Chamber and committees

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.

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.

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.

NHS continuing healthcare has never been subject to a specific funding stream, and no funding has ceased as a consequence of our publication of new guidance. Delayed discharge patients are awaiting discharge from the NHS. If a patient was eligible for NHS continuing healthcare guidance, or is eligible for Hospital Based Complex Clinical Care, then they are by definition not ready for discharge, and are not delayed.

NHS continuing healthcare has never been subject to a specific funding stream. Rather, healthcare is provided by NHS boards from their overall funding allocation as provided by the Scottish Government. Information on how many people received NHS continuing healthcare in the community is available on the Information Services Division website: http://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/NHS-Continuing-Care/. Data collection started in 2008.

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.

The GP retainer scheme is an initiative which is run by health boards and National Education Scotland, as such it is not a government run programme, however the improved GP retainer scheme will have greater educational input and direction than was possible under the previous arrangements.

England and Scotland have applied different systems for a number of years regarding NHS continuing healthcare and free personal care. The Scottish Government is not monitoring cross border movement in terms of NHS continuing healthcare neither is it monitoring movement to Scotland in order to take advantage of free personal care.

Anyone eligible for NHS continuing healthcare prior to June 2015 will continue to receive this in any setting, as long as they remain eligible under the previous eligibility criteria contained in CEL 6 (2008). This is made clear in our new guidance DL (2015) 11 – Hospital Based Complex Clinical Care.

The Care Inspectorate is in regular contact, and meets, with senior managers of Four Seasons Health Care. A range of issues are discussed including information relevant to financial viability. This information helps determine the level of risk, potential impact and any action that may be required in terms of contingency planning. Four Seasons Health Care has 57 care homes and one support service in Scotland and these are operated through 23 named providers from the Four Seasons group.

Guidance on Hospital Based Complex Clinical Care issued in May 2015 and makes it clear that people should only receive care in a hospital if they cannot be cared for in a more appropriate place. This will require health and social care teams to work in an integrated way to provide more care in homely settings. Care home providers are working with us – as well as our partners in local government and the health service – to design cost-effective and flexible models of specialist residential care.

The Scottish Government is committed to ensuring that compassionate, high quality palliative and end of life care is provided for anyone who requires it. We are now working with all stakeholders across health and social care to develop a Palliative and End of Life Care Strategic Framework for Action. This will provide an additional focus and support the delivery of high quality palliative and end of life care, including in a residential care setting. This framework will be published towards the end of 2015.