Health, Wellbeing and Sport
Good afternoon, everyone. The first item of business is portfolio question time. To get as many questions and answers in as possible, I would be grateful if they were as brief as possible.
Queen Elizabeth University Hospital (Accident and Emergency Performance)
To ask the Scottish Government what the Cabinet Secretary for Health, Wellbeing and Sport’s position is on the performance of the accident and emergency department at Queen Elizabeth university hospital, Glasgow. (S4O-04795)
Despite improvements over the summer, the level of variation in performance at Queen Elizabeth university hospital’s A and E is unacceptable. The national unscheduled care team continues to work closely with the local team on a number of improvement initiatives to ensure continuous improvement.
Figures that were published yesterday for the week ending 8 November show a 2.5 percentage point improvement on the figures for the previous week, to 88.6 per cent. The health board has suggested that performance in the latest week—the week ending 15 November—has significantly improved on performance in recent weeks, but progress continues towards the sustainable improvement that is required.
Regrettably, the performance of the Queen Elizabeth A and E has been a constant source of concern since that £842 million flagship hospital opened. Before the summer recess, two requests by me for a statement on the issue were declined. When Parliament returned in September, I was directed—when I had the temerity to raise the issue—to an answer that was given to Bob Doris.
Despite the hard work and efforts of staff, performance continues to be poor at Queen Elizabeth A and E. As I am sure the cabinet secretary knows, that was compounded by the inexcusable death of an elderly man who was left languishing on a trolley. I say to her that my west of Scotland constituents, having been redirected to the Queen Elizabeth following the closure of the more easily reached Victoria infirmary, find themselves in a vastly superior facility but with an inferior service. They have heard the warm words.
Can you come to the question, please?
Those words were added to this week by promises of the achievement of targets and improved services by the spring—I emphasise the spring. However, this summer’s similar promises came to nothing. What my constituents want to know now is not that everything is being done but, specifically, what exactly is being done by both the health board and the cabinet secretary. Can she tell us?
First, it is essential that the new flagship hospital, as Jackson Carlaw described it, performs well not just in its A and E department but across the hospital. I confirm that staff are working hard to achieve that and that the support team has continued its work. Of course, an answer was given about that team’s work over the summer.
Jackson Carlaw mentioned the immediate assessment unit, which is not the same as the A and E department but is an important component of the new hospital. I deeply regret the death of the elderly gentleman on a trolley. That is unacceptable and a full review into his treatment has been initiated. It is very important that that happens.
I can say that further developments around the immediate assessment unit have been taken forward. As of this week, there is a new ambulatory care area that is capable of seeing 10 patients at a time and there is an alternative location for the assessment of surgical and neurology patients. I visited the assessment unit and the ambulatory service this morning, and I can tell Jackson Carlaw that staff are working hard to make the changes and that improvements from those changes are already visible.
I assure Jackson Carlaw and everyone else in the chamber that I take a daily interest in the issue because it is important that the hospital performs as it should. The staff need to be supported to deliver that.
I do not think that any of us doubts that the cabinet secretary is trying to be on top of this, and nor do we doubt that the staff are working hard. However, the continuing problem with the A and E unit indicates that it is underresourced: there is not enough space, staff or time to get patients through.
In addition, we now know that, under various names, there are 13 similar immediate assessment units across Scotland, which are not subject to the A and E waiting times. The public require a clear explanation of what is going on. Will the cabinet secretary provide a statement about what is actually going on? The Queen Elizabeth hospital’s problems are no longer teething problems; they involve serious issues that might have long-term effects.
Richard Simpson again conflated two things—the A and E unit and the immediate assessment unit. Let us talk about the immediate assessment unit. NHS Greater Glasgow and Clyde has said clearly that that needs to be bigger than the modelling that was done suggested, so steps are being taken immediately to create the ambulatory care area and to make the other changes that I mentioned in order to free up capacity. The health board is also expanding the size of the unit, which it has been given until mid-December to do. It is doing that so that the unit is the size that is required. That is not about not having enough staff in A and E; it is about the immediate assessment unit not being big enough and not having the capacity. That is being acted on and will be changed.
