Chamber and committees

In relation to the NHS, the testing, diagnosis and treatment of people with hepatitis C has been a Government priority since the publication of the Hepatitis C Phase 2 Action Plan in 2008. This priority is maintained in the Sexual Health and Blood Borne Virus Framework, which specifically requires multi-agency partners in local areas to work together to deliver local strategies on early diagnosis and treatment of those infected.

As a result of the government’s investment in these activities the cumulative number of individuals diagnosed with hepatitis C, and not known to have died, has increased from 18,638 in 2007, to 29,952 in 2013. Likewise the number of people commencing hepatitis C therapy every year has more than doubled from fewer than 500 per year to over 1,000 per year.

In relation to alcohol and drug partnerships (ADPS) the Scottish Government has worked in partnership with ADPs to strengthen governance and accountability arrangements and to develop and agree a set of core ADP outcomes and indicators. One of the national indicators that ADPs are expected to report against on an annual basis is the prevalence of hepatitis C among people who inject drugs. It is expected that ADPs will already be providing this information to their local community planning partnerships.

A confidential blood borne virus service, incorporating hepatitis C, is available to all prisoners within the Scottish Prison Service. This service includes immunisations, testing and counselling, treatment and harm reduction awareness-raising. Around 580 prisoners have been tested for hepatitis C every year since 2010. The Sexual Health and Blood Borne Virus Framework highlights the importance of ensuring that around 10% of those initiated onto treatment every year are prisoners. This target has been met, with more than 10% of all treatment initiations in Scotland taking place in prison every year since 2009-10.

Data on the number of people in the prison setting who have received a test for hepatitis C and who were diagnosed is provided in Table 1 below, along with the annual total number of diagnoses in prison. The test data represent tests undertaken in NHS Greater Glasgow and Clyde, NHS Lothian, NHS Grampian and NHS Tayside.

The number of chronically infected people initiated on hepatitis C antiviral therapy within the prison setting is provided in Table 2. These data are available by financial year only. These data indicate an increase in provision of therapy in this setting.

Data on treatment completion and response to treatment are not available at this time for the prison setting

Table 1: Hepatitis C testing and diagnosis in the prison setting 2007-2013:

	2007	2008	2009	2010	2011	2012	2013
Number receiving an HCV test in prison each year*	262	299	495	580	600	583	578
Number newly diagnosed with HCV in prison in Scotland's four largest NHS boards	47	44	57	73	76	76	72
Number newly diagnosed with HCV in prison in Scotland (All NHS boards)	72	55	92	96	104	94	98

*HCV testing data currently only available for NHS Greater Glasgow and Clyde, NHS Lothian, NHS Tayside and NHS Grampian

 

 

 

 

 

 

 

 

Table 2: Number of chronically infected people initiated on hepatitis C antiviral therapy within the prison setting, Scotland 2007 -2013

	2007-08	2008-09	2009-10	2010-11	2011-12	2012-13	2013-14*
Number on HCV treatment in the prison setting	17	37	112	143	102	117	141
Proportion of annual treatment initiations (%)	4	6	12	14	10	11	14

* Data for this year are provisional.

NHS National Services Scotland manages the contract for high secure services in Scotland on behalf of NHS Scotland.

The State Hospital, Carstairs stopped admitting female patients in 2008. The costs for female patients treated in high secure services in England are only available from 2011-12 and are as follows:

2011-12	£236,970
2012-13	£670,887
2013-14	£676,321

The Scottish Government will publish an updated framework in 2015, as a successor to the current framework. The new framework will retain the current high level outcomes, but will reflect relevant major developments, including changes in the hepatitis C treatment landscape.

The Sexual Health and Blood Borne Virus Framework sets out five high level outcomes the government wishes to see delivered. To support monitoring of progress against these outcomes the frameworks includes a range of detailed data indicators. When the current framework comes to an end in 2015, the Scottish Government will produce a report evaluating the progress made under the framework, based on these key indicators as well as reports on progress from NHS boards and other partners.

With access to NHS dental services improving it is appropriate for NHS Dumfries and Galloway to review their service provision in order to ensure routine dental care is provided by independent contractors where possible.

The proposed changes are about migrating patients in need of routine dental care from salaried General Dental Services (GDS) to independent contractor GDS with a consequential shift in resources.

The Broxden Dental Centre in Perth will rarely run with one surgery. These rare occasions, when a single surgery emergency service is run, will be on public holidays over and above Christmas and New year, and on two occasions per year when NHS Tayside dental service have a board area-wide meeting.

The decision to enable dental patients to be treated by independent dental contractors, rather than the public dental service, has been driven by the Scottish Government’s aim to improve access to NHS General Dental Services for people in Scotland, and for those services to be provided by independent contractors where possible.

Changes in arrangements have been communicated to patients by NHS Tayside.

The Scottish Government will continue to ensure that people who wish to have access to a NHS dentist, can do so. Over 4.4 million people across Scotland are now registered with a NHS dentist. This constitutes an increase of 1.8 million since March 2007.

We will also continue to prioritise child oral health through preventative programmes such as Childsmile. The latest report from the National Dental Inspection Programme showed that almost 70 per cent of P1 pupils have no obvious sign of tooth decay compared with only 44 per cent in 2003.

In the course of developing the Hepatitis C Phase 1 Action Plan, Health Protection Scotland estimated the costs of the current and future burden of chronic hepatitis C disease on the NHS in Scotland. This work was completed in February 2007.

Health Protection Scotland estimated that the annual health service costs associated with the monitoring, management and treatment of people with diagnosed chronic hepatitis C disease in Scotland was £11.8 million in 2005. This figure included £2.8 million for antiviral therapy for hepatitis C.

The same work also estimated potential future costs, assuming uptake of hepatitis C antiviral therapy by around 1,000 former injecting drug users a year. In this scenario it was estimated that costs would rise to around £22 million in 2015, comprising around £13 million for the costs associated with the management of chronic hepatitis C disease and around £9 million for the costs of antiviral therapy. (These costs do not take account of inflation and were calculated based on 2005 prices).

The decision by the Chief Dental Officer was based on a request by NHS Highland to recruit a fixed term vacant salaried dentist post. This decision has no bearing on the Scottish Government’s long term commitment to NHS dental services in Skye.

NHS Highland is currently formalising a strategy for primary care dental services. Recruitment to a fixed term post at this stage will provide flexibility in terms of planning.