Chamber and committees

Through our Programme for Government commitments we are already reflecting the aims of the European Stroke Organisation’s Stroke Action Plan for Europe.

In particular the ESO’s target that 90% of all patients with stroke in Europe should be treated in a stroke unit as the first level of care is already reflected within the Scottish Stroke Care Standards (Access to Stroke Unit - 90% within 1 day of admission).

The ESO also recommends ‘national plans for stroke encompassing the entire chain of care’. We already have a national plan on stroke - the Stroke Improvement Plan - which we are in the process of refreshing. To do so, we are developing a progressive stroke pathway document which will set out our vision for what stroke services across Scotland should deliver across the entire patient pathway. Following this, a refreshed improvement plan will support its delivery.

All 14 NHS Boards have hospitals providing acute stroke care. A map showing all hospitals that contribute data on stroke unit admission to the Scottish Stroke Care Audit can be found in the Scottish Stroke Improvement Programme report at: https://www.strokeaudit.scot.nhs.uk/index.html . Of those sites shown on the map, Stracathro, Stobhill, Vale of Leven, Queen Margaret, Falkirk Community Hospital and Stirling Community Hospital are shown because they contributed data solely on stroke rehabilitation.

The remaining hospitals provide acute beds for stroke patients, either in a unit which has solely acute beds with offsite stroke rehabilitation units for ongoing care, within an integrated stroke unit (combining acute and rehabilitation beds) or in a hyperacute unit. The seven smallest general hospitals define stroke unit admission as gaining access to the appropriate acute medical ward.

Further to the answer given to question S6W-04701 I can confirm that the team of reviewers in NHS Lothian were made up of clinical staff at consultant and senior nurse level who are all suitably qualified in their fields and span across various disciplines including Haematology, Microbiology, Infection Prevention and Control and Critical Care.

The Treatment Time Guarantee already outlines that after a diagnosis is determined and treatment agreed, each health board must ensure that patients receive inpatient and day case treatment within 12 weeks. This applies to all treatments and services apart from fertility treatment, obstetrics services, organ and tissue transplantation, direct referrals to Allied Health Professionals, dental treatment provided by undergraduate dental students, direct access referrals to diagnostic services, and mental health services.

The current unprecedented pressures on the NHS means that Health Boards are not currently able to reinstate services to such a degree as to be in a position to meet the existing waiting times standards and targets, which is why we published the NHS Recovery Plan. This includes a focus on providing alternative pathways of care that will allow people to be treated more quickly closer to home, delivering long term sustainability.

At this time, the Scottish Government has no plans to develop any further waiting time targets for cardiovascular disease.

Further to the answer given to question S6W-04701, I can confirm that one of the seven clinicians who undertook the peer review was an experienced Haematology consultant who has expertise in the care of haematological malignancies and the associated protocols.

The Scottish Stroke Care Standards can be found here: ( https://www.strokeaudit.scot.nhs.uk/index.html ). The current standard relating to brain imaging already sets out that 90% of patients should receive this within 12 hours of arrival at first hospital, unless there is a documented contraindication.

The Scottish Stroke Care Standards are regularly reviewed in line with current evidence and updated guidelines. We monitor the implementation of these standards through the Scottish Stroke Care Audit to ensure that stroke patients in Scotland are receiving high quality care.

Further to the answer to question S6W-04701 I can confirm that the case review was undertaken by a small number of NHS Lothian clinicians who are all suitably qualified and experienced in their relevant fields. As none of the clinicians who undertook the review had previously looked after Mr Slorance there was no conflict of interest in undertaking the review.

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.

The requested information is not centrally held. NHS Education for Scotland publishes annual data on joiners/leavers, but this information does not specify start date or professional background of joiners. Information on joiners/leavers by staff group for each financial year can be found on the following link: NHSScotland workforce | Turas Data Intelligence

In October 2021, SG officials wrote to those remaining on the COVID-19 temporary registers with advice on how to view and access NHS Board vacancies, encouraging them to consider returning to the service. Prospective candidates were directed to vacancies hosted by individual NHS Boards, who are fully responsible for local recruitment.

Our overall assessment, from the numbers that remained on the registers and feedback from boards, is that a reasonable return rate would have been in the region of 5-10%; or around 200 doctors, nurses and midwives, allied health professionals and pharmacists (headcount) nationally. However, as candidates were directed to NHS Board vacancies, the Scottish Government does not hold data on the number of returners joining as a result of this measure.

A decision was taken, in discussion with Boards, that monitoring the rate of applicants in autumn and winter who had applied from emergency registers would be a burdensome task for already pressured Health Board recruitment teams.

Those who experience difficulties carrying out a LFD test can ask someone they trust to assist them with the swabbing and testing process. Walk-in asymptomatic test sites (ATS) can advise people how to use an LFD test. After self-swabbing, the person hands their used swab to a site operative for it to be analysed.

Where a person is part of a workplace testing scheme and is not able to self-swab, if they have capacity to consent, they should be asked if they will allow someone to help them do the test, or to allow someone to do the test for them. Each case should be assessed on a case-by-case basis and if required, the Personal Assistant or family member can consult their GP in case specific care is required to swab the person.

People identified as contacts of a case who are unable or do not have the support to carry out LFD testing can call the National Contact Tracing Centre on 0800 030 8012, for advice.

Regular testing for people without symptoms is voluntary and for some people with additional support needs it may not be appropriate for testing to take place. Those working most closely with individuals with additional support needs, will be best placed to decide whether testing will be appropriate, taking into consideration the needs of the individual.