Richard Simpson mentioned the units that, as he said, have grown up across Scotland in different ways over many years. He is right—they are not subject to the four-hour target. I hope that he is aware that the Royal College of Physicians of Edinburgh has begun work with the Scottish Government over the past few months on whether we can standardise those units and how we can ensure that performance is monitored and that patient safety is at the forefront of all that work. That work is on-going and, when it concludes, I will be more than happy to inform Parliament of that in whatever way makes the most sense.
If we are going to get through the questions, we need short questions and answers, please.
Royal Infirmary of Edinburgh (Private Finance Initiative)
To ask the Scottish Government what recent discussions it has had with NHS Lothian regarding the private finance initiative contract at the Royal infirmary of Edinburgh. (S4O-04796)
Scottish Government officials meet NHS Lothian staff regularly to discuss a range of finance and infrastructure topics. The management of the Royal infirmary of Edinburgh contract is NHS Lothian’s responsibility; any particular issues relating to the contract can be discussed in that forum. Since April, NHS Lothian has been working to develop and consider a range of options to improve the Royal infirmary of Edinburgh contract. Officials are supporting NHS Lothian in those efforts.
I welcome the Scottish Government’s commitment to work with NHS Lothian to improve the cost-effectiveness and transparency of a PFI contract that is widely believed to be against the public interest. I am aware that part of the process of identifying savings was the establishment of an expert review group at the hospital to carry out a full financial health check of the contract’s current and retrospective performance. Will the cabinet secretary provide me with an update on that health check and whether any further savings have been identified for the benefit of the taxpayer?
I am certainly aware of the member’s concerns about—and interest in—the contract for the hospital. He can be assured that I share his concerns and that I support NHS Lothian’s work to make those improvements. It has established a group to identify and examine a full range of options for the future management and operation of the PFI contract with the goal of improving value for money. It is being supported in that work by officials and by the Scottish Futures Trust.
The focus is on a long-term improvement in the performance and value for money of the services that are delivered through the PFI contract rather than simply achieving savings in the short term. NHS Lothian is actively investigating ways in which the contract might be improved and has strengthened the in-house management arrangements.
Proposals made by the group will be fully considered as regards affordability, value for money and the benefits that they will deliver. I am happy to keep the member informed about that.
Question 3, in the name of Neil Bibby, has not been lodged. An explanation has been provided.
Breast Cancer Treatment (Availability of Drugs)
To ask the Scottish Government for what reason the drug, Afinitor, is not available on the national health service in Scotland for the treatment of breast cancer. (S4O-04798)
The Scottish Medicines Consortium provides advice to NHS Scotland on newly licensed medicines. The independence of the Scottish Medicines Consortium’s decisions on individual drugs is well established.
The SMC did not recommend everolimus for breast cancer because of uncertainties surrounding the overall clinical benefit that the medicine would provide for patients taken against the price that is charged for the drug. As the member will be aware, the SMC is expecting a resubmission from the pharmaceutical company for the drug.
I thank the cabinet secretary for that answer. The matter is of great concern to my constituents, as they have to travel south to get certain treatments on the NHS, including Afinitor. Have any steps been taken to ensure that that does not need to happen?
Sometimes different decisions on drug availability are made by the National Institute for Health and Care Excellence and the SMC. Sometimes NICE does not approve drugs that are available in Scotland.
We base our decision making on what the SMC advises. I remind the member that we have a £90 million new medicines fund that has been established for the purpose of getting drugs for orphan and ultra-orphan conditions into patients’ hands. Even when the SMC has not approved a drug for widespread use, there is still an opportunity for the patient to apply through the individual patient treatment pathway.
I remind the member that we are reviewing the SMC, and patients’ views on such issues will be an important part of that process.
General Practitioner Services (Mid Scotland and Fife)
To ask the Scottish Government what action it is taking to ensure access to GP services in the Mid Scotland and Fife region. (S4O-04799)
Under the legal framework for service provision, national health service boards are responsible for ensuring the provision of primary medical services for their areas. NHS Fife works with general practitioner practices to ensure that everyone in Fife has access to GP services.
