Chamber and committees

I refer the member to the answer to question S4W-26516 on 30 July 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.

The quality and productivity indicators for 2012-13 to reduce avoidable A&E attendances were part of the programme to support NHS boards in shifting the balance of unscheduled care so that patients receive emergency care at the most appropriate level of the care system, as quickly and conveniently as possible. The programme included supporting NHS boards to develop locally agreed targets and trajectories for the reduction of attendances at A&E.

The programme functioned by facilitating the development and sharing of innovative and evidence-based approaches across the emergency care system. There was a focus on shifting activity, clinical leadership, social marketing, mental health, people with mental complex care, and children. The programme reviewed its focus on an annual basis.

The official statistics show that across Scotland, the rate of attendances at Emergency Departments reduced by 4% over the period covered by the target - 2009-10 and 2013-14. The programme also saw the development of the ‘Know Who To Turn To’ mobile platform and unscheduled care data mart.

This work is now being taken forward through the new national unscheduled care programme.

The Chronic Medication Service (CMS) allows patients with long term conditions to register with a community pharmacy of their choice to receive the service. The CMS consists of three stages:

1. Assessment of pharmaceutical care issues;

2. Pharmaceutical care planning for patients with problems identified though the assessment; and

3. Serial prescribing and dispensing at pre-determined intervals for a 24-week, 48-week or 56-week period.

As at 6 July 2015 467,297 patients were registered for CMS. All of these registrations are active.

The ePharmacy programme has provided the necessary infrastructure to connect community pharmacies and GP practices electronically. Almost all community pharmacies and general practices are enabled for services including CMS serial prescribing and dispensing, but early adopters are making much more use of this linkage than those connected more recently. Work is ongoing within the ePharmacy programme to maximise use of these links in order to optimise patient care and GP and pharmacist intervention in the serial prescribing process, including that for CMS.

<>The number of accesses to the key information summary are as follows:

a. Clinicians or health professionals (including NHS24 and out-of-hours users)

01 April 2013 to 31 March 2014: 91,905

01 April 2014 to 31 March 2015: 403,574

01 April 2015 to 10 July 2015: 169,584

 

b. Out-of-hours key information summary accesses (excluding NHS24 out-of-hours users)

01 April 2013 to 31 March 2014: 43,722

01 April 2014 to 31 March 2015: 124,663

01 April 2015 to 10 July 2015: 43,293

 

c. NHS24 key information summary accesses

01 April 2013 to 31 March 2014: 23,154

01 April 2014 to 31 March 2015: 101,554

01 April 2015 to 10 July 2015: 34,530

As at the end of June 2015, 150,211 patients have a key information summary.

<>The system was down on 29 June 2015 from 1030 until 1730. The UK wide NHSmail (NHS.net) service was affected by an issue affecting the BTN3 network. This affected all NHSmail users throughout the UK. The N3 service continued to be accessible over the Internet and this remained largely unaffected. Remote dial in and mobile phone access were not affected. The service was restored later in the day when BTN3 completed a hardware replacement allowing network traffic back through the NHSmail platform. Some messaging would have been slowed or delayed following this work while the backlog of messages cleared. Root cause investigations will be completed in due course although the current understanding is that this was a hardware failure issue with BTN3 which blocked access to and from the Vodafone managed mail service. NHS National Services Scotland will work with both suppliers involved her to establish the root cause and investigate why resilience measures were less effective than should have been the case. There were no reports of any adverse impact on services to patients or any reports that data or messages were not received or sent.

In the circumstances where a certifying doctor is able to confirm on the Medical Certificate of Cause of Death (MCCD) that the application of the benefits system contributed to the death, it can be coded accordingly and reported by National Records of Scotland (NRS), under a code from Z55 to Z65, depending on circumstances, which relate to persons with potential health hazards related to socioeconomic and psychosocial circumstances.

However, certifying doctors may not have the required information to ascertain and state, to the best of their knowledge and belief in a legal document, whether the benefits system was a contributory factor to the death of an individual. Other professionals are more likely to have better information of the financial circumstances of individuals, such as social workers.

The MCCD was updated via the implementation of the Certification of Death (Scotland) Act 2011 and came into force on 6 August 2014, supported by training of all certifying doctors by NHS Education for Scotland and joint guidance from NRS and the CMO.

The Scottish Government has not undertaken specific research on the cost-effectiveness of prescriptions issued in hospital for patients on discharge.

All NHS Boards in Scotland use local joint formularies which recommend use of the same medicines for both primary and secondary care. The choice for inclusion of a medicine in these local formularies is based on its safety, clinical effectiveness and cost-effectiveness. Prescribing compliance with NHS Board local joint formularies is encouraged for all clinicians, whether in primary or secondary care. The principle of a shared list of recommended medicines helps to ensure that patients receive continuation of essential treatment at all interfaces of care, including hospital admission and discharge.

The information requested is not available centrally.

The Scottish Government supports the appropriate use of approved name (generic) prescribing, an approach which is promoted by NHS Board Area Drug and Therapeutics Committees. NHS Board local joint formularies are built on this principle, which applies to both primary and secondary care medicines. The use of approved name prescribing helps ensure the supply of essential medicines for patients and is central to deriving value for money for the NHS on the cost of medicines.

<>The information requested is not held centrally. However, as with all vaccines and medicines the Medicines and Healthcare products Regulatory Agency (MHRA) monitors and provides advice on the safety of the HPV vaccine in the UK. Since the introduction of the HPV vaccine in 2008 it has been used in millions of girls across the UK and around the world, and the MHRA continue to advise that the vaccine has a very good safety profile. The MHRA keeps the HPV vaccine under close and continual review and would take regulatory action if new evidence emerged which called into question the safety of the HPV vaccine or any other vaccine currently in use.