Chamber and committees

The review groupincludes patient and carer representatives nominated by the Scottish HealthCouncil. The council has also agreed to ensure that the group is made fullyaware of the views of patients in the five NHS board areas where hospital carparking charges have been introduced.

The ScottishGovernment has made it clear that there will be a presumption againstcentralisation of services. National guidance on major service change indicatesthat boards must ensure that any potentially adverse impact of a proposedservice change on, for example, the travel arrangements of patients, carers,visitors and staff have been taken account of in the final proposal. This is anissue which revised guidance on car parking will need to take into account.

The review groupmet for the first time on 2 October 2007 and is due to reportby the end of November. The group has agreed arrangements to seek the views ofpatients, the public and staff.

The group willtake full account of the statutory and policy context, including the NationalTransport Strategy for Scotland. This sets out the Government’s long-termvision, objectives, priorities and plans, and specifically provides for “alllocal authorities and major hospitals and health facilities to have operationaltravel plans by April 2008”. It will also take account of the environmental managementpolicy for NHSScotland which requires that:

 “An NHSScotland body’senvironmental management strategy must include measures aimed at promoting moresustainable travel choices through the implementation of green travel plans, inassociation with local authorities”.

The review groupincludes staff side representatives to ensure that the group is fully aware of the views of staff about hospital car parking arrangements and charges.

The Audit Scotland reporton long-term conditions draws attention to the links between chronic obstructive pulmonary disease (COPD) and deprivation.

Better Health, Better Care sets out our commitment to putting health inequalitiesat the heart of the NHSScotland agenda, in particular by targeting resources onservices that support disadvantaged people, particularly those with the most complexneeds. The Minister for Public Health is leading a task force on health inequalitiesto identify and prioritise practical actions to reduce the most significant andwidening health inequalities in Scotland.

Taken together, clinicalstandards for COPD and respiratory Managed Clinical Networks would address the issuesabout inconsistency and patchiness of services highlighted in the Audit Scotlandreport on long-term conditions.

One of the main inequitieshighlighted in the Audit Scotland report on long-term conditions was pulmonary rehabilitationservices, and these are included in the Scottish Enhanced Services Programme toencourage NHS boards to address this issue.

The development ofManaged Clinical Networks, whether for chronic obstructive pulmonary disease (COPD)or respiratory conditions more generally, gives those with COPD, their carers, andthose who speak on their behalf, an opportunity to contribute to the way servicesare designed and delivered. They will also have opportunities to contribute to thedevelopment of clinical standards for COPD services in Scotland.

People from localorganisations such as the British Lung Foundation’s “Breathe Easy” Groups can playan important role in Community Health Partnerships’ Public Partnership fora in relationto the organisation and development of services in their locality.

The development ofclinical standards is a matter for NHS Quality Improvement Scotland. It is keepingin close touch with work on the National Service Framework (NSF) for chronic obstructivepulmonary disease (COPD) being developed in England and will consider whether thestandards in the NSF can be adopted for Scotland as they stand, or whether theyrequire adjustment to suit Scottish circumstances. These standards would be mandatoryon all boards providing services for people with COPD.

Respiratory ManagedClinical Networks would be an excellentvehicle for promoting implementation of such standards locally.

That would be theexpectation.

While the Audit Scotland report contains very useful information on chronic obstructive pulmonary disease, its recommendations are couched in relationto all long-term conditions. We will take these into account in the plan for long-termconditions which is being developed by the Chief Medical Officer in partnershipwith the Long Term Conditions Alliance Scotland and which will feed into the actionplan flowing from Better Health, Better Care.