Chamber and committees

Timescales for implementation will be agreed by individual boards in accordance with their local policy review timescales. It is therefore not possible to be prescriptive about what is considered to be reasonable. Boards will, however, as part of monitoring performance against the NHSScotland Staff Governance Standard, be required to identify timescales within which their local policies will be compliant with each new/revised partnership information network (PIN) policy and, subsequently, to evidence compliance within that identified timescale. The results of such performance monitoring are used to inform Board Annual Reviews. Timescales for compliance can also be monitored through the national and local NHSScotland partnership structures.

<>I refer the member to the answer to question S4W-06713 on 26 April 2012. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

<>The exact information is not centrally held. However published information showing whole time equivalent and headcount for administrative services Staff is available on the National Services Scotland, Information Services Division website at the following link: http://www.isdscotland.org/Health-Topics/Workforce/Overall-Staff-and-Turnover/.

Establishment of a register of all medical implants will be considered when the recommendations of the reviews led by Lord Howe and Sir Bruce Keogh are published.

The prescribing of antipsychotic medications in care homes and other settings will be informed by best clinical practice and by national SIGN guideline 86 on the management of patients with dementia, which includes evidence-based recommendations on interventions to manage challenging behaviour symptoms which can be associated with dementia. This guideline was reviewed in 2009. In addition, there were two major regulatory warnings, in 2004 and 2009, which cautioned that antipsychotics were associated with an increased risk of stroke and death in people with dementia. Evidence shows that both warnings had a effect on prescribing by GPs.

The dementia standards, published last year, state that NHS boards must ensure that systems are in place to ensure that capacity to consent to treatment (including the prescribing of psychoactive medication) is considered and that appropriate documentation is in place, in line with Part 5 of The Adults With Incapacity (Scotland) Act 2000. The Act says that if the person cannot give valid consent then the view of any proxy decision maker (a welfare power of attorney or welfare guardian) should be sought. A certificate of incapacity must be completed under section 47 of the AWI when someone lacks capacity to consent – this certificate authorised treatment and ensure treatment is given lawfully.

They also state that services must demonstrate knowledge of whether the person with dementia has appointed someone as their welfare power of attorney or if there is a welfare guardian, and that any challenging behaviour must always be addressed by means of an integrated assessment to establish the cause and put a care plan in place to manage it, in line with the relevant SIGN clinical guidelines.

We have a specific commitment in the national dementia strategy to reduce the inappropriate prescribing of psychoactive medication. We are currently considering the findings and recommendations of an academic report we commissioned into time trends in the prescribing of antipsychotic and other psychotropic medications to older people with dementia between 2001-11 and the report will inform a commitment to reduce inappropriate prescribing of psychoactive medication to be finalised this year.

Clinical decision-making in individual cases is taken by the relevant professional, and of course there are cases when the prescribing of psychoactive medication is appropriate and the best treatment option at that particular time, particularly when psychotic symptoms manifest themselves in behaviour which cannot be managed without medication. For example such drugs may be helpful for some in relieving symptoms such as agitation, delusions or hallucinations, and, although there are risks, where the prescribing of psychoactive medication is appropriate, clinical decision-making will always need to weigh any risk against the risks around not prescribing.

I refer the member to the answer to question S4W-06713 on 26 April 2012. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at

http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

This is an operational matter for the Principal Reporter of the Scottish Children’s Reporter Administration(SCRA ). Referrals to the Reporter and to children’s hearings are made in respect of individual children, not of their parents, expectant parents or other family members, and the data reporting reflects that. The Principal Reporter intends to write to the member to arrange a more detailed discussion on SCRA data and research.

The revised Implementing and Reviewing Whistleblowing Arrangements in NHSScotland Partnership Information Network (PIN) Policy details the rights and responsibilities of staff in relation to whistleblowing. NHSScotland boards’ local HR policies must meet or exceed the minimum standards set out within the national PIN Policies and, in line with the NHSScotland Staff Governance Standard, must be appropriately communicated to staff. Additionally, the Implementing and Reviewing Whistleblowing Arrangements in NHSScotland PIN Policy itself clearly sets out boards’ obligations in terms of communicating local policies developed in line with the PIN.

Adherence by boards to PIN Policies will be monitored as part of the ongoing process of monitoring performance against the wider NHSScotland Staff Governance Standard.

The revised Implementing and Reviewing Whistleblowing Arrangements in NHSScotland PIN Policy can be found at:

http://www.scotland.gov.uk/Publications/2011/12/06141807/0.

As advised in my response to your additional question S4W-06383 on 24 April 2012, the Scottish Workforce and Staff Governance Committee have considered the issue of a helpline and concluded that it was not required at that stage. However, I will ask them to revisit the issue of a helpline in light of implementation of the new Implementing and Reviewing Whistleblowing Arrangements in NHSScotland Partnership Information Network (PIN) Policy and report back to me before the end of the year.

All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

As part of Scotland’s National Dementia Strategy, we commissioned an academic report into time trends in the prescribing of antipsychotic and other psychotropic medication to older people with dementia between 2001-11. This report includes an analysis of the national and wider factors influencing such prescribing trends by GPs and other medical professionals.

We are currently considering the report’s findings and recommendations and they will inform a commitment to reduce inappropriate prescribing of psychoactive medication for dementia to be finalised this year.