NHS Tayside fares well in the statistics due to a ‘continuous flow’ model at Ninewells Hospital, which means that some patients who would be waiting on trolleys to be seen in A&E elsewhere wait instead on trolleys in the acute medical receiving unit – where they do not count towards the waiting times estimates. It is not for us to say how hospitals should manage their emergency admissions policies, but the Office for Statistics Regulation has urged PHS to make it clear where this is likely to create difficulties in comparing waiting time statistics across hospitals and boards.

Finally, it is important to ensure that PHS guidance on data collection and classification is applied consistently across health boards. PHS has advised us that it is reviewing this guidance due to the increasing emergence of new clinical pathways to A&E. The Office for Statistics Regulation will continue to engage with PHS as it does so and as it responds to our feedback on the presentation of its statistics.

The issues raised in this case around difficulties making comparisons on NHS data in Scotland are indicative of a longstanding broader challenge in getting comparable data on healthcare provision across the UK, between nations and within them. It is important that users of statistics are able to compare the performance of the NHS across the UK on issues such as the waiting times for emergency care, and I encourage statistical producers to take this into account as they develop their statistics.

Yours sincerely,

Sir Robert Chote

Response from Sir Robert Chote to Alex Cole-Hamilton MSP – Scottish renewable energy statistics

Dear Mr Cole-Hamilton,

Thank you for your letters of 14 November and 28 November regarding statistics on renewable energy in Scotland. You asked us to consider the claim that Scotland has 25 per cent of Europe’s renewable energy potential and cited several examples. Upon reviewing these, we identified that the precise claim made is that Scotland has 25 per cent of Europe’s potential offshore wind resource and it is this claim that we have examined.

This claim is based on external research reports rather than official statistics. This is outside our formal remit, but we have investigated these issues because, as a general principle, we consider that high profile numerical statements should be supported by sound evidence and clearly identified sources.

The claim originated in a 2010 publication by the Scottish Government, drawing on estimates that Scotland has an offshore wind potential of 25GW and Europe one of 102GW. However, these figures are derived from separate studies that are both more than 20 years old and not directly comparable:

The estimate of Scotland’s offshore wind potential^[1] included all resource at least 5km from the shoreline in waters up to 30m deep, and assumed a turbine density of 8 MW per square km. It did not consider technical, navigational, or environmental issues that may affect installation of turbines.
The estimate of Europe’s offshore wind potential only included waters up to 20m deep, and assumed a turbine density of 6 MW per square km. It included only 10 per cent of the resource 0-10km from the shoreline, 50 per cent of the resource 10-30km from the shoreline and none beyond 30km. According to the report, they were based on a “very conservative approach” to come up with the likely “exploitable resource”. The figure is also based on just 11 countries from the then European Community and excludes countries like Norway, Sweden and Finland which have large offshore wind potential.

In summary, the calculation for Europe’s offshore wind potential was much more restrictive than that for Scotland. So, when the figures are used together, they give an inflated picture of Scotland’s potential relative to the rest of Europe.

We understand that Scottish Government and Ministers are already aware that this 25 per cent figure is inaccurate. On 15 November, the Minister for Green Skills, Circular Economy and Biodiversity, Lorna Slater (Scottish Greens), acknowledged in Holyrood that the figure was “outdated”, but not that it was poorly constructed.

It is good practice for elected representatives to correct their use of official statistics. My office is engaging with the Scottish National Party about its ongoing use of the claim and with the offices of those who have recently used it to emphasise the importance of using quantitative evidence appropriately. The Office for Statistics Regulation is also engaging with colleagues in Scottish Government to understand what more can be done to avoid further use of this claim and to obtain a more accurate and up to date figure for Scotland’s offshore wind potential in comparison to Europe.

Yours sincerely,

Sir Robert Chote

[1] Scotland’s Renewable Resource 2001 [no longer available in full online], Garrad Hassan, 7 December 2001

Alex Cole-Hamilton MSP to Sir Robert Chote – Scottish renewable energy statistics

Dear Sir Robert,

I am writing with regard to the serial misuse and mismanagement of a recently debunked renewable energy statistic by a succession of Scottish National Party and Scottish Green Party ministers and politicians and in Scottish Government documents.

