Chamber and committees

The proportion of GP-to-hospital referrals made electronically rather than on paper has increased from 75% in October 2008 to 91% in November 2009.

The national eReferral team is supporting NHS boards to continue to improve their performance.

The issue of community optometrists'' involvement in the Diabetic Retinopathy Screening (DRS) Programme was raised in the consultation on the revision of the 2006 Diabetes Action Plan. Further thinking on the subject will be set out in the revised action plan, which we expect the Scottish Diabetes Group to submit later this year. This will draw on the assessment of a pilot project in NHS Highland and NHS Borders, under which community optometrists have captured retinal images for the DRS Programme.

Neuromodulation surgery can be undertaken in an outpatient setting or as inpatient or day case treatment. The current 15 weeks waiting times standard for outpatients only relates to first outpatient consultation following referral and does not cover subsequent treatment undertaken in outpatients. Neuromodulation surgery undertaken as either inpatient or day case is covered by the current 15 weeks maximum waiting time standard.

Neuromodulation surgery undertaken in an outpatient setting will however be covered by the 18 weeks referral to treatment target which is due to be delivered by the end of 2011. NHS boards are now working to reduce long waits in services previously excluded from waiting time standards to ensure delivery of the 18 weeks referral to treatment target.

The information requested is not available centrally.

Where orthoptists are not available, it is the responsibility of NHS boards to make the most appropriate local arrangements to carry out pre-school vision screening. These arrangements should be made based on clinical effectiveness, availability of and ease of access to other health professionals, including optometrists.

The Scottish Government Health Directorate will shortly issue a Chief Executive Letter (CEL) to reinforce the recommendations for implementation contained in Health for all children 4: Guidance on Implementation in Scotland and this will include further advice on the actions required by NHS boards to find solutions to vision screening issues where no orthoptist screening programme is achievable locally in the short term.

Information on the number of drug and alcohol rehabilitation facilities is not held centrally. However, information from the National Directory of Drug Treatment Services, maintained by the Scottish Drugs Forum, showed that 27 facilities currently offer residential places for rehabilitation. Of these, 16 facilities with 342 beds in total, have indicated that they offer services for clients with mental health problems. Services listed in the directory are primarily for the treatment of drugs though some facilities also treat clients for alcohol rehabilitation.

In terms of alcohol rehabilitation facilities, this information is not held centrally. The Scottish Alcohol Needs Assessment report (published by the Scottish Association of Alcohol and Drug Action Teams) mapped the number of publicly-funded alcohol treatment provision falling within tiers 2, 3 and 4 modalities of care as defined by Models of Care for Alcohol Misusers (The National Treatment Agency for Substance Misuse, 2006). It identified 97 services in Scotland in 2006-07 as providing specialist alcohol interventions, of which 10 were residential agencies and the remainder (87) were community-based. The majority (59.4%) provided services for both drug and alcohol misusers and 37.5% provided exclusively alcohol services. The report did not provide a breakdown or services by individual health boards (just groups of health boards) or the number of beds available.

The National Directory of Drug Treatment Services, maintained by Scottish Drugs Forum, lists 72 services who offer specific assistance to people with mental health problems.

We continue to work with NHS boards, local authorities and their partners to ensure the best possible care and treatment for all.

Our 2007 report Mind the Gaps - Making a Difference, which can be found in the Scottish Parliament''s Information Centre (Bib. number 44565), focused on improving awareness of the needs of those with co-occurring mental health and substance misuse problems; improving support and service provision, and influencing positive supportive attitudes toward this care group. Forward action from the report has reflected these aims by promoting and encouraging joined-up local and other services with attention on prevention and recovery.

The National Forum on Drug-related Deaths believe that the majority of deaths are amongst a high cohort of ageing drug users, who are in poor health due to a long history of drug misuse and where their tolerance levels are lower.

From the end of this year, the National Drug-related Deaths database will give a better indication of the circumstances behind each death. This will help us to target key resources and ensure services are better able to meet the needs of these vulnerable individuals most at risk of dying.

The HEAT target for March 2009 of 4% was a very challenging target. Four NHS boards achieved a rate of less than 4%, two boards achieved their individual targets of 5% and 6% respectively and of the remaining 16 NHS boards only one reported a rate higher than 5%.

When compared to March 2008 NHSScotland reported a 0.63% improvement in absence rates which equates to over 650,000 more hours being available for the service. Seventeen NHS boards reported improvements in their sickness absence rates when compared to March 2008.

There is an expectation that NHS boards will continue to develop strategies that will promote attendance at work and further reduce absence towards a standard of 4%.

The performance of NHS boards against each of the HEAT targets due for delivery in 2007-08 and 2008-09 are available from the Scottish Parliament Information Centre (Bib. number 50010).

The latest performance on 2009-10 HEAT targets is available through official statistics published throughout the year (for example, waiting times statistics on the ISD website: http://www.isdscotland.org/isd/5557.html and C.diff statistics on the Health Protection Scotland website: http://www.documents.hps.scot.nhs.uk/ewr/pdf2009/0927.pdf).

In addition the Scottish Government will shortly be bringing this information together in the Scotland Performs area of the Scottish Government website (http://www.scotland.gov.uk/About/scotPerforms).