Chamber and committees

We have no plans to extend the Scotland-wide Free Bus Travel Scheme for Older and Disabled People at this time. However, it is our intention to amend bus registration legislation to allow flexibly routed community and demand responsive transport services that are available to the general public to become local registered bus services. As a consequence, such services will qualify for concessionary travel under the Scotland-wide Free Bus Travel Scheme for Older and Disabled People.

The King’s Fund report reflects on the organisation of health and social care services in England, and lacks an analysis of the Scottish context. Its broad conclusions for better quality, and improved co-ordination and delivery of care for those with co-morbidities are, however, consistent with the Scottish Government’s current policies and priorities for those with mental health and long term conditions. We have achieved tangible improvements through delivery of our Long Tem Conditions Action, and are now embedding and widening progress through the Quality Strategy delivery groups.

Ensuring our health care professionals have the right knowledge, skills and access to development opportunities remains a high priority, and we continue to work with the professional regulators, and NHS Scotland boards, in delivering required educational standards, and in responding to identified needs. For example, NHS Education for Scotland (NES) is leading a programme of work that is specifically addressing workforce development in relation to the psychological wellbeing and mental health needs of people with long-term conditions.

We currently have no plans to introduce a compulsory alcohol sobriety scheme for problem drinkers convicted of serious drink-related offences, but will follow the success of the pilot proposed by the Mayor of London with interest.

Computer-based therapies are not intended to replace face-to-face therapies but to add to the options and personal choices available to those patients for whom this type of intervention is appropriate, welcomed, likely to be effective, and safe.

In many cases patients are referred through their GP, who will note any symptoms and problems during a face-to-face consultation, and refer or prescribe accordingly. Good practice suggests that on first contact with a computer based therapy service, patients should be subject to an initial assessment, whether referred through their GP, self-referred or arriving at the service through any other route, to establish whether computer based therapy is suitable for the level of complexity and severity of their problem or illness.

Thereafter, ongoing review should take place to ensure that they are benefitting from the intervention and to assess whether other interventions are required. In most cases, standardised tools to rate depression and anxiety levels are used, and if a patient is scoring highly in these, there should be a mechanism in place to alert the support worker and advise the user to seek other help urgently.

Computer-based therapies are not intended to replace face-to-face therapies but to add to the options, flexibility and personal choices available to patients, many of whom prefer this type of interaction. In all cases, an assessment should take place, which will establish whether a computer based therapy is appropriate for and wanted by the patient, and also to establish whether it is safe for them to use this approach.

This type of intervention is in many cases offered as part of a package of care which may also include face-to-face sessions and drug treatment as appropriate, alongside other initiatives such as exercise referral and bibliotherapy.

There is an evidence base for the effectiveness of computer based therapies, with National Institute for Health and Clinical Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines recommending them. Good practice guidelines recommend computer based therapies are delivered with guidance and monitoring from a support worker.

Other advantages of providing the option of computer-based therapy include making a contribution to overall service improvement through freeing up time for more complex face-to-face therapy, where required, and for more high intensity therapies. Computer-based therapy is also particularly valuable in remote and rural areas where it gives individuals access to support in their own homes.

The introduction of nuchal translucancy screening has been delayed in NHS Greater and Clyde and NHS Western Isles as there is a shortage of trained sonographers within these board areas.

The information requested is not held centrally.

The information requested is not held centrally.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies.

People with a mental health problem and long-term condition will benefit from the record investment and the range of improvements being delivered as part of the Scottish Government’s wider health and mental health improvement programmes, including the Healthcare Quality Strategy.

The Scottish Government provided £548,000 funding to 2011 for the three year Living Better partnership project led by RCGP Scotland to help local primary care services improve detection and diagnosis of mental health problems in people living with long term conditions such as diabetes, chronic heart disease, and chronic obstructive pulmonary disease (www.livingbetter-scotland.org.uk).

We are also currently considering consultation responses on the future direction of our mental health strategy to 2015. The consultation document recognised the importance of delivering key outcomes such as ensuring mental health services work well with, and are integrated in, other services and settings, and that people and communities act to protect and promote their mental health to reduce the likelihood that they will become unwell. Detailed plans will be set out in the final strategy which will be published in the spring.

NHS boards report Healthcare Associated Infection outbreaks and ward closures to Health Protection Scotland (HPS).

HPS have received no reports of ward closures as a result of E.coli in the last three years. Reports are submitted on a voluntary basis and therefore this data may not necessarily be comprehensive.