Chamber and committees

The NHS Centre for Integrative Care (CIC) is a facility that all NHS Boards across Scotland have the option of referring patients to for services not available locally.

The Scottish Government is providing £12.4 billion for frontline NHS boards, which is a £327 million (3.2%) increase. This is the first step to ensuring that frontline funding - which directly supports patient services - increases by at least £2.5 billion by 2026-27.

Over 50% of frontline spend will go towards community health services, delivering on our commitment to increase primary care funding by 25% over this Parliament, providing more care for people in a place and way that meets their needs.

The Scottish Government has invested in the Detect Cancer Early programme in this area, has committed to investing in an AI Hub, and has prioritised the 25 by 25 programme for innovation investment in 2022.

This will enable AI innovation in the form of AI enabled triage, diagnostics, and treatment decision making support for Clinicians.

The Centre for Sustainable Delivery (CfSD) (and prior to this the Modernising Patient Pathways Programme within Scottish Government), have supported the rollout of the Digital Dermatology Appointment (DDA) system. This platform allows patients to interact with dermatologists by answering a series of questions and uploading images of their skin condition for the clinician to review. This system is used for both new and return patients. The system was offered for rollout to all Health Boards during COVID and to date is live in five Health Boards, with over 4000 patients having appointments this way.

In addition, the CfSD is actively promoting Active Clinical Referral Triage in Dermatology and encouraging the use of images to support this where this can be done safely. We are currently engaged in a piece of work to understand the use of images in referral pathways across all Scottish Health Boards and the output of this will support key work in 2022 to increase the use of images to support timely access to Dermatology care.

The Scottish Government is not considering the possibility of allowing Health Boards to take over the running of community pharmacies that are struggling to remain open. Community pharmacies, along with other primary care contractors, are wholly independent private entities providing NHS services on behalf the Health Board. Any challenges faced by community pharmacy contractors in delivering existing pharmaceutical care services should be discussed with the Health Boards who will be able to consider actions to support service provision.

There is a range of projects being undertaken in Scotland to explore the use of AI in further high-demand medical areas, ranging from robotic surgery to the use of virtual reality in supporting mental wellbeing is currently being researched, evaluated, and implemented in Scotland.

The Industrial Centre for Artificial Intelligence Research in Digital Diagnostics (iCAIRD) website provides more information:

iCAIRD – Industrial Centre for Artificial Intelligence Research in Digital Diagnostics .

The information requested regarding whether the Health and Safety Executive (HSE) has invoked a Divisional Major Incident Response Plan, in relation to deaths due to hospital associated infection at the Queen Elizabeth University Hospital, is not centrally held by the Scottish Government.

Health and safety at work is a reserved matter. HSE has confirmed that the issues raised with them did not meet the criteria for a ‘Divisional Major Incident’ as outlined in their published response plans og-00076-appendix-4.pdf (hse.gov.uk) .

The information requested regarding whether the Health and Safety Executive (HSE) has carried out any investigation into deaths due to hospital-acquired infection at the Queen Elizabeth University Hospital is not centrally held by the Scottish Government.

Health and safety at work is a reserved matter. HSE has confirmed that their published policy is generally not to investigate hospital acquired infections Who regulates health care (hse.gov.uk) . They have not investigated deaths at the Queen Elizabeth University Hospital that may have been caused by a hospital associated infection.

HSE did however carry out an investigation into concerns raised with them in December 2019 about the ventilation within two wards at the Queen Elizabeth University Hospital and the control of legionella in water systems across the hospital.

HSE was satisfied with the control of legionella but wrote to the Chief Executive of Greater Glasgow Health Board/NHS Greater Glasgow and Clyde requesting improvements to the ventilation systems. An Improvement Notice was served in relation to the ventilation system within Ward 4C.

Further information is available on the NHS GGC webpage: https://www.nhsggc.org.uk/about-us/media-centre/news/2019/12/hse-improvement-notice/ . The Improvement Notice is being appealed by the Health Board. However, HSE is satisfied that appropriate remedial action has been taken.

Causes of death in Scotland are recorded by National Records of Scotland (NRS). The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) system, which is used in the UK to classify deaths, does not allow deep venous thrombosis to be separated from phlebitis (inflammation of a vein).

Figures from NRS are provided below, for which deep vein thrombosis (DVT) has been taken to refer to thrombosis of the deep veins of the leg. Deaths from DVT frequently occur from complications of the DVT, principally pulmonary embolism, so deaths from pulmonary embolism have been included in these figures. As mentioned above the ICD-10 does not allow DVT to be separated from phlebitis, so these figures may include a small number of deaths due to phlebitis.

Deaths attributed to deep vein thrombosis (DVT)* registered in Scotland, 2014 to 2020

A key component to freeing up bed capacity in our hospitals this winter is to reduce the level of delayed discharge and strengthen community services to help avoid acute admissions and maximise capacity. To support this, we are providing £300 million to bolster the workforce and help get people the care they need as quickly as possible this winter. Controlling Covid admissions will also be vital to freeing up hospital beds and helping those who are working so hard in the NHS and social care to keep us safe

We continue to work with NHS Boards and their partners to implement their winter plans which includes increasing the number of staffed beds available. Recruitment for this is underway across acute and community services to ensure best use of available resource.

In November I announced additional winter funding of £10 million for Health Boards to ensure resilience over winter. This funding will be targeted towards enhancing local teams. For example, the deployment of expert physio and occupational therapy staff at A&E units to help triage people best treated elsewhere.

Additionally, as part of our winter plan we’re providing boards with £10 million for two new specialist programmes which will speed up the hospital discharge process or provide an alternative to hospital care altogether.

The 2022-23 Scottish Budget delivers record funding of £18 billion for the health portfolio to support our vital health and care services, including those services that are supporting the needs of people living with long COVID, chronic fatigue syndromes and chronic pain.

We have published ‘Scotland's long COVID service’, which sets out our approach and 16 commitments to improve care and support for people with long COVID in Scotland.

In addition, our £10million ‘long COVID Support Fund’ will provide NHS Boards with additional resource to respond in a flexible and tailored manner to the needs of people with long COVID.

In light of the final National Institute for Health and Care Excellence (NICE) guidelines for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS being published, we are pleased to confirm that a formal stakeholder consultation project will begin in early 2022. The main focus of this is to work collaboratively with key stakeholders towards implementing the recommendations within these guidelines, in Scotland.

We are continuing to work with Health Boards to ensure the remobilisation of appropriate pain management support as quickly and as safely as possible. As part of this we providing funding to enhance the capacity of pain management care through the Chronic Pain Winter Support Fund. We will shortly announce the outcome of this funding call. The projects we fund will boost the support available for people with chronic pain at the national and local level to help them maintain their health and wellbeing over the months ahead.