The commissioning of NHS services such as pharmacist prescribing services is a matter for the NHS boards who are best placed to assess local service and patient needs. There are currently approximately 90 such pharmacist prescribing services in place in Scotland.

NHS National Education for Scotland funds training for pharmacist prescribing through Robert Gordon and Strathclyde Universities. The first courses for pharmacist supplementary prescribers began in 2003. Since 2006, changes to legislation enable pharmacists to train as independent prescribers. Conversion courses have been provided to allow supplementary prescribers to develop and convert their prescribing skills to become independent prescribers.

The following table shows the total number of pharmacists who have trained as supplementary and independent prescribers and the number of pharmacists who have successfully completed and are undertaking the conversion course.

Course	Total
Number of Pharmacists who have Completed the Supplementary Prescribing Course	467
Number of Pharmacists Currently Undertaking the Supplementary Prescribing Course	105
Number of Pharmacists who have Completed the Independent Prescribing Conversion Course	96
Number of Pharmacists Currently Undertaking the Independent Prescribing Conversion Course	173

Note: The data in the table has been provided by NHS Education for Scotland.

The Scottish Government recognises the importance of promoting the health of those working in the public sector and the benefits for both the wellbeing of the individual and for improved efficiency and productivity for the employer.

One hundred and forty-one NHS organisations and 28 local authorities already hold a Healthy Working Lives award or the predecessor Scotland''s health at work (SHAW) award. The Scottish Government is currently working towards acquiring the gold healthy working lives award.

The award programme is run by the Scottish Centre for Healthy Working Lives and is funded by the Scottish Government through NHS Health Scotland. The Centre''s Healthy Working Lives advisers can provide employers with advice on good workplace policies that promote health and wellbeing, such as healthy eating, physical activity, tobacco cessation and mental wellbeing. The centre promotes the uptake of the award scheme widely across the public, private and third sectors.

The Chief Executive of NHSScotland issued a letter to all NHS boards on 20 March 2008 (CEL 14 [2008]) on the role of the acute sector as a health promoting health service. Included in this is a requirement for all NHS board acute services to work towards acquiring a healthy working lives award, or a higher level of award where one is already held, as soon as possible.

The Better Health, Better Care: Action Plan also sets out the Scottish Government''s commitment to ensuring safe and health-promoting environments, and to ensuring that all NHS boards, both as employers and as service providers, adopt existing good practice in working with community planning partners and employability services to enable people to work in a health promoting environment, retain work if ill, or return to work from illness or injury.

The priority for eHealth investment is to give clinicians electronic access to current information on their patients such as test results, and as a by-product such information is retained electronically. The full hospital record can however contain hand-written material such as charts, however digitally scanning such paper records is not seen as a patient care priority for eHealth investment.

GPs already have electronic access to results of investigations conducted for their patients by hospital clinicians, via the SCI Store IT system. There are no general plans to routinely provide GP e-access to the full hospital medical record. The approach adopted is to concentrate on putting shared online records arrangements in place for patients with particular conditions where co-ordinated care is most important, with the most complete example being the SCI Diabetes Collaborative linked IT systems.

Access to all patient identifiable information including health records is on a strict need to know basis in accordance with the Caldicott principles, Data Protection Act 1998, NHS Scotland Information Governance Standards and various codes of professional conduct. In accordance with these principles, NHS boards define policies and procedures to audit the access to patient identifiable information.

The Scottish Government recognise the positive contribution made by dispensing opticians to the provision of eye care in the community. However, no formal assessment and audit has been undertaken.

Patients treated in hospitals can be seen in a variety of settings including accident and emergency, out-patients, day cases and in-patients.

Information held centrally on attendances at accident and emergency departments and outpatient departments does not include detailed information on diagnosis. However, information held on discharges from hospitals includes information on whether a patient was admitted to hospital with an alcohol-related diagnosis by NHS board area of treatment. It is not possible to distinguish between people who were treated in hospital and people who were admitted to hospital but not treated.

Information in relation to the number of patients discharged from NHS general acute hospitals with an alcohol related diagnosis between 2002-03 and 2006-07 by NHS board of treatment for people aged (a) under 15, (b) 15 to 18, (c) 19 to 21 and (d) over 21 is available from the Scottish Parliament Information Centre (Bib. number 45547).

