APPENDIX IV

MEMORANDUM PREPARED BY

THE SCOTTISH HOME AND HEALTH DEPARTMENT

RESEARCH AND INTELLIGENCE UNIT

In the Scottish Home and Health Department, in 1965, was set up a Health Services Research and Intelligence Unit within which was incorporated the existing small operational research unit and the health statistics branch together with additional appropriate professional staff. The aim was to have available a group of officers relieved of day-to-day administrative responsibility who would be able to collect and analyze information about all aspects of the health services, study long-term trends and thus provide those responsible for making decisions about future policy with a sound factual basis for these decisions.

Functions

The main functions of the Unit are:

To collect information, including statistical information, about
the incidence of disease, the effectiveness of the arrangements
for its control and treatment, and the working of the various
parts of the Health Service;

To present and circulate this information in convenient form,
not only within the Department but also as appropriate through-
out the Health Service;

To conduct research (other than medical research) into the
working of the Health Services (know as "operational research")'

To stimulate the conduct of operational research by individuals,
Health Service authorities and university departments into the
working of the Health Service; to give advice as requested on
such projects; and, in certain cases, to provide financial
support;

To support the development of computer policy in the Health
Service.

Operational Research

The Research Officers of the Unit conduct research at tactical level into the working of the Health Services and projects have been undertaken in Such projects have included the future requirement of mental many fields. hospital beds; the computerization of general practice medical records with the long-term aim of integrating these with local authority and hospital records; the use of nurses in general practice; procedures for suggestions and complaints in hospitals; workload in a physiotherapy department; utilisetion of x-rays in Health Centres; variations in indices of consultant practice studies of the use of services by the elderly, etc.

The Unit provides assistance (including financial assistance) to individuals in, for example, University and hospital departments engaged in carrying out studies into the working of the various parts of the Health Service and into computer development in the Health Service; much assist informal advice is also provided. Longer term financial support to the establishment or development of research units to undertake programmes of research is provided to the University of Strathclyde (jointly with Regional Hospital Boards), the North-Eastern Regional Research and Intelligence Unit; the Scottish Council of the Royal College of General Practitioners and the University of Edinburgh for the establishment of a Nursing Research Unit in the Department of Nursing Studies. Negotiations have just been concluded for support to the establishment of a Social Paediatric and Obstetric Research Unit attached jointly to Glasgow University and Glasgow Corporation. Details of projects and Units toward which financial support was given during the year 1970 is contained in the attached extracts from the Department's report for that year on the Health Services in Scotland (Cand. 4667).

In addition to the grants awarded to individuals, financial support has been given to the Universities of Aberdeen, Edinburgh and Glasgow for a scheme to enable doctors to undertake training in operational research (including the carrying out of research projects); to Strathclyde University for a student in an operational research study on a Health Service subject; and to the Eastern Regional Hospital Board for a three year fellowship for research into community medicine. The Department also provides two annual fellowships of two years' duration for nurses to gain experience in research methods and to carry out research into the nursing services.

Studies of manpower planning and Health Board planning in the Health Service were commissioned and these are being undertaken by the Institute of Operational Research, (an independent non-profit making body). Consideration is presently being given to possible studies in the planning and building field of the service and on the effect of the administrative re-organization of the Health Service.

Intelligence

One of the functions of the Unit is to disseminate information throughout the Health Services in Scotland on operational research matters by various means, viz., a study series of publications containing reports of appropriate individual studies; and the Chief Medical Officer's "Health Bulletin", issued quarterly, which is oriented towards operational research. A register containing information about operational research projects planned, in progress, or completed in Scotland is maintained and circulated at intervals to interested persons or bodies.

Statistics

The Unit is responsible for the central collection and processing of all Health Service statistics. Increasing use has been made of computers to process and set out this material in convenient form and the widespread circulation of

analyses from the statistical data has led to a growing awareness outside the Department of the volume of useful information available both for the general management of the Health Services and for research purposes.

