Chamber and committees

The current Scottish Stroke Care Standards are available at the following link ( https://www.strokeaudit.scot.nhs.uk/index.html)x . At present, they largely relate to acute stroke care.

However, the Scottish Stroke Improvement Programme also includes performance targets which reflect access to rehabilitation in inpatient settings, intensity of provision in stroke units and access to stroke specialist Early Supported Discharge and community teams. The Rehabilitation Sub-Group of the Stroke National Advisory Committee is currently considering future updates to measure rehabilitation service delivery, patient outcomes and experiences within the Scottish Stroke Improvement Programme report.

We welcome the publication of the Scottish Diabetes Survey which provides an annual summary of key issues and trends in diabetes care and treatment in Scotland. As in previous years, the number of people living with diabetes in Scotland is increasing. However, we are not seeing a great increase in the number of new cases, but rather people with diabetes are living longer with the condition.

At the end of December 2020 the Scottish Diabetes Survey reported that 317,128 people have been diagnosed with diabetes of all types in Scotland compared to 312,390 people diagnosed in 2019.

We are committed to ensuring that everyone living with diabetes in Scotland can access appropriate, high-quality, person-centred care. In February 2021, we published our Diabetes Improvement Plan refresh, which builds on the progress made since 2014 and sets out our priorities to deliver safe, effective and person-centred healthcare, treatment and support to those living with diabetes.

Our Type 2 Diabetes Early Detection, Intervention and Prevention Framework was published in 2018 and is designed to support those at risk of, or diagnosed with, type 2 diabetes. It provides guidance to NHS boards on the provision of evidence-based, person-centred targeted interventions across diabetes and weight management services.

In July 2019, the Scottish standards for the delivery of tier 2 and tier 3 weight management services to children and young people and to adults were published. These standards provide a detailed framework to drive forward consistent, equitable and evidence-based approaches across Scotland in the treatment of higher body weight and associated health risks.

a) NHS Staffing

In all areas of NHS Scotland, a great deal of effort is going into ensuring that services have sufficient capacity to deal with COVID-19, manage other risks and resume planned services as safely and effectively as possible. Although NHS Scotland’s staffing levels are at a record high, following nine years of consecutive growth, we are fully aware of the difficult circumstances that Boards and frontline staff are working in. That is why we have announced a record £300 million of new investment in measures to help services deal with system pressures over winter.

Measures we are taking as part of this investment include the recruitment of 1,000 additional healthcare support staff to support patients in hospitals and in community health teams, as well as £4.5 million of funding to attract registered nurses to Scotland. This activity is supplemented by an additional £1 million to enhance Boards’ capacity for recruitment.

Decisions on local staffing requirements and recruitment are the responsibility of individual NHS Boards. However, Scottish Government officials are continually engaging with NHS Boards to identify particular areas of concern.

(b) Social Care Staffing

The Scottish Government launched a national recruitment campaign on 8 November to attract more people to the social care sector. This campaign emphasises the value of a career within social care by showcasing the benefits of the sector beyond pay, and towards the extrinsic and intrinsic rewards of the role.

Officials are working at pace with SSSC and other key sector partners to develop a national induction programme to support new entrants into Adult Social Care; to promote career opportunities and deliver policies on fair work, upskilling and developing the workforce. This commitment is crucial to improving the experience of the social care workforce and addressing long standing recruitment issues in the sector.

As a result of lobbying efforts from the Scottish Government, the Home Office have temporarily extended the Shortage Occupation List for EU workers. Social care workers, care assistants and home care workers are to become eligible for a health and care visa for a 12-month period.

The Scottish Government will continue to push for a migration system tailored to Scotland’s needs, including a Scottish Visa, and work with partners and employers to develop proposals that suit their requirements.

(c) Public Transport Staffing

For bus service staffing, Transport Scotland and Scottish Government Officials are continuing to work closely with bus service sector representatives and other partners to help facilitate solutions to the staffing pressures brought by the COVID-19 pandemic compounded by the consequences of EU Exit. This has included work to help connect local employability partnerships with bus service operators as well as ensuring that the sector is represented in the Labour and Skills Shortages Action Plan process.

For rail service staffing, due to an increase in COVID-related absences and subsequent disruption in December, ScotRail has put a temporary timetable in place to provide a more stable and reliable service. ScotRail staff COVID-related cancellations have now reduced significantly following the successful introduction of a reduced timetable on 4 January. Around 8% of services have been withdrawn in this temporary timetable – largely additional peak services – leaving a more reliable core timetable in place. It is planned to retain the revised timetable until the end of the month, but ScotRail will keep this under review to balance staffing resources and demand from passengers as best as possible.

Where it is clinically appropriate to do so, patients of all ages will be examined with a stethoscope to listen for breathing and heart sounds. They may also have ECG electrical recordings of their heart rate, blood tests and have access to other investigations such as Echocardiograms, rhythm monitors and blood pressure recordings, should these be required.

Primary care professionals have access to multiple sources of education and update regarding heart valve disease and management both at undergraduate and postgraduate level. Through local interface groups local pathways to support diagnosis and management have been developed at board level with opportunities for specialist advice and rapid referral where required.

Scottish Government has no current plans to carry out a public awareness campaign on heart valve disease.

Priority 2 within the Heart Disease Action Plan makes clear our commitment to developing nationally agreed pathways of care for all cardiac conditions.

This work is underway. It is led by our recently appointed Heart Disease Improvement Coordinator, who is engaging with clinical colleagues across Scotland to understand service provision, identify needs and collate examples of good practice to inform this programme of work.

The Heart Disease Action Plan recognises the need to ensure timely and equitable access to diagnostics, including echocardiography.

As set out within the plan, we are working to address key workforce issues relating to cardiac physiology. Cardiac Physiologists are healthcare professionals who are vital to the delivery of many aspects of cardiac care, including the provision of echocardiography.

Furthermore, we have also recently provided funding for the delivery of a pilot project to improve access to echocardiography. The learning from this will support us in understanding how best to further support improvement across Scotland.

Employers with ten or more staff are eligible to participate in the workplace asymptomatic testing programme. The programme allows participating organisations to offer COVID-19 testing to any individuals who work at the location, including employees, volunteers, contractors and agency staff. Agencies which meet the criteria can also enrol in the programme to provide their staff with tests. This includes agencies providing staff to the health and social care sectors.

If an employer or agency does not provide workplace testing, lateral flow device test kits are widely available to individuals through the universally accessible testing offer. Kits can be collected from test sites, pharmacies and local authority collection points, or ordered online for home delivery.

The requested information is not centrally held. Data is published annually, by NHS Education for Scotland on the total medical agency spend by NHS Scotland Boards; and the total WTE hours and cost for Nursing and Midwifery bank and agency staff, but this data does not specify start dates. This information can be found on the following link: NHSScotland workforce | Turas Data Intelligence

We are committed to reducing the impact of inequalities on health outcomes for people living with diabetes, and equity of access is highlighted as a key priority in our Diabetes Improvement Plan refresh, published in February 2021.

We are working with key partners including NHS Boards, Health & Social Care Partnerships, Diabetes Scotland and people living with diabetes to ensure that evolving care models address existing health inequalities by integrating pathways with existing services and resources such as social work, mental health services, education and third sector.

As diabetes services evolve and include more virtual offerings, we will work to ensure that those people with diabetes who are unable to access services digitally are not disadvantaged as a result of digital exclusion.