Chamber and committees

Principles deriving from the Treaty on the Functioning of the European Union require that all public bodies treat all suppliers bidding for public contracts equally and without discrimination, including on the basis of size. It is for bidders to determine how best they will offer to deliver a contract and public bodies cannot, in normal circumstances, within invitations to tender specify that the successful bidder must sub-contract to a third party.

The following number of practices have introduced restrictions on new patients registering other than for geographical reasons in each NHS board.

NHS Board	Restrictions other than for geographical reasons on new patient registration
Ayrshire and Arran	0
Borders	0
Dumfries and Galloway	0
Fife	10*
Forth Valley	0**
Grampian	3*
Greater Glasgow and Clyde	0
Highland	0
Lanarkshire	0
Lothian	33
Orkney	0
Shetland	0
Tayside	0
Western Isles	0
Total	46

Circumstances will arise where a practice experiences capacity issues and is unable to routinely accept new patients onto its list. We expect health boards to work with practices as constructively and as flexibly as is appropriate to help manage the situation and ensure that all patients have access to GP services.

*Open but full.

**Occasionally NHS Forth Valley practices may, for a period of time, only routinely accept patients with family members already registered with the practice, however they would always continue to accept any new patients assigned to the practice by Practitioner Services Division.

As part of the Scottish Government's on-going monitoring of the use of unavailability it became clear that NHS Greater Glasgow and Clyde's use of social unavailability was higher than other health boards.

The board’s local policy had been to apply unavailability to patients not wishing to travel to alternative places for treatment such that patients do not start their waiting time all over again. It was NHS Greater Glasgow and Clyde's view that some patients may come from some of the most vulnerable part of society and therefore resetting or referring back to their GP may not be in the best interest of the patient. The board has now been advised their local operating policy must be fully compliant by 1 April 2016.

The following number of practices are closed to new patient registrations in each NHS board:

NHS Board	Closed to new patient registrations
Ayrshire and Arran	0
Borders	0
Dumfries and Galloway	0
Fife	0
Forth Valley	0
Grampian	0
Greater Glasgow and Clyde	1*
Highland	0
Lanarkshire	2
Lothian	0
Orkney	0
Shetland	0
Tayside	7
Western Isles	0
Total	10

Circumstances will arise where a practice experiences capacity issues and is unable to routinely accept new patients onto its list. We expect health boards to work with practices as constructively and as flexibly as is appropriate to help manage the situation and ensure that all patients have access to GP services.

*Due to open 16 June 2016

The Community Health Activity Data project collects data on individuals being seen within community health services. To date, data submissions relate to district nursing activity only, and Community Health Index has been missing from only 0.08% of submissions.

As regulator of the medical profession in the UK, the General Medical Council (GMC) is responsible for monitoring the quality of medical training provided, and to decide where improvement actions need to be taken. This quality assurance role is conducted in partnership with NHS Education for Scotland (NES).

Details of hospitals, specialties and dates being monitored can be found on the GMC website.

The opinion of the Assistant Commissioner for Scotland and Northern Ireland was not sought before data sets were issued for collecting information on individual patients in relation to (a) community nursing and (b) community mental health services.

National Services Scotland does not routinely seek the opinion of The Information Commissioner’s Office before establishing a new data collection from NHS Scotland boards, unless the nature of the collection is substantially different from that in existing collections. The privacy impact assessment is used to indicate when wider consultation is required.

Scotland set challenging targets (now standards) to ensure faster access to child and adolescent mental health services as well as psychological therapies for all ages within 18 weeks from referral to treatment. This was undertaken to improve access to mental health services in recognition of the valuable contribution such therapies can have in treating a wide range of mental illness and this includes treatment for infant mental health issues.

These mental health waiting times standards have been included within the Local Delivery Plan Guidance for 2016-17. The inclusion of the mental health waiting times standards will require Boards to develop concise plans focusing on reducing waiting times and on improving access to mental health services within each board in line with local need, including infant mental health services. The plans should include an assessment of the level of access currently provided by the board and with the anticipated level of need locally, including benchmarking with other boards in Scotland.

A child and adolescent mental health (CAMH) balanced scorecard is published by Information Services Division Scotland on a quarterly basis. It allows comparisons between boards on a range of performance measures for these services. The data is collected from a CAMHS benchmarking toolkit. This was created in response to commitment 9 of the mental health strategy. A specialist CAMHS service (Tier 4 CAMHs) data set is also used and this was created in relation to commitment 12. Scottish Government is working to refine these measures and to create an overarching National specialist mental health service key performance indicator suite that will contain measures appropriate to CAMHS as well as other mental health services.

The Draft statutory guidance on Part 4 (Named Person), Part 5 (Child’s Plan) and Part 18 and Section 96 (Assessment of Wellbeing) of the Children and Young People (Scotland) Act 2014 (the Act), was released on 1 December 2015 and can be accessed at: http://www.gov.scot/Topics/People/Young-People/gettingitright/publications/revised-draft-guidance

Chapter 10 of the guidance sets out information sharing duties under the Named Person provisions of the Act, with section 10.13 specifically focusing on duties of confidentiality and section 10.14 the disclosure of information provided in breach of a duty of confidentiality.

Under the Act a named person who is not an NHS clinician will not be provided open access to confidential medical notes, any medical information shared with a named person will be a decision for the information holder. All sharing of information within the context of the Act is subject to the Data Protection Act and working within the European Convention on Human Rights. Any information shared, medical or otherwise, must be specific information shared for an identified purpose. These restrictions are the same whether the named person is part of the NHS or not. The Act and the draft statutory guidance provides a framework for information holders to consider what if any relevant information ought to be shared with a named person.

They must consider the following:

That there is specific information that is likely to be relevant to the functions of a named person i.e. it is thought that on receiving the information that the named person is likely to take action to promote, support or safeguard a child or young person’s wellbeing by providing advice, information, support or help to access a service.

They have sought and listened to the views of the child or young person about sharing information (taking into account their age and maturity).

They have sought and listened to the views of parents except if it was contrary to the child’s views or where it was likely to be detrimental to the child’s wellbeing.

If the likely benefit of sharing the information outweighs any likely adverse effect on the wellbeing of the child or young person.

They must conclude that sharing the information would not prejudice the conduct of a criminal investigation or the prosecution of any offence.

Only after all of these considerations have taken place can the information holder share relevant information with a named person, at this time the Act allows for confidential information to be shared that the information holder believes is likely to be relevant and ought to be shared. Any onward sharing of this information is subject to the same considerations.

The Information Commissioner’s Office (ICO) has already clarified that the kind of information sharing envisaged by the Act is already lawful. The ICO’s statement of 28 March 2013 is available at:

http://www.gov.scot/Resource/0041/00418080.pdf

Hospital at Night is a clinical system used in a number of NHS boards to ensure that high quality consistent care is provided to hospital inpatients overnight, and that staff working in the out of hours period do so under direct senior supervision. It is also an example of strong multidisciplinary working, involving a team of junior doctors, nurses and allied health professionals working under the supervision of a senior nurse and senior doctor. Tasks and duties are co-ordinated through the team leader who ensures that the right person with the right skills is deployed to carry out the relevant clinical task. There has been no national evaluation of Hospital at Night, but boards continue to evaluate their clinical care systems to ensure they are delivering high quality care.