I have written to the cabinet secretary recently regarding The Cannons surgery in Methil, which has recently been taken over by NHS Fife due to a failure to recruit two principal GPs. Kirkcaldy is also experiencing severe pressure, with eight surgeries now closing their lists to patients. Can she tell us how much of the additional £60 million that was announced in June will go towards supporting GP services in Fife?
In her recent reply to me, the cabinet secretary said that the Government was developing short-term recruitment initiatives. Can she tell me what discussions she has had with NHS Fife to make progress in that respect?
I recently discussed a number of issues with the chair of NHS Fife. I assure Claire Baker that we are determined, through our investment of £60 million, to tackle recruitment and retention issues.
Some of those issues will be addressed in the medium to long term as we encourage more young doctors into general practice. In the meantime, we are doing everything that we can through recruitment and retention initiatives to attract both people who may have left the profession but might be encouraged to come back and those who are looking for positions in the health service in Scotland. We are offering opportunities for GPs and others to come and work in the NHS in Scotland and are looking at every opportunity to promote those.
Claire Baker mentioned the surgery in Methil. It is not uncommon for boards to take over practices to ensure continuity of service to patients, and it should not be viewed as negative.
I accept—as I am sure Claire Baker has heard me say before—that we have a lot more to do to ensure the sustainability of GP services in Fife and elsewhere in Scotland, but we are determined to do that.
The cabinet secretary recently wrote to me, stating:
“there is an increasing awareness of practices facing sustainability challenges across Scotland”.—[Written Answers, 13 November 2015; S4W-28198.]
Including the Mid Scotland and Fife region, six health boards have experienced decreases in GP numbers since 2007, and we face a shortage of 900 GPs in the next 10 years. I would like more detail from the Scottish Government today on how it will guarantee that rural and remote areas such as Mid Scotland and Fife will not be disproportionately affected by GP shortages.
I am sure that Jim Hume will be aware of all the discussions that we are having around making general practice more attractive. The new contract discussions are under way; we are looking at a transition year, with a major dismantling of the quality outcome framework arrangements in advance of a new contract being put in place; and there are new models of primary care, all of which are designed to encourage young doctors to choose general practice as an option.
We will look at the other mechanisms or methods that we require in order to make general practice the choice of young doctors and we are looking at how we expand access to medicine. We have also, of course, just expanded the number of GP training places by a third.
We are doing a lot of comprehensive work on the issue. Some parts of that will take a bit longer than other parts to deliver, but the member can be assured that we absolutely give the matter top priority.
Community Optometry Services (Glasgow)
To ask the Scottish Government how it is seeking to enhance community optometry services in the Glasgow region. (S4O-04800)
The term “general ophthalmic services” describes the national arrangements for the provision of high-street optometric services, including, since 2006, the provision of free eye examinations for people living in Scotland. Where appropriate, national health service boards, including NHS Greater Glasgow and Clyde, can use shared service arrangements to tailor service provision in their area to suit local needs, such as by rebalancing service provision from acute centres to high-street optometrists.
Many more patients are now being treated in the community, with optometrists able to manage the treatment of certain eye conditions such as glaucoma. That is supported by our recent investment of £1.5 million to provide every community optometrist with a pachymeter—a device that will help to better refine referrals for glaucoma and ocular hypertension—and to enable more patients to be retained and managed in the community in line with the Scottish Government’s 2020 vision.
The minister mentioned the redesign of services in Glasgow so that my constituents can get speedier and more effective treatment in the acute sector where necessary. Does the minister agree that it is important that my constituents know that the first port of call for eye care should be the community optometrist, thereby taking pressure off the acute sector and ensuring that they get quality treatment in the local community for their eye health? Does the minister agree that we should raise awareness of that to ensure that everyone is as informed as possible and sees the most appropriate allied healthcare professional for their healthcare needs?
Yes, the Scottish Government is committed to providing a first-class community-based eye healthcare service in Scotland. As I said, treating more patients in the community is entirely consistent with our 2020 vision. Community optometrists are better placed than ever to manage a wide range of conditions in the community. For example, the provision of national health service prescribing pads is allowing an increasing number of optometrists in Scotland to treat acute eye conditions. A third of all the independent prescribing optometrists in the United Kingdom are in Scotland.
