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.

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.

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.

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.

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.

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.

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.

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.

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.