Chamber and committees

Information on patients resident in Scotland who were treated in hospitals in England for each financial year from 1999-00 to 2011-12 has been provided. This information is for all inpatients and day cases (elective and emergency admissions).

Information on the cost is not collected centrally.

Count of Finished Admission Episodes ^1,2,3 carried out in an English NHS hospital for inpatient and day case patients whose NHS Board of Residence is in Scotland, by NHS board of Residence; financial years 1999-00 to 2011-12.

Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre

1. All in-patient and day case admissions are included, elective and emergency.

2. Activity in English NHS hospitals and English NHS commissioned activity in the independent sector is included.

3. A finished admission episode (FAE) is the first period of inpatient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year.

A small expert group is currently being set up to consider the provision of ulipristal acetate in Scotland. This group will consider the available evidence and make recommendations based on this evidence. This will include consideration of access to ulipristal acetate via community pharmacies.

A small expert group is currently being set up to look at the provision of ulipristal acetate in Scotland. This group will consider the available evidence and make recommendations based on this evidence on the provision of ulipristal acetate in Scotland. This will include consideration of access to ulipristal acetate via community pharmacies.

The Scottish Government’s national drugs strategy, The Road to Recovery, published in 2008 and re-affirmed with cross-party support by this Parliament in 2012, still stands strong as the key over-arching policy document for the delivery of recovery-focused support and treatment in Scotland. The strategy is underpinned by key guidance contained in the UK Guidelines on Clinical Management for Drug Misuse and Dependence (2007) and the Scottish Advisory Committee on Drugs Misuse (SACDM) Essential Care report (2008) which advocate for the provision of evidence-based, holistic and recovery-focused support where the individual has a say in their treatment options and associated recovery pathway.

In 2010, the NHS Healthcare Quality Strategy was published as a new approach to making our NHS even better, now and in the future, by building on a firm foundation of quality services, dedicated staff and strong values. The strategy is focused on three key Quality Ambitions to ensure that our NHS is safe, effective and person-centred.

Moreover, delivering on a key commitment within Changing Scotland’s Relationship with Alcohol: A Framework for Action, The Quality Alcohol Treatment and Support report (QATS) report, published in March 2011:

http://www.scotland.gov.uk/Publications/2011/03/21111515/0,

builds on existing guidance contained both within the Alcohol Problems Support and Treatment Framework (2002) and the SACDM Essential Care report (2008). While focused on alcohol interventions, the QATS report sets out recommendations and expectations for the delivery of treatment and support in the wider addictions field. This is in line with the integrated way in which the majority of treatment services in Scotland are delivered to support people to recover, irrespective of the substance involved.

The QATS report contains 14 key recommendations targeted at Scottish Government; Alcohol and Drug Partnerships (ADPs) and treatment services with the aim of improving the quality of service delivery to better support and empower people to recover.

To build on this work, Scottish Government officials are progressing with the development of a drug and alcohol Quality Improvement Framework for services in Scotland. This quality improvement framework is the focus of the next stage of delivery of The Road to Recovery strategy, and builds on recommendations within the Quality Alcohol Treatment and Support Report (2011) - making sure 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. The Quality Improvement Framework will drive further improvements setting standards of care, which will be measured by quality indicators of recovery.

The Scottish Government is working with third sector organisations across Scotland including the Scottish Drugs Forum, the Scottish Recovery Consortium and the Scottish Families Affected by Drugs, to ensure that the views of service users and their families are heard and listened to, in the development of quality services.

It is not possible from the data currently available to make direct comparisons between the percentage of people with opioid addiction in drug treatment in Scotland compared to England and other European countries.

The Scottish Government continues to work closely with the UK Focal Point on Drugs and the European Monitoring Centre on Drugs and Drug Addiction to ensure that Scotland’s position in relation to the rest of the UK and other countries can be analysed and monitored.

The Chief Medical Officer, Sir Harry Burns, is currently leading an independent expert group to gather evidence on opiate replacement therapies used to treat people with drug addiction. The group is due to report its findings in the next few months.

The Scottish Intercollegiate Guidelines Network (SIGN) provides robust, evidence based clinical practice guidelines for NHSScotland. These provide the evidence base for NHS boards to identify and implement the best practice locally, it is the responsibility of NHS boards, who are responsible for the planning and provision of services to meet the needs of their population, to audit and monitor the implementation of these guidelines.

SIGN guidelines are derived from a systematic review of the scientific literature and are designed as a vehicle for accelerating the translation of new knowledge into action to meet our aim of reducing variations in practice, and improving patient-important outcomes. All SIGN guidelines are independently reviewed by specialist referees prior to publication and there are a number of opportunities for interested parties to get involved during the development phase.

This is a matter for individual local authorities in Scotland. The information is not held centrally.

The Scottish Government has committed to revise the 2006 National Quality Standards for Substance Misuse Services through the development of an Alcohol and Drug Quality Improvement Framework. This Quality Improvement Framework is the focus of the next stage of delivery in the Road to Recovery Strategy and builds on recommendations within the Quality Alcohol Treatment and Support Report, making sure 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. The Quality Improvement Framework will drive further improvements setting standards of care, which will be measured by quality indicators of recovery.

Quality standards, improved data and evidence, and planning and reporting requirements will all contribute to an effective Recovery Orientated System of Care delivering an integrated approach to service planning, commissioning, design and delivery focused on individual needs.

The Chief Medical Officer, Sir Harry Burns, is currently leading an independent expert group to gather evidence on opiate replacement therapies used to treat people with drug addiction in Scotland and the practice and availability of community and residential rehabilitation. The group is due to report its findings in the next few months.

The work on the National Quality Standards, the findings of the Independent Expert Group and the on-going advice of the National Forum on Drug-Related Deaths, will further inform the Scottish Government’s thinking on any updates to the Drug Misuse and Dependence: UK guidelines on Clinical Management in line with recovery. Until all of this work is concluded, the Scottish Government has not held any discussions with, or has made any recommendations to the Department of Health in relation to the guidelines.

Decisions on the type of treatment for problem drug use are for professionals, in discussion with their clients to agree upon within the context of long term recovery.

The Scottish Government’s national drugs strategy the Road to Recovery is clear; that substitute prescribing such as buprenorphine, is one of a number of methods of drug treatment in a package of care, treatment and recovery that can be offered to individuals to help them recover from problem drug use.

Steps are in place to improve all aspect of quality in how drug treatment is delivered. The Chief Medical Officer, Sir Harry Burns, is currently leading an independent expert group to gather evidence on opiate replacement therapies used to treat people with drug addiction in Scotland and the practice and availability of community and residential rehabilitation. The group is due to report its findings in the next few months.