Red and Processed Meat (Carcinogenicity)
To ask the Scottish Government what its response is to the recent World Health Organization report on the carcinogenicity of red and processed meat. (S4O-04801)
We welcome the latest report on the issue from the WHO. The report classes the consumption of red meat as probably carcinogenic to humans and the consumption of processed meat as carcinogenic to humans. The findings are broadly in line with the recommendations in 2010 from the independent United Kingdom Scientific Advisory Committee on Nutrition, which are that we limit intakes of red and processed meat to no more than 70g a day.
Scotland’s dietary goal for red and processed meat is based on the latest evidence from the Scientific Advisory Committee on Nutrition’s report “Iron and Health”, which reflects the links between high consumption of processed meat and certain cancers while recognising that red meat is a good source of nutrients and can be consumed as part of a healthy balanced diet.
In view of the additional advice from the World Health Organization based on studies that show a higher risk of colorectal cancer in people who eat a diet that is low in vegetables, legumes and whole cereals, does the minister agree that we need to heed overall collected advice about a healthy diet and recognise the value of vegetable consumption and a high-fibre diet generally?
Yes, and I recognise the member’s continuing interest in the area. He is correct that we need to look at the overall balance of the diet. Food Standards Scotland advises eating a healthy balanced diet, including plenty of fruit, vegetables and starchy carbohydrates, as well as some dairy foods and some meat, fish or vegetarian alternatives, while, as we know, avoiding foods that are high in fat, sugar and salt. The Scottish Government is taking a range of action to improve diet. We are spending more than £10 million in the four years to 2016 on projects to encourage healthy eating. Those include our eat better feel better campaign, which will launch its next phase in January and will include advice on how to affordably increase fruit, veg and fibre intake.
We know from the evidence from academics and the cancer conference that took place this Monday that public health campaigns are valuable but do not hit those of our populations that suffer the most health inequalities. Given that 40 per cent of cancers are preventable, what specific action is the Scottish Government taking on diet and public health?
In my previous answer I gave an example of some of the ways in which we are trying to improve the country’s health. I recognise that, as Jenny Marra suggests, there is still inequality in relation to those who suffer from cancer, but the figures are going in the right direction. However, we know that more is needed to be done.
General Practitioner Services (Staffing Levels)
To ask the Scottish Government what assistance is available for general practices that encounter problems regarding staffing levels. (S4O-04802)
Over the next three years, the Scottish Government will invest £60 million, as part of the primary care fund, to address immediate workload and recruitment issues in primary care, and will put in place long-term sustainable change to support general practitioners and improve access to services for patients.
As part of that, £2.5 million will be invested in work to explore with key stakeholders the issues surrounding GP recruitment and retention. That investment is beginning the process of finding new ways of working, which is helping to address the problems of recruitment and retention that are common to primary care services across the United Kingdom
We have on a number of occasions in the chamber explored the deep-end practices—in particular, the Balmore practice in my constituency. What action will the cabinet secretary take to assist that practice, which has been reviewed by NHS Greater Glasgow and Clyde and has been told that it will have further help to review its processes and help with “lean working”—whatever that might be? Such practices need help now; money that will be invested in the future will not help them out of the immediate crisis. What action can be taken to assist them now?
It would be unfair to suggest that no support has been given to the Balmore practice. I have a list here of the support that is being provided. The practice is being provided with three additional doctor sessions per week, which is providing the headroom to engage in a comprehensive review package that involves several other professional groups, in order to better understand the underlying reasons for the situation. The practice review support team includes an experienced GP and other clinical support.
I am aware that the health board has again been in discussions with the Balmore practice about extending support for it into the new year. The board has no interest in leaving the practice in a fragile state; it wants to continue to work with and support it.
In her wider point, Patricia Ferguson raised issues about which I have spoken to her before in the chamber. The new contract provides an opportunity to better recognise the needs of practices that work in areas of deprivation than the current contract does. I am very keen to take that forward. In the meantime, I will keep a very close eye on the communications between NHS Greater Glasgow and Clyde and the Balmore practice. It is important that those communications lead to the practice being sustainable, not just in the short term, but as we go forward.
