Health, Wellbeing and Sport
Good afternoon. The first item of business this afternoon is portfolio questions on health, wellbeing and sport. As ever, in order to get in as many members as possible, short and succinct questions and answers would be helpful.
General Practitioner Appointments
To ask the Scottish Government how many GP appointments were missed by patients in the last 12 months. (S4O-03881)
As independent contractors, GP partners are responsible for their own practice appointment and patient consultation arrangements. However, the Scottish Government expects health boards and their contracted practices to ensure that satisfactory appointment systems are in place for patients, reviewing outlier performance and providing advice and support where necessary.
Additionally, as part of the negotiated general medical services contract settlement for 2014-15, access will be reviewed in Scottish GP practices by March 2015.
I have recently been in discussions with local GPs about what solutions can be employed to minimise missed appointments and so ease the burden on GP practices. Will the cabinet secretary update the Parliament on what initiatives the Government is undertaking to enable patients to cancel appointments easily?
Online services are available to all GP practices in Scotland via existing clinical systems, and Scottish Government officials are actively looking to promote the uptake and usage of those services, which include online appointments and repeat prescriptions. We certainly welcome any new and innovative ideas, and I would be happy to keep the member informed of progress.
At the most recent audit, I think that only about 50 per cent of practices were using the services, so the initiative to increase their use is welcome.
The Government has announced that there will be an inspection system for general practice. That is about 18 months behind the one in England, which has been going for that length of time. When will the inspection system start?
Will the Government look at the recent article by Ron Neville, a GP in Dundee, who has an appointment system that seems to me to be absolute best practice? I hope that the Government will look at it and promote that.
Work is certainly going on apace on the new inspection system for GPs, but I will update the member, perhaps at the meeting that we have towards the end of this month.
I agree that we should have a closer look at the system that Ron Neville has developed, which the member described. As I have said before, I am always keen to ensure that best practice in these matters is rolled out elsewhere. Again, I will be able to update the member further on that at the end of the month.
The cabinet secretary will be aware of the pilots by a number of GP practices, using text messaging to help to reduce the number of missed appointments and to help patients to manage their healthcare. What plans does the Scottish Government have to roll that out across health boards?
As I said to Richard Simpson, I welcome innovative ideas, some of which can be simple. Given the use of text messaging more generally, I think that it is an effective way of reminding people about their appointments, but also giving them opportunities to cancel appointments in advance, which means that they can be given to others.
I am keen that all these things become standard practice. Sometimes that takes longer than we would all wish. Again, I am happy to update the member on how we will ensure that we roll these things out as quickly as possible.
Autism Strategies (Local Authorities)
To ask the Scottish Government what recent discussions it has had with local authorities that have yet to submit a draft or completed autism strategy. (S4O-03882)
The Scottish Government is funding a national co-ordination team, which is based at the University of Strathclyde, to bridge the Scottish autism strategy and its implementation at a local level. In the past few months, the team has made contact with all local authorities, and the nine that are yet to submit drafts are finalising them locally and submitting them to committees for sign-off. They have until 31 March 2015 to submit their action plans and strategies. The national co-ordination team will meet all local authority autism leads on 19 January to continue those discussions.
The minister might be aware that Aberdeen City Council has not yet submitted a draft or completed autism strategy. I note that the minister said that they have until 31 March 2015, but my understanding is that, when the funding was initially allocated, the hope was that the strategies would be submitted by March 2014.
I am due to meet the council leader next week to discuss the issue and I am concerned that the autism strategy appears to have been conflated with the council’s school inclusion review, which, although important, is not the same thing. Has the minister received information from Aberdeen City Council about when its autism strategy will be completed, especially given the anxieties of service users and their families that this important piece of work has been on-going for some considerable time with no sign of progress?
I acknowledge Mr McDonald’s personal and political interest in the issue. He is a great champion for it.
Aberdeen City Council has assured the Scottish Government that its autism strategy was finalised last week and will be submitted to the Scottish Government this week. I am aware that the final draft will go before the Aberdeen City Council committee this month and that, once it is signed off, the final strategy will be made public.