Information in relation to the number of patients discharged from NHS psychiatric units and mental illness hospitals with an alcohol-related diagnosis between 2001-02 and 2005-06 and by NHS board of treatment for people aged (a) under 15, (b) 15 to 18, (c) 19 to 21 and (d) over 21 is available from the Scottish Parliament Information Centre (Bib. number 45548).

The following notes should be read in conjunction with the information available from the Scottish Parliament Information Centre:

Notes:

1. A patient was defined as having excess alcohol consumption if their diagnosis contained an alcohol-related condition.

2. Information on discharges from acute non-obstetric, non-psychiatric hospitals is available from the Scottish Morbidity Record, SMR01.

3. Information on discharges from psychiatric units and mental illness hospitals is available from the Scottish Morbidity Record, SMR04.

4. 2005-06 is the most recent year for which SMR04 information is available.

5. The information available from the Scottish Parliament Information Centre (Bib. number 45547) excludes transfers. For the definition of transfers, please see the ISD Data Dictionary at:

http://www.datadictionaryadmin.scot.nhs.uk/isddd/ISD_DT_TOP_Content.jsp?pContentID=1817&p_applic=CCC&p_service=Content.show&.

6. Information is based on date of discharge (rather than date of admission) because the SMR01 dataset is a discharge summary record.  SMR04 data is presented as discharges data to maintain consistency.

7. Caution is necessary when interpreting these figures. The recording of mental and behavioural disorders due to use of alcohol may vary from hospital to hospital. Where alcohol misuse is suspected but unconfirmed it may not be recorded by the hospital.

8. Figures in the information available from the Scottish Parliament Information Centre (Bib. numbers 45547and 45548) only relate to those individuals who are treated as in-patients. They do not include individuals managed as out-patients.

Table 1 shows the number of patients discharged from NHS general acute hospitals with a mental illness and drug-related diagnosis between 2002-03 and 2006-07 in Scotland.

Table 2 shows the number of patients discharged from NHS psychiatric units and mental illness hospitals with a mental illness and drug-related diagnosis between 2001-02 and 2005-06 in Scotland.

Table 1: Patients Discharged from NHS General Acute Hospitals¹ with a Diagnosis of Mental Illness and Drug Misuse^2,3 in any Position: Scotland 2002-03 to 2006-07^P

	2002-03	2003-04	2004-05	2005-06	2006-07P
Scotland	775	854	956	942	1115

Source: ISD Scotland (SMR01).

^PProvisional.

Notes:

1. Excludes mental illness hospitals, psychiatric units and maternity hospitals and transfers.

2. Excludes misuse of tobacco or alcohol.

3. Diseases recorded using the World Health Organization''s International Classification of Diseases 10th Revision (ICD10). Drug-related conditions: F11, F12, F13, F14, F15, F16, F18, F19.  Mental illness: F00-F10, F17, F20-F99.

Table 2: Patients Discharged from Psychiatric Hospitals¹ with a Diagnosis of Mental Illness and Drug Misuse^2,3 in any Position: Scotland 2001-02 to 2005-06^P

	2001-02	2002-03	2003-04	2004-05	2005-06P
Scotland	710	725	646	753	689

Source: ISD Scotland (SMR04).

^PProvisional.

Notes:

1. Excludes acute and maternity hospitals.

2. Excludes misuse of tobacco or alcohol.

3. Diseases recorded using the World Health Organization''s International Classification of Diseases 10th Revision (ICD10). Drug related conditions: F11, F12, F13, F14, F15, F16, F18, F19.  Mental Illness: F00-F10, F17, F20-F99.

The essential services element of the GP contract includes the on-going management of the long-term conditions, while the quality and outcomes framework targets a specific range of chronic medical conditions as does the Scottish enhanced services programme for primary care.

Any future changes to chronic disease management under the GP contract will largely be determined by clinical research evidence.

We currently have in place an enhanced service for falls prevention and bone health as part of the Scottish enhanced services programme for primary and community care. This service will provide the opportunity to build on in the future.