Considerable emphasis has been given to the promotion of schemes for the improvement of medical care and examples of these are: datarecording of patients discharged from maternity hospitals; revision of cancer registration and abstract cards to provide better analyses of treatment and follow-up; a register of handicapped children of schoolleaving age by each local authority area; and a feed-back to individual consultants about their own work to enable them to compare and evaluate certain aspects of their individual performance. Much work has also been done on record linkage, 1.e. the means whereby the records of individual patients made out by different hospitals by general practitioners can conveniently be brought together.

Computer Policy and Development

The Computer Branch of the Unit consists of an administrative section headed by a Senior Executive Officer, and is assisted by a Medical Officer and a Principal Scientific Officer. The Branch services the Scottish Advisory Committee on Computers in the Health Service and its various subcommittees. It administers the development of a computer policy within the Scottish Health Service, and is concerned with liaison with the various elements of the Health Service, the computer manufacturers, and the Computer Policy and Development Branch of the Department of Health and Social Security.

M

D

PESEARCH

1

Dr A. Cartwright, Institute of Community Studies. Transport systems in general practice (funded jointly with the Department of Health and Social Security).

NORTH-EASTERN REGION

Prof. R. Deans Weir, Department of Social Medicine, University of Aberdeen. A study into drug-prescribing errors and the ascertainment of drug toxicity.

'Development of operational research studies in the health services in the NorthEast Region by the Regional Research and Intelligence Unit.

1Prof. R. Deans Weir and Dr Ian Simpson, Department of Public Health & Social Medicine. Aberdeen University. Study of peripheral out-patient services.

Mr N. G. C. Hendry, Orthopaedic Unit, Aberdeen Royal Infirmary. Pilot survey of record systems in orthopaedic departments for automated data storage.

Prof. W. M. Millar, Department of Mental Health, Aberdeen University. An investigation into the needs of all mentally ill patients in the North-East Region.

Dr J. M. Richardson, General Practice Teaching and Research Unit, University of Aberdeen. (1) Study of doctor/patient contacts in North-East Scotland. (2) Work study in general practice. 'Prof. G. Smith, Professorial Surgical Unit, University of Aberdeen. System of individual patient costing.

Mr J. Steyn, Department of Urology, Aberdeen Royal Infirmary. Urological case records. Dr A. Sutherland, Department of Public Health and Social Medicine, University of Aberdeen. Study of long-stay patients in Aberdeen hospitals.

EASTERN REGION

The Senior Administrative Medical Officer, Regional Hospital Board. Research Fellowship in Community Medicine.

'Prof. J. Crooks, Department of Pharmacology and Therapeutics. Study of drug information systems.

SOUTH-EASTERN REGION

1Prof. G. M. Carstairs, University Department of Psychiatry, Royal Edinburgh Hospital. Evaluation of a psychiatric niglo hospital.

'Dr A. H. Duncan, Medical Superintendent, Bangour General Hospital. Study of GP/General Medical Unit in Bangour General Hospital.

Prof. Finney, Department of Statistics, University of Edinburgh. Operational research in medicine. Computer simulation of hospital departments.

'Dr A. Frame, Department of Social Medicine, Edinburgh University. Experimental attachment of GPs to medical units of Western General Hospital, Edinburgh. 'Dr E. B. French, Department of Medicine, Western General Hospital, Edinburgh. Study of out-patient activity-Department of Medicinc—Western General Hospital, Prof. F. J. Gillingham, Department of Surgical Neurology, University of Edinburgh. Research into head injuries.

Dr M. Grant, Health and Welfare Department, Fife County Council. Fife pregnancy survey.

Dr R. Gruer, Department of Social Medicine, University of Edinburgh. (1) Future shape of the health and social services in the Borders. (2) Provision of health and social services in the Borders.

