Chamber and committees

Living and Dying Well, Scotland''s first national action plan for the provision of palliative and end of life care highlighted the increasing importance of care homes in meeting the palliative and end of life care needs of older people. A multiagency group has been established to ensure the development of arrangements to ensure palliative and end of life care can be provided in care homes where this is appropriate.

Considerable progress has been made in recent years to raise standards of care, in particular through Making good care better: National practice statements for general palliative care in adult care homes in Scotland which was published by the Scottish Partnership for Palliative Care and the then Scottish Executive in May 2006. The Care Commission paid particular attention to this aspect of care in its inspection activities during year 2007-2008 together with the National Care Standards for care homes for older people. These set out the standards of care that service users should expect from care homes.

The Care Commission''s subsequent report, Better Care Every Step of the Way, highlights both the good practice achieved and what has still to be done to achieve a uniformly high standard of palliative and end of life care in care homes throughout Scotland. The report makes a series of recommendations for bringing this about.

Renal dialysis can be a suitable treatment for people living with acute kidney injury (acute renal failure) or established renal failure (ERF). Data on the number of people diagnosed with ERF is collected by the Scottish Renal Registry (SRR) and is shown in the following table.

Table: Number of People ^1,2,3 Receiving Dialysis ⁴ Each Year in Scotland ⁵ Between 2000 and 2009 ⁶

Year	Hospital Haemodialysis	Home Haemodialysis	Continuous Ambulatory Peritoneal Dialysis	Automated Peritoneal Dialysis	Total
2000	1,152	52	320	149	1,673
2001	1,237	47	245	160	1,689
2002	1,352	44	228	160	1,784
2003	1,434	44	194	179	1,851
2004	1,480	44	206	181	1,911
2005	1,577	43	205	199	2,024
2006	1,665	37	182	223	2,107
2007	1,752	40	151	226	2,169
2008	1,770	47	116	212	2,145
2009	1,815	52	102	200	2,169

Notes:

1. Includes people whose treatment started on or before 31 December of each reported year, and who were still alive and resident in Scotland on that date.

2. Excludes people who: have been lost through follow up; where the date, renal unit of dialysis and type of dialysis is unknown on or before 31 December of each reported year. 

3. Excludes people who have recovered renal function within 90 days of receiving renal        replacement therapy.

4. The data do not contain the number of people who have received dialysis for acute renal injury as these are not collected by the SRR.

5. Includes people who are receiving dialysis for end stage renal failure only.

6. Excludes people who have moved outside of Scotland on or before 31 December of each reported year.

7. Data are presented for each calendar year between 2000 and 2009.

Source: SRR.

Ref: IR2010-02825.

The information requested is not held centrally.

We are developing an access target for evidence-based psychological therapies for inclusion in HEAT in 2011-12 which will allow us to measure the referral to treatment times for psychological therapies.

At March 2010 there were 4,610 residents in care homes for older people which are run by local authorities and 29,331 residents in private and voluntary sector care homes for older people.

Independent and voluntary sector care homes are currently being used for the continuing care and rehabilitation of older people. The Scottish Government is keen to continue to shift the focus of care from a hospital setting to one where care is planned, delivered and evaluated close to people''s homes, when this is the most appropriate option.

The Better Health Better Care Action Plan (http://www.scotland.gov.uk/Publications/2007/12/11103453/0) and the Shifting the Balance of Care agenda both encourage this change in the focus and setting of care.

The Delivery Framework for Adult Rehabilitation in Scotland (http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/adultrehabilitation/rehabframework) also recognises that services should be provided locally, with a strong community focus. Rehabilitation teams are already working within a diverse range of settings, including care homes, people''s homes, sheltered housing, community centres and leisure services accommodation.

Data on the number of people receiving NHS continuing healthcare, and the settings it is provided in, has been collected since September 2008. The most recent data from March 2010 was published in June 2010. This census identified that 448 patients were receiving NHS continuing healthcare in a care home setting.

Full details from the fourth balance of care/continuing care census can be found on the NHS Information Services Division website at:

http://www.isdscotland.org/isd/5910.html.

In response to a request for proposals supporting the management of long term conditions NHS Shetland has proposed a telehealth solution including links to care homes. Decisions on the funding of long-term conditions bids will be made before the end of the calendar year. Telecare is already used in a number of areas across Scotland to support older people living within care homes and avoid unnecessary admission to hospital.

I refer the member to the answer to question S3W-37337 on 22 November 2010. All answers to written Parliamentary questions are available on the Parliament''s website, the search facility which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

The Reshaping Care for Older People programme has highlighted that the way care services for older people are currently provided, at times, acts against our agreed policy objective of optimising the independence and wellbeing of older people, for as long as possible, in their own homes or another homely setting.

Scotland''s Spending Plans and the Draft Scottish Budget 2011-12, published on 17 November 2010, set out our plans for a Change Fund for older people''s services. This fund will provide bridging funding to enable local health and social care partnerships to introduce innovation and improvements throughout older people''s services, across health and social care.

The change fund will encourage a greater degree of integrated commissioning and will act as a catalyst for significant changes in service planning and provision including a much more innovative use of care home capacity, such as the care hub model as set out in Scottish Care''s manifesto for the future of care.

Following a recommendation in July 2010 by the UK Blood Services Standing Advisory Committee on the Care and Selection of Donors and the Joint Professional Advisory Committee, from 1 November 2010 across the UK, those with a history of myalgic encephalomyelitis/chronic fatigue syndrome are permanently deferred from donating blood for the protection of their own health. This decision was made to bring the donor deferral criteria for those in this group into line with those with other relapsing conditions, such as multiple sclerosis.