The claim has been that Scotland has 25% of Europe’s renewable energy potential. However research by the thinktank These Islands has demonstrated that this statistic was based on a bogus analysis of a mixture of reports dating all the way back to 1993, when the technology was in its infancy, and using a definition of Europe that excluded renewable powerhouses like Sweden, Norway and Finland. It wasn’t the case that it was accurate in 2010 as a Scottish Government spokesperson claimed last week – it was never accurate.

Freedom of information requests have also revealed that civil servants have been privately warning against its use for at least two years, warning it has “never…been properly sourced” and that the figures had been recycled “robotically without really checking them”.

Nevertheless, this is a claim that has been made by First Minister Nicola Sturgeon, the Westminster leader of the Scottish National Party Ian Blackford, successive Scottish Government environment secretaries, former SNP First Minister Alex Salmond and deputy First Minister John Swinney amongst others. It featured multiple times in the recent SNP-led debate on independence in the House of Commons a fortnight ago.

This matters because this Scottish Government has put this claim at the heart of the debates around Scotland’s energy security, on independence and on meeting our climate targets, including it in their National Strategy for Economic Transformation as recently as March 2022.

I have suggested publicly that the Scottish Government should make a statement to Parliament acknowledging that this figure was not accurate and committing not to repeat the claim further. However, that still leaves unresolved the fact that this bogus fact has littered the public and parliamentary records for years. I would appreciate guidance from the UK Statistics Authority as to what good practice the Government should undertake to clear up the public and parliamentary records.

Should, for example, the government be expected to provide a true figure to inform future debates on renewables generation? Should notes be affixed to the official parliamentary report, acknowledging that this fact is untrue? Should documents such as the National Strategy for Economic Transformation be amended and the corrections made clear?

I fully support the expansion of Scotland’s renewable sector and I desperately want to see Scotland fulfil our renewable potential. But the strong case for that isn’t helped when the figures used by the Scottish Government leave it open to the charge of misleading and misrepresenting. I would appreciate input from the UK Statistics Authority as to how this might be corrected and avoided in future.

Yours sincerely,

Alex Cole-Hamilton MSP

Dr Sandesh Gulhane MSP to Sir Robert Chote – Waiting time statistics

Dear Sirs,

As an MSP for the Glasgow Region and Scottish Conservative Shadow Cabinet Secretary for Health and Social Care, I write with concern regarding the article published in The Scotsman yesterday which discloses allegations by a whistle-blower that patients who present at the Acute Assessment Unit (AAU) of Glasgow’s Queen Elizabeth University Hospital (QEUH) are deliberately not included in Accident and Emergency Department waiting time statistics. The article estimates that 2,000 patients each month are being omitted from the QEUH’s waiting time statistics. Such patients are likely to include those with potentially serious and life-threatening illnesses.

The article highlights that waiting time statistics for the Western General Infirmary in Edinburgh do include patients presenting at their medical assessment unit. This, of course, raises grave concerns over a lack of consistency in the application of PHS guidance in the collection and processing of data across Scotland. If the allegations of the article are founded, the public is clearly not being informed of the true extent of A&E waiting times across the country. At best this may be considered as unprofessional collating of information, at worst
some may regard this as a deliberate action to corrupt the data.

These latest allegations follow earlier reports that statistics from NHS Tayside do not accurately reflect true waiting times as A&E patients are moved to trolleys elsewhere in the hospital under a ‘continuous flow’ policy – meaning they do not form part of A&E waiting time statistics.

I would be grateful if these matters could be investigated by the UK Statistics Authority and if appropriate, the necessary steps taken to ensure the accurate and consistent collection and reporting of data across Scotland.

Yours sincerely,
Dr Sandesh Gulhane MSP

Sir Robert Chote to Stephen Kerr MSP – Renewable energy

Dear Mr Kerr,

Thank you for your letter to the National Statistician about renewable electricity in Scotland. I am responding as Chair of the UK Statistics Authority. You asked us to consider a claim by the Scottish National Party that almost all of Scotland’s electricity needs are met by renewable generation.

