Chamber and committees

Standard 17 of the NHS Quality Improvement Scotland (NHS QIS) Clinical Standards for Neurological Health Services requires an effective and comprehensive Parkinson''s disease service to be delivered through a multidisciplinary team, including a Parkinson''s disease nurse specialist. Standard 18.2 is that patients with Parkinson''s disease and their carers are provided with ongoing access to a Parkinson''s Disease Nurse Specialist.

At the same time as the formal launch of the clinical standards, on 21 January 2010, NHS QIS published an Implementation and Improvement Support Plan to assist NHS boards in achieving the standards. It is complemented by the work of the Scottish Government''s Neurological Services Task & Finish Group, issued to NHSScotland as CEL 3 (2010) on 4 February 2010.

Standard 17 of the NHS Quality Improvement Scotland (NHS QIS) Clinical Standards for Neurological Health Services requires care to be delivered by a defined Parkinson''s Disease multi-disciplinary team that specifically includes physiotherapy. Standard 19 stipulates that patients with Parkinson''s Disease and their carers have ongoing access to the specialist team.

As noted in the answer to question S3W-32083 on 11 March 2010, the standards will be taken forward through the NHS QIS Implementation and Improvement Support Plan and the materials made available to NHS boards from the Neurological Services Task & Finish Group.

This is complemented by the work on falls prevention being taken forward as part of implementation of our Delivery Framework for Adult Rehabilitation, published in February 2007. The Practice Development Unit at NHS QIS is supporting a national, multi-agency programme of falls and fracture prevention. The falls prevention pathway should identify someone with Parkinson''s disease who is considered to be at particular risk of falling.

All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

Currently, there are no specific guidelines on the sale of energy drinks to these groups of people.

One of the main ingredients of energy drinks is caffeine, and the Food Labelling Regulations 1996 (as amended) require caffeine to be indicated in the ingredients list when used as a flavouring or ingredient. In the case of drinks containing high levels of caffeine (in excess of 150 milligrams per litre), the Regulations require containers to carry the declaration High caffeine content in the same field of vision as the name of the drink.

The information requested, which relates to the national services provided by the Scottish Advanced Heart Failure Service, is included in the following table:

Referrals to the Scottish Advanced Heart Failure Service

NHS Board	2005-06	2006-07	2007-08	2008-09
Ayrshire and Arran	12	7	12	27
Borders	1	1	0	0
Dumfries and Galloway	2	2	3	0
Fife	1	2	10	6
Forth Valley	11	7	10	9
Grampian	1	2	2	6
Greater Glasgow and Clyde	29	35	76	68
Highland	7	6	6	9
Lanarkshire	8	21	21	19
Lothian	7	7	10	12
Orkney	0	0	0	0
Shetland	0	0	0	0
Tayside	10	4	9	4
Western Isles	0	0	1	6

Source: National Services Division, NHS National Service Scotland.

In July to September 2009, 72% (5,060 clients) of those offered an appointment for assessment were offered a date within 14 days of referral compared to 66% (4,674) during April to June 2009.

Of those who were still waiting for an appointment for assessment, 7% (122 clients) had waited more than 52 weeks by the end of September 2009 compared to 11% (216 clients) in July 2009.

Of those who were offered a treatment intervention date (4,083 clients) during July to September 2009, 94% (3,845 clients) were offered first treatment within four weeks of care plan being agreed.

These figures are drawn from data submitted by all drug treatment services to ISD. Historically, there have been concerns about the quality of, and compliance with, submission of drug treatment waiting times data which have limited the scope to make comparisons over time.

The Scottish Government target, To offer drug misusers faster access to appropriate treatment to support their recovery 2009 to 2010 is within it''s developmental year with the target going live from April 2010. The HEAT target that ˜by March 2013, 90% of clients will wait no longer than three weeks from referral received to appropriate drug or alcohol treatment that supports their recovery'' was agreed with NHS boards and announced in November 2009. Progress made by NHS boards is, therefore, prior to the measurable HEAT target.

As a first step to the 2013 target it is expected that, by December 2010, 90% of clients will be offered an assessment date that falls within four weeks of the referral date and 90% of clients will be offered a treatment date that falls within four weeks of the assessment date.

Baseline data gathered during the April to June (2009) audit of drug treatment waiting times is being used to monitor progress towards the performance indicators set for December 2010.

Cardiac resynchronisation therapy (CRT) services are provided by each of the three regional planning groups, based on a common protocol to ensure consistency of access across Scotland.

The information requested is given in the following table. As the Cardiac Resynchronisation Therapy (CRT) service operates on a regional basis, the table includes equivalent information on all of the centres providing CRT.

	2005-06	2006-07	2007-08	2008-09	2009-10
Golden Jubilee National Hospital	N/A	N/A	N/A	126 >1	142 >2
Aberdeen Royal Infirmary	28	30	25	45	55 >2
Royal Infirmary of Edinburgh	12	10	14	15	33 >2

Source: Service managers and Cardiac Managed Clinical Networks.

Notes:

1. The Cardiac Resynchronisation Therapy (CRT) service for the West of Scotland transferred to the National Centre for the Treatment of Advanced Heart Failure at the Golden Jubilee National Hospital in April 2008. Prior to that, the service was provided at Glasgow Royal Infirmary.

2. Includes referrals up to February 2010.

All NHS boards offer Cardiac Resynchronisation Therapy, which is organised on a regional basis. The service is provided at:

Aberdeen Royal Infirmary;

the Royal Infirmary of Edinburgh, and

the Golden Jubilee National Hospital.

Patients referred to the Scottish Advanced Heart Failure Service are treated within the national waiting time guarantee of 12 weeks, which will reduce to nine weeks at the end of March this year. It should be borne in mind, however, that waiting times for heart transplantation are dependent on the availability of suitable organs.

As most energy drink manufacturers advise through voluntary warning labelling that such products are not suitable for consumption by children, retailers, in acting responsibly, would wish to take account of such warnings and not sell such drinks to children. However, there are no specific guidelines regarding the sale of energy drinks.

Regarding pregnant women, the Food Standards Agency Scotland advises that pregnant women should limit their daily caffeine intake, ideally keeping this below 200mg a day.