Chamber and committees

The Scottish Government monitoring of implementation of the Scottish Government guidance CEL 17 (2010) and subsequent related guidance published in 2011 and 2012 is on-going.

The recently announced New Medicines Review to assess the current systems for making new medicines available across NHSScotland will include a strand of work to look at every aspect of the introduction of new medicines from national advice through to local decision-making to establish whether any further improvements can be made.

The review also captures the need to assess NHS boards’ compliance with the current guidance in relation to the introduction and availability of newly licensed medicines.

Any recommendations made as a result of the review will be considered early next year.

Nursing and Midwifery Pre-Registration Education in Scotland is a devolved matter falling within the remit of the Scottish Government.

The number of nurses or midwives who completed the Specialist Community Public Health Nurse/Health Visiting course in each of the last five years is shown in the following table.

This is not a matter for the Scottish Government. It is a decision for the board of NHS National Services Scotland (NSS). However, the proposed merger was discussed with the Minister for Public Health at the NSS Annual Review 2012.

Health Protection Scotland (HPS) and Information Services Division (ISD) have been part of the same organisation since their predecessors were brought together under the Common Services Agency (CSA) in 1974.

The CSA now operates as NHS National Services Scotland (NSS), which delivers a wide range of services to the rest of NHS Scotland. In line with national policy to reduce the number of senior managers in the NHS, NSS is proposing to reduce the number of senior managers within HPS and ISD, and bring them under one director.

Customers will continue to receive quality public health and information services. The changes will improve transparency and collaboration between the two areas and so offer customers a better service, especially in the area of public health information. NSS will also be better placed to anticipate and develop new services to help support Scotland’s health.

The Scottish Medicines Consortium (SMC) has developed modifiers which allow greater flexibility in its decision making to allow consideration of additional factors in certain circumstances when the pharmaceutical company has submitted a robust case. These may allow the SMC to accept either more uncertainty in the health economic case or a higher cost per quality adjusted life year.

Further information on how these might apply in the SMC appraisal process is set out on the SMC website. A link is attached:

http://www.scottishmedicines.org.uk/About_SMC/Policy_Statements/SMC_Modifiersused_in_Appraising_New_Medicines

Orphan medicines which have been accepted for use by the Scottish Medicines Consortium (SMC) are available to prescribers within NHSScotland in accordance with clinical need.

Where the SMC have not accepted a medicine, NHS boards are not expected to make it routinely available.

The Scottish Government has not undertaken an assessment of equity of access to orphan medicines between each NHS Board and the rest of (a) UK and (b) EU.

Figures relating to spend on orphan drugs can not be provided from data held centrally. The spend relating to branded and other medicines in each of the last five years can be found in the following table.

Figures relate mainly to primary care prescribing and dispensing, although some items may have been prescribed in a hospital setting.

Table 1: The Gross Ingredient Cost for branded and other medicines by financial year

Source: Prescribing Information System.

Further information on Prescribing can be found on the following ISD website:

http://www.isdscotland.org/Health-Topics/Prescribing-and-Medicines/.

The Patient and Public Involvement Group (PAPIG) has three public partners who are members of the Scottish Medicines Consortium and contribute to the decision making. Where there are Patient Interest Group submissions for medicines under assessment, these are included in the meeting papers sent to all members and one of the public partners presents a summary of the Patient Interest Group submissions verbally to the committee at the monthly SMC meeting. Further information on these arrangements are set out on the SMC website. A link is attached:

http://www.scottishmedicines.org.uk/Public_Involvement/SMC_Explained/Further_Reading.

The SMC website provides information on how patient interest groups can participate in the SMC appraisal arrangements. A link is attached:

http://www.scottishmedicines.org.uk/Public_Involvement/Template_and_Guidance_Documents.

The total number of students enrolled at each of the university nursing schools in each of the last five years and the attrition rates for those cohorts completing in each of the last five years are as detailed in the following tables:

Source: Data from NHS Education for Scotland.

Since 2009, there has been an increase in the number of qualified nurses graduating because more students than ever before are successfully completing their studies. The student intake is set every year to make sure we have the right number of nurses and midwives for the future.

The number of Clinical Nurse Specialists (CNS) has increased in recent years as detailed in the following table.