Chamber and committees

SCOTTISH PARLIAMENT

WRITTEN ANSWER

6 November 2012

Index Heading: Health and Social Care

Helen Eadie (Cowdenbeath) (Scottish Labour): To ask the Scottish Government how it will ensure that GPs make information on rheumatoid arthritis available to the public.

(S4W-10462)

Michael Matheson: A Health Care Needs Assessment (HCNA) on Rheumatoid Arthritis (RA) has recently been published. This was conducted by the Scottish Public Health Network at the request of Scottish Government and outlines current RA service provision across Scotland. It makes a number of recommendations that aim to assist NHS boards to plan and develop services for people living with RA.

The HCNA highlights the role of primary care and the need for clear referral pathways, as well as the importance of informed self management in the management of RA.

It is for NHS boards to plan and provide services in accordance with national and local priorities, in line with the health needs of their resident populations. NHS boards will need to consider how they will take the recommendations in the HCNA forward.

NHS Inform website already provides a range of information on RA and links to voluntary organisations who can provide advice and support on living with the condition. Further information is available at:

http://www.nhsinform.co.uk/health-library/articles/r/rheumatoid-arthritis/introduction.

The Scottish Government has provided funding to Arthritis Care Scotland to help establish its website “Connect Scotland”. The site has been written by and is for people living with arthritis. It aims to help them and health professionals to access information, share experiences and build community networks.

The recently published Health Care Needs Assessment (HCNA) on Rheumatoid Arthritis was conducted by the Scottish Public Health Network at the request of Scottish Government. The HCNA outlines current RA service provision across Scotland and makes a number of recommendations that aim to assist NHS boards to plan and develop services for people living with RA and support them to become more person centred, safe and effective.

The report highlights the role of the multidisciplinary team (MDT) in the management of RA in both the early and chronic disease stages and provides a recommendation for NHS boards that all patients should have access to assessment by a full MDT.

It is for NHS boards to plan and provide services in accordance with national and local priorities, in line with the health needs of their resident populations. NHS boards will need to consider how they will take the recommendations in the HCNA forward.

In addition the consultation on proposals for the integration of adult health and social care in Scotland was launched on 8 May 2012 and concluded on 11 September 2012 .

The objectives of the intended changes to legislation are:

That Health and social care services are firmly integrated around the needs of individuals, their carers and other family members;

That they are characterised by strong and consistent clinical and care professional leadership;

That the providers of services are held to account jointly and effectively for improved delivery; and

That services are underpinned by flexible, sustainable financial mechanisms that give priority to the needs of the people they serve – rather than the organisations through which they are delivered.

The role of the Scottish Government is to provide policies frameworks and resources to NHS boards in order that they can deliver services that meet the needs of their local population.

It is for NHS boards to plan and provide services in accordance with national and local priorities and in line with the health needs of their resident populations. NHS boards are expected to review services and facilities regularly to ensure that they continue to reflect local needs and provide quality healthcare services.

This information is not held centrally.

The Scottish Government is committed to patients in Scotland receiving medicines of established cost-effectiveness and therapeutic value.

NHS boards and clinicians are expected to take full account of advice from the Scottish Medicines Consortium and Healthcare Improvement Scotland in the planning and provision of NHS services.

The decisions of individual clinicians in relation to patient care are a matter of professional judgement. However, all NHS staff operate within the management framework of their employing organisations.

SCOTTISH PARLIAMENT

WRITTEN ANSWER

6 November 2012

Index Heading: Health and Social Care

Helen Eadie (Cowdenbeath) (Scottish Labour): To ask the Scottish Government how it will ensure that GPs have greater awareness of rheumatoid arthritis to enable earlier identification of the disease.

(S4W-10461)

Michael Matheson: A Health Care Needs Assessment (HCNA) on Rheumatoid Arthritis (RA) has recently been published. This was conducted by the Scottish Public Health Network at the request of Scottish Government and outlines current RA service provision across Scotland. It also made a number of recommendations that aim to assist NHS boards to plan and develop services for people living with RA.

In addition, the Scottish Intercollegiate Guideline (SIGN) 123 on the Management of Early Rheumatoid Arthritis, provides clinicians in NHSScotland with evidence based recommendations for the diagnosis and management of early rheumatoid arthritis. Implementation of the guideline is a key way of supporting delivering safe, effective and person centred services and raising awareness of this condition.

The Scottish Government has good working relationships with stakeholders who care for and support people living with RA, including voluntary sector organisations. We will continue to work with stakeholders to help raise awareness of RA in Scotland.

The Scottish Government has also provided 16B funding of £81,000 over three years to Arthritis Care Scotland to help establish its website 'Connect Scotland'. The site is has been written by and for people living with arthritis, and aims to help them, and health professionals, to access information, share experiences and build community networks.