I emphasise the point that I have already made: the Scottish Government will continue to hold discussions with local authorities to ensure that all autism strategies and action plans are made public.
Constituents have told me that the strategy is not working and that they feel that there is no access to appropriate services in Highlands, which leaves them and their families unsupported.
I am pleased that the University of Strathclyde has been asked to co-ordinate the national strategy, but what work will it do with local authorities and NHS boards, and will it include service users and their families in designing local services?
Highland Council is one of the local authorities that has submitted its draft strategy. We want to ensure that service users and those who take a great interest in the issue are consulted. The team to which I have referred will maintain a great interest in what is happening in the Highland Council area and across the country.
Acute Hospitals (Red Alert)
To ask the Scottish Government how many acute hospitals were on red alert in the last week of 2014 and first week of 2015. (S4O-03883)
While hospitals have experienced pressures during the recent holiday period, none has needed to declare a major incident because of the demands that it was facing. Boards have been keeping the Scottish Government informed daily about the pressures that they face and the actions that are being taken to address them. Additional support has been provided to the boards when required.
There is no doubt that the crisis in Scotland’s accident and emergency units has intensified in recent weeks, with many patients, including constituents of mine, facing unacceptably long waiting times. Does the cabinet secretary agree that that is unacceptable? Does she accept responsibility and can she say how many patients have waited for more than 12 hours in each of the past two weeks?
It is absolutely unacceptable that anyone should have to wait longer than they should in an accident and emergency department, but departments across Scotland and the rest of these islands have been under unprecedented pressure.
For example, Greater Glasgow and Clyde NHS Board has told me in some detail about the very sick elderly patients who are turning up in numbers that the health board has not seen during winter in any other year. There have been many more admissions than normal, which of course puts pressure on the whole system.
In answer to James Kelly’s specific question, the number of 12-hour waits in the Greater Glasgow and Clyde NHS Board area for the week ending 11 January was 84. That is a significant proportion of the 175 for the whole of Scotland. Those patients should not have had to wait for 12 hours, but we need to understand that accident and emergency staff were doing absolutely the best that they could. The winter pressure preparations were gone through in great detail and staff and managers had put in place everything that they could but, unfortunately, because of the surge of patients who had to be admitted, accident and emergency departments, particularly in Glasgow and Clyde, came under unprecedented pressure.
We will absolutely learn lessons from this winter and, in preparation for the coming months, will ensure that we deal with some of the pressures, in particular delayed discharges. They are not the whole story, especially given the level of admissions, but they add to the pressures that health boards are facing.
NHS Ayrshire and Arran (Meetings)
To ask the Scottish Government when it last met NHS Ayrshire and Arran and what issues were discussed. (S4O-03884)
Ministers and Scottish Government officials regularly meet representatives of all health boards, including NHS Ayrshire and Arran, to discuss matters of importance to local people. It was a pleasure to conduct NHS Ayrshire and Arran’s annual review, which is the first one that I have done since becoming cabinet secretary.
As the cabinet secretary knows, Crosshouse hospital has been in the headlines for the wrong reasons recently. First, £1.3 million-worth of surgical equipment was stolen and sold on the black market. That led to cancellations of operations and, of course, the cost of replacement. Secondly, an unannounced inspection found widespread blood contamination of patient equipment in maternity and accident and emergency departments. A second inspection a month later saw some improvement, but the hospital still did not get a clean bill of health.
Staff are doing all that they can, but they are underfunded and overstretched. Are those two issues indicative of what is happening to our health service across Scotland under this Scottish Government? It recently—
Can I hurry you along, please?
I am just coming to the end of my question. Recently, the Scottish Government announced £3.2 million for NHS Ayrshire and Arran, which will not even cover the replacement of the stolen instruments. What is the cabinet secretary going to do to ensure that our once-envied health service is properly funded and supported?
Our health service is still envied across the world and is properly funded, with a £380 million rise in the budget next year, which will mean that the budget will breach £12 billion for the first time ever. By any reasonable person’s standards, £12 billion is a lot of money for the health budget.
