% of Cardiac Arrests with Successful Return of Spontaneous Circulation

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1 HEAT Target H1 % of Cardiac Arrests with Successful Return of Spontaneous Circulation Performance against this indicator improved in October to 15.8% compared to 15.5% in September, within target range, although South West and East Central divisions fell marginally below target for the month. YTD performance remains well within target range at 17.3% with all divisions ahead of target for the year. South East division continues to perform ahead of target, reflecting the positive impact of the TOPCAT study currently ongoing. % of cardiac arrest patients with successful return of spontaneous circulation - Scotland % ROSC November December January February March April May June July August September October % ROSC Lower Range Upper Range Cardiac Arrests No ROSC

2 Cardiac arrest by type performance continues to be above target, most notably in respect of non-vf cardiac arrest patients, with a successful ROSC rate of 16.9% in October improving the YTD position to 20.2%. The Board is aware that non-vf cardiac arrest patients are the least viable and a ROSC rate of 10% is normally anticipated and the Service is performing significantly above this level.

3 HEAT Target H2 % of Cardiac Arrests patients responded to within 8 Minutes Performance against this indicator fell marginally in October to 80.8%, well above the 75% target. Only North division fell below target for the month, although remains on target YTD. YTD performance remains ahead of target at 80.1%, with all five divisions ahead of target for the year.

4 HEAT TARGET T3 Reducing Hospital Admissions: % of Emergency Calls Treated at Scene Performance against this indicator in October was 11.8% (5,143 patients) treated at scene. YTD, performance remains ahead of target at 11.6% (35,409 patients). The percentage of emergency calls stopped at EMDC fell in October to 30.3% (13,176 calls), giving a YTD performance of 32.4% (98,702 calls). Scotland Total % emergency calls stopped at EMDC as a % of all emergency calls 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Series1 34.1% 35.0% 32.9% 32.9% 32.0% 33.0% 33.5% 32.6% 34.0% 32.5% 30.8% 30.3% Series2 33.2% 33.2% 33.2% 33.2% 33.2% 33.2% 33.2% 33.2% 33.2% 33.2% 33.2% 32.8% Scotland Total % emergency calls treated at scene as a % of all emergency calls 12.0% 11.8% 11.6% 11.4% 11.2% 11.0% 10.8% 10.6% 10.4% 10.2% Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 % Calls Trtd/Refd at Scene 10.9% 11.1% 10.8% 11.1% 11.2% 10.9% 11.6% 11.9% 11.7% 11.9% 11.5% 11.8% Average 11.4% 11.4% 11.4% 11.5% 11.6% 11.6% 11.7% 11.8% 11.7% 11.7% 11.7% 11.8%

5 HEAT TARGET T4 SEWS score: the % of patients with a SEWS score above 4 taken to hospital Performance in September and October was within target at 96.9% and 96.1% respectively. YTD performance at 97.7% achieves the upper range of the target set for the year and continuous improvement has been evident throughout.

6 HEAT TARGET T5 Hyper acute stroke: the % of hyper acute stroke patients taken to hospital within 55 minutes Performance in Q2 fell to 67.4% giving a YTD performance of 71.6%. Although short of target, the Board is aware that this is a developmental target for the Service and part of a wider NHS development of stroke services. Unlike other response time targets, this indicator is measured from the time the call was received to the time the patient arrives at a hospital with a CT scanner; this presents crews with a number of challenges. Firstly, the average service time across all areas of Scotland for emergencies from receipt of call to close of call at hospital is between 55 and 60 minutes. This means that the 55 minutes target is in itself in line with that average and, as such, does not leave much room for deviation. This is further evidenced by the fact that all areas are missing the target as opposed to only those in the more rural areas. Secondly, progress in the development of stroke services in Scotland is not consistent across all Health Board areas. Whilst there are CT scanners in place in all HB areas bar Orkney, the availability of the CT scanners on a 24/7 basis is patchy and the availability of consultants to administer thrombolysis is also inconsistent. In some areas, there are multi-hospital sites with CT scanners but thrombolysis services are only based at one location, currently on a pilot basis, and not available 24/7. This can result in crews diverting to hospital sites dependent of time of day or day of week, thus creating further potential for delay. The Service has developed a Chest and Stroke Care Action Plan, which has been approved by Clinical Governance Committee and has put in place local divisional leads to liaise with stroke MCNs around Scotland. There is work underway in the West of Scotland through the regional planning group to develop referral pathways and this work still requires to be done across Scotland once stroke thrombolysis services are fully up and running in all areas.