Chamber and committees

There are a number of reasons why patients may be returned to their GP many to do with patient behaviour for example a patient has not attended their appointment or have for the third time cancelled their agreed appointment date. GPs can of course re-refer any patient back to the hospital.

We expect all boards to continue to review their own local arrangements for booking scheduling and managing appointments. For example, if a patient agrees a reasonable offer of appointment some boards are phoning or texting patient to remind them of their appointment in a bid to reduce did not attends.

The Scottish Government will continue to review and monitor this with all boards as part of the normal performance management process.

The Scottish Government are aware of capacity issues in NHS Grampian in delivering waiting time standards particularly for general surgery and orthopaedics. The board have advised that the high level reflects patients indicating they would rather wait longer to receive their appointment locally rather than accept an appointment at an external provider within the waiting time standard. This means that the patient has agreed to a period of unavailability being applied to their waiting time.

NHS Grampian have recently agreed a £16 million investment programme that will increase capacity by employing more doctors, nurses and support staff as well as increasing theatre capacity. This additional local capacity will be available in 2014.

As the Member will be aware, the current waiting time standard for the four key radiology tests is six weeks. The latest figures show that the number of patients waiting more than six weeks in March 2013 was 994.

In relation to the increase of 1,200 rise over 60% of the increase in the number of patients waiting more than four weeks relates to in NHS Fife and my officials are working with the board to support improvement.

I refer the member to the answer to question S4W-15356 on 13 June 2013. 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.

Prescribing may be under taken by appropriately qualified practitioners, on the NHS Boards list, within their area of competency and are accountable for all aspects of their prescribing decision.

The FNP programme is delivered to the mother. Therefore, the ‘households’ are the number we capture as the nurses have capacity to deliver the programme to up to 25 clients at any one time. There may be more than one eligible child per household, due to multiple births, but it is the number of clients on the programme that we count, in terms of capacity.

Provided the expansion continues at the expected rate, we should have the capacity to reach (i) 1,970 households in 2013-14 (ii) 3,420 in 2014-15 and (iii) 5,470 in 2015-16. We are committed to expanding the programme to all NHS boards who meet the criteria to deliver the programme, by the end of 2015. We are also committed to looking at expansion within existing NHS boards, during that timeframe.

NHSScotland Boards are responsible for ensuring that they have an appropriately skilled workforce within their area to provide person-centred, safe and effective care. Individual Boards are supported and facilitated to meet training and continuous professional development needs by NHS Education for Scotland(NES).

With regard to stoma care, and new stoma care appliances, relevant healthcare staff are required to acquire and keep up to date their knowledge and skills to address the needs of their patients and to deliver high quality care, through medical journals, training and information from the Royal Colleges, GP magazines, national and local guidelines (e.g. British National Formulary and local formularies), NHS Knowledge Network, and others.

In addition to facilitating access to relevant information sources, NES also provides specific online stoma care presentations and webcasts that enable staff to gain greater insight into caring for the stoma patient, prescribing and common pharmaceutical care issues, and a ‘trouble-shooting’ workshop based upon case scenarios. These resources are reviewed regularly, and adapted as required.

Information regarding how many stoma care clinical nurse specialists there have been in NHS hospitals in each year from 2004, broken down by NHS board is not available as prior to the Agenda for Change (2007) information was not held at the level requested.

The following tables show the total number of stoma care clinical nurse specialists there have been employed in NHS boards, each year from 2004, however, the figures quoted will contain stoma care clinical staff from community and hospital based locations.

Table 1. Number of stoma care clinical nurse specialists by NHS Board (WTE) from 31-03-2004 to 31-03-2012

Source: ISD Scotland.

Note: NHS Argyll and Clyde ceased to exist at 1st April 2006. NHS Greater Glasgow and Clyde and NHS Highland board areas were revised to include Argyll and Clyde.

Table 2. Number of stoma care clinical nurse specialists by NHS Board (Headcount) from 31-03-2004 to 31-03-2012

Source: ISD Scotland.

Note: NHS Argyll and Clyde ceased to exist at 1st April 2006. NHS Greater Glasgow and Clyde and NHS Highland board areas were revised to include Argyll and Clyde.

The number and rate of singletons born with neural tube defects are available in the Scottish Perinatal and Infant Mortality and Morbidity Report 2011 (tables A22 and A23a). The congenital anomaly tables from the SPIMMR report are currently only available up to 2010 as all infants are followed up from birth for a period of one year to allow detection of anomalies from hospital inpatient records or NRS death registrations. This information is available on ISD’s website via the following link:

http://www.isdscotland.org/Health-Topics/Maternity-and-Births/Stillbirth-and-Infant-Deaths.

Due to the sensitivity of abortion data and disclosure issues around this topic the only data available for terminations following a diagnosis of neural tube abnormality are the suppressed figures from the Abortion Act Statistics 2012 (Table 1). The three groups which make up neural tube defects are Anencephaly, Encephalocele and Spina Bifida. This information is available on ISD’s website via the following link:

http://www.isdscotland.org/Health-Topics/Sexual-Health/Abortions.

The Scottish Stoma Forum audited patient opinion back in August 2010 to inform the development of a national audit system. Further work to establish a national group is to be taken forward and will be tasked with developing a national audit system building on patient opinion.