I thank the cabinet secretary for meeting me to discuss retention problems at Balmore practice in Possilpark. I welcome the fact that GP locum support will be extended into January, but I ask the cabinet secretary to urge—as I have done—NHS Greater Glasgow and Clyde to extend that support to the end of March in order to support the practice at the height of its winter pressures and to provide it with the breathing space to find a long-term solution.
I will continue to have discussions with the NHS board, as I intimated to Bob Doris when I met him and as I have said today. I want the board to do what it can to support the Balmore practice.
I should say that NHS Greater Glasgow and Clyde is in communication with other practices in the area that are performing very well indeed, so it is not fair to say that all the practices in the area face the same challenges. Balmore has challenges that are particular to Balmore: it is important to recognise that.
It is important that the health board supports Balmore. We want the practice to be a success and I will encourage the board as far as I can to do all that it can to support the practice through the winter and beyond.
Pancreatic Cancer (Treatment)
To ask the Scottish Government what the success rate is of the treatment of pancreatic cancer and whether it will provide an update on progress with research. (S4O-04803)
We know that the outlook for people who are diagnosed with pancreatic cancer remains poor in comparison with other cancers. In Scotland, age-standardised five-year relative survival for men is approximately 3.6 per cent and for women it is approximately 5.5 per cent.
Scotland is currently the only part of the United Kingdom whose Government is specifically co-funding research into pancreatic cancer with a charity. Our chief scientist office and Pancreatic Cancer UK committed £75,000 to fund two Scottish-led projects that submitted bids to the research innovation fund. I was delighted to confirm at the pancreatic cancer event at the Scottish Parliament earlier this week that the co-funding arrangement is to be extended for a further year, which will make almost £400,000 available to fund research into pancreatic cancer in Scotland.
I thank the cabinet secretary for her answer. She is clearly aware that survival rates for the disease lie far behind those of other cancers, particularly when measured over the one-year and five-year survival rate period. We know that early detection of cancer is vital, but it is particularly difficult with pancreatic cancer. Will the cabinet secretary consider how we make further progress with it through public education, screening or further research?
At last night’s event, I spoke to clinicians and patients and was struck by the importance of detecting pancreatic cancer early. Because of the nature of its symptoms, that is not easy to do. Patients who had survived had done so because the cancer had been detected early. That is why research is very important; the resources that I mentioned in my first answer will help.
We are well placed to be a leader in research. The stratified medicine Scotland innovation centre that is based at the new hospital in Glasgow is an example of a Scotland-wide initiative that will allow many diseases in the population to be studied at molecular level. I hope that the new cancer plan that we are working on with stakeholders will help to gather some of the issues for pancreatic and other cancers in order to see how we will take this forward during the next five to 10 years.
National Health Service Workforce Challenges (Rural Areas)
To ask the Scottish Government what action it is taking to tackle NHS workforce challenges in rural areas. (S4O-04804)
We recognise the particular challenges that are faced by national health service boards in securing a sustainable workforce for the future in remote and rural areas. The Scottish Government is supporting a number of initiatives to help to address that. We are working with boards to sustain services in remote and rural hospitals by developing networks with urban hospitals. In some areas, that involves rotating staff between hospitals. Through the being here programme, the Scottish Government is funding new primary care approaches in four NHS Highland sites. NHS Education Scotland has developed rural fellowships to give qualified general practitioners the opportunity to work in rural areas and to develop the generalist skills that are required for work in those areas.
I thank the cabinet secretary for that answer. As she knows, the NHS Tayside 20:20 vision document seeks to increase the delivery of health services in rural settings. However, projected population-change figures for Angus up to 2037 predict a marked downturn in the number of residents from the age range from which the NHS could recruit staff, and a sizeable increase in the number of over-75s, which is the age group that is most likely to require health services.
Is the Scottish Government aware of the demographic challenge to NHS Tayside that is peculiar to Angus? What measures might be taken to tackle the problem?
We are aware of that challenge and we expect NHS board workforce planners, including those in NHS Tayside, to take full account of local factors, including the demographic to which Graeme Dey has referred, in preparing the required workforce plans and projections.
We are working with human resources directors and board workforce planners to support a more consistent and sustained approach to national NHS workforce data and intelligence, to ensure that there are enough staff and that they are in the right place doing the right thing at the right time. I am sure that that will help to address some of the concerns that Graeme Dey has for parts of his constituency.
