Chamber and committees

Boards have responsibility for ensuring that the clinical portal is implemented in a cost-effective, efficient and secure manner. For example the West of Scotland eHealth leads (NHS Greater Glasgow and Clyde, NHS Ayrshire and Arran, NHS Lanarkshire, NHS Forth Valley, NHS 24 and the National Waiting Times Centre) are currently scoping a project which will look at sharing information and workflow on a regional basis. In the first instance this work will take place within the West of Scotland Cancer Network multi-disciplinary teams. Any solutions are likely to be portal based and the supplier will respond to the business requirements of boards.

All three drugs have been approved by the Scottish Medicines Consortium (SMC) for use in the management of patients with atrial fibrillation and venous thromboembolism.

NHS board Area Drug and Therapeutics Committees consider this SMC advice in the context of their overall use of anticoagulant drugs, and decide on inclusion into their local joint formularies: https://www.scottishmedicines.org.uk/Home

NHS boards also consider the advice issued by Health Improvement Scotland, which helps identify those groups of patient, with atrial fibrillation, most likely to benefit from either dabigatran or rivaroxaban, when compared to more traditional anticoagulants: http://www.healthcareimprovementscotland.org/our_work/cardiovascular_disease/stroke_and_systemic_embolism/stroke_and_systemic_embolism.aspx

The Scottish Government considers that further central advice is not required at this stage.

Information regarding how many prisoners serving sentences of under six months have alcohol problems is not collected in this way and therefore not held centrally, however the Scottish Prison Service Prisoner Survey 2013 – Substance Misuse shows that alcohol harms are a significant feature of the prison population.

The Scottish Government’s Alcohol Brief Intervention (ABI) programme is evidence-based, with the three priority settings (primary care, accident and emergency, antenatal) identified in line with Scottish Intercollegiate Guidelines Network Guideline 74. The programme also allows for 10% of ABI delivery to be in wider settings, as determined by local partners. Alongside other work to tackle substance misuse, a number of ABIs are delivered within the prisoner population as part of this wider setting activity.

Overall, health in Scotland is improving, and people are living longer, healthier lives. Reducing the health gap between people in Scotland’s most deprived and affluent communities is one of our greatest challenges.

Our approach to improving mental health services is exactly the same as our approach to physical health. We are working with NHS boards and partners to ensure monitoring information about who is accessing services, such as ethnicity and sexuality, is consistently available to inform decisions about service design and to remove barriers to services.

The following NHS boards are using clinical portals: NHS Borders, NHS Dumfries and Galloway, NHS Fife, NHS Greater Glasgow and Clyde, NHS Lanarkshire, NHS Lothian, NHS Tayside, NHS Ayrshire and Arran and NHS Golden Jubilee. NHS Grampian use the TrakCare patient management system (PMS) as the clinical portal as it provides, in their case, the majority of agreed information. NHS Shetland and NHS Orkney are implementing PMS hosted by NHS Grampian and will follow their approach. NHS Highland implemented the TrakCare PMS system in March 2014 and effort is concentrated on this. Their portal strategy is yet to be developed although links with the Greater Glasgow and Clyde portal are in place for NHS Highland patients based in Argyll and Bute who receive the majority of their treatment within Greater Glasgow and Clyde. NHS Western Isle have just completed testing of their portal solution and intend to commence implementation on an incremental basis by the end of March 2015.

Access by clinicians to another health board’s portal is not monitored centrally. There are over 65,000 clinicians registered to use the clinical portal across Scotland. Through regional working health boards are exploring how best their clinical portals can be integrated to provide clinicians with the access they need across health board systems. This area of work is receiving added emphasis in the refreshed eHealth Strategy for 2011-17 which will be published shortly.

The Scottish Government notes the publication of this study which sought to explore the relationship between clinicians’ mindfulness and their perceived therapeutic alliance with their clients. The evidence that the quality of the therapeutic relationship is associated with client outcome is well recognised and this paper finds aspects of a mindfulness approach as being effective. Mindfulness based practice and training are therefore recommended.

Currently the concept of mindfulness is widely promoted in a variety of mental health settings. This is both for staff in their therapeutic encounters and personal occupational mental health, and for patients as a therapeutic tool in enhancing their mental health and wellbeing. Training opportunities exist for NHS Scotland staff and partners.

A total of almost £15.7 million has been spent on mental health research since 2007.

The majority of this funding has come from the Chief Scientist Office – almost
£15 million. The combined annual awarded funding for mental health related research grants and funding to the Mental Health Network is as follows:

Analytical Services in the Scottish Government spent a further £0.7 million on
policy-related evaluation and research. Please note this is presented as the year the funds were committed, not necessarily the year they were spent.

A number of other studies and surveys commissioned by Scottish Government Analytical Services also collect and report on mental health and mental wellbeing as part of their remit. It is not possible to disaggregate the costs of the mental health component. These include the Scottish Health Survey, Growing Up in Scotland, the Scottish Schools Adolescent Lifestyle and Substance Use Survey and GoWell.

There is no current programme of work with the sole aim of making laboratory results available to any NHS clinician in any location who requires access. Laboratory results are just one of the elements of the electronic patient health record that NHS boards are working to make more widely available to healthcare staff both within and across boards. NHS boards copy laboratory results into their local Scottish Care Information (SCI) Store repository to provide a highly available source of information that can be used directly or by other systems. The capability already exists for boards to agree cross-boundary SCI Store connectivity, and they decide together how it will be used and managed. All NHS boards have established live store to store connections with neighbouring or other boards where there are recognised clinical pathways. For example NHS Golden Jubilee, which routinely treats patients from across Scotland, has increased SCI Store connections from 8 to 11 since August 2013. Since August 2013, the number of live store to store connections across NHSScotland has increased from 39 to 70. The case for providing store to store connectivity for ad hoc or emergency access would be determined by individual boards in line with local policies. NHS boards are increasingly providing access to laboratory results through their clinical portals, and work to progress portal to portal information exchange is ongoing.

This information requested is not held centrally.

The Scottish Government is currently working with the Scottish crisis and acute inpatient network on commitment 23 of the Mental Health Strategy 2012-15 to develop a core data set that will allow effective comparison of the effectiveness of different models of crisis resolution/home treatment services across NHS Scotland. This work will help identify the key components of crisis prevention approaches and as a basis for a review of the standards for crisis services.

This information is not collected. However we recognise that LGBT people can experience more difficulty than others in accessing mental health services to meet their needs. This can be because some groups are less likely to try to access services, for example due to stigma, or because there are gaps or lack of capacity in some services.

The Scottish Government is working with NHS boards and partners to ensure that monitoring information about who is accessing services is consistently available to inform decisions about service design and to remove barriers to services.

We also provided £410,000 of funding to the LGBT Centre for Health and Wellbeing to run the Demonstration Project. This project was launched in response to evidence of the inequalities experienced by LGBT people around mental health. The project completed in 2014 and an impact report, which will be used to inform next steps, was published in November 2014.