On Crosshouse hospital, I was very impressed with the hospital and the staff who were working hard when I visited. The theft of the surgical equipment was reprehensible, and the police investigation is on-going and has reached an advanced stage.
The inspection reports are important. Previously, of course, there was no such inspection regime. I think that, even when a report makes difficult reading, it is important that the Healthcare Environment Inspectorate is going in and shining a light on all our hospitals, particularly when it does so unannounced. That means that it knows where matters have to be put right, and a lot of work has been done by NHS Ayrshire and Arran, particularly in Crosshouse hospital, to address the issues that have been raised in the inspection reports.
There is still more to be done—I am the first to accept that—but let us not undersell the good things that the NHS provides or the hard-working staff within it.
The cabinet secretary will be aware of the on-going lack of bed availability at Ayr and Crosshouse hospitals, and the occasional closures of Crosshouse hospital, which will lead to extra burdens on staff, particularly at Ayr hospital. Notwithstanding the almost Herculean efforts of nurses and doctors at both hospitals, that entirely foreseeable, predictable and now well-documented problem remains. What is the cabinet secretary doing by way of discussion and planning with NHS Ayrshire and Arran’s senior management to get this now long-standing problem resolved?
That is absolutely a discussion that is going on between ourselves and NHS Ayrshire and Arran. It is important that all parts of the health system have the right number of beds in the right places with the right staff to support them at the right time.
We also need to ensure that those beds are being used to their optimum. Because of the issue and challenge of delayed discharge, that is not the case at the moment. Too many beds are being used by people who do not require them but who cannot be discharged, because of all the reasons that we know about in terms of care in the community and support requirements.
We are doing a lot on that issue, and I will have more to say about it in the next few weeks. I assure John Scott that those discussions are on-going, and I will update him on the latest news from them.
Dumfries and Galloway Royal Infirmary (Update)
To ask the Scottish Government whether it will provide an update on the progress of the new Dumfries and Galloway royal infirmary. (S4O-03885)
The replacement for the Dumfries and Galloway royal infirmary is currently progressing as planned, with construction due to commence in spring 2015, following the financial close of the project in February.
The board is working in partnership with the consortium, High Wood Health, which was appointed as preferred bidder. Full unconditional planning consent for the project was obtained on 16 December. The construction and handover of the new hospital to the health board by HWH is planned for the end of August 2017, with the facility becoming fully operational by the end of that year.
NHS Dumfries and Galloway has said that it is fully committed to delivering community benefits as part of the procurement, construction and operational phase of the hospital project. Will the cabinet secretary outline what sustainable training, employment and local development opportunities the project will provide?
Yes. NHS Dumfries and Galloway has a requirement in the project agreement for targeted community benefits, which include recruitment and training, small and medium enterprise supplier development and educational opportunities.
High Wood Health, the project delivery partner, is working closely with NHS Dumfries and Galloway employment and education specialists. That work includes a commitment to create 150 new jobs, 36 of which will be apprenticeships. NHS Dumfries and Galloway’s project team will, as enablers, work in partnership with HWH and agencies to maximise the opportunities that arise during the delivery of the contract.
NHS Fife (Accident and Emergency Waiting Time Targets)
To ask the Scottish Government how many times NHS Fife failed to meet its four, eight and 12 hour accident and emergency waiting time targets between 24 December 2014 and 4 January 2015. (S4O-03886)
Unvalidated figures have been reported to the Government for the two-week festive period. NHS Fife’s four-hour A and E performance for core A and E departments was 87.3 per cent in the two weeks ending 4 January 2015.
Official ISD Scotland statistics on A and E activity for October, November and December of last year will be published on 3 February. A and E figures will thereafter be published monthly.
I put on record my sincere thanks to all the workers in our hospitals and throughout the public services who worked over Christmas and new year to look after and care for our elderly and the most vulnerable in our communities.
The figures that I have show that the four-hour target was not achieved 154 times, the eight-hour target was not achieved 25 times and the 12-hour target was not achieved three times. I would be grateful for a meeting with the cabinet secretary to follow up on those figures.
