The available information showing the number of new podiatry patients treated in Scotland is presented in the table:

NHSScotland New Podiatry Patients

	Patients Treated Hospital1	Patients Treated Community2
1999	69,715	424,418
2000	61,151	424,808
2001	60,102	437,478
2002	58,928	431,232
2003	54,651	445,068p
2004	57,088p	n/a

Source: ISD Scotland Forms (ISD(S)1, ISD(S)8.

^PProvisional.

Notes:

1. Year ending March.

2. Year ending December.

Direct Payments Scotland is a time limited project that was extended to ensure that maximum support could be offered to certain disabled groups who were originally eligible for direct payments. The Executive also funds the Scottish Personal Assistants Employers Network (SPAEN) to assist those who wish to employ their own workers through a direct payment. The intention now is to make direct payments available to all community care groups and support will be offered to the relevant organisations to make this possible e.g. to older peoples’ organisations for roll out to older people.

The information requested is not held centrally.

There is currently no national screening programme for the detection of foot problems or abnormal gait in children. The most recent Royal College of Paediatrics and Child Health review of childhood screening and surveillance activity found little evidence to support a formal screening programme for defective or abnormal gait. However, a check of the hips is part of the general physical examination of all children within the first 24 hours of birth and at six to eight weeks. Health professionals will also explore any cause for concern in the course of their regular contact with children and their families. Information about local practice is not held centrally.

Decisions on treatment interventions and options are for individual patients and their medical and social care professionals. We published a summary of the Drug Treatment and Rehabilitation Review on 27 October 2004, in the form of an action plan which contains several recommendations aimed at Improving Service Quality and Consistency available at  http://www.scotland.gov.uk/library5/health/drugrehabreview.pdf, including action to update clinical guidelines dealing with issues such as methadone prescribing.

In coming to a decision about the use of a medicine not specifically licensed for children, clinicians will take into account guidance from various sources including “Medicines for Children”, a UK paediatric formulary produced jointly by the Royal College of Paediatrics and Child Health and the Neonatal and Paediatric Pharmacists Group. The British National Formulary (BNF) also contains information about dose calculation and advises that children’s doses may be calculated from adult doses by using age, body-weight or body-surface, or by a combination of these factors. The BNF can be accessed at www.bnf.org

This information is not available centrally. Prescription data collected centrally are not patient-specific but relate to the number and cost of prescribed items dispensed by community pharmacists and dispensing doctors.

At the end of August, there were 230 patients from Scotland and Northern Ireland being cared for at the State Hospital, 42 of whom had been assessed by State Hospital clinicians as being ready for transfer. For 10 out of the 42 clinical agreement had been reached with the prospective receiving clinicians that these patients were suitable for transfer to a medium secure unit.

Based on two needs assessments that have been carried out over the last five years, it is expected that the numbers of patients at the State Hospital will reduce over time, with around 100 patients being cared for in other levels of security, including medium secure units.

NHS boards and their local authority partners have already provided new forensic psychiatric facilities and services for East Scotland and plans are advancing for further new provision across Scotland in accordance with the established policy set out in NHS Management Executive Letter (1999)5, (Bib. number 12317) and NHS Health Department Letter (2001)9, (Bib. number 12345).

The forecast demands arising from the new rights of appeal from May 2006 will be taken into account by the planning partners, informed by the 2004 NationalAssessment of Mental Health Services (Bib. numbers 30221-30234 and 30236). 

It also remains open for NHS boards to commission forensic psychiatric care and accommodation from other providers.

The Orchard Clinic was opened on the Royal Edinburgh Hospital campus in 2001 and has 50 beds. Planning permission has been granted for a 76 bed unit at the Stobhill Hospital site in Glasgow. On 23 March 2004, the four West of Scotland NHS Boards (with the exception of NHS Greater Glasgow) agreed to locate a 36 bed West of Scotland Medium Secure Unit at Dykebar Hospital near Paisley.

Discussions about the size and location of a medium secure unit for patients in the north of Scotland are continuing, following agreement among the NHS boards concerned that such a unit is needed. Some facilities are already available at Royal Cornhill Hospital, Aberdeen and at Murray Royal Hospital, Perth.