Chamber and committees

The recommendations within the Cavendish Review are very broad, and primarily focus on the healthcare support workforce arrangements and issues that apply in England.

Scotland led the way in employer-led regulation of healthcare support workers (HCSW) by introducing mandatory induction standards and a code of conduct for new workers joining NHS Scotland since 31 December 2010. Our original work is formally credited in the new Code of Conduct for Healthcare Support Workers in England, published in March 2013 by Skills for Health and Skills for Care. In April 2013, officials responded to a request from the Cavendish Review for details of our HCSW scheme.

While the scope of our HCSW scheme is broader than the role performed by healthcare assistants in England, officials will consider the Cavendish review’s recommendations for any consequential impacts for the Scottish healthcare workforce as part of our strategic commitment to deliver the 2020 Workforce Vision.

The Scottish National Blood Transfusion Service has always met the transfusion needs of patients in Scotland, however it should be noted that for rare components for named patients, it is sometimes required to import components from outwith Scotland. The National Frozen Blood Bank for rare components is situated in England and the European Frozen Blood Bank for rare components is situated in Holland.

The answer to the question is set out in the following table. Figures for Scotland are also included for comparison purposes. Lung and heart/lung transplantation is undertaken on the basis of a contractual arrangement with the Freeman Hospital in Newcastle. All other transplant activity undertaken outwith Scotland is funded on a cost per case basis in line with the risk share agreement NHS National Services Scotland has in place with NHS England.

Source: NHS Blood and Transplant

The following table details the number of units of blood products imported by the Scottish National Blood Transfusion Service (SNBTS) from outside sources since 1999.

It is important to note that SNBTS also exports blood products to the other UK Blood Services. For example, in 2012 there were 579 blood component units issued to the Northern Ireland Blood Transfusion Service (NIBTS) and 462 units to NHS Blood and Transplant (NHSBT), totalling 1,041 units issued.

Imported units represent a very small proportion of the blood components used by SNBTS. In 2012 there were 246,216 blood component units processed and tested by SNBTS. The 2,934 units imported represented 1.2% of this total:

Note 1: ‘Total Other’ represents imports from sources other than UK Blood Services, i.e. Republic of Ireland (IBTS), Dutch Red Cross, Bergen Blood Centre, American Rare Donor Panel, Maco-Pharma.

Note 2: The components 2004-2010 in ‘Total Other’ are predominately 18,201 Fresh Frozen Plasma from Bergen, a USA supplier (due to nvCJD risk reduction).

Note 3: The rise in components from NHSBT in 2010 aligns with the move of supplier from Bergen to NHSBT for methylene blue-treated and reduced plasma for patients post 01-01-96 (nvCJD risk reduction).

Note 4: The imports from NHSBT will include both imports of standard blood components and of non-standard or rare units for specific patients.

Note 5: Imports of standard red blood cells are covered by the UK Blood Services Technical agreements (SNBTS also export units to the other UK Blood Services under this agreement).

Note 6: There is a Memorandum of Understanding between the UK Blood Services for mutual assistance in times of extreme shortage. This requires sharing of blood components to balance inventory e.g. there was an export from SNBTS of 90 units on 15 July 2013 to the Welsh Blood Service due to extreme blood shortages in Wales.

Note 7: Year 2013 is from 01-01-13 to 30-06-13.

Blood policy is already fully devolved to the Scottish Parliament. The Scottish National Blood Transfusion Service is the specialist provider of transfusion medicine in Scotland, supplying high quality blood, tissues, cells and services. Their key priority is to ensure that NHSScotland has enough blood to meet the transfusion needs of patients in Scotland.

Organ donation and transplant activity across the UK is co-ordinated by NHS Blood and Transplant (NHSBT) which operates in Scotland under a contractual arrangement with the Scottish Government. The Scottish Government contributes to the running costs of NHSBT, and the organisation is accountable to Scottish Ministers for the organ donation and transplantation activities it undertakes in Scotland.

Donation and transplantation activity has always been delivered on a collaborative basis across the UK as it is in the best interests of patients to ensure that organs have the best match to recipients. If Scotland becomes independent this will continue to be the case, in much the same way that the Health Service Executive of the Republic of Ireland cooperates with the UK on transplants currently. This mirrors the experience in other parts of Europe where groups of countries work collaboratively across borders to achieve the best outcomes for their patients.

To define the purpose and scope of the Quality Improvement Framework, Scottish Government officials established a short life working group on Quality Standards (SLWG). This is a reference group of senior stakeholders comprising representatives from Alcohol and Drug Partnerships (ADPs), the NHS, alcohol and drug treatment and support services, scrutiny bodies, and the third sector. In collaboration with service users and people in recovery, the SLWG produced a set of draft Quality Principles for services. The inclusion of this lived experience has put people at the heart of the Quality Improvement Framework and continues to influence its development. The Quality Improvement Framework has been developed in a consultative way and the various outputs from the SLWG will continue to be consulted upon and tested by ADPs, services and service users, and people in recovery.

For Scotland, National Institute for Health and Care Excellence (NICE) Technology Appraisals are taken forward by Healthcare Improvement Scotland (HIS) who have responsibility for considering the applicability of NICE Technology Appraisals within the Scottish context.

NICE Technology Appraisal TA114, methadone and buprenorphine for the management of opioid dependence has been considered by HIS and guidance is available on the HIS website using the following link:

http://www.qisstaging.scot.nhs.uk/HIS/our_work/technologies_and_medicines/mta_resources/appraisal_114.aspx.

NHS boards are expected to implement the HIS guidance.

In keeping with the established Framework for Local Partnerships on Alcohol and Drugs:

http://www.scotland.gov.uk/Resource/Doc/270101/0080412.pdf.

The Quality Improvement Framework will be delivered at a local level under the leadership of Alcohol and Drug Partnerships and drug and alcohol treatment and support services, for the benefit of service users and their families.

The focus of the third phase of delivery of Scotland’s drug strategy, The Road to Recovery, is ensuring quality is embedded across all services in Scotland;quality in the provision of care, treatment and recovery services; and quality in the data that will evidence the medium and long term outcomes of people in recovery; delivered by a quality workforce. The Quality Improvement Framework, which is guided by a Short Life Working Group (SLWG), will begin to be implemented from March 2014.

As part of this the SLWG has agreed a set of Quality Principles for the effective delivery of services. In the summer of 2013 we will consult on these principles with Alcohol and Drug Partnerships (ADPs), service users and people in recovery.

To support ADPs effectively report outcomes to community planning partnerships the Scottish Government will publish updated planning and reporting guidance in July 2013.

Access to quality data is a key part of ensuring quality in services, consultation on a new single integrated national Drug and Alcohol Information System, including recovery indicators, is on-going and will close on 12 July 2013. This will inform the development of a data system which is expected to be implemented in 2015.

In support of embedding quality in services across Scotland, The Scottish Government has in place a Workforce Development Programme which is underpinned by the 2010 statement Supporting the Development of Scotland’s Alcohol and Drug Workforce:

http://www.scotland.gov.uk/Resource/Doc/254429/0110090.pdf.