As you say, this claim has been challenged by fact-checking organisations. Subsequently, the First Minister has identified this as an error and provided a correction to a speech made in the Scottish Parliament on 29 September. The corrected text reads “Under this Government, the equivalent of 98.8% of our gross electricity consumption is already provided by renewable energy sources. [emphasis added].” It is always welcome when elected representatives correct or clarify their use of official statistics, especially when, as in this case, the figure represents a complex mixture of different statistics.

In 2020, 51,865 GWh (gigawatt hours) of electricity was generated in Scotland, of which 32,121 GWh was from renewable sources such as wind, solar, and hydroelectric. Electricity is transferred between Scotland and England through the National Grid and to Northern Ireland though undersea cables, and the direction of these transfers varies hour by hour according to supply and demand across Great Britain. In 2020, this resulted in a net transfer of 19,347 GWh out of Scotland². Therefore, gross electricity consumption in Scotland (electricity generated less net transfers) was 32,518 GWh, or approximately equal to renewable generation.

However, as a gross measure, this does not mean that all the electricity used in Scotland came from renewable sources. The most recently available data show that in the year October 2021 to September 2022, 63.1 per cent of the electricity consumed in Scotland came from renewable sources.

The Scottish Government’s target to have the equivalent of Scotland’s whole electricity demand generated by renewable sources is further explained on its Scottish Energy Statistics Hub. The accompanying commentary states that “this does not mean that Scotland would be fully dependent on renewables generation, but rather that renewables would form the key part of the overall electricity mix.” The portal provides the following diagram to explain the calculation of the target measure:

Source: Scottish Energy Statistics Hub (Renewable Electricity Target, ‘Calculation’ tab)

Where statements are made in public debate it should be clear what the underlying statistics measure, to avoid misinterpretation. We have asked the Chief Statistician in Scotland to ensure that the First Minister’s office is briefed on this matter.

Yours sincerely,

Sir Robert Chote
Chair

Response from Sir Robert Chote to Jackie Baillie MSP – NHS waiting times

Dear Ms Baillie,

Thank you for your letter of 5 October to the Director General for Regulation about statistics on waiting times for NHS treatment as they appear in the new NHS Inform dashboard. You were concerned about media reports suggesting that this website understated waiting times for certain procedures.

The dashboard shows the numbers of patients treated in the last quarter and their median wait times by clinical specialty. However, patients who have not yet been treated, some of whom may have been waiting a long time, are not included in these medians. Therefore, the dashboard could potentially mislead some patients about the length of time they may have to wait, particularly if treatment is not classified as urgent.

The Director General for Regulation has today written to Public Health Scotland and the Scottish Government setting out improvements we would like to see made to the site. These include considering the addition of other metrics to reflect the range of waiting times experienced by patients and more accessible information about the strengths and limitations of the statistics.

While the statistics currently presented in the NHS Inform dashboard do not include patients who are still waiting, the official statistics from which they are sourced provide a wider range of metrics, such as patients waiting at month-end and patient unavailability.

Yours sincerely,

Sir Robert Chote

Jackie Baillie MSP to Ed Humpherson – NHS waiting times

Dear Ed,

RE: Misleading and inaccurate information on waiting times for NHS treatment

I write to you regarding the above matter.

I was deeply concerned to read a news article in The Times newspaper, on 29th September 2022, claiming that “[p]eople on waiting lists for procedures such as hip and knee replacements are waiting six weeks longer than suggested by the NHS Inform patient portal’.

NHS Inform is Scotland’s national health information service for the people of Scotland, which is supposed to provide ‘accurate and relevant information to help them make informed decisions about their own health and the health of the people they care for’. It is very concerning, therefore, to hear that concerns have been raised about the accuracy of the information presented on this website, including by senior clinicians.

The correct use of statistics and data is vital to encourage public confidence. Patients, in particular, rely on accurate wait times to get through the long weeks before surgery. Releasing inaccurate time scales gives false hope to those languishing on waiting lists.

It is imperative that the public have faith in the accuracy and truthfulness of statistics that are cited by Government ministers. As such, I would be grateful if you could investigate and provide guidance on the matter.

