Chamber and committees

Almost £25 million has been made available to NHS boards in 2008-09 specifically for tackling alcohol misuse. We have made it clear that first call on this funding is to implement screening for alcohol misuse and delivery of brief interventions where appropriate, in line with a new NHS target. Priority areas are primary care, emergency departments and antenatal care.

The State Hospital has a business continuity plan in place to deal with the potential loss of staff at the hospital. It provides a high-level analysis for each of the key service processes that could affect the delivery of patient care and guidance to the hospital in regards to contingency arrangements for the loss of key staff and risk assessment of the critical processes and activities. The purpose of the plan is to ensure that staffing is available in all foreseeable circumstances in order that an acceptable level of patient care is maintained.

Discussions are ongoing at the State Hospital with all concerned working towards mutually acceptable outcomes.

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.

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.

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.

There are currently two patients'' travelling expenses schemes A non-means tested Highlands and Islands Scheme for patients resident or working in the former Highlands and Islands Development Board area and a means tested scheme covering the rest of the country. Under the schemes eligible patients and, where considered medically necessary, their escorts, travelling to hospital for treatment, are reimbursed, either fully or partially, their travelling expenses. In addition, the cost of overnight expenses can be reimbursed if it is considered that an overnight stay is, in practice, unavoidable.

The Highlands and Islands Scheme provides for the reimbursement of travelling expenses in excess of £10. Eligible patients are those who are resident or working in the former Highlands and Islands Development Board area. The distance travelled from the patient''s home (or place of residence) to hospital must be 30 miles or more or involve a journey by sea of more than five miles. Patients in receipt of income support, income-based job seekers'' allowance, pension credit guarantee credit, are entitled to, or are named on, a valid NHS tax credit exemption certificate or who are assessed as eligible on low income grounds, may not be required to meet any of the costs.

Eligible patients under the means tested scheme are those who are in receipt of Income Support, Income-based Job-seekers'' Allowance, Pension Credit guarantee credit, are entitled to, or are named on, a valid NHS tax credit exemption certificate or who are assessed as eligible on low income grounds.

This information is not held centrally.

The information requested is shown in the following table:

Cause of Death	2003	2004	2005	2006	2007 (Provisional)
Coronary thrombosis - all cases are due to it (1)	6,962	6,311	6,046	5,494	5,337
Coronary thrombosis - most cases are due to it (2)	4,346	4,340	4,123	3,782	3,756
Cerebral thrombosis (venous and arterial) - all cases are due to it (3)	44	33	31	20	21
Cerebral thrombosis (venous and arterial) - most cases are due to cerebral or pre-cerebral thrombosis (4)	3,365	3,258	2,922	2,834	2,734
Peripheral arterial thrombosis - most cases are due to it (5)	248	245	265	302	277
Venous thrombosis at various sites - all cases are due to it (6)	2	6	4	1	3
Venous thrombosis at various sites - most cases are due to it (7)	170	161	142	137	127
Other conditions caused by thrombosis - all cases are due to it (8)	0	0	0	0	0
Other conditions caused by thrombosis - most cases are due to it (9)	17	21	15	10	20

Source: General Register Office for Scotland.

The figures provided for 2007 are provisional, pending the publication of the Registrar General''s Annual Report in August. The table uses groups of causes of death which are defined in terms of the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). In the case of some of the groups, it is thought that all the deaths from those causes are due to the specified type of thrombosis. In the case of the other groups, it is thought that most of the deaths from those causes are due to the specified type of thrombosis.

We agree with the conclusions of the UK National Screening Committee that it would be inappropriate to introduce population screening for Venous Thromboembolism (VTE). The UK National Screening Committee considers each proposal for screening on its merits and will keep the issue of Factor V Leiden screening under review.

It is however now fairly commonplace for people at risk of a predisposition to thrombosis, including relatives of patients who have Factor V Leiden (and other similar genetic conditions) to be offered screening.

Current guidance to NHS boards draws their attention to the need to ensure information is widely available about the options available to patients for reimbursement of travelling expenses.

In particular, boards are advised to arrange for notices providing information about the schemes to be displayed in all patient areas and to include details of the schemes and local transport and concessionary fares arrangements with appointment or admission letters.