Chamber and committees

The Framework for supporting people through Recovery and Rehabilitation during and after the COVID-19 was published in August 2020. We then undertook a significant scoping exercise to understand the current status of rehabilitation services in Scotland, from the perspective of the staff working in them. This was done using a self-assessment tool and the report on the findings ( Rehabilitation Framework Self-Assessment Tool: Analysis of Survey Responses ) was published on 9th December 2021.

The findings from the self-assessment tool, along with demand and capacity data, will inform the development of a national programme of improvement work which we will work with NHS Boards, Health and Social Care Partnerships and the third sector to implement. This will deliver a ‘Once for Scotland’ rehabilitation pathway that will ensure everyone who requires rehabilitation will be able to access it.

The National Advisory Board for Rehabilitation last met in October 2021, and it is expected it will meet again in early 2022 now that the report on the self-assessment tool had been published.

I refer the member to the answer to question S6W-05521 on 24 January 2022. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

The Scottish Cardiac Audit Programme, within Public Health Scotland, have been actively seeking data submissions from all sites across Scotland that previously contributed to the UK National Cardiac Audit Programme, managed by the National Institute for Cardiovascular Outcomes Research (NICOR). This includes sites which carry out TAVI procedures.

Scottish participation in the UK National Cardiac Audit Programme (NCAP), managed by the National Institute for Cardiovascular Outcomes Research (NICOR), was previously enabled through the Healthcare Quality Improvement Partnership (HQIP).

The Scottish Government had been working with HQIP since November 2018 to identify a mutually agreeable legal basis that would support Scotland’s continued participation in a number of UK wide audits, including the NCAP programme. It was not possible to identify one and as a result, throughout 2020/21 there was a phased withdrawal of Scottish Government participation in HQIP associated audits as an appropriate point was reached in each.

As replacement for the NCAP, in April 2021 we commissioned Public Health Scotland (PHS) to develop the Scottish Cardiac Audit Programme. PHS have been actively seeking data submissions from all sites across Scotland which previously contributed to the NCAP.

PHS are currently working with clinicians and patients across Scotland to undertake further development of the audit programme.

Further to the answer given to question S6W-04701 I can confirm that the Case Note review carried out by NHS Greater Glasgow and Clyde along with the report of the peer review undertaken by NHS Lothian have both now been shared with Mrs Slorance.

The Scottish Stroke Care Audit (SSCA) already measures quality of care of Stroke Services in Scotland against the Scottish Stroke Care Standards. Health Boards are provided with reports on a monthly basis. Performance is monitored locally and nationally and actions agreed to improve delivery of stroke care in Scotland. The most recent annual report can be found here: Scottish stroke improvement programme 2021 national report - Scottish stroke improvement programme - Publications - Public Health Scotland

This is similar to the aims of the Sentinel Stroke National Audit Programme (SSNAP) which measures the quality and organisation of stroke care in the NHS across England, Wales, and Northern Ireland.

The Scottish Intercollegiate Guidelines Network (SIGN) guidelines on stroke have been withdrawn due to being over 10 years old. SIGN therefore recommend that healthcare professionals look to other up-to-date evidence-based guidelines to inform practice. A good source is the National Institute of Health and Care Excellence (NICE) evidence search that includes trusted sources from a wide range of organisations: https://www.evidence.nhs.uk/

It has been agreed that a four nations approach will be taken to update the Royal College of Physicians Guidelines for Stroke (2016). SIGN is involved in the development process so that the revised guideline will be a collaborative national guideline which will be applicable for use in Scotland.

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.