Chamber and committees

The Scottish Government is actively considering workload as part of the Scottish GP contract negotiations for 2017.

NHS Continuing Healthcare has never been subject to a specific funding stream so no funding has ceased as a consequence of our publication of new guidance. Rather, healthcare is provided by NHS boards from their overall funding allocations as provided by the Scottish Government.

Nursing care is provided free of charge whatever the setting. People eligible to NHS Continuing Healthcare prior to June 2015 will continue to have their entire costs met by the NHS as long as they remain eligible under the previous guidance.

The GP retainer scheme is intended to help doctors under the age of 55, with well-founded reasons for not making a substantive current commitment to working in general practice, to maintain the skills and confidence working within a practice to enable them to return to a more substantive post when circumstances permit.

Practices have the ability to apply to employ a GP retainer and there is no cap on the number of practices that can apply. Recruitment is organised by the practice. The cost of employing the retainer is paid by the practice with partial subsidy from the health board.

The following table shows the number of GP retainers in post from 2010-14.

In the last five years the Scottish Government has provided the following support for return to practice programmes:

We have recently announced investment of £450,000 over the next three years for nursing and midwifery return to practice programmes. This will bring around 75 former practitioners back into the NHS. Prior to this, support was available via the part-time fee grant. The following table sets out the number of students undertaking nursing and midwifery return to practice programmes in the past five years.

Notes:

*These figures are reported annually by NHS Education for Scotland (NES) in its Nursing and Midwifery Annual Statistical Supplement.

**Year runs from 1 April to 31 March.

***Data for 2015 intake is incomplete and is reported as “completed index form submitted at 19-10-15”.

Allied Health Professions:

Allied Health Professionals who have been out of practice for more than two years and who were previously registered with the Health and Care Professions Council (HCPC) are required to undertake a period of updating their skills and knowledge before they can become re-registered with the HCPC.

The updating of their knowledge and skills can be made up of any combination of supervised practice, formal study or private study. The HCPC requires that any private study makes up no more than a maximum of half of the period. The period of updating should be completed within the 12 months before they apply for registration. The Scottish Government does not provide funding for this.

Medical Professions:

Regarding the support for GPs to return to practice, I refer the member to the question S4W-27299 answered on 17 September 2015. 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.

On 27 October 2015, the First Minister announced further investment to increase the effectiveness of the existing GP returners’ scheme. NES also funds the placement of medical trainees seeking to return to training after being out of programme and requiring additional support, for example after long term illness, and in other categories of out of programme activities i.e. maternity leave, research, working abroad etc. In the former category, NES advises that on average around 15 to 20 do so each year, in the latter category, approximately 600 trainees per year are placed back into training placements on their return.

The expert group on transvaginal mesh implants will work directly with medical directors to develop recording and reporting of adverse events and in addition will take account of the Scottish Government's work to consider alternative methods for the capture of adverse events.

Work on adverse event reporting has already been taken forward and, in collaboration with NHS boards, Healthcare Improvement Scotland (HIS) has led in the development of the national approach to learning from adverse events. HIS is continuing to develop the national framework and is driving implementation through an improvement programme, which is supporting NHS boards and other organisations, to have a consistent approach to managing and learning from adverse events.

Since the answer given to question S4W-20593 on 4 April 2014 by the then Cabinet Secretary, Alex Neil MSP, we have been exploring the complexities of the scope, shape and development of a no-fault compensation scheme for Scotland. Careful consideration is being given to how such an approach might fit with recent developments such as: the proposed introduction of a statutory duty of candour (being pursued through Part 2 of the Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill 2015), the National Framework for Learning from adverse events through reporting and review, the existing claims procedure and the current review of the NHS complaints process. We hope to be in a position to consult on specific draft proposals for a preferred way forward in the near future.

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.

COSLA supported the new guidance on Hospital Based Complex Clinical Care. Eligibility will remain a clinical decision with associated funding being the responsibility of new Integration Joint Boards. Taking funding decisions across health and social care, to improve outcomes by using the totality of available resources, is one of our key drivers for integration.

Indemnity insurance is one of a range of issues that will be considered in the context of negotiating the new GP contract of 2017. These negotiations are on-going and their content must remain confidential between the negotiating parties, however we will continue to work with the Scottish General Practitioners Committee so that a new contract is in place by April 2017.

The primary role of the general practice based clinical pharmacist will be to work with patient groups identified by the health board as being a priority to support care pathways in the community. This will include patients with multiple and complex conditions who are prescribed multiple medicines and who have been identified as being at risk of hospital admission or readmission, such as the frail elderly.

These pharmacists will be allocated caseloads of patients by GPs within the practices in which they will work to deliver continuity of care and to get the best possible health outcomes from their medicines. They will carry out medicines reviews and support patients in the management of their long term conditions.

Taken together this will help to free up GP time to spend with other patients making the best use of the skill mix across the primary care team.

An inter-hospital transfer (IHT) is defined as a request to move a patient from one hospital to another. In 2014-15, the Scottish Ambulance Service (SAS) handled 95,258 IHTs. Like all ambulance activity they are categorised into emergency, urgent and routine depending on the acuity as determined by the requesting clinician at the hospital. The majority of IHTs are urgent (58%), with 34% emergency and 8% routine (these proportions are for 2014-15 activity).

SAS is actively reviewing how it manages inter-hospital transfers with a view to improving the interface between the SAS and NHS board colleagues and will implement any agreed changes.