Chamber and committees

The NHS Quality Improvement Scotlandpublication National Overview January 2007 Maternity Services reported thatfollowing their review of their Clinical Standards for Maternity Services (carriedout between November 2005 and June 2006), 10 out of the then 15 health boards routinelycarried out anomaly scans at 18 to 22 weeks.

In those areaswhere routine anomaly scans at 18 to 22 weeks are not carried out, women are selectedfor further scans on the basis of clinical need. Local policies will establish thecriteria by which these decisions are made.

The Executive is working closely with all NHS boards to ensurethat developments in screening during pregnancy are introduced efficiently and effectivelyand this includes the introduction of routine foetal anomaly scanning in thoseboards that do not currently offer this service.

The anticipatedvolume of postal testing kits for chlamydia required by NHS boards does not merita national contract.

However, Healthy Respect, the nationalhealth demonstration project, based in NHS Lothian will process orders on behalfof NHS boards to ensure a cost effective purchasing arrangement.

A workshop for NHS boards to learn more about the systems neededprior to placing an order for kits is being hosted by Healthy Respect.

A number of separate initiatives are being carried out by NHSboards, these include: making a range of condoms and lubricants more extensivelyavailable free of charge to targeted high risk groups; improved links and crossmembership between strategy groups responsible for drugs, alcohol, blood borne virusesand contraceptive services to those with substance misuse problems; improved familyplanning advice and contraceptive services to those with substance misuse problemsat the point of contact when they are being offered treatment, and a sexual healthclinic specifically to target hard to reach groups including drug users and femaleand male sex workers.

The National Sexual HealthStrategy makes it clear that the Executive would expect the full range of contraceptivemethods, including long-acting reversible contraception, to be made availableto women, who will be facilitated to make an informed choice.

In addition, Scottish Executive Officials wrote to all NHS boardson 8 February 2007, detailing the introduction of a new key clinical indicatorwhich will aim to measure the proportion of women of reproductive age using long-actingreversible contraception in each NHS board. This data is being collected atpresent and a report will be produced in the summer.

Local NHSboards are working with drug and alcohol teams to ensure that women with problematicdrug use have access to specialist family planning services and this should includelong-acting reversible contraception.

We expect allthose working with vulnerable pregnant and postnatal women to provide them withthe necessary information and advice to access appropriate contraceptive advicepostnatally.

We expect the results of an audit by NHS Health Scotland of practicesrelated to data in response to substance misuse to provide us with useful informationto plan future educational programmes and support for staff working with this vulnerablegroup.

Three NHS boards currently provide Postal Testing Kits for chlamydiato their patients. These are NHS Lothian, NHS Borders and NHS Ayrshire and Arran.

It is for GPs, as independentpractitioners, to identify their own personal learning needs related to thehealth needs of their own patients, facilitated by annual appraisal system, andseek training in specific areas accordingly. The General Medical Servicescontract incentivises GP practices to under take family planning activitiesthrough enhanced services.

Following a recommendation withinRespect and Responsibility, NHS boards are seeking to identify if there aregaps in sexual health training and put in place plans to take appropriateaction to address them.

In addition, the faculty ofFamily Planning and Reproductive Health of the Royal College of Obstetriciansand Gynaecologists, specifies the training requirements for contraceptiveservices, with specifications including the requirements for trainers.

The National Sexual Health Advisory Committee, which Ichair, has a sub-group specifically considering training for health careprofessionals who provide sexual health and well-being services withinNHSScotland. That sub-group is due to report later this year.

In the year ending 31 March 2006, 93% of GP practices with prescriptions dispensed in this period prescribed long-actingreversible methods of contraception in the form of injections, implants and intra-uterinedevices.

Information on the provision of long-acting reversible methodsof contraception by family planning clinics is not held centrally.

The Scottish Centre for Healthy WorkingLives, which was established in April 2005 within NHS Health Scotland, encouragesemployers to adopt workplace practices and policies that support and encourage healthand wellbeing. The centre offers advice to employers on developing workplace policiesthat support a healthy work-life balance.

As an employer itself the Executive has in place a number ofpolices to enable employees to achieve a healthy work-life balance. These policiesinclude flexible working hours, alternative working patterns and working from home.

Information on the number ofpatients receiving contraception is not held centrally.

However, the following tableshows the number of prescription items for contraceptive implants, injectionsand intra-uterine devices prescribed in Scotland during last three financialyears by GP practices. Data given refer to prescriptions dispensed by communitypharmacists and dispensing doctors, but do not take into account medicinesdispensed by hospitals or hospital based clinics.

Health Board	Year Ending 31 March
Prescribing Health Board	2004	2005	2006
NHS Ayrshire and Arran	6,209	6,503	5,605
NHS Borders	2,409	2,758	2,622
NHS Dumfries and Galloway	4,346	4,381	3,876
NHS Fife	8,088	8,524	8,362
NHS Forth Valley	6,402	6,437	5,760
NHS Grampian	15,264	16,111	16,079
NHS Greater Glasgow and Clyde	15,065	15,764	15,216
NHS Highland	6,862	7,313	7,331
NHS Lanarkshire	7,502	8,166	7,787
NHS Lothian	12,063	12,495	12,083
NHS Orkney	564	588	596
NHS Shetland	463	507	458
NHS Tayside	8,364	9,332	9,262
NHS Western Isles	647	677	569
Total	94,248	99,556	95,606