In her answer to the previous question, the cabinet secretary talked about delayed discharges. Is she aware that NHS Fife took the decision to shift nine patients and then another 13 patients into care homes without a social work assessment taking place, which is a form of boarding patients into care homes? Does she support such a move? Will she agree to look into whether that is a change in policy and practice on boarding patients into care homes and respond to me?
I would be happy to meet Alex Rowley to discuss those issues in more detail. As I am sure he is aware, NHS Fife and Fife Council came to see me jointly to discuss the challenges of delayed discharge in their area. It was a productive meeting. From that meeting, a number of actions were agreed and Scottish Government officials have been supporting the partnership in implementing some of them.
Those measures include considering the boosting of home care to get people moving home safely. Another was the opening of what we call intermediate care beds. Those are step-up, step-down beds that can be used for people who are ready to be discharged but perhaps not ready to go home. They are not people who are boarded out—they are ready for discharge—but they perhaps need a bit of rehabilitation to be able to go home independently.
I am happy to discuss that in more detail with Alex Rowley in due course.
Commonwealth Games Legacy Sporting Facilities (Glasgow)
To ask the Scottish Government whether it will provide an update regarding the proposed Commonwealth games legacy sporting facilities that will benefit the people of Glasgow. (S4O-03887)
Glasgow 2014 has been used as a catalyst to raise the profile of sport in Glasgow, accelerate the development of sport and create a lasting legacy of world-class sporting facilities.
The people of Glasgow continue to benefit from the fantastic facilities used to host the Commonwealth games, such as the Emirates arena and the Glasgow national hockey centre. Furthermore, communities throughout Scotland have been supported by the legacy 2014 active places fund. Since its launch in 2012, a total of 154 projects from 31 local authorities, including 13 in Glasgow, have received awards totalling more than £8.1 million.
I thank the minister for that answer. Can he furnish me with any information on the possibility of the development of any all-weather 3G pitches in my Glasgow Anniesland constituency?
I can certainly say to Mr Kidd that there has been investment in his constituency. As regards sports facilities, there are nine community sport hubs up and running in Glasgow, including an area-based hub in Drumchapel that is based in a variety of local venues, including the high school sports centre and leisure centre, and a disability sport hub that is based at Scotstoun leisure centre. I am sure that he will be interested in that.
Sportscotland has not provided any funding towards 3G pitches in the member’s constituency in recent years, but various funding sources for sports projects can be applied for, including for the installation of 3G pitches. If there is any specific project in Anniesland and I can be of assistance in pointing Mr Kidd or others in the direction of those funding sources, Mr Kidd just needs to ask.
Mental Health Officers (Training)
To ask the Scottish Government what plans it has to increase the number of mental health officers being trained. (S4O-03888)
Local authorities have a legal duty to appoint a sufficient number of mental health officers to discharge functions under the relevant legislation. They must decide on the number of mental health officers appointed in their area, taking into account local needs and circumstances. The Scottish Social Services Council’s latest mental health officers report indicates a 39 per cent increase in admissions to mental health officer award programmes in 2013-14.
Evidence from the SSSC shows that the number of mental health officers is declining and the workforce is ageing. The Mental Welfare Commission for Scotland stated that 42 per cent of emergency detentions in hospitals had no mental health officer consent, even though that should be the case, and that 62 per cent of short-term detentions did not have a social circumstances report, which is critical to patients getting the right treatment and care. When will the Government address the shortage of mental health officers? Will it look to have a Scotland-wide recruitment and training strategy for them this year?
Of course, we will always take seriously the views of the SSSC, the MWC and others who express a view on these matters. I go back to my original answer and make the point again that the latest mental health officers report indicates a 39 per cent increase in admissions to mental health officer award programmes in 2013-14. However, we are exploring mental health officer capacity and other issues with key stakeholders, including local authorities and mental health officers, to better understand what the issues are and what plans there are locally to address any shortfall in officers. The Government places great priority on that.
Given that the number of out-of-hours mental health officers is at an all-time low, what recourse do mental health patients have to the Government when there is no mental health officer to provide them with the advice and support that they need in accordance with mental health legislation?
The Government takes very seriously the provision of mental health services across Scotland. I have made the point that capacity is increasing. We hope to see more mental health officers come on stream.
