Chamber and committees

The commitment to increase the number of qualified health visitors by 500 is unprecedented and is almost a 50% increase in the number of qualified health visitors in Scotland. From March 2014 to March 2017 there are at least an additional 242 Whole Time Equivalent health visitors in post. The total number of students completing health visitor training courses from the September 2014 to June 2017 is 486.

The numbers competing health visitor training courses in each of the last six years at 18 July 2017 is contained in the following table:

Source:

*Data from 2011 to 2015 – NHS Education for Scotland Nursing & Midwifery Annual Statistical Supplement available on request from NHS Education for Scotland

**NHS Education for Scotland management information

In 2014 the Scottish Government announced funding with the goal of increasing the Health Visitor workforce by 500 Whole Time Equivalent (WTE) by the end of 2018.

WTE information provides a better indicator of total labour input than a simple headcount. It is useful to support workforce planning and therefore continues to be in demand.

It is for individual NHSScotland Boards to determine whether posts are filled by one person or through a number of part-time appointees.

ISD Scotland workforce data on Health Visitor staff in post is published as both WTE and as headcount and can be found on the workforce statistics website at:-

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-06-06/Health_Visitors_M2017.xls

While the Scottish Government sets strategic policies for the NHS in Scotland, it is for each NHS Board to plan their workforce to ensure that enough professional staff and facilities are available to provide the best possible care for patients in a variety of settings. NHS Boards account for Health Visitor staff retirement as part of the workforce planning process.

The age profile of the current Health Visitor workforce has been published by ISD Scotland since March 2015 to support workforce planning and can be found on the workforce statistics website at:-

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-06-06/Health_Visitors_M2017.xls

The Scottish Government does not hold this information centrally. Local information may be available from each NHS Board.

Workforce data on Health Visitors in contracted hours (part-time or full-time) is published quarterly by ISD Scotland and is available from March 2015 onwards at the workforce statistics web site:-

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-06-06/Health_Visitors_M2017.xls

Health Visitors were part of a recent review of community nurses data. Therefore, information on the Health Visitor workforce prior to March 2015 is not comparable with previous years.

The Scottish Government’s commitment to an additional 500 health visitors by 2018 was based on the national application of a validated caseload weighting tool to support consistency in determining Health Visitor numbers across Scotland. The tool is based on population data and allows calculation of the number of Health Visitors required and weight this according to local deprivation.

The information from the application of the Health Visiting caseload weighting tool should be used locally by NHS Boards in conjunction with the Nursing and Midwifery Workload Workforce Planning tool to determine local Health Visiting staff requirements. The Nursing and Midwifery Workload Workforce Planning tool takes account of the workload attributed to the individual patient, enables professional judgement and local context in which care is being provided to be considered. Caseload Weighting Tool All of this information should be considered to enable NHS Boards to use evidence-based decision making on future requirements for Health Visitor staffing.

In addition the National Health and Social Care Workforce Plan which was published on 28 June sets out how we will work withall major stakeholders across Health and Social Care to secure sustainable NHS staffing.

The numbers competing Registered Specialist Community Public Health Nurse – Health Visitor training in each of the last six years at 18 July 2017 is contained in the following table:

Source:

*Data from 2011 to 2015 – NHS Education for Scotland Nursing & Midwifery Annual Statistical Supplement available on request from NHS Education for Scotland

**NHS Education for Scotland management information

In addition to the above course, students can choose the Specialist Community Public Health Nursing Generic course. The total number of students who completed both courses from 2011 to 2016 is 658.

The Broadband 2.0 report that was published by the British Infrastructure Group of MPs in July 2017 raises some interesting issues, particularly around consumer protection in relation to broadband. However, the analysis of speeds which informed the league table of worst performing areas is somewhat flawed, in that it is primarily based on data gathered from consumer speed tests not actual broadband availability. As a result, the figures reflect the speeds available as part of individual consumers’ packages; not the top speed that may be available on faster, more expensive packages.

Ofcom’s annual Connected Nations reports set out information on both broadband availability and take-up across Scotland. Their 2016 report highlighted that, while there is still more to do in terms of extending coverage in our more rural authorities, superfast broadband coverage in Scotland increased by 14% over the last 12 months – the largest increase of any of the UK nations

Telecoms, like defence and foreign affairs, is a matter reserved to the UK Government, meaning UK Ministers have the power to force broadband infrastructure providers to do more, particularly in rural areas. However, to date, they have chosen not to do so and their emerging plans for a Universal Service Obligation for broadband fall well short of our ambitions. That is why the Scottish Government has committed to delivering 100% superfast broadband access by 2021.

The “Evidence Review of the Potential Wider Impacts of Climate Change Mitigation Options: Built Environment Sector” (http://www.gov.scot/Publications/2017/01/3358) published in 2017 to inform the draft Climate Change Plan found evidence that measures to improve the energy efficiency of homes, including by insulating them, can result in benefits to residents’ health, particularly among those living in fuel poverty. Physical health benefits can arise from warmer homes; and mental health benefits can arise from reduced energy bills and hence reduced stress.

In addition, GoWell, funded by the Scottish Government, published the research “Can housing improvements cure or prevent the onset of health conditions over time in deprived areas?” (http://link.springer.com/article/10.1186/s12889-015-2524-5/fulltext.html) in November 2015. This research indicated that receipt of fabric works was associated with higher likelihood of recovery from mental health problems and circulatory conditions. Receipt of central heating was also associated with higher likelihood of recovery from circulatory conditions. The research also noted that health gains from housing improvements appears most likely when targeted at those in greatest health need. GoWell also published in November 2016 “Housing improvements, fuel payment difficulties and mental health in deprived communities” (http://www.tandfonline.com/doi/full/10.1080/14616718.2016.1248526) which showed that increases in the difficulty to pay fuel bills is associated with worsening mental health. The analysis showed that the biggest positive impact on paying fuel bills was either gaining, or remaining in, employment.

The Fuel Poverty Evidence Review published in 2012 by the Scottish Government examined evidence on the relationship between cold homes and poor health outcomes. It concluded that there was evidence suggesting that there was an association between thermal comfort and physical and mental well-being.