Chamber and committees

A number of boards have alreadyexperimented with patient-held care plans but none have introduced them for allpatients. This is something which the local diabetes Managed Clinical Networks willwish to consider, given the success of the patient-held records developed by thecardiac services Managed Clinical Network in Dumfries and Galloway.

The Scottish Diabetes Group willbe responsible for monitoring progress in addressing the issues raised in the NHSQuality Improvement Scotland national overview, and will take account of these aspart of the current process of reviewing the Scottish Diabetes Framework. The diabetesManaged Clinical Networks being developed in each NHS board area will be the mainvehicle for local implementation of the messages from both the national overviewand the local report, and have already begun to consider this. Progress will berecorded in each network’s annual report.

The Scottish Care Information- Diabetes Collaboration (SCI-DC) is a £3 million national programme to provideeffective IT to support the delivery of diabetes care. The SCI-DC team, all theSCI-DC software and the central hardware are funded by the Scottish ExecutiveHealth Department. Boards are reimbursed for 50% of the costs of local hardwarepurchased specifically for SCI-DC implementation. In recognition of the widespreadinterest in and support for the SCI-DC systems, and in light of the findings of the NHS Quality Improvement Scotland national overview report (March 2004), the Scottish Diabetes Group and NHS Quality Improvement Scotland are identifying additionalfunding to appoint a Project Officer to help co-ordinate implementation.

The Scottish Executive recognisesthe importance of people with diabetes being reviewed in order to monitor the managementand progression of their condition. It is a matter for NHS boards to put servicesin place to provide patients with the necessary health monitoring. Central supportfor the national diabetes IT system (SCI-DC) will greatly assist diabetes servicesto record the results of patient reviews and highlight which patients or which elementsof the review are overdue.

The Scottish Diabetes Group iscurrently developing a comprehensive set of patient information leaflets. In addition,steps are being taken to draw attention to the significant array of existing highquality patient information produced by NHS boards and by organisations such asDiabetes UK. This work will link in to the initiative by NHS24 toestablish a single gateway to information.

The Scottish Medicines Consortium(SMC) has advised that Ebixa is not recommended for use in NHSScotland.

SMC advice does not overridethe individual responsibility of health professionals to make appropriate decisionsin the circumstances of the individual patient.

A Partnership for a Better Scotland committed to trebling the existing number of nurse consultants to 54. Currently there are 23 nurse consultants in post in Scotland. A further five posts have been approved and are awaiting appointment.

Nurse Consultant Posts in Scotland

Fields of Practice	Number of Posts
Public Health	3
Cancer	3
Mental Health	3
Learning Disabilities	2
Older Peoples’ Services	2
Child	2
Midwifery	2
Infection Control	2
Acute Receiving	1
Health Protection	1
Family Planning and Sexual Health	1
Epidemology	1
Total	23

MEL(1999)67 was issued to theNHS in September 1999 and enclosed a Good Practice Guide on Access to Services Equalityfor disabled people in the NHS in Scotland as well as a training video producedby the Department of Health in England about the needs of deaf and hard-of-hearingpeople using NHS services. The good practice guide detailed the various needs ofdeaf and hard-of-hearing people and stressed the importance of responding appropriatelyand sensitively to their requirements.

The Health Department is currentlydeveloping an Equality and Diversity Strategy for the NHS and deaf awareness willbe central to this. The voluntary sector will be key stakeholders in the developmentand implementation of this process and I will ensure that the Royal National Institutefor the Deaf and the Scottish Council on Deafness are involved.

In addition, the Department hasentered into a partnership with the Disability Rights Commission Scotland to lookat the requirements of the Disability Discrimination Act on the NHS. This partnershipwill support and advise NHS boards in developing a disability strategy which willhighlight accessibility issues as part of the approach to delivering patient-centredand responsive services.

Through the development of an integrated equality and diversity strategy as part of their wider patient focus and public involvement work, the Scottish Executive Health Department will ensure that the views and needs of deaf and hard-of-hearing people are addressed in an effective way to involve them in decisions about their own care and the design,development and review of the services they use. The strategy is being developed in partnership with individuals from all excluded groups, including deaf people,and will be used to remind and encourage NHS boards of their responsibilities to meet the needs of disabled people, including statutory responsibilities.

The Health Department maintains an ongoing dialogue with the organisations which represent the views of deaf and deaf blind people and there have already been a number of awareness-raising events to highlight some of the issues faced by people who are disabled.

The Health Department are also developing a strategic partnership with the Disability Rights Commission to ensure that they are able to advise NHS boards on the changes that will need to take place to fully address the needs of disabled people, both in terms of compliance with the requirements of the Disability Discrimination Act 1995 and other steps that can be taken to respond to individual needs.

At the last meeting of the Audiology Advisory group in January, there was an agreement to establish a patient issues sub-group. The sub-group includes representation from the National Deaf Children’sSociety, the Royal National Institute for the Deaf and the Scottish Council on Deafness,as well as health service staff and planners, and local authority social work departments.

The group will provide the Audiology Advisory group with proposals for the development of patient and public-focussed activities based on the priorities identified within the Public Health InstituteScotland Needs Assessment Report on NHS Audiology Services in Scotland.

The experiences and recommendationscontained within the Royal National Institute for the Deaf report of last month,A Simple Cure, will be considered as part of the Health Department’s developingEquality and Diversity Strategy and the new partnership with the Disability RightsCommission Scotland.I also refer the member to theanswers given to questions S2W-7380 and S2W-7381 on 28 April 2004. All answers towritten parliamentary questions are available on the Parliament's website, the searchfacility for which can be found at http://www.scottish.parliament.uk/webapp/search_wa.