Chamber and committees

The information requested is not held centrally.

Scottish Intercollegiate Guidelines Network (SIGN) Guideline 62 on prophylaxis of venous thromboembolism (VTE) has been replaced by SIGN Guideline 122 on the prevention and treatment of VTE, which was launched on 10 December. One of the new guideline''s key recommendations is that all patients admitted to hospital should be individually assessed for risk of VTE and bleeding, and that the risks and benefits of prophylaxis must be discussed with the patient. SIGN has produced an implementation plan to accompany the guideline, to ensure that its recommendations are widely publicised and implemented throughout NHSScotland.

SIGN Guideline 36 on antithrombotic therapy is also being revised, and a new Guideline on the topic is expected next year.

Achieving reliable VTE prophylaxis in surgical patients is already part of the Scottish Patient Safety Programme''s peri-operative workstream. The Programme has recently agreed to extend its work to include the assessment of all patients, medical as well as surgical, for VTE prophylaxis.

UK residents based in England can receive free NHS dental and eye examinations in Scotland.

The existing right to complain is not set out in primary legislation. However, anyone making a formal complaint about NHS care or services in the last ten years was entitled to have their representations investigated by the relevant NHS body provider under the NHS complaints procedure. Guidance is available at: 

http://www.show.scot.nhs.uk/App_Download/pdf/1guidance010405.pdf

The statutory right included in the Patient Rights Bill will help to give patients the confidence that it is appropriate to exercise this right.

This is an operational matter for Highlands and Islands Enterprise. I will ask its Chief Executive to write to the member.

Under the Regulation of Care (Scotland) Act 2001 (the Act) Scottish Ministers are responsible for setting the maximum regulatory fees which may be charged per year by the Care Commission. It is for the commission to fix fee levels within these maxima, having regard to its reasonable expenses in carrying out its functions under the Act.

The current maximum fee for care home services, as set out in the Regulation of Care (Fees) (Scotland) Order 2005, is £165 per place. In 2010-11 the Commission has set fees at that amount. For care homes of the sizes indicated the fees are:

(a) for 20 places, £3,300;

(b) for 30 places, £4,950;

(c) for 50 places, £8,250; and

(d) for 60 places, £9,900.

The Scottish Government and COSLA issued joint guidance on National Eligibility Criteria for Social Care Services for Older People and Waiting Times for Personal and Nursing Care on 28 September 2009. The guidance is intended to help achieve better outcomes for older people. It delivers a standard eligibility framework for older people which is applied by all local authorities.

It also delivers a commitment to provide personal and nursing care services to older people within a maximum period of six weeks following the identification of need, where an individual is identified as being at critical or substantial risk as regards their independent living or wellbeing. Where an individual''s needs have been assessed as being less than at critical or substantial risk the local authority should have arrangements in place to meet, manage or review that individual''s needs.

The target of a maximum period of six weeks is also in line with the local authority and NHS partnerships'' standard of having no patients delayed in hospital for longer than six weeks.

The delayed discharge target is monitored and published on a quarterly basis, and the most recent report can be accessed at:

http://www.isdscotland.org/isd/6209.html.

Data collection is under development with local authorities on a quarterly return on the target waiting time for service delivery for free personal and nursing care, and will be published in due course.

The Regulation of Care (Scotland) Act 2001 requires the Care Commission to inspect care homes a minimum of twice a year, with at least one of those inspections being unannounced. Information about announced and unannounced inspections is an operational matter for the Care Commission and the member can contact the Chief Executive, Mrs Jacquie Roberts OBE at:

The Care Commission

Compass House

11 Riverside Drive

Dundee

DD1 4NY

Tel: 01382 207 100

From 1 April 2011 the regulatory functions of the Care Commission, apart from those relating to independent healthcare, will be transferred to Social Care and Social Work Improvement Scotland (SCSWIS), which was established by the Public Services Reform (Scotland) Act 2010. All inspections carried out by SCSWIS in 2011-12 will be proportionate and based on consideration of the risks to service quality and vulnerable people. SCSWIS''s inspection plans will be shaped by the budget to be agreed by the Parliament early in 2011.

The provision of palliative and end of life care in a patient''s home is based on the needs of the individual concerned. The composition of the teams providing care will reflect the particular needs of individuals which may change over time. NHS boards, through the implementation of Living and Dying Well, are encouraged to work with their independent and voluntary sector colleagues in order to achieve a multi-disciplinary approach to addressing the palliative and end of life needs of patients and their carers. The provision of services by independent and voluntary sector care homes is a matter for the organisation concerned.

Independent and voluntary sector care homes, able to provide nursing care, can be used for the non-specialist assessment, intervention and care of older people. Some NHS board areas currently commission care homes places for this purpose in the absence of community hospitals, with the direct involvement of GPs in the homes. However, the direct referral from an emergency situation, or accident and emergency attendance, to a care home may be more difficult to achieve.

Work has also recently started on the development of an intermediate care framework which aims to provide guidance on the local development of intermediate care, and ensure consistency of service delivery across Scotland. The care home sector will play an important part in the development of this policy.

Evidence from the Reshaping Care programme, and from elsewhere in the UK and wider afield, demonstrates that better outcomes for people, including older people, coupled with better use of resources and a better experience of care, can all flow when services are planned and delivered in an effectively integrated way between GPs, hospitals and community based health and social care teams.

The role of GPs in accessing an appropriate range of referral options is significant in achieving better outcomes for individuals. That is why the Scottish Government is working with partners in NHS Scotland and local government to improve their understanding and use of resources across all of older people''s services.