Chamber and committees

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.

On 3 November 2020 the Scottish Government published a rapid review of outbreaks to learn lessons for practices within care homes Coronavirus (COVID-19): care home outbreaks - root cause analysis - gov.scot (www.gov.scot)

In doing so, the report collated and evaluated local level experiences and responses to COVID-19 outbreaks within care homes. It identified a number of recommendations to support working practices to prevent transmission of COVID. We continue to work to ensure the recommendations are implemented and have recently set up a working group to examine whether further work is required given where we now are in the pandemic.

Providing consistent high quality, safe and effective personalised care for people is our top priority for our health and care services. We continue to take a public health and a clinical evidence based response to the pandemic. In doing so, this continually ensures working practices are fit for purpose, for example Infection Prevention and Control, Personal Protective Equipment and Testing to Protect which continue to be of paramount importance as we come to deal with the impact of the pandemic and apply lessons learned.

In addition, to support the needs and wellbeing of the social care workforce and unpaid carers, we have put in place a combination of measures including working practices which were outlined in the Adult Social Care Winter Plan available at the following link: Adult social care - winter preparedness plan: 2021-22 - gov.scot (www.gov.scot)

As we look to the future and rebuild and remobilise our social care sector in Scotland, we have a significant opportunity to ensure that staff and users of social care people are placed at the centre of the recovery. We are proactively developing an Older People’s Strategy and a Healthcare Framework for adults and older people living in care homes. These principles will also be critical as we establish a National Care Service in Scotland.

The Heart Disease Action Plan 2021, sets out a strategic vision to address the impact of heart disease across Scotland. This means that the plan does not provide detailed information on specific conditions but instead identifies four priority areas. These are 1) tackling risk factors, 2) ensuring timely and equitable access to diagnosis, treatment and care, 3) addressing key issues within the cardiac workforce, and 4) ensuring effective use of data to support improvement.

The actions within these priority areas should impact across a number of cardiac conditions and therefore improve services for everyone with heart disease, including for people living with heart valve 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.

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.