I should make the point that workforce planning is a matter for each local authority but, as part of its mental health responsibilities, the Government announced on 20 November 2014 an additional investment of £15 million over the next three years to improve mental health services. That gives some indication of the importance that we give this area.
Women’s Football
To ask the Scottish Government what steps it is taking to promote women’s football. (S4O-03889)
The Scottish Government is a committed supporter of Scottish women’s football and recognises the positive impact that football can have in communities throughout Scotland. In May 2014, under the cashback for communities programme, the Scottish Football Association was awarded up to £2.25 million through to 2017. That funding is supporting the development of various aspects of girls’ and women’s football, including proactive engagement with girls via regional development officers to increase participation for females aged between nine and 24.
I know that the minister is a committed football supporter. Sadly, Scotland’s women’s football team did not qualify for the 2015 world cup in Canada. What steps is the Scottish Government taking to improve our chances of qualifying for the next women’s football world cup, in 2019?
Although the women’s national team unfortunately did not qualify for the 2015 world cup in Canada, we should recognise the tremendous progress that it has made. The team performed very well in a strong qualification group; it reached the play-offs for the first time in its history and is now ranked 21st in the FIFA world rankings and 12th in the European rankings.
I hope that Richard Lyle and other members in the chamber will understand that I do not particularly want ministerial responsibility for guaranteeing that our national teams qualify for international tournaments. However, to go back to my initial answer, we are leveraging significant funding directly into women’s football.
We have also committed £500,000 each year since 2008 to support the active girls programme, which aims to increase the number of girls who participate in physical education, physical activity and sport in and around schools, which of course includes football. I am sure that I speak for all members in the chamber when I wish the women’s national team all the best in its efforts to qualify for the next world cup.
Heart Failure Nurses
To ask the Scottish Government how often the short-life working group on heart failure has met and what conclusions it has reached regarding strengthening the role of heart failure nurses. (S4O-03890)
The heart failure hub has met in a formal capacity twice and has been integral to two learning events, the second of which will take place on 6 February. The national programme of work that the hub is taking forward recognises that heart failure care is critically dependent on heart failure teams, with heart failure nurses being central to that. To that end, we have appointed two heart failure nurses to support the hub’s work and to draw heart failure nurses even more closely into advancing that agenda.
I thank the minister for her response and belatedly welcome her to her post. She will be aware that Orkney is the only area in the country without a heart failure nurse, which is an issue that I raised in the chamber back in 2013. It is also a concern of the Orkney heart support group, which has been in regular contact with NHS Orkney. The board accepts that a heart failure nurse would be cost effective and beneficial to patients and could reduce hospital readmissions. Will the minister agree to engage with the board to see whether it can include the appointment of a heart failure nurse in Orkney in its delivery plan for the coming year?
I am happy to engage with NHS Orkney on the matter. As Liam McArthur said, the board recognises that it does not have a heart failure nurse service, as detailed in the Scottish heart failure nurse forum’s report “Review of Specialist Heart Failure Nurse Services: Scotland 2013”.
However, we should recognise that Orkney has two consultant physicians in post and has recently recruited a third. The care of heart failure patients in Orkney is shared between the physicians who are based at Balfour hospital, who both have previous cardiology experience; NHS Grampian; and the local primary care teams. Orkney does not have a formal heart failure nurse service, but the cardiac specialist nurse, who is a heart failure nurse practitioner, and the hospital pharmacist provide advice to any member of the multidisciplinary team who is caring for a patient with heart failure in Orkney.
Lipoedema (Support)
To ask the Scottish Government what support it provides to people with lipoedema. (S4O-03891)
The Scottish Government recognises that lipoedema can be a distressing and painful condition. As with all long-term conditions, we want people who are living with lipoedema to be able to access the best care and support wherever that is possible. The recommendation of any particular treatment is a matter for discussion between a patient and their doctor, and any issues surrounding the provision of a treatment are a matter for the relevant national health service board.
Will the Scottish Government consider how to improve the support that is offered to those who have lipoedema and whether that will include increasing the number of specialists employed by NHS Scotland? I understand that, at present, there are only two such specialists in Scotland.