·1Dr J. D. Haldane, Department of Child and Family Psychiatry, Playfield House, Cupar, Fife. Child and family psychiatry records.

Mrs M. C. Hope, Department of Social Medicine, University of Edinburgh. A study of mentally handicapped school leavers.

'Dr Keith Hope, Nuffield College, Oxford, and Miss Angela Skrimshire, Institute of Occupational Medicine, Edinburgh. The multivariate search for hospital efficiency. Prof. James, Princess Margaret Rose Orthopaedic Hospital. Trials of treatment in orthopaedic surgery.

Mr W. Lutz, Department of Social Medicine, University of Edinburgh. Domiciliary feeding of the elderly.

Dr Stewart MacGregor, Department of Social Medicine, University of Edinburgh. Study of nurse use in general practice.

Dr R. M. McGregor, general practitioner, Hawick. Assessment of the work of the family doctor during the first 20 years of the National Health Service.

Dr Una Mel can, Department of Social Medicine, University of Edinburgh. Patterns of help seeking among mothers in an Edinburgh council estate.

Dr Mair. Director of Social Work, Edinburgh.

advice centre, Craigmillar, Edinburgh.

Experimental health, welfare and

N

Prof. D. Michie, Department of Machine Intelligence and Perception, University of Eu Edinburgh. Study of low cost methods of on-line record retrieval.

Prof. S. L. Morrison, Department of Social Medicine. Usher Institute, Edinburgh. Cardiac Intensive Care Unit.

'Study of angina of recent onset.

'Mr A. W. Patterson, Department of Pharmacy, Heriot-Watt University, Edinburgh. Analysis of drugs.

'Dr P. D. Robertson, Community Medical Care Research Unit, Edinburgh. Diabetic clinic study.

Dr Seiler, Edinburgh. Survey of incidence of disability.

'Prof. N. C. Sidwell, Department of Building, Heriot-Watt University, Edinburgh. Maintenance requirements of CLASP buildings.

Prof. J. Spencer, Department of Social Administration, University of Edinburgh. General practitioners' attitudes on mental health.

The Royal Edinburgh Hospital. Automated record system.

WESTERN REGION

'Prof. A. C. Forrester, Department of Anaesthetics, Glasgow Royal Infirmary. Assess ment of the application of automated teaching techniques of the audio-visual type in anaesthesia.

'Dr V. M. Hawthorn, Glasgow University. Cardio-respiratory screening. Dr Bernard Isaacs, Geriatric Service, Glasgow Royal Infirmary. (1) Social consequence of stroke. (2) The measurement of need in old people (utilisation of geriatric beds).

'Dr J. F. Kirk, Medical Superintendent, Stobhill General Hospital. Proposed out patient survey-Stobhill General Hospital.

Dr J. C. Little, Department of Clinical Chemistry, Crichton Royal, Dumfries. Data on patients referred to psychiatric service.

Dr W. J. Macl ennan, Department of Epidemiology and Preventive Medicine, Ruchill Hospital, Glasgow. Care of the young chronic sick.

1 Dr 1. D. G. Richards, Department of Child Health, University of Glasgow. Children at risk-non-clinic attenders.

Prof. D. J. White, Department of Operational Research, University of Strathclyde (1) Study of Scottish Ambulance Service. (2) Study of orthotic services in Scotland. Mr R. Wilkie, Strathclyde University. Investigation into organisational changes planned within Glasgow Royal Infirmary.

GENERAL

The Institute of Community Studies. Study of medicines in the home.

The Institute of Operational Research. Studies of manpower and arca health service planning.

UK Atomic Energy Authority. Development of computer coding/diagnoses. Department of Operational Research, University of Strathclyde. Establishment of Scottish Health Service Operational Research Unit (jointly with Scottish Regional Hospital Boards).

Scottish Council, Royal College of General Practitioners. Establishment of general practitioner research support centre in the Department of General Practice, Univer sity of Dundee.