Chamber and committees

The revised criteria assessing NHS Boards requires more rigorous reporting on stroke service governance structures and data reporting, and these will take time to fully implement.

I expect NHS Boards to prioritise their stroke governance structures and have scheduled a roundtable meeting with the accountable individuals from all NHS Boards where the importance of service governance will be emphasised.

The Scottish Stroke Care Standards are designed to enhance service delivery and improve patient outcomes. Monitoring performance against these standards through the Scottish Stroke Care Audit allows us to identify where challenges are being faced in the delivery of stroke care and implement quality improvements where required.

We recognise the standards are challenging and continue to expect Health Boards to identify aspects of their stroke services which do not meet these standards and to work to improve their standards of care locally to meet the Scottish Stroke Care Standards.

We expect staff providing care for individuals who have had a stroke to be fully trained in providing stroke care. However, in smaller Health Boards, it is not always possible to maintain a dedicated stroke unit.

A range of online stroke care competency training programmes are available and as part of the Scottish Stroke Improvement Programme review process all NHS Boards are asked to complete an education template highlighting the training stroke staff have undertaken.

We expect staff providing care for individuals who have had a stroke to be fully trained in providing stroke care. However, in smaller Health Boards, it is not always.

The cost incurred to date in relation to the planned National Treatment Centre in NHS Ayrshire and Arran, NHS Grampian, NHS Lanarkshire, NHS Lothian and NHS Tayside is as follows.

The Scottish Stroke Improvement Programme team works closely with stroke services in all NHS boards to use learning from the Scottish Stroke Care Audit to support improvement across the whole stroke pathway, including timely access to thrombolysis.

We have established a National Stroke Engagement Forum, with representation from every NHS Board, with the aim of tackling common challenges in the delivery of stroke care and sharing best practice and novel approaches to care delivery. Improving thrombolysis times will be a focus of the National Stroke Engagement Forum.

The Scottish Stroke Improvement Programme Board review process allows for an evaluation of stroke service performance, identification of areas for improvement and agreement of steps to implement local action plans to improve the delivery of stroke care in every Board.

Many of the areas on the RAG chart, especially those around rehabilitation pathways, were new requirements in the last reporting year to reflect the commitments in the Stroke Improvement Plan. The expectation is that boards will progress and improve in their status as they implement the guidance.

Where areas of stroke care have been identified as not fully meeting criteria, Boards are asked to agree action plans to drive service improvement.

A funded stroke bed is a bed which has established funding for the provision of stroke nurse and therapist staffing. There are currently 531 stroke beds available in Scotland, including hyperacute, acute and integrated stroke beds. However, stroke services may adjust the number of beds available to meet service demands.

Internal legal costs are not available because in line with usual practice, details of individual tasks carried out by civil servants, including the number of hours spent on them, are not routinely recorded because there is no business need to do this.

The legal costs in defending and settling the Judicial Review brought by Mr Salmond in 2018 are published on the Scottish Government website.

The costs of legal services regarding the former First Minister’s judicial review are published at: Costs of legal services regarding former First Minister's judicial review: FOI release - gov.scot (www.gov.scot).

The costs of the settlement in respect of the former First Minister’s legal fees in the Judicial Review are published at: Former First Minister Legal fees: FOI release - gov.scot (www.gov.scot).

As the action brought by Mr Salmond against the Scottish Government is live litigation, we are not able to publish the Scottish Government’s legal costs at this stage. We will publish this information in due course.

Legal advice was provided to individuals in relation to the Scottish Parliament Committee on the Scottish Government Handling of Harassment Complaints. The total costs were £151,811.17 (exclusive of VAT). This information is already published at Cost to Scottish Government of its participation of recent inquiry’s: FOI release - gov.scot (www.gov.scot)

The then First Minister, Nicola Sturgeon did not consult a lawyer of any kind ahead of her evidence session at the Scottish Parliament's Committee on the Scottish Government's Handling of Harassment Complaints.

The Scottish Government set out in June 2021 our plan for implementing the recommendations of James Hamilton’s report, alongside the recommendations of the reports by Laura Dunlop QC and the Scottish Parliament Committee on the Handling of Harassment Complaints. Implementation was delivered through the Continuous Improvement Programme, which was reported regularly to the Scottish Parliament’s Finance and Public Administration Committee. The final report on the Continuous Improvement Programme was provided in January 2023, and with the agreement of the Committee the programme was then concluded and activities absorbed into ongoing work.