Chamber and committees

Most pain clinics provide services to patients in an outpatient setting. Information on out patient waiting lists are collected centrally at speciality level only and does not differentiate between different types of clinics within the specialty. Consequently the information requested is not available centrally.

Latest official statistics on the defined daily dose per capita for antidepressants, prescribed in Scotland that were dispensed by community pharmacists or dispensing doctors anywhere in the UK can be found on the ISDScotland website at:

www.isdscotland.org/isd/3671.html.

Information is presented by NHS board for financial years up to 2008-09. Provisional statistics for financial year 2009-10 are planned to be published on the
28 September 2010.

We do not anticipate that any NHS board will meet the target to level off the annual rate of increase of defined daily dose per capita of antidepressants which was due to be achieved by 31 March this year.

However, the HEAT target has driven a much better understanding of the issues that impact on anti-depressant prescribing across Scotland. As our understanding has improved, it has become clearer that we can not be sure that implementing evidence based prescribing behaviour will lead to a reduction in antidepressant usage. We have therefore reviewed the target and are committed to developing an access to psychological therapies target for inclusion in HEAT in 2011-12. We will continue to track antidepressant prescribing across Scotland to see what impact improving access to psychological therapies has on prescribing behaviour.

We continue to support the Managed Clinical Network for Chronic Pain in NHS Greater Glasgow and Clyde. To help promote that MCN approach, the Lead Clinician of the Network is a member of the Scottish Chronic Pain Steering Group set up by our Lead Clinician for Chronic Pain.

In line with Scottish Intercollegiate Guidelines Network (SIGN) Guideline 73 on the management of sleep apnoea in adults, sleep medicine services routinely provide weight reduction management advice as one of the lifestyle management factors that can have a positive effect on reducing the symptomatic effects of the condition.

In doing so, they will be assisted by our Counterweight programme, a Primary Care initiative under which a Weight Management Adviser provides adults referred to the programme with advice on how to achieve and maintain a healthy weight through diet and physical activity.

Clinicians in NHSScotland are expected to follow the recommendations in Scottish Intercollegiate Guidelines Network (SIGN) Guideline 73 in relation to the diagnosis and treatment of sleep apnoea in adults.

NHS Boards are working to reduce waiting times for services such as sleep apnoea, which were previously excluded from waiting time standards, to ensure that they meet the 18 weeks referral to treatment target by the end of 2011.

Children with additional and complex support needs require care services according to their specific needs, these are led by the Community Dental Service in each Board area who has staff trained in treating children with complex medical conditions and developmental issues. There is however a universal element of the Childsmile programme (for example dental practice programme and nursery toothbrushing programme) which children should receive if they are in mainstream schools and nursery.

NHS boards across Scotland recognise the importance of smooth transition with clearly defined pathways to support children and young people with life limiting and long term conditions moving from child to adult NHS services.

It is recognised that transition arrangements can and should be improved as identified in the National Delivery Plan which highlights that at present adult medicine is not configured to meet the needs of young people moving from paediatric services.

Various work streams involving multiprofessional, multiagency, service users and the voluntary sector are currently underway to address this important issue.

For example, a working group has been established to develop proposals for the long-term care of children with complex and life-limiting conditions. Models of effective transition will be identified and reproduced.

Managed Clinical Networks are also considering transition on a specialty basis and are in the process of developing protocols and pathways. For example, the cancer network CATSCAN has established a Teenagers and Transition Working Group, which is mapping existing services for teenagers and young people in Scotland. A sub Group of The Children with Exceptional Healthcare Needs MCN is currently reviewing care pathways.

The Guidance Hospital Services for Young People in Scotland which was published on 5 May 2009 emphasises the need for good transition arrangements for young people moving into the adult care sector across all specialities. This report expects NHS boards to have the following in place for young people with long term conditions:

Incorporate well-structured transition arrangements that accord with best-practice guidance;

Take advantage of the flexibility offered by the revised age limits to defer formal transfer to adult services until the most appropriate developmental stage for the young person; and

Give consideration to the benefits of identifying a key worker to support each young person through the transition process.

The Guidance is available at:

 http://www.scotland.gov.uk/Publications/2009/05/07130749/10.

NHS boards recognise the importance of supporting families whose children are being treated in hospital and provide a range of facilities for families. The facilities and support provided varies dependent on the size and type of service provided. However, all NHS boards have facilities to allow parents to stay overnight, when necessary.

NHS boards across Scotland recognise the importance of play specialist support for children and young people to support them in adjusting to the hospital environment and assist with their treatment. NHS boards offer a range of play services delivered by play specialists, play assistants and/or trained nursery nurses. NHS boards are responsible for planning and delivery of services, according to the local population''s needs. This includes the provision of play therapy.

Highlands and Islands Enterprise are continuing to develop their relationship with Virgin Galactic with a view to supporting possible space operations from Scotland. Virgin Galactic have reiterated their ongoing commitment to the concept of using RAF Lossiemouth as a commercial base of operations for suborbital space tourist flights during summer months. They feel that RAF Lossiemouth offers an advantage by utilising the closed air space in the area which would be ideal for launching a spaceship at 50,000ft, and it benefits from having a runway at the edge of the sea, enabling take-off over the Moray Firth. However, there are significant regulatory and planning issues to overcome first to support space flights from Scotland and Virgin Galactic have always said that they would not even consider operations outside the USA until at least 2013.