Chamber and committees

I have asked Tony Cameron, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:I refer the member to the answer given to question S1W-26897.

The Primary Care Modernisation Group's report identified chronic disease management as a priority in improving and developing primary care services. NHS boards have responsibility for ensuring the actions identified in the report are implemented locally. There is already a programme of investment and reform in primary care, to improve access to a broader range of services and reduce inequalities. The additional £30 million of funding for primary care announced in August 2001 is being invested through Local Health Care Co-operatives to develop and improve chronic disease management in primary care.

I have asked Tony Cameron, Chief Executive of the Scottish Prison Service (SPS) to respond. His response is as follows:The results of an audit of Health Care Standards carried out in 1999 are shown in the following table.Following on from this piece of work, an external adviser was engaged by the Scottish Prison Service to consider how development of SPS' Health Care Standards might best be taken forward. It was agreed that by way of improving auditability, it was appropriate to revise our Health Care Standards. This work is now to hand.

	No of Prisons
Standard	Achieved	Partially Achieved	Not Achieved	Not Applicable
1. 100% of prisoners will have their weight recorded on each admission to prison and their height recorded on their initial admission to prison.	12(63%)	4(21%)	1(5%)	2(11%)
2. Basic equipment to be provided within each consulting room, minimum size of 10.8m2, in the health centre shall include an examination couch, a mercury sphygmomanometer, scales, desk, three chairs, examination/treatment lamp, stethoscope, eye charts, ophthalmoscope, auroscope and a copy of BNF in 100% of cases.	16(84%)	2(11%)	1(5%)	-
3. Provision of a telephone on a direct line in 100% of cases.	18(95%)	-	1(5%)	-
4. 90% of appointments at outside hospitals will be kept.	19(100%)	-	-	-
5. The maximum waiting time for a prisoner to be seen by a Visiting Specialist from date of referral to be urgent cases - 4 weeks and routine cases - 12 weeks in 80% of cases.	18(95%)	-	-	1(5%)
6. Adequate facilities must be provided for Visiting Psychiatrists in 100% of cases.	14(74%)	2(11%)	-	3(16%)
7. Routine cases referred to the Psychiatrist to be seen within four weeks in 100% of cases.	18(95%)	1(5%)	-	-
8. Urgent cases referred to the Psychiatrist to be seen within seven days in 100% of cases.	17(89%)	2(11%)	-	-
9. Emergency (psychiatric) cases should be seen within 24 hours in 100% of cases.	13(68%)	2(11%)	4(21%)	-
10. A Mental Health Nurse will be available to provide specialist nursing care and advice in 100% of cases.	17(90%)	-	1(5%)	1(5%)
11. Transfer to hospital following completion of a Section under the Mental Health (Scotland) Act 1984 should be effected within the timescale agreed by the health care staff and the Forensic Psychiatrist in 100% of cases.	16(85%)	1(5%)	1(5%)	1(5%)
12. Health centre staff will be given 24 hours' notice of proposed transfer on 100% of occasions.	3(16%)	6(31%)	10(53%)	-
13 100% of prisoners aged 55 or over and in prison for more than four weeks will be offered a urinalysis check if not carried out within the last three years.	6(31%)	4(22%)	6(31%)	3(16%)
14. 100% of prisoners aged 35 and over and in prison for more than four weeks will be offered the opportunity to have their blood pressure (BP) recorded if not carried out within the last five years.	10(53%)	3(16%)	5(26%)	1(5%)
15. Where a prisoner requests Hepatitis B immunisation, this will be offered in 100% of cases.	19(100%)	-	-	-
16. 80% of cases with acute/severe dental pain will be seen within 24 hours.	14(73%)	2(11%)	3(16%)	-"

The Primary Care Modernisation Group's report identified mild to moderate mental health problems as a priority in improving and developing primary care services. NHS boards have responsibility for ensuring the actions identified in the report are implemented locally. There is already a programme of investment and reform, including the £30 million investment announced last year, which is ensuring that primary care can drive change, working with patients and frontline staff to redesign services to provide more comprehensive and better co-ordinated care to individuals. As part of the formal accountability review arrangements in NHSScotland, the Mental Health and Well Being Support Group is working with NHS boards to ensure consistency in the planning and delivery of mental health services in primary care.

The Remote and Rural Areas Resource Initiative's (RARARI) Solutions Group report was intended to stimulate interest within NHS boards in piloting a range of work aimed at improving remote and rural services.The development of a fast inshore marine ambulance is an operational matter for the Scottish Ambulance Service. The Service has appointed a Project Officer who, over the next few months and with the assistance of a local GP, will produce a feasibility study on the introduction of marine ambulances. The Project Officer is based in South West Ambulance Division, which covers Ayrshire and Arran, Argyll and Clyde and Dumfries and Galloway.

Maximising access to services is an important part of NHS Boards' responsibilities, particularly in rural areas. The Remote and Rural Areas Resource Initiative's (RARARI) Solutions Group report was intended to stimulate interest within NHS boards in piloting some of the work suggested. RARARI has received a number of responses and will be taking these forward in due course. The Scottish Health Plan requires boards serving rural areas to draw up plans for rolling out good practice from RARARI projects.

The report of the Primary Care Modernisation Group which was issued to NHSScotland on 22 March 2002 identified access to services as a priority in improving and developing primary care. The Chief Executive of NHSScotland has informed NHS boards that they have responsibility for leading the implementation of the actions identified in the report in their local areas.There is already a programme of investment and reform underway in primary care. This includes the £30 million announced last year to increase capacity in primary care and to improve access to a broader range of services. An announcement was made in April this year of an initial package of £1million to encourage more dentists to work within the NHS and to improve patients' access to NHS dental treatment in remote and rural Scotland. By October this year there will be an action plan and timetable in every NHS board area for the delivery of 48-hour maximum waits to see the right member of the primary care team. Together, these measures demonstrate that concerted action is being taken to improve access to primary care services.

An additional investment package of £2 million per year was announced in November 2001 to improve the recruitment and retention of general practitioners, particularly in remote and rural areas. We are also establishing new workforce development arrangements, which will support boards and trusts in assessing and providing for their workforce needs and will bring a more co-ordinated approach to issues of recruitment and retention. We have also commissioned a Review of the Scottish Medical Workforce, which will report in July. This report will help inform the future planning of the medical workforce across Scotland, and will be a key element of the new arrangements.I also refer the member to the answer given to question S1W-26899.

The Remote and Rural Areas Resource Initiative's (RARARI) Solutions Group report recognises that community hospitals can contribute in a number of ways to the delivery of health care services in remote and rural parts of Scotland. The report was intended to stimulate interest within NHS boards in piloting a range of work aimed at improving remote and rural services. RARARI has received a number of responses and will be taking these forward in due course. The Scottish Health Plan requires boards serving rural areas to draw up plans for rolling out good practice from RARARI projects.

Funding of infection control procedures are incorporated in the fee scale system where dentists receive payments for each item of service given on each patient. The British Dental Association Advice Sheet "Infection Control in Dentistry" is used as the model of good practice in primary care dental practices.Over the last three years the Executive has given improvement grants to general dental practices. These are for purposes of patient safety and access and to address the requirements of the Disability Discrimination Act. The sums involved are:

2000-01	£0.5 million
2001-02	£3.8 million
2002-03	£3 million

This has enabled practitioners to make improvements to dental practices and ensure they are fit for purpose.