Chamber and committees

We are not currently stockpiling pneumococcal vaccines to prevent the spread of secondary respiratory infection in the event of a pandemic. Pneumococcal vaccination for children is currently provided as part of the existing childhood vaccination schedule and those over the age of 65 are also offered the vaccination along with the seasonal flu vaccination every year.

The Joint Committee on Vaccination and Immunisation (JCVI) has recently considered the need for a wider pneumococcal vaccination programme for an influenza pandemic. While supportive of the current pneumococcal vaccination programme, they concluded that the evidence of additional benefit from a wider programme in the event of a pandemic was not sufficient to support action, such as stockpiling of vaccines. They will continue to consider any evidence that emerges.

I refer the member to the answer to question S3W-11972 on 25 April 2008.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/webapp/wa.search.

Work is currently being undertaken to produce Pandemic Flu Scottish Guidance on Health Workforce. This will include advice to NHS employers regarding the need to build up a local pool of staff currently outside the NHS such as the recently retired. Boards should seek to build up for themselves as detailed a picture as possible of the skills of their staff and in doing so assess likely capacity and identify training requirements.

Plans are also being developed to create surge capacity to allow flexibility in meeting demand during a pandemic or other emergency.

A draft version of the guidance can be viewed on:

www.Scotland.gov.uk/Topics/Health/health/AvianInfluenza/PandemicFlu.

The Scottish Government is not responsible for creating training modules for individual health care practitioners. This is because the content of any up-skilling programme must accommodate the individual learning needs of the practitioner in question and the specific competencies that require to be refreshed.

Legislation is in hand to ensure that retired and non-practising persons, or suitably experienced persons without the relevant qualifications, can be registered to provide healthcare during times of national emergency involving, or potentially involving, large scale loss of human life or human illness. It will be for the General Medical Council (GMC), Royal Pharmaceutical Society of Great Britain (RPSGB), or the Nursing and Midwifery Council (NMC) to decide whether the person or specified group of persons in question should be temporarily registered as medical practitioners, pharmacists or as nurses or midwives with greater prescribing rights.

The Scottish Government has produced a range of guidance to support local planners. In July 2006, planning guidance was issued to schools and childcare settings, including secure units. This was followed in February 2008 by infection control guidance for these settings.

In November 2007, guidance documents on planning and infection control were issued to all care homes in Scotland. To date no specific guidance has been issued to hospices although the general pandemic flu planning and infection control guidance produced by the Scottish Government is applicable to this setting.

All of these documents are available on the Scottish Government website at:

www.scotland.gov.uk/pandemicflu.

As it is an Immigration Removal Centre, guidance on pandemic preparedness for Dungavel is issued by the UK Government.

While there are no specific plans to develop a national strategy for epilepsy and learning disability, a number of other actions have been taken.

SIGN Guideline 70 on the Diagnosis and Management of Epilepsy in Adults and SIGN Guideline 81 on the management of epilepsies in children and young people each has a section dealing with the management of those with learning disabilities and epilepsy, and we expect NHS boards to implement the recommendations in these guidelines through local protocols.

NHS Quality Improvement Scotland is developing clinical standards for neurological conditions, including clinical standards specific to epilepsy. These standards, once finalised, will be mandatory across NHSScotland.

The national review of learning disability services, The Same as You?, emphasises the importance of addressing the range of health care needs of people with learning disabilities who also have specific medical problems, of which epilepsy is one. NHS Quality Improvement Scotland assesses NHS boards'' performance against Learning Disability Quality Indicators, which include specific health needs such as epilepsy.

The Scottish Government is committed to ensuring that patients have rapid access to the full range of services they need from the NHS. Specific targets are in place for first out-patient appointments following referral by a general medical or dental practitioner, for acute hospital admissions following a decision to place a patient on the waiting list, and for treatment for specific conditions, including heart disease and cancer. But the government is also committed to improving access and reducing waiting times for a broader range of services, and is supporting the NHS in Scotland to drive down waiting times for services not presently covered by waiting times targets.

We have published four targets for all NHS boards and 14 commitments for change and improvement in mental health services, incorporating reductions in re-admissions, anti-depressant prescribing and the rate of suicides, while also addressing increases in suicide assessment training and earlier diagnosis and support for those with dementia. The underlying commitments address specific measurable improvements across the range of mental health services, ages and needs.

I refer the member to the answer to question S3W-11601 on 23 April 2008. 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/webapp/wa.search.

The question is relevant to patients who are on a waiting list for hospital treatment and who become unavailable for treatment for medical reasons. Decisions about how best to manage the patient''s medical condition are clinical matters for the healthcare professional responsible for that patient''s treatment. The responsible health care professional will normally be the hospital consultant or another appropriate member of the clinical team, who will decide whether to discuss management of the patient''s case further, taking account of the individual circumstances of the case.

Published national guidance on the management of waiting lists makes it clear that the patient and the patient''s GP should be informed if a decision is made to return a patient to the care of the GP. The GP can of course decide to re-refer the patient.

A decision to return a patient to the care of their GP can be made only by the health care professional responsible for treating the patient, who will not remove a patient from a waiting list if it is clinically inappropriate to do so.

Published guidance on the management of waiting lists makes it clear that where for medical reasons a patient becomes unavailable while they are waiting for treatment, and is likely to be unavailable for more than seven days, then the patient''s waiting times clock will be stopped and re-started when the patient becomes available again.

The guidance further states that patients who are unavailable for treatment for medical reasons should be reviewed within 13 weeks. If no end date to the unavailability is known at that review, then the health care professional responsible for the patient''s treatment will decide whether the patient should remain on the waiting list or be returned to the care of their GP. This decision can be made only by the health care professional responsible for treating the patient, who will not remove a patient if it is clinically inappropriate to do so.

Arrangements for discussing a patient''s care and treatment with them, including their medical availability for treatment, are matters for the clinicians concerned. It would be good practice for the responsible clinician to discuss with a patient future arrangements for managing their condition, including any decision to return the patient to the care of their GP.