Chamber and committees

Standards have previously been adopted by the projects and services that require them. The eHealth Programme have now instituted a process for agreeing standards and they will be published by the eHealth Design Authority. New standards will go through this process and progressively other standards in use in NHSScotland will be re-validated through it to provide a comprehensive list of approved standards.

READv2 has been adopted for use in a number of IT systems in NHSScotland. For example, it was a requirement of the recently let national framework contract for the General Practice IT(GPIT) systems. The Systematised Nomenclature of Medicine - Clinical Terms (SNOMED - CT) is emerging as the standard preferred by suppliers of clinical IT systems, and is also built into the products purchased to support GPIT and the Patient Management System. Given the likely scale of adoption of this standard by the industry, the eHealth Programme will be considering its approval as a standard for use in NHSScotland.

Information standards are developed by various groups within NHS Scotland within a specific area of interest. Information standards will generally be published by the groups that create and maintain them. A comprehensive list of information standards that are current or in development by NHS Scotland is not currently maintained. The eHealth Programme has instituted a process for agreeing standards and these will be published by the eHealth Design Authority. New standards will go through this process and progressively other standards in use in use in NHSScotland will be re-validated through it to provide a comprehensive list of approved standards.

Some of the information standards in use in Scotland are the same as those promoted by the NHS Information Standards Board in England. These include ones widely recognised in the health sector such as the International Statistical Classification of Diseases (ICD10), which is developed by the World Health Organization, and has been adopted by numerous systems and organisations in NHSScotland.

There are no plans for the CHI to be a compulsory field in the proposed revised medical certificate of cause of death. Certifying doctors will be asked to provide the number where it is available to them to help with the efficient management of their patient''s record.

We recognise that the data collected by the Scottish Ambulance Service (SAS) on overdose and poisoning related calls provides valuable information on drug overdoses and we are exploring how to make best use of this data to inform approaches to drug treatment and the prevention of drug-related deaths.

The Scottish Government recognises the important role SAS staff play in responding to, and recording information on, overdose and poisoning related calls. SAS staff, along with the police, are often the first on the scene of an overdose and provide life-saving interventions to the individual in overdose and also information and advice to their family and friends.

SAS is working with a number of groups across Scotland to attempt to link and share data, for example in relation to the Scottish National Naloxone Programme. The service is keen to share information and good practice to provide a more effective service for this patient group.

In recognition of the unique perspective SAS can bring to discussions around how best to prevent drug-related deaths, they are a member of the National Forum on Drug-related Deaths. The role of this forum is to examine any trends and to disseminate good practice around how to reduce the number of drug-related deaths in Scotland. In particular, the role of this forum is to make recommendations to Scottish Government ministers, alcohol and drug partnerships and other agencies, as appropriate, on action and policy changes relating to the reduction of drug-related deaths.

Furthermore, SAS was one of the primary data sources which provided information to the National Drug-related Death Database. This database, which reports for the first time on 25 January 2011, will provide in-depth information on the nature and circumstances of individuals who have died a drug-related death. This information will help to inform local drug treatment and support services of how they can tailor and target their interventions to help prevent drug-related deaths.

When an individual is treated at accident and emergency following an overdose, whether they are brought in by the ambulance service or other means, it is important that they are signposted and, where appropriate, referred to local drug treatment and support services. Work is underway to investigate how best to support this process.

It is not for Scottish ministers to raise awareness of specific products, nor to promote or advise on the use of products of this kind to the wider public.

I have asked John Ewing, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

The information requested is shown in the following table.

Admissions of Persons Under 16 to Scottish Prison-Young Offenders Institution

2008
Quarter 1: 1 January 2008 to 31 March 2008	4
Quarter 2: 1 April 2008 to 30 June 2008	10
Quarter 3: 1 July 2008 to 30 September 2008	2
Quarter 4: 1 October 2008 to 31 December 2008	2
2009
Quarter 1: 1 January 2009 to 31 March 2009	0
Quarter 2: 1 April 2009 to 30 June 2009	2
Quarter 3: 1 July 2009 to 30 September 2009	1
Quarter 4: 1 October 2009 to 31 December 2009	2
2010
Quarter 1: 1 January 2010 to 31 March 2010	1

Notes:

1.  Data are derived from the Scottish Prison Service PR2 information management system. This is a live system and data are updated and quality assured on an ongoing basis. The figures shown here may therefore differ slightly from historic data.