Figures for hospital stays for rheumatoid arthritis are shown in Table 1 and for “juvenile arthritis” in Table 2, as follows:

Table 1 - Number of rheumatoid arthritis hospital stays by financial years 2007-08 –2011-12, by (a) primary and (b) secondary diagnosis based on ICD10 codes M05 and M06

Source: ISD Scotland SMR01.

p - provisional - Due to the implementation of new Patient Management Systems by some NHS boards there is known data incompleteness for NHS Grampian in the most recent year. Figures may increase in future revisions.

Table 2 - Number of “juvenile arthritis” hospital stays by financial years 2007-08 – 2011-12, by (a) primary and (b) secondary diagnosis, based on ICD10 code M08 excluding M08.1.

Source: ISD Scotland SMR01.

p - provisional - Due to the implementation of new Patient Management Systems by some NHS boards there is known data incompleteness for NHS Grampian in the most recent year. Figures may increase in future revisions.

A Health Care Needs Assessment (HCNA) on Rheumatoid Arthritis (RA) was recently published. It was conducted by the Scottish Public Health Network at the request of Scottish Government and makes a number of recommendations that aim to assist NHS boards to plan and develop services for people living with RA.

NHS boards will need to consider how they will take the recommendations in the HCNA forward. A number of the recommendations within the HCNA are applicable nationally and we are considering these and how we can support NHS Boards to take them forward. This will be done through discussions with NHS Boards and stakeholders including NHS Education for Scotland for any training and educational needs that may be identified as a result of the HCNA.

The training provided to GP trainees is guided by the learning outcomes described in the Royal College of General Practitioners (RCGP) UK curriculum for GP training. The curriculum has a section on the care of people with Musculoskeletal problems, which includes inflammatory arthritis such RA. The outcomes include management of the condition, with the teams in primary and specialist care, following timely diagnosis. The training delivers competencies in holistic and comprehensive approach.

The policy of annual appraisal process, which contributes to the revalidation of GPs, helps GPs to identify their learning needs to address the healthcare needs of their patients. GPs are supported by health boards (e.g. Protected Learning Time), and other organisations such as the post graduate deaneries, NHS Education for Scotland, the Medical Royal Colleges and others, who provide the opportunities for GPs to undertake relevant and high quality Continuous Professional Development activities.

These can be accessed in several different ways such as through medical journals, national and local guidelines, courses, electronically through the Knowledge Network, and others. GPs as Members or Fellows of the RCGP can access the learning materials and guidelines developed and supported by the RCGP, and delivered in various accessible formats e.g. lectures, journals, research articles, e-learning.

NHS boards and clinicians are expected to take full account of advice from the Scottish Medicines Consortium and Healthcare Improvement Scotland in the planning and provision of NHS services.

Information on which NHS boards have not yet made treatment approved by the Scottish Medicines Consortium or the National Institute for Health and Clinical Excellence (NICE) for use in rheumatoid arthritis available to people with a clinical need is not held centrally.

The information is not collected or held centrally to the level of detail requested.

SCOTTISH PARLIAMENT

WRITTEN ANSWER

6 November 2012

Index Heading: Health and Social Care

Helen Eadie (Cowdenbeath) (Scottish Labour): To ask the Scottish Government what progress it has made in reviewing evidence on the need for better access to flare-up and pain management services for people with rheumatoid arthritis and when it will produce an action plan.

(S4W-10479)

Michael Matheson: A Health Care Needs Assessment (HCNA) on Rheumatoid Arthritis (RA) has recently been published. This was conducted by the Scottish Public Health Network at the request of Scottish Government and outlines current RA service provision across Scotland. It also makes a number of recommendations that aim to assist NHS boards to plan and develop services for people living with RA.

The HCNA highlights the role of the multidisciplinary team (MDT) in the management of RA in both the early and chronic disease stages and provides a recommendation for NHS boards that all patients should have access to assessment by a full MDT. The report also recommends that patients and primary care teams have easy access to the rheumatology team for rapid assessment in the event of a flare up.

The role of the Scottish Government is to provide policies, frameworks and resources to NHS boards in order that they can deliver services that meet the needs of their local population.

It is for NHS boards to plan and provide services in accordance with national and local priorities, in line with the health needs of their resident populations. NHS boards will need to consider how they will take the recommendations in the HCNA forward.

The Scottish Government are working with Healthcare Improvement Scotland to improve services for people living with chronic pain. The National Lead Clinician and Steering Group for Chronic Pain to implement the Scottish Service Model for Chronic Pain. The Scottish Government has made funding of £100,000 available over two years to assist with the establishment service improvement groups/managed clinical networks. This will benefit people living with a range of long term conditions including arthritis.