The cabinet secretary will be aware that professional recognition and pay often depend on the depth of knowledge that a clinician or member of the medical team has, rather than the breadth of knowledge that is often required in rural medicine. What will she do to change that balance and make rural medicine more attractive?
Rhoda Grant makes a fair point. We know that the skills mix and the level of skill that is required to work in rural medicine, whether in primary or in secondary care, are very challenging and are not recognised as they should be.
A lot of good work has been done on recognising rural medicine as a discipline in itself. The sustainability of the six rural general hospitals has been about putting that discipline of rural medicine to the fore. There is more work that we can do to help recruit and retain staff and I am happy to look at that in more detail as we take those matters forward.
Public Access Defibrillators
To ask the Scottish Government what support is available to provide public access defibrillators to communities. (S4O-04805)
Increasing the accessibility of public access defibrillators—PADs—is a key part of our goal to reduce the number of out-of-hospital cardiac deaths. In 2014, the Scottish Government invested considerably in providing PADs across Scotland. That included £1 million to install defibrillators in dental surgeries and £100,000 to increase the number of PADs available across Scotland’s communities. The Scottish Ambulance Service offers support and advice to organisations that are interested in putting a defibrillator in place. That includes guidance on funding sources, and there is a range of initiatives to provide support for PADs.
A key aim of our strategy for out-of-hospital cardiac arrest, which was launched in March 2015, is to enable the public to recognise early signs of cardiac arrest and take appropriate action to save lives. To realise that, communities across Scotland participated in the launch of save a life for Scotland, which was held in October 2015 and provided opportunities to learn cardiopulmonary resuscitation.
What training is given to dispatchers at the Scottish Ambulance Service’s command and control centres regarding the location of PADs and when they should be used? What procedures are in place to ensure that PADs across Scotland are accurately logged into the system?
The member makes a good point. The Scottish Ambulance Service is pivotal in the co-ordination, clinical governance, quality assurance and delivery of much of the response to our out-of-hospital cardiac arrest strategy. It has agreed to realise a number of actions to support the successful leadership and implementation of the strategy. A key commitment of the strategy is to optimise systems and training in ambulance control centres to provide a rapid recognition of cardiac arrest and expert support to bystanders in using PADs and to maintain and extend the community first responder network.
Child and Adolescent Mental Health Services
To ask the Scottish Government what action it is taking to improve child and adolescent mental health services. (S4O-04806)
We introduced the CAMHS health improvement, efficiency and governance, access and treatment—HEAT—target for faster access to specialist care. That has resulted in significant reductions in the time that children and young people have to wait to access specialist child and adolescent mental health services. Since 2009, we have made £16.9 million available to national health service boards to increase the number of psychologists working in specialist CAMHS, and we have further committed another £3.5 million this year.
In May 2015, we announced an additional £85 million over five years for mental health. That is in addition to the £15 million over three years that was announced in November 2014 for the mental health innovation fund. Part of that money will go to make further improvements to child and adolescent mental health services and to bring down waiting times.
The Audit Scotland report “NHS in Scotland 2015” shows that the 90 per cent target for CAMHS was not met in 2015. It was at 81.1 per cent, which was down from 98.5 in 2013, after the waiting times were lowered from 26 weeks to 18 weeks. Although reducing the waiting time is a positive step, the Scottish Government will fail young children who suffer from mental health issues unless sufficient resources are in place. Of particular concern to me are the 6,000 children a year whose referrals are rejected. Will the Government at the very least undertake an audit of the outcomes for those children?
We are disappointed that some NHS boards will not meet the target, but we should reflect on the journey that has been taken. We have seen an increase in the number of referrals from 4,734 in June 2012 to 7,077 in June 2015 and an increase in the number of children seen from 2,640 in June 2012 to 4,444 in June 2015. NHS boards are doing a significant amount of work in redesigning their services to increase their capacity to meet the CAMHS target on a sustainable basis.
We not only monitor the outcomes of the children who are in referral but continue to notice how many are not referred onwards.
