Chamber and committees

Work is currently underway on a revision to the leaflet Your guide to free NHS eye examinations in Scotland. Supplies of the leaflet will be sent to opticians and to GP practices and to CHPs to distribute locally to vulnerable groups. We will consider whether a wider circulation should be undertaken. In addition, there are some projects being developed through pump-priming funding, such as the Glasgow Ethnic Minorities eye care project, which encourage people to attend for NHS eye examinations

We recognise that smoking can be a contributory factor to vision loss in some cases. The smoke-free legislation has increased the awareness of the risks associated with smoking and in particular the dangers of passive smoking.

The forthcoming smoking cessation marketing campaign, planned for launch in the autumn, aims to increase referrals to NHS Stop Smoking Services to build upon the ever increasing reach of those services.

Work is also ongoing to increase the number of brief interventions and referrals for specialist smoking cessation support delivered by all health professionals. Included in that would be the range of professions involved in the assessment and treatment of patients where there may be a risk of sight loss.

Vision screening programmes are in place including, pre-school screening, screening for those on specific drugs and diabetic retinopathy screening.

It is a central role of diabetes services to help support people with diabetes and make sure they are aware of the importance of achieving good control of blood glucose levels. This is essential to ensuring that the risk of complications such as diabetic retinopathy and sight loss are minimised.

Diabetic retinopathy is a major cause of blindness. Our Scottish Diabetic Retinopathy Screening programme offers retinopathy screening to all eligible people with diabetes in Scotland.

the NHS eye examination, which is free to all in Scotland, allows for early diagnosis of potential sight threatening disease. Optometrists can directly refer patients to the hospital eye service;

the Scottish Diabetic Retinopathy Screening programme which aims to promote accessible and equitable delivery of diabetic retinopathy screening across Scotland. 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;

a waiting time standard of 18 weeks from referral by a GP or optometrist to cataract surgery;

treatment for wet age-related macular degeneration, where detected quickly. Treatment does not restore any lost vision but has the potential to prevent further loss.

the Scottish Uveitis Network which, through collaboration and multi-discipline working, will result in significant improvement in the outcome of people with sight-threatening uveitis, and

NHS boards can make arrangements with optometrists to provide services on their behalf which are normally carried out in a hospital setting. Under these services accredited optometrists with further training can provide a range of services on behalf of boards. A number of these services are in place, including low vision aid services, the Glasgow Integrated Eye Service, the Lothian Optometry Cataract Initiative and the Grampian Eye Health Network.

In addition, NHS Fife has put in place a referral scheme whereby optometrists refer any eye problems directly to the hospital eye service by email. These referrals are screened by specialist nursing staff who allocate an appointment as appropriate. In some cases this allows non-sight threatening conditions to be monitored by optometrists in the community. Sight threatening conditions, are allocated an appointment within 48 hours.

Research work undertaken by the University of Aberdeen, and published in the British Journal of General Practice, September 2009, would suggest that in 99% of cases, the prescribing is in accordance with clinical guidelines.

The Scottish Drug Misuse Database (SDMD) does, however, collect information on the number of new patients/clients receiving a specialist assessment of their drug misuse care needs and whether, at the time of presenting, the client or their partner are pregnant. In 2008-09, 226 new female patients/clients reporting that they or their partners were pregnant were recorded as having received an assessment on the SDMD. It should be noted that this is the number who were assessed for their drug misuse care needs, not necessarily the number who went on to receive treatment.

The development of a follow-up reporting system for the SDMD, currently being rolled-out across Scotland, will allow patients to be tracked through the treatment system and reveal more information on the number of individuals engaging with treatment provision at any given time. It is also anticipated that this follow-up information, collected at set points throughout an individual''s care episode, will provide a fuller picture of the number of individuals, who self-report that they or their partner is pregnant.

http://www.drugmisuse.isdscotland.org/publications/09dmss/09dmss-100.htm.

Source: Prescribing Information System, ISD Scotland, IR2010-01543.

It should be noted that prescribing rates can be influenced not only by prevalence and detection rates of depression, but also prescribing practice around the dosage and duration of the prescription “ for example the same people might be staying on antidepressants for longer periods, or they may be receiving a higher dose.

We will ensure those who need antidepressants will continue to receive them in accordance with clinical guidelines, while investing in alternatives that increase choice for clinicians and service users through improved access to evidence based interventions such as psychological therapies.

NHS Quality Improvement Scotland''s Best Practice Statement on Maternal History Taking, which was published in August 2008, sets what information should be included as part of the Scottish Woman Held Maternity Record (SWHMR). This includes comprehensive information about a pregnant women''s personal physical health history in order to identify significant risks which may require referral to an obstetrician or other specialist service, including risk factors such as a body mass index (BMI) of over 35.

Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight (published February 2010) sets out both national and local governments'' respective long-term commitment to tackling overweight and obesity, to help achieve a healthier Scotland and contribute towards sustainable economic growth. The Route Map acknowledges that the rise in the number of women who are obese during pregnancy is a cause for concern due to the risks that obesity poses to the health of both the mother and infant, as well as its influence on long-term adult health. There are a number of actions within the Route Map aimed at supporting pregnant women and new mothers to develop healthy lifestyle behaviours.

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.

Estimates are based on data from a small sample of general practices in Scotland that participate in the Practice Team Information (PTI) scheme. The patients registered to PTI practices are representative of Scotland as a whole in terms of their age, gender and deprivation profile. Precise estimates are difficult to generate for small age groups and/or for conditions where patients consult relatively rarely. Confidence intervals, introduced from 31 March 2009, are shown to indicate the degree of precision of these estimates.

Because the method for estimating numbers of consultations has been revised since a similar question was answered last year (S3W-21249 on 18 March 2009), the table also includes revised estimates for the years 2003-04 to 2006-07. 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.

Figures are not shown for men as robust estimates could not be calculated. Relatively few PTI practices in recent years have recorded any eating disorders consultations for men aged 10-30 and in those that do the total number of consultations recorded is very small.

Female patients in Scotland consulting a GP or practice-employed nurse for an eating disorder at least once in the year (Estimated numbers¹, with 95% confidence intervals²):

Notes:

1. Based on data from 59, 53, 51, 49, 48 and 58 PTI practices that submitted complete GP and practice nurse data for the years ending 31 March 2004, 2005, 2006, 2007, 2008 and 2009 respectively.

2. As the estimates are based on data from a sample of practices, 95% confidence intervals are included to indicate the relative degree of certainty of these estimates.