Chamber and committees

In most circumstances, mixed sex accommodation has been eliminated in NHS Scotland. However, there are exceptions such as high dependency areas, intensive care units and receiving units where single sex accommodation is not practicable.

At certain times, hospitals may also experience extreme situations/pressure on beds that may necessitate patients being admitted to an area occupied by patients of the opposite sex. If this occurs, they will be transferred to single-sex accommodation as soon as possible. NHS boards are expected to take steps, in line with NHS Quality Improvement Scotland standards, to ensure patients'' dignity and privacy is protected at all times.

A range of outcomes can be used to measure improvements for patients including success in self-care management together with improved relationships, maintaining employment, participation in social activities, reduced isolation, improved diet and physical activity, and reduced reliance on medication.

We also continue to work with local health and social care partners to develop a community care framework to better assess outcomes from the service user and carer perspectives. Delivery of our benchmarking initiative is also supporting change and improvement by mental health service providers.

NHS boards are expected to implement SIGN Guideline 13 on the Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention.

Stroke SIGN Guidelines 13 and 14 are under review and will reflect recent evidence that thrombolytic therapy up to 4.5 hours is now effective. The NHS QIS stroke standards will also be updated to reflect the new recommendations.

The Scottish Centre for Telehealth (SCT) and the Scottish Stroke Research Network are working together with Stroke Managed Clinical Networks to introduce telemedicine links between hospitals and between consultants homes and hospitals to help ensure that thrombolysis is administered to appropriate patients and to ensure equity of access to this treatment.

The Scottish Government is currently conducting a review of best practice in order to provide advice to health boards about their local healthy weight strategies regarding prevention and management of overweight and obesity. Advice will cover treatment in primary, secondary and tertiary care and address how boards might co-ordinate services through local, regional and national pathways to provide consistent referral and equality of access. It is expected that we will issue advice by the end of the year.

A pilot in Aberdeen which provided videoconferencing facilities coupled with a selection of medical devices, for use by a patient, appropriately supported, at a distance has just been successfully completed. Clinicians have been satisfied as to patient safety considerations. This pilot has now been extended to NHS Orkney to pilot the concept in a more remote situation. NHS Lothian and Lanarkshire are undertaking pilots of home telehealth, whereby patients can monitor their conditions and receive appropriate support through the use of technology in the home setting. The ability to apply the benefits of these types of projects nationally is an important element of the business case and evaluation for these projects.

Subject to the agreement of other partners, we expect councils to publish their annual reports on single outcome agreements in the autumn of each year. An interim progress report is expected (for the first year only) around the turn of the financial year with the first annual report expected in autumn of 2009.

The Scottish Centre for TeleHealth (SCT) has been established to support and guide the development of telehealth for clinical, managerial and educational purposes across Scotland. The SCT is involved in a variety of projects aimed at reducing patient journeys. A specific example is the use made of videoconferencing in NHS Grampian to support patients with minor injuries. Patients present at their local community hospital and, by using video conferencing, can be seen by an accident and emergency (A&E) specialist in Aberdeen. Results demonstrate that approximately 90% of telemedicine patients have avoided transfer to Aberdeen. This results in time savings, zero cost of travel, reduced impact on the environment and reduced demand on A&E in Aberdeen. Details of further projects can be found in the SCT''s 2007-08 annual report and on its website:

http://www.sct.scot.nhs.uk/.

Looking to the future, work to review the future direction of telehealth and SCT is underway and will report in spring 2009.

Figures for the infant death rate (the number of deaths in the first month of life, expressed per thousand live births) in each health board area are published annually by the General Register Office for Scotland (GROS). The figures for 1998, 1999 and 2000 are given in the tables numbered 1.3 in the Annual Reports of the Registrar General for Scotland for those years, copies of which are available in the Scottish Parliament Information Centre (Bib. numbers 4049, 7222 and 15009 respectively). The figures for each subsequent year are available from the GROS website, in the relevant years'' versions of Vital Events Reference Tables, Section 1, Table 1.3, which can be found via http://www.gro-scotland.gov.uk/statistics/publications-and-data/vital-events/index.html.

Care should be taken when interpreting rates and trends where there are a small number of deaths each year. For example, the rate would appear to double and then halve if the numbers of deaths in consecutive years were one, two and one.

The Scottish Government, in partnership with COSLA, is developing a Framework for Supported Employment to provide support to people with disabilities to secure and maintain paid employment in the open labour market. The framework will concentrate on supporting individuals who have a learning or physical disability and those with mental health conditions.

A task group has been established to oversee the development of the framework. It includes stakeholders from the Scottish Union of Supported Employment, Jobcentre Plus, DWP, Skills Development Scotland, Scottish Association of Mental Health and the Scottish Development Centre for Mental Health.

It is anticipated the model will be transferable for other client groups.

The Scottish Index of Multiple Deprivation (SIMD) has been designed for a specific purpose, to identify small area concentrations of multiple deprivation across Scotland, and does this well. The indicators which make up the SIMD are chosen because they are measures of deprivation regardless of where a person lives.

Discussions with rural stakeholders have demonstrated that rural disadvantage isn''t about small area concentrations of multiple deprivation so amending or creating a new SIMD for rural areas would not help and we do not intend to do so.

To inform policy relating to these issues other work and methodologies need to be used. Specific projects being taken forward include research into the experience of poverty in urban and rural areas and an analysis of the data sources that can be used to inform understanding of the cost of living in urban and rural areas. This work will help us better understand rural disadvantage and how it can best be tackled, possibly working towards the development of a set of indicators that can better measure rural disadvantage.