Cleft Palate Unit (Edinburgh)
To ask the Scottish Government whether the cleft palate unit in Edinburgh will be retained. (S4O-04807)
Yes, because only the specialist surgical element of cleft services is within the scope of the review that is under way. All other services that are delivered by the cleft palate unit in Edinburgh and the wider cleft network are unaffected and will continue to be delivered locally, because only the specialist surgical element of cleft services is part of this consideration.
A review is under way to identify sustainable delivery of high-quality, specialist cleft surgery in Scotland. We have seen the recommendation from the options appraisal group to locate cleft surgery on a single site in Glasgow, but that does not represent our final decision at this stage.
I thank the cabinet secretary for the clarity of that answer and say to her that parents were devastated at the decision to remove cleft surgery from Edinburgh. Surgery is a key part of that unit. Will she clarify whether the serious concerns about outcomes for patients with cleft surgery have been acknowledged? That is a key issue. People are worried that there will be damage to patient health and that the analysis was not carried out—
What is the question?
Is the cabinet secretary aware that the analysis to look at patient outcomes was not properly carried out; that people are very concerned that there was no proper, independent review; and that parents, patients, staff and other stakeholders were not consulted about the decision, which they were reassured four months ago would not happen?
The cleft community across Scotland was consulted on the need for an options appraisal in August. The aim of the consultation was to invite comments not just from clinicians but from patients, families and the Cleft Lip and Palate Association to inform the options appraisal exercise. A public engagement meeting was hosted by the national services division and supported by CLAPA in October. That engagement highlighted that the options appraisal would consider the configuration of the cleft surgical service only, not other services.
The NSD has advised that stakeholders will have further opportunities for input before a final decision is made. The process for that, briefly, is that the findings from the options appraisal group will be considered by the national specialist services committee on 9 December. It will then make a recommendation on the way forward to NHS board chief executives, before the final recommendation is passed to the Scottish ministers for a decision in the new year.
Acquired Brain Injury Survivors (Lothian)
To ask the Scottish Government what plans it has to improve outcomes for people who have survived an acquired brain injury in Lothian. (S4O-04808)
This year, the Scottish Government has provided £40,000 grant funding to NHS Lothian to support a pilot project, designed by the Scottish acquired brain injury network, that aims to ensure that all admitted head-injured patients will be cared for by neuroscience clinicians in a dedicated multidisciplinary service. The project aims to deliver recommendations for a systematic roll-out of the model across Scotland which, if implemented, could represent a huge improvement in standards and put Scotland at the forefront of integrated brain injury services.
Does the cabinet secretary agree that the Edinburgh Headway Group is doing a phenomenal job in the field and does she share my view that it has a vital role to play?
Yes, I agree with that. I pay tribute to the work of the Edinburgh Headway Group, which does a fantastic job, as do many organisations working in the field. It is a particularly stand-out organisation, and I hope that it continues to do that work.
National Health Service Boards (Winter Planning)
To ask the Scottish Government what discussions it has had with national health service boards regarding planning for winter. (S4O-04809)
Scottish Government officials and I engaged with NHS boards over the spring and summer to agree and develop winter planning guidance for 2015-16. That guidance was issued to boards almost two months earlier than the guidance was issued last year. As part of the winter planning process, we met all boards at a national event on 17 September to discuss winter plans and preparations. I have monthly meetings with the chairs of boards and, at our most recent meeting, we considered boards’ winter preparations. This year, we have allocated over £10.7 million of additional funding to help boards to prepare for winter.
The cabinet secretary will be aware that NHS Lothian faced a challenging winter period last year. What reassurances can she give the people in my constituency and throughout the Lothians that the challenges will be met this year and going forward?
NHS Lothian and its partners have strengthened their winter planning this year by taking an approach across all health and social care services within the board. Their winter plan sets out how the board and its partners will support the avoidance of admissions and delayed discharge this winter. The board also has contingency plans to open additional staffed acute beds in a managed and orderly way, and it is investing in its allied health professional and imaging workforce to enable seven-day working to support effective discharge.
We have learned lessons from last winter about what the additional moneys should focus on. One important element, not just in Lothian but elsewhere, will be ensuring that weekend discharge takes place and social care assessments happen over the festive period.
I apologise to those members who have been unable to ask their questions.