2.  Individuals may be admitted more than once on separate occasions. Figures refer to those aged over 14 and under 16 at date of admission.

Source: Scottish Government Justice Analytical Services.

Information for the remainder of 2010 will not be available until after the publication of the final 2010-11 data later in 2011.

There is clear evidence of the benefits from ensuring that people who have had a stroke are admitted to a stroke unit as quickly as possible. In revising its clinical standards for stroke service in June 2009 to bring them into line with the new SIGN (Scottish Intercollegiate Guidelines Network) Guideline on stroke management, NHS Quality Improvement Scotland (NHS QIS) set a more challenging standard than previously for admission to a stroke unit.  The standard that NHS Boards are now expected to meet is that:

1. 60% of all patients admitted to hospital with diagnosis of stroke should be admitted to a stroke unit on the day of admission to hospital, and

2. 90% of patients should be admitted to a stroke unit within one day of admission.

Each Scottish hospital''s performance in relation to this standard in 2009 is shown in the following table:

NHS Board	Hospital	On Day of Admission (%)	Within One Day of Admission
NHS Ayrshire and Arran	Ayr Hospital	66	81
	Crosshouse Hospital	55	71
NHS Borders	Borders General Hospital	17	48
NHS Dumfries and Galloway	Dumfries and Galloway Royal	38	67
	Galloway Community Hospital*	0	0
NHS Fife	Queen Margaret Hospital	25	59
	Victoria Hospital Kirkcaldy	38	69
NHS Forth Valley	Forth Valley	27	52
NHS Greater Glasgow and Clyde	Royal Infirmary Glasgow	27	62
	Stobhill Hospital	18	59
	Western Infirmary Glasgow	62	81
	Southern General Hospital	73	79
	Inverclyde Royal Hospital	6	18
	Royal Alexandra Hospital	27	59
	Vale of Leven Hospital	11	20
NHS Grampian	Aberdeen Royal Infirmary	64	75
	Dr Grays, Elgin*	0	0
NHS Highland	Raigmore Hospital	17	40
	Lorn and Islands Hospital	64	75
	Belford Hospital*	0	0
	Caithness Hospital*	0	0
NHS Lanarkshire	Hairmyres Hospital	45	70
	Monklands Hospital	43	80
	Wishaw General Hospital	35	82
NHS Lothian	Royal Infirmary Edinburgh	21	50
	St Johns Hospital	28	52
	Western General Hospital	38	59
NHS Orkney	Orkney*	38	38
NHS Shetland	Shetland*	0	0
NHS Tayside	Ninewells	30	70
	Perth Royal Infirmary*	3	7
NHS Western Isles	Western Isles**	35	35

Source:  Scottish Stroke Care Audit.

Notes:

*These hospitals do not have designated acute stroke units. For NHS Orkney, patients are airlifted to Aberdeen Royal Infirmary and a proportion arrive in sufficient time to be admitted to the stroke unit within the time required to meet NHS QIS standard.

**Uist and Barra data are included in the table, but it should be noted that Uist and Barra do not have a stroke unit. A proportion of patients may be transferred to Western Isles and may arrive in sufficient time to be admitted to the Stroke Unit there within the required NHS QIS standard.  

Because of the change to the relevant clinical standard, it is not possible to make a direct comparison with the data provided in the answer to S3W-17106. We pointed out in our Heart Disease and Stroke Action Plan that, overall, more patients are being admitted to a stroke unit and being managed according to agreed standards. We acknowledged, however, that NHS boards had struggled to meet the then standards on a sustained basis, and would therefore need to give serious consideration to the re-design of services in order to meet the revised standard.

In order to deliver further improvements in performance consistently across the country, we are introducing a new HEAT target from April 2011. It expects the territorial NHS boards to ensure that 90% of all patients admitted with a diagnosis of stroke are admitted to a stroke unit on the day of admission, or the following day. NHS boards will work towards achieving this target by March 2013.

£2.5 million was included in the 2007-08 local government finance settlement for enforcing the smoke-free laws. This funding, which has been maintained, was included as part of the general block grant and it is a matter for individual local authorities to allocate the total resources available to them on the basis of local needs and priorities.