The Scottish Government will now ask the Maternity Services Action Group to consider the study in full, and a range of options to address issues raised in the study.

Workload and workforce planning within maternity services has been ongoing this past year utilising the birthrate plus methodology. The results of this exercise are expected by the end of September 2008. Due consideration will be given to the findings by NHS boards in relation to the impact of midwifery staffing on in-utero transfers.

Development work is currently underway to further enhance the neonatal workload and workforce tool with a view to the tool being ready for further rollout by April 2009.

It is estimated that this project could be implemented by 2011-2012. Atkins has recently been commissioned by Network Rail to develop a feasibility study to take this project forward.

The study will validate the assumptions in the Room for Growth report, which will provide better cost certainty and clearer information on the timescales for implementation.

To improve journey times and increase frequency of services from the central belt to Inverness will require a combination of infrastructure works, procurement of additional rolling stock and timetable changes. Feasibility work is currently underway and this will determine the timetable for the work. It is estimated that the project could be implemented by 2011-12.

There is currently no national screening plan for these age groups. However, for patients over the age of 50 there are two routes into assessment, through referral by the patient''s general practitioner or through the local NHS Board Audiology Service directly.

The information requested is not centrally available. However, whilst data on this subject has not routinely been collected in the past, the perinatal collaborative transport study, which was published by NHS Quality Improvement Scotland, on Sunday 27 July 2008, sought to collect this type of data over a six month period to February 2007.

A link to the study is attached below:

http://www.nhshealthquality.org/nhsqis/files/CoTS%20Final%20Report.pdf.

Four board areas provide bariatric surgery for the Scottish population: NHS Grampian, NHS Lothian, NHS Greater Glasgow and Clyde and NHS Lanarkshire. The two main procedures that fall under bariatric surgery are adjustable gastric banding and Roux en Y gastric bypass. Both procedures reduce the volume of food which can be ingested and gastric bypass also causes a degree of mal absorption.

Bariatric surgery is one element in the management of obesity. We are currently conducting a review of best practice in order to publish guidance to NHS boards on preparing local healthy weight strategies. This will cover treatment in primary, secondary and tertiary care and address coordination of services through local regional and national pathways. It is anticipated that this guidance will provide greater clarity to both GPs and NHS boards when it is published at the end of 2008.

It is estimated that 2.5% of the adult population of Scotland is in the BMI category for which bariatric surgery may be indicated (BMI>40), however not all would meet the clinical criteria defined by the National Institute for Health and Clinical Excellence.

Bariatric surgery is only one element in the management of obesity. We are currently conducting a review of best practice in order to publish guidance to NHS boards on preparing local healthy weight strategies. This will cover treatment in primary, secondary and tertiary care and address coordination of services through local regional and national pathways. It is anticipated that this guidance will provide greater clarity to both GPs and NHS boards when it is published at the end of 2008.

The Scottish Government works with a range of delivery partners in the commercial and voluntary sector on initiatives outlined in Healthy Eating, Active Living: An action plan to improve diet, increase physical activity and tackle obesity. We will publish guidance for NHS boards on locally delivered healthy weight strategies by the end of 2008. This will cover treatment in primary, secondary and tertiary care, addressing coordination of services through local regional and national pathways. The guidance will encourage NHS boards to work with partners in these sectors wherever possible.

As set out in Healthy Eating, Active Living, the Scottish Government funds a range of initiatives to encourage physical activity, healthy eating and healthy weight aimed at children and their families. Of the £56 million available for initiatives dedicated to tackling obesity, and promoting healthy eating and physical activity, £6 million will be made available to NHS boards to support delivery of family-focused childhood healthy weight intervention programmes and £19 million will be made available to improve nutrition of women of childbearing age, pregnant women and children under five in disadvantaged communities.