Chamber and committees

The health care professional responsible for treatment. Patients may decide they no longer require treatment, and ask to be removed from the waiting list.

Information on whether patients removed from waiting lists following the introduction of “New Ways” of defining and measuring waiting times held an Availability Status Code is not collected centrally.

Interim guidance on the new definitions and main principles of “New Ways” was issued in March 2005. This guidance was produced by a multi-disciplinary group of the health service - including a GP - and the Scottish Executive Health Department. The main principles of this guidance remain in place today. The guidance stressed the need for NHS boards to ensure that all relevant staff, including hospital clinicians and GPs, were fully informed of the guidance and involved in the issues covered

I wrote to all GP practices in Scotland in September 2007, to seek general practitioners’ help in ensuring that patients understood how the new system of defining and measuring waiting times across Scotland would operate. I also indicated that a leaflet had already been issued to general practices to familiarise practice staff with the new approach and to assist them in implementing it, and that NHS boards would be offering training or awareness events.

I have personally received no complaints from patients or from their representatives about the operation of the New Ways system.

The number of complaints about waiting times made to NHS boards during the year ending 31 March 2008 will be published by ISD Scotland later this year. This period includes nine months prior to the introduction of New Ways. The first publication of complaints data covering the whole full year will be during 2009. It will not be possible to separate complaints relating to the operation of New Ways from complaints about other aspects of waiting times.

The information requested, for new out-patients is provided in the following table. Information for in-patients, day cases and return out-patients is not centrally available.

NHSScotland: New Out-patients Removed from Waiting List Where the Patient was Not Referred by a General Medical Practitioner or General Dental Practitioner. Codes Used During Quarter Ending 31 March 2008

Removal Reason	Removal Reason Description
10	Attended/admitted
20	Referred back to GP - Social unavailability
21	Referred back to GP - Medical unavailability
37	Referred back to GP - Could not attend
38	Referred back to GP - Did not attend
40	Referred back to GP - Refused “reasonable offer”
41	Referred back to GP - No response to offer
42	Referred back to GP - Inappropriate referral
43	Inappropriate addition to list
50	Transferred within NHS Board area to another specialty
51	Transferred within NHS Board area to another hospital
59	Transferred to another NHS Board area
80	Treatment no longer required
90	Died

Source: Waiting Times Data Warehouse, ISD Scotland.

The recently established Mental Health Collaborative will be working with every NHS board area to drive the delivery of this target through change and improvement. This attention and focus will complement the integrated care pathway standards for depression and the work with and through NHS Education for Scotland to build the infrastructure around psychological therapies. We will monitor and measure change through these and other data systems/processes.

In further support we have published a guidance report last year setting out the care advantages of and steps toward social prescribing for those with anxiety and depression or other mental illness.

That report, Developing Social Prescribing and Community Referrals for Mental Health in Scotland (Bib. number 45194) provides current service examples and offers guidance on steps that can be taken to encourage and arrange access to the arts; creativity, physical activity, learning, volunteering and other approaches for the potential positive impact these pursuits can have on mental wellbeing. The report sets out roles for Community Mental Health Partnerships and others.

Attention on progress is maintained through our focus on delivering the now four HEAT targets for mental health which include action on alternatives to medication and on reducing admissions to hospital care both of which have relevance to the objectives set.

The student intake numbers for mental health nursing have been agreed at 366 for 2008-09. NHS boards recommended a target of 340, reflecting falling board demand for mental health nurses. The Scottish Government encouraged an additional uplift of 26 training places. The reduction of 156 on the 2006-07 intake reflects a declining uptake of places, the desire to improve student experience and to reduce the attrition rate within courses.

It is wholly a matter for Post Office Ltd to decide which post offices it considers to be sustainable. Post offices are reserved under Schedule 5 (Section C11) of the Scotland Act 1998. The Scottish Government cannot fund post offices directly. The Scottish Government''s position on this issue was set out in the Cabinet Secretary for Finance and Sustainable Growth''s letter dated 29 January 2008 to the Petitions Committee of the Scottish Parliament, which is available on the Parliament''s website at:

http://www.scottish.parliament.uk/s3/committees/petitions/petitionsubmissions/sub-08/08-PE1102D.pdf.

The NHS in Scotland continues to reinforce the message that the recommended way to protect your child is through the combined MMR vaccination.

Communication from a trusted health professional is key in supporting uptake and minimising parent anxiety. NHS Health Scotland continues to support NHS boards and Health Protection Scotland to achieve good MMR uptake rates through the provision of a range of accessible information for parents and health professionals, along with supporting materials.

The revised MMR discussion pack will be launched later this year. It will build on the positively evaluated first edition and will further reinforce the importance of maintaining open and ongoing communication with parents about MMR.

In addition, the MMR: it''s never too late campaign materials are supplied by NHS Health Scotland to NHS boards to support local activity and include specific information for parents whose children have had single vaccines as well as those who have missed either one or both MMR doses.

A catch-up exercise was carried out at the time that the pneumococcal conjugate vaccine was introduced into the childhood schedule. In total 88% of the children who were offered catch-up immunisation at this time have been immunised appropriately for their age. Among the youngest of these children, who were aged two to eight months at the time, 95.9% have been immunised.

There are no further catch-up plans at this time. In the longer term it would be for the joint committee on vaccination and immunisation to consider the evidence and provide advice on whether or not a further period of catch-up vaccination was required.