Chamber and committees

Information on expenditure on agency locum doctors is shown in the following table:

NHS Board	2006-07	2007-08	2008-09	2009-10
Ayrshire and Arran	£5,733,592	£6,017,043	£2,048,004	£3,583,996
Argyll and Bute	-	£497,896	£380,018	£0
Borders	£398,530	£422,522	£299,016	£542,367
Dumfries and Galloway	£1,579,143	£1,680,058	£1,382,631	£2,735,478
Fife	£1,621,714	£1,581,676	£2,235,818	£2,708,564
Forth Valley	£1,979,891	£1,484,407	£1,390,000	£1,499,487
Greater Glasgow and Clyde	£1,605,703	£2,836,492	£6,408,816	£7,288,868
Grampian	£448,602	£2,644,764	£2,934,454	£3,276,282
Highland	£1,941,441	£2,442,900	£3,018,694	£3,408,344
Lanarkshire	£1,564,088	£1,772,429	£3,069,234	£3,069,551
Lothian	£1,152,867	£2,169,541	£2,771,294	£4,999,299
Orkney	£695,603	£328,206	£1,070,737	£729,686
Shetland	-	£283,298	£307,424	£433,838
Tayside	£788,902	£581,694	£1,055,830	£2,054,320
Western Isles	£188,488	£468,153	£645,209	£614,046
Total	£19,598,566	£25,211,082	£28,557,535	£36,892,619

Source: NHS National Services Scotland National Procurement data collected from NHSScotland boards accounts payable information.

To reduce the use and costs of agency locum doctors we have reminded Chief Executives of the importance of following the existing Code of Practice on the employment of supplementary medical staff in order to ensure patient safety and achieve best value for money. Guidance has also been issued to NHS boards for action on reducing the demand for supplementary medical staff and, where their use is unavoidable, to ensure that they are high quality and affordable. The guidance describes the steps necessary to reduce demand for supplementary staff and the development of medical banks at NHS board or regional level.

In addition, NHS National Services Scotland National Procurement put in place a new framework contract for the procurement of agency medical staff, which should make the process easier and more cost-effective.

Sixty-seven members of staff from the Directorate-General for Health have been on work-related trips abroad between 2008 and 2010. They visited a number of countries in Europe as well as the United States of America, Canada, New Zealand and India.

The information on NHS agencies and NHS boards is not centrally held.

We are committed to improving the quality and accessibility of information that is available to people and their carers throughout their care journey, both to raise awareness of individual conditions such as endometriosis, and to support their effective diagnosis and management.

NHS Inform is our nationally co-ordinated approach to the provision of health and health service information. It is intended as a first point of contact for trusted quality assured health information for the public, patients and carers in Scotland.

NHS Inform provides information on the symptoms, diagnosis and treatment of endometriosis, which can be accessed by calling 0800, 22 44 88 or:

http://www.nhsinform.co.uk/health-library/articles/e/endometriosis/introduction.aspx.

Providing safe, effective, timely and person centred care is at the heart of the Government''s Quality Strategy.

The clinical guidelines published by the Royal College of Obstetricians and Gynaecologists in 2006 deal with the investigation and management of endometriosis, and should help with timely diagnosis. Implementation of these guidelines is a matter for NHS boards, and we expect all bodies within boards that have responsibility for clinical governance to have regard to such clinical guidelines.

Gynaecological conditions, including endometriosis, are covered in the trainee GP curriculum and are assessed as part of the GP e-portfolio, a training resource overseen by the Royal Collage of General Practitioners (RCGP).

Existing GPs are contractually committed to an annual educational appraisal and to developing their own learning needs. If a GP has recognised endometriosis as a learning need, this should form part of their Personal Education Plan.

We are committed to shorter waiting times in GP practices and hospitals as they can lead to earlier diagnosis and better health outcomes for patients. NHS boards are working to deliver the challenging target that by the end of this year no patient should wait more than 18 weeks between GP referral and treatment.

The Scottish Government''s Healthy Working Lives strategy promotes the benefits of policies and practices in the workplace that support staff to be fitter and healthier.

The Scottish Centre for Healthy Working Lives is working with employers to promote and improve the health and wellbeing of employees, and to support those living with long term health conditions such as endometriosis. The centre provides a network of advisers, who offer information, access to tools and workplace visits to help implement the healthy working lives approach.

In 2009, the Healthy Working Lives strategy underwent a review to refresh it in the light of the latest evidence and practices in working age health and wellbeing. The result is Health Works, an update that identifies a programme of action to ensure that the working age strategy remains relevant to the needs of the modern workplace. It encourages healthcare staff to take account of people''s employment aims.

It is the responsibility of NHS boards to provide the healthcare services required to meet the needs of their local populations, using the funding allocated to them by the Government.

Our Long Term Conditions Action Plan (June 2009) sets out our aim that throughout Scotland, those living with long term conditions such as endometriosis, and those who support them, feel valued, confident and able to enjoy full and positive lives.

The Scottish Government does not collect information on the level of spend by NHSScotland and its agencies on legal services.

However, the answer to question S3W-39382 on 3 March 2011 includes details of legal fees paid by NHS boards in the last five years.

All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

The Scottish Government does not collect information on how much NHS boards or community health partnerships spend on legal fees. However, National Services Scotland''s Central Legal Office (CLO) provides NHSScotland with legal advice and assistance in every area of law relevant to the health service including employment, litigation, commercial contracts and commercial property, and endowments. The following table sets out the costs for the legal fees provided by CLO to NHS boards:

NHS Board	2005-06 £''000	2006-07 £''000	2007-08 £''000	2008-09 £''000	2009-10 £''000
*Argyll and Clyde	283.6	180.2	n/a	n/a	n/a
Ayrshire and  Arran	188.8	311.6	339.7	354.9	248.2
Borders	57.3	112.8	83.3	97.8	85.8
Dumfries and Galloway	158.8	143.7	150.5	199.0	177.6
Fife	210.2	200.7	167.4	226.6	239.3
Forth Valley	144.6	207.9	153.7	201.9	213.3
Grampian	324.6	261.1	288.1	292.4	279.1
Greater Glasgow and Clyde	740.0	847.8	1,191.5	1,279.0	1,335.5
Highland	167.2	162.3	280.3	231.8	237.5
Lanarkshire	360.8	357.5	364.9	372.7	487.8
Lothian	564.5	700.5	695.5	847.2	815.2
Orkney	10.2	19.6	16.5	19.2	19.9
Shetland	39.2	37.8	20.5	26.9	58.2
Tayside	325.6	381.9	381.2	373.2	318.2
Western Isles	24.8	35.6	32.5	35.3	34.5
NHS 24	74.6	34.5	80.1	71.5	106.2
NHS Education Scotland	27.2	22.6	36.5	44.5	41.7
NHS Health Scotland	22.1	40.0	18.0	16.4	21.0
National Services Scotland	601.7	601.0	489.6	668.7	857.2
State Hospital	49.7	34.0	31.7	21.1	18.6
National Waiting Time Centre	18.0	18.2	23.3	26.6	29.9
Quality Improvement Scotland	22.2	22.2	37.8	15.4	23.8
Scottish Ambulance Service	107.3	118.8	97.2	157.9	158.7
Total	4,523.0	4,852.3	4,979.8	5,580.0	5,807.2

Source: NHS National Services Scotland.

Note: *From 2007-08 costs were subsumed by NHS Greater Glasgow and Clyde and NHS Highland.