I understand that lipoedema can cause many difficulties and can be very painful for people who have it. I am also aware that it can take some time for some patients to receive the correct diagnosis. Increasing awareness of lipoedema is important, and I am pleased to note that the Royal College of General Practitioners launched a lipoedema course for GPs and medics in May 2014, which was developed in partnership with Lipoedema UK.
I recognise the importance of the third sector in providing valuable support to those with lipoedema, and my officials have confirmed that they will update lipoedema charities about possible opportunities for grant applications for 2015-16 under the section 16B scheme.
The Scottish Government is fully committed to providing the people of Scotland with NHS services that meet their needs and maintain high standards of care. Although the Government provides the policy framework and resources for high-quality healthcare, it is for each NHS board to decide how best to deliver services to meet the population’s needs.
Community Hospitals
To ask the Scottish Government whether it supports the role that community hospitals play in helping with the provision of local healthcare and freeing up beds in larger hospitals. (S4O-03892)
Community hospitals can play a vital role in the provision of local healthcare and are being developed to provide a range of community services. For example, bed-based intermediate care services or health and social care hubs may be developed to provide a range of medical and social care services in one place. Bed-based intermediate care can be provided as step up from home as an alternative to hospital admission, or as a step down following a hospital stay. We encourage partnerships to develop more of those services as alternatives to acute hospital admission.
The minister might be aware that, as part of a review of clinical services, NHS Borders is considering the future of hospitals in Duns, Hawick, Kelso and Peebles. I have been flooded with emails and letters from concerned residents, patients and staff who cannot understand why busy local hospitals that free up beds in the Borders general hospital might be lost.
The Scottish Government’s community hospital strategy states that community hospitals
“are more important than ever in providing both health and social care services for local communities.”
As the strategy points out, the Scottish Government’s vision for healthcare includes
“shifting the balance of care from large institutions into community settings.”
Has the minister had any discussions with NHS Borders on the suggestion that facilities in Duns, Hawick, Kelso and Peebles might close? Given the Scottish Government’s apparent support for community hospitals, will the minister join me in making it clear to NHS Borders that those local facilities must stay open, and will he rule out supporting any closures in the Borders?
I acknowledge that Mr Lamont is doing what we might expect, in that he is representing his constituency interests. However, we should not put the cart before the horse. Ultimately, the matter is for NHS Borders. I am aware that the board proposes to carry out a review of all of its clinical services and not just community hospitals. I expect any review to be carried out in line with our 2020 vision for the future of healthcare in Scotland. The proposals will have to give clear evidence of how the board will address the impact and the outcomes for people in communities.
NHS Lanarkshire (Staffing Levels)
To ask the Scottish Government whether it considers staffing levels in NHS Lanarkshire satisfactory. (S4O-03893)
In NHS Lanarkshire, staff-in-post numbers are at a record high, the number of consultants is at a record high and the numbers of qualified nurses and midwives are at record highs. National health service boards, including NHS Lanarkshire, are responsible for ensuring that they have the correct mix and number of staff to deliver and maintain high-quality services for their patients.
We expect all NHS boards to plan for their workforce, utilising staff banks where appropriate, and we have supported the development of workload and workforce planning tools, the use of which was mandated in April 2013.
Is the cabinet secretary aware that the out-of-hours service in Cumbernauld has now been closed since June 2014 because of a lack of available general practitioners, which means that local people now have to travel to Monklands hospital in Airdrie, which adds more pressure to that service? Does the cabinet secretary think that it is acceptable that that situation has been allowed to drag on for more than seven months? What action can she take to get Cumbernauld’s out-of-hours service operational again?
As Mark Griffin will be aware, NHS Lanarkshire is embarking on a review of its out-of-hours service. It is important that NHS Lanarkshire ensures that the out-of-hours service meets the needs of the local population. I hope that Mark Griffin will welcome the fact that NHS Lanarkshire will be one of the biggest gainers from the NRAC—NHS Scotland resource allocation committee—uplift that I announced this week, and is set to receive an uplift of £13.5 million in next year’s budget. I am sure that that will help when the board considers the design and provision of its out-of-hours service.
