Chamber and committees

There is various planned and actual activity around the use of telehealth to enhance the provision of emergency and unscheduled care. The focus for this work is NHS 24 and the Scottish Ambulance Service.

The Scottish Ambulance Service, in partnership with NHS 24 and GP out-of-hours services across Scotland, has established a professional to professional help line that gives ambulance staff the ability to contact another health care professional such as a senior GP for advice and support in real-time decision making and management of patients. This may for example allow a patient who previously would have been transferred from home to a distant hospital to be either managed at home or within their local community.

The ambulance service are also making use of defibrillators that allow transmission of ECGs to the local cardiac or accident and emergency unit to support the early diagnosis of myocardial infarction. This may mean immediate transfer to a centre for the administration of thrombolysis (clot busting). The new defibrillators can also capture further information regarding the crews'' performance during resuscitation, not only giving immediate feedback on the effectiveness of their intervention but also transmitting that information to a database for further detailed analysis and feedback. The ambulance service is currently piloting this.

NHS 24, through the Scottish Centre for Telehealth (SCT), is working with NHS Grampian to develop an integrated telemedicine solution utilising the network of community hospitals across rural Grampian. The evolving model will allow patients to be assessed in their community hospital by either a senior nurse or local GP supported by a specialist consultant in accident and emergency based in Aberdeen.

The Scottish Ambulance Service, through its investment in cab-based technology already has the capability to provide a level of decision making support to front line staff. Following a successful pilot project in Ayrshire where the patient record and clinical recordings were transmitted from the ambulance to the receiving accident and emergency department before the patient arrived, work is now ongoing with NHS Fife to further refine this development with the intention of extending the capability across Scotland.

Currently, first responders have access to senior paramedic support accessed by telephone to the emergency medical despatch centres of the ambulance service. There are currently no plans in place to further enhance this capability in the immediate future. However NHS 24/SCT is engaging with industry to monitor decision support solutions that deliver mobile telemedicine and looking at the future advances in technology and monitoring equipment to determine how these may realistically be deployed to benefit patients and support care providers.

I refer the member to the answer to question S3W-35257 on 3 August 2010. 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/Apps2/Business/PQA/Default.aspx.

Data for 2009-10 is not complete at this time and is, as yet, unpublished. Data for 2009-10 will be available from 28 September 2010.

I refer the member to the answer to question S3W-35257 on 3 August 2010. 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/Apps2/Business/PQA/Default.aspx.

Latest official statistics on the defined daily dose per capita for antidepressants, prescribed in Scotland that were dispensed by community pharmacists or dispensing doctors anywhere in the UK can be found on the ISDScotland website at www.isdscotland.org/isd/3671.html.

Information is presented by NHS board for financial years up to 2008-09. Provisional statistics for financial year 2009-10 are planned to be published on the 28 September 2010.

Ayrshire Power submitted a full Environmental Statement to Scottish Ministers in support of their application. This states in Chapter 18, paragraph 18.4.30, that the 4.6 million tonnes of coal would increase shipping movements by 35-40 per annum (approximately 4 per month) while the 800,000 tonnes of biomass would increase shipping movements by 40 per annum (approximately 4 per month).

The Health Board (Membership and Elections) Scotland Act 2009 stipulates that an independent evaluation, be carried out into the Pilot Health Board Elections. The London School of Economics in association with the University of St Andrews has been appointed to undertake this task, and this will also look at the effects of the non-statutory pilots which are underway. The Scottish Government expects the findings of this Independent Evaluation to be laid before Parliament in the autumn of 2012.

I wrote to you in March 2009 prior to Stage 3 of the Act to outline the approach that I intend to take in delivering non statutory alternative pilots. This involved a mix of the following approaches across NHS Grampian and NHS Lothian:

strengthening the role of Public Partnership Forums by appointing at least one of their members to the local health board;

reducing the number of Executive members on a Board to 5 and increasing the number of non executive members. This will give a clear majority to non executive and councillor members;

enhancing the public appointments process in the pilot area to increase the diversity around the board table.

I can confirm that a member of Midlothian Public Partnership Forum has been appointed to the NHS Lothian Board after a selection process overseen by the Office of the Commissioner for Public Appointments. You will also wish to note that the number of Executive Directors in both non-statutory pilot areas has been reduced to 5 which is consistent with the reductions in both Pilot Elected Health Boards. 

An enhanced public appointment process to appoint 2 additional members in NHS Grampian is currently underway which is aimed at increasing diversity around the board table. A further appointment will also be made to the NHS Lothian Board in due course using the alternative proposals.

S3W-34283 was answered on the basis of a specific analysis by the Information Services Division of NHS National Services Scotland which was limited in the extent to which it could fully reflect the true prevalence of errors in surgery. Accordingly, there are no plans for this analysis to be repeated. NHS boards collect information on adverse events, which will include those arising from surgery. In contrast to hospital discharge records, the source used in the previous analysis, locally held adverse event data give an indication of whether or not harm occurred. Monitoring these data is the responsibility of NHS boards and they are not collated or evaluated centrally.

S3W-34286 was answered on the basis of a specific analysis by the Information Services Division of NHS National Services Scotland which was limited in the extent to which it could fully reflect the true prevalence of errors in surgery. Accordingly, there are no plans for this analysis to be repeated. NHS boards collect information on adverse events, which will include those arising from surgery. In contrast to hospital discharge records, the source used in the previous analysis, locally held adverse event data give an indication of whether or not harm occurred. Monitoring these data is the responsibility of NHS boards and they are not collated or evaluated centrally.

There are a number of measures already in place in Scotland to help prevent sight loss, including free NHS eye examinations for all and diabetic retinopathy screening.

The NHS eye examination is tailored to meet the needs of the patient, taking into account their history and symptoms, allowing the patient to receive, free of charge, an appropriate health assessment of their whole visual system and allowing for early diagnosis of potential sight threatening disease.

Diabetic retinopathy is regarded as the leading cause of blindness in people of working age. It is therefore essential that retinopathy is detected and treated as early as possible.

The Scottish Diabetic Retinopathy Screening (DRS) programme aims to promote accessible and equitable delivery of diabetic retinal screening across Scotland.

The DRS programme is widely regarded as a world class service and has robust processes in place to ensure that all people who are eligible for diabetic retinopathy screening are offered it on a regular basis. The programme''s report for 2008‘09 states that 83% of eligible people with diabetes in Scotland were screened for retinopathy, exceeding the NHS Quality Improvement Scotland standard of 80%.

This programme is very much a part of our wider commitment to ensure that people with diabetes get the best possible care, and we will continue to monitor its progress through the annual Scottish Diabetes Survey.