Chamber and committees

The Scottish Government is currently exploring what further opportunities exist for Scotland to contribute to the emerging evidence base. Officials have recently met with academics, the Chair of the UK National Screening Committee, and the Scottish Screening Committee to discuss ongoing studies and trials to identify where Scotland can best add value.

The Scottish Government has supported a large academically-led evaluation of an early lung cancer detection test (the ECLS trial: http://eclsstudy.org/ ) involving around 12,000 people in Scotland. The trial is in the data analysis phase with first findings due to be published over the coming months.

Any further recommendations regarding potential pilot programmes in Scotland will be carefully considered.

All Screening programmes implemented by the Scottish Government have been introduced following the advice of the UK National Screening Committee (UK NSC), an independent expert advisory group which advises the Scottish Government, along with the rest of the UK, on all aspects of screening.

The Scottish Government is committed to the early detection of cancer – this is reflected in our £42 million Detect Cancer Early (DCE) Programme that aims to improve cancer survival rates in Scotland by finding and treating the disease at an early stage. The Programme has traditionally focused on Scotland’s most common cancers - breast, bowel and lung - which account for around 45% of all primary cancers diagnosed in Scotland. However, following an options appraisal exercise, malignant melanoma was added to the Programme in 2016. Since then, Boards have introduced local pilots to explore and promote best practice for referrals of Suspicious Pigmented Lesions (SPL), in order to achieve earlier diagnosis of cancer.

Meanwhile, DCE’s latest awareness campaign – Survivors – is currently running across Scotland to highlight the fact that more people are surviving cancer than ever before and getting checked early plays a big part. All channels - including TV, radio and digital - signpost to DCE’s website where people can learn about the common signs and symptoms of cancer, including melanoma. A roadshow will be travelling the country later this year to raise further awareness and help empower people who notice any unusual/persistent changes to act early.

Further to this, there is advice available to the public through the following NHS Inform pages:

https://www.nhsinform.scot/campaigns/summer-health

https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/skin-cancer-non-melanoma

I refer the member to the answer to question S5W-24020 on 22 July 2019. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at: http://www.parliament.scot/parliamentarybusiness/28877.aspx

We recognise the value of robust and sensitive processes for capturing and utilising feedback on the quality of end of life care.

Earlier this year, the Scottish Government asked an NHS Lothian based project team to take forward work to provide options on how best to establish a more coherent picture of the quality of end of life care, including the views of the bereaved, which can also be used for improving service delivery. The project team are undertaking scoping work which includes the National Audit of Care at the End of Life (NACEL) and are due to report back to officials by the end of the year.

With this approach, the Scottish Government has no plans to commission an audit of end of life services or join the National Audit of Care at End of Life at this time.

Good care at the end of life requires collaborative, multi-disciplinary support, which is why Integration Authorities have been given statutory responsibility for meeting this need.

The Scottish Government continues to work with Integration Authorities to help ensure that a range of clinical and health economic expertise and information is available to support them in undertaking local evaluations to inform the commissioning of high quality, person centred, palliative and end of services to meet the specific needs of their communities. As such we do not centrally hold information regarding clinical and health economic evaluations relating to palliative and end of life care models.

However as part of this programme of work to support Integration Authorities, in March 2019 Healthcare Improvement Scotland published an overarching review of evidence on approaches that can improve continuity and coordination of palliative care. This review brings together the high-level evidence on key approaches to care co-ordination in palliative and end of life care and the benefit of such approaches. Further information on this work can be found at:
https://ihub.scot/improvement-programmes/living-well-in-communities/people-nearing-the-end-of-their-lives/

In 2016, the Palliative and End of Life Care National Implementation Advisory Group discussed how best to communicate learning and improvement work associated with the Framework for Action.

The Group agreed to maintain a living workplan document that captures improvement work associated with each of the commitments in Framework, which can be shared easily and used to support the development of local improvement and implementation plans. These are published on the Scottish Government website and can be found at: http://sh45inta/Topics/Health/Quality-Improvement-Performance/peolc/Implementation-SFA-peolc

Reducing paper usage and manual administration is a priority for NHS Scotland. Current initiatives include Paper-Lite programmes, the introduction of Regional Clinical Portals and the roll out of HEPMA ( Hospital Electronic Prescribing and Medicines Administration ) systems across Scotland. These projects present a range of benefits including reduction in the need to scan hard copies of documentation, supporting interoperability of data sharing between existing electronic systems, and improvement in the quality of electronic information shared amongst clinicians.

As part of the Digital Health & Care strategy a new National Digital Platform is underway which will start to bring together service data from across the Boards and make it appropriately accessible as an electronic patient record to the workforce regardless of where they are based, negating the need for transfer of paper records.

The first deliverable from the National Digital Platform, under test currently, will be an electronic version of the current paper ReSPECT form.

Nursing Vacancy data can be found by selecting the Nursing and Midwifery Vacancies Tab where the drop down can be used to select Total Vacancies in the Non-medical trend table published on the ISD website available here: https://www.isdscotland.org/Health-Topics/Workforce/Publications/2019-06-04/Non-Medical_Trend_M2019.xls

The whole time equivalent for Nursing vacancies broken down by board from March 2015 - March 2019 can be seen in Table 1.

Table 1: NHSScotland - Nursing Vacancies by Health Board (WTE) - Trend March 2015 to March 2019

It is not possible to reliably identify cases of diabetic ketoacidosis or hypoglycaemic coma from hospital admissions data. This relates to the way that complications of diabetes are coded in the international ICD10 coding system.

The following tables show the number of emergency admissions for diabetic ketoacidosis without coma. These figures do not include cases of diabetic ketoacidosis with coma, which cannot be identified separately. The tables also show figures for coma due to diabetes, which include cases due to hypoglycaemia as well as other causes. The figures are shown for each year since 2015-16, broken down by (a) age, (b) gender and (c) NHS board area where possible.

Table 1

Number of emergency hospital admissions for diabetic ketoacidosis without coma in each year since 2015-16, by age and financial year. Note that these figures do not include diabetic ketoacidosis with coma.