Child and Adolescent Mental Health Services (North East Scotland)
To ask the Scottish Government what its position is on the availability of child and adolescent mental health services in North East Scotland. (S4O-03894)
National health service boards have done significant work in service redesign to increase their capacity to meet the CAMHS target on a sustainable basis. As a result, NHS Grampian has identified where it needs to increase capacity and we support the board in the work that it has done, on the back of a process that gives sustainable performance.
In-patient facilities covering the north of Scotland, which includes NHS Grampian, are provided by Dudhope house in Dundee, in which an additional six beds will become available in May 2015. The additional six beds will increase the bed base serving the north of Scotland and improve the quality of the estate.
As the minister says, there is no CAMHS in-patient facility in the NHS Grampian area. Instead, a young patient from, say, my home town of Ellon would be placed more than 100 miles away from home in Raigmore hospital in Inverness, which currently has the sole CAMHS bed in the north. Even Dudhope house, which the minister mentioned, is more than 82 miles away. How are families to support their children at such distances?
One general practitioner who responded to a recent Scottish Association for Mental Health survey said:
“For mental health it needs to be local, local, local and, as much as possible, face to face”.
I need you to hurry along, please.
Does the minister agree, and how does he intend to improve my younger constituents’ access to local, responsive and age-appropriate services?
There is always an important balance to be struck and I recognise that we should seek to provide services as locally as possible where we can. CAMHS are specialist services and sadly we cannot provide them at every location, which is why they are located in specialist centres.
There is always the possibility that beds can be made available at other locations, in certain circumstances where that might be appropriate. That can be taken forward.
Delayed Discharge (Adverse Incident Reviews of Deaths)
To ask the Scottish Government whether national health service boards are required to undertake adverse incident reviews for patients dying while on the delayed discharge database. (S4O-03895)
NHS boards must ensure that a system to record such cases is in place and the medical director should consider all such cases and carry out a review if it is thought that the delay in discharge had been a contributory factor in the person’s death. Any adverse incident review should be carried out in line with guidance in the “Learning from adverse events through reporting and review” document.
There were 1,000 deaths of patients on the delayed discharge database—in other words, patients who were fit for discharge. A freedom of information request by the Labour health team shows that only two reviews were carried out. Does the cabinet secretary find that appropriate and, if not, what action will be taken?
Reviews are carried out if it is thought that a delay in discharge has been a contributory factor in the person’s death. As I described in my earlier answer, a process in the guidance in the “Learning from adverse events through reporting and review” document sets out which cases should be reviewed.
We are talking about very frail elderly people, many of whom had a number of conditions. However, I would be the first to acknowledge that, with regard to end-of-life care, many of those frail elderly people would not want to die in hospital, but would want to die with their family at home. It is quite right that they should be given that option. It is for that reason that I have said that dealing with delayed discharge and eradicating it from the health system is my top priority.
Question 16 has been withdrawn and a satisfactory explanation has been provided.
NHS Staff (Injuries at Work and Sick Leave)
To ask the Scottish Government what measures it is taking to protect national health service staff in light of recent reports of high levels of injuries at work and sick leave due to stress. (S4O-03897)
Our staff are at the heart of our NHS and their health and wellbeing is something that the Government takes very seriously. The staff governance standard for NHS Scotland commits all boards to providing a continuously improving and safe working environment, promoting the health and wellbeing of staff, patients and the wider community. Through our monitoring arrangements, we are ensuring that boards have policies and actions in place to support staff.
I am sure that everyone will agree that injuries and sickness in the NHS are a serious problem, whatever the cause. Does the cabinet secretary agree that it would be useful if health boards made available regular updates on the nature and incidence of such problems and the action that they are taking to address them?
Yes—I agree with John Pentland. What he suggests might well be useful, so I will be happy to consider how we could do that. It is important that we understand the nature of injuries, particularly when violence has been involved, and that we understand what action boards are taking to address the issues, as John Pentland said. I am happy to take that forward and I will get back to him in due course.
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