Yours sincerely,

Jackie Baillie

MSP for Dumbarton

Stephen Kerr MSP to Sir Ian Diamond – Renewable energy

Dear Sir Ian,

I’m writing on the subject of statistics used by the Scottish Government, the SNP, and the “Yes” campaign, which is at least partially run by the SNP.

As you will of course know, the SNP Scottish Government are putting a great deal of resource into pushing for the break-up of the United Kingdom. This has included the dissemination of many statistics, many from the Scottish Government’s own studies and many from external sources.

However, there have been repeated occurrences of the SNP, and their campaigns, deliberately mis-using these statistics when communicating to the Scottish people.

As an example, on multiple occasions the SNP and their associated campaigns have repeated the line that 97.4% (or “almost 100%”) of Scotland’s energy demands are generated by renewables.

This is being spread by literature delivered door-to-door by the Yes campaign, and in November 2021 First Minister Nicola Sturgeon said:
“Just short of 100% of all the electricity we use is from renewable sources.”

As has been pointed out by fact-checking websites such as full-fact, it is clearly not the case that Scotland’s energy needs are met at this level from renewables. There is deliberate misconstruction of two separate statistics, the total amount of energy generated, and the energy demands from Scotland.

Given the importance of giving the public a fair and correct view of official statistics, I was wondering what you could do to ensure that mis-use of statistics is called out.

Thank you for reading and I hope to hear from you.
Yours sincerely,

Stephen Kerr MSP

Response from Sir David Norgrove to Willie Rennie MSP – COVID infections in England and Scotland

Dear Mr Rennie,

Thank you for your letter of 21 January about the First Minister’s use of statistics from the Coronavirus Infection Survey (CIS).

CIS estimated that in the week ending 15 January 2022, 5.47 per cent of people in England and 4.49 per cent of people in Scotland had COVID-19^[1]. The First Minister was comparing these two proportions and correctly stated that the figure for England was more than 20 per cent higher than the figure for Scotland. It would also be correct to say that the prevalence of COVID-19 was around one percentage point higher in England than in Scotland. Quantitative comparisons between the two estimates should take account of the precision with which they are available^[2], but the data does suggest that the rate of infection is lower in Scotland than in England.

The distinction between percentages (parts per hundred) and percentage points (the simple difference between two percentages) can be made easier to understand by quoting the two numbers being compared. For clarity, when publishing results from CIS the Office for National Statistics gives the absolute number of people with COVID-19; the percentage of the population with COVID-19; and the number of people with COVID-19 as a ratio to the whole population (for example, “1 in 20 people”).

Yours sincerely,

Sir David Norgrove

[1] Coronavirus (COVID-19) Infection Survey, UK: 21 January 2022. Headline results from this bulletin were published on 19 January.

[2] The 95% credible intervals were between 5.29% and 5.64% in England and between 4.03% and 5.00% in Scotland. Credible intervals give an indication of the degree of uncertainty of the estimates. More information on credible intervals can be found in the CIS methods and further information article.

Response from Sir Robert Chote to Dr Sandesh Gulhane MSP – Waiting time statistics

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Response from Sir Robert Chote to Alex Cole-Hamilton MSP – Scottish renewable energy statistics

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Alex Cole-Hamilton MSP to Sir Robert Chote – Further letter on Scottish renewable energy statistics

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Alex Cole-Hamilton MSP to Sir Robert Chote – Scottish renewable energy statistics

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Dr Sandesh Gulhane MSP to Sir Robert Chote – Waiting time statistics

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Sir Robert Chote to Stephen Kerr MSP – Renewable energy

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Response from Sir Robert Chote to Jackie Baillie MSP – NHS waiting times

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Jackie Baillie MSP to Ed Humpherson – NHS waiting times

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Stephen Kerr MSP to Sir Ian Diamond – Renewable energy

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Response from Sir David Norgrove to Willie Rennie MSP – COVID infections in England and Scotland

[1] Coronavirus (COVID-19) Infection Survey, UK: 21 January 2022. Headline results from this bulletin were published on 19 January.

[2] The 95% credible intervals were between 5.29% and 5.64% in England and between 4.03% and 5.00% in Scotland. Credible intervals give an indication of the degree of uncertainty of the estimates. More information on credible intervals can be found in the CIS methods and further information article.

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