Chamber and committees

The Scottish Government introduced free car parking on all NHS owned car parks in December 2008, a policy which has saved patients, staff and visitors over £41 million since it was introduced.

The Scottish Government is actively pursuing a long term solution for the parking situation at the three PFI owned hospital car parks, but due to the commercial sensitivities of any option being considered, we are not in a position to provide a detailed update at this point.

Ministers have made it repeatedly clear that the guidance on the use of Do Not Attempt Cardiopulmonary (DNACPR) forms has not changed in light of the Covid-19 outbreak and that they expect conversations around such matters to be handled with the utmost compassion, care and tact.

Where concerns have been shared with Ministers about the use of DNACPR forms for specific individuals, they have asked Scottish Government officials to raise this with the relevant health and social care organisation so that any issues can be quickly resolved.

On the 10 April, the Chief Medical Officer, Chair of the Scottish General Practitioners Committee of the BMA and Chair of the Royal College of General Practitioners (RCGP) wrote to GPs to provide advice and support on having anticipatory care planning conversations and to make clear that there is no requirement for health professionals to have a DNACPR discussion as part of this conversation, unless the patient wishes to discuss it or clinician feels strongly it is necessary to raise in conversation for the patient’s wellbeing. On the 17 April, a further joint letter from the Scottish Government’s Chief Medical Officer, BMA and RCGP was sent to GPs to reinforce the advice already provided.

I have asked Teresa Medhurst, Interim Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

NHS Health Boards are responsible for the treatment and care of those with mental conditions in Scotland’s prisons, this includes those who may have a bipolar disorder. SPS are working with partners, including NHS, to support those in custody during this time.

If any person in custody wishes access to a member of the Mental Health Team, then they are able to self-refer. A Healthcare Professional will conduct an assessment within 7 to 14 days of a self-referral being submitted.

SPS staff are experienced in dealing with and supporting people who have mental health conditions. Where SPS staff have any immediate concerns regarding an individual’s mental health or risk of suicide, they can request an urgent assessment by the Mental Health Team. Where someone is identified as at risk of self-harm or suicide, SPS staff will initiate a concern form and interview the individual concerned. Those at risk of suicide are managed under SPS’ suicide prevention process, ‘Talk to Me’.

Self-help support leaflets, designed by SPS Psychologists, have been issued to everyone in custody and these provide information and tools which can be used to maintain a sense of wellbeing during the current pandemic.

All prisons continue to have Chaplains on site and they are available to talk to individuals who request pastoral support.

The average total turnaround time for NHS labs is 19 hours. This measure is the time from when the patient swab sample is taken by the clinician to when the final laboratory result is available. Total turnaround time includes the time taken for a patient’s swab sample to reach the laboratory in addition to laboratory pre-analytical, analytical and post-analytical steps.

A quality framework for care homes for older people was published by the Care Inspectorate in 2018.

Self-evaluation is an important marker of quality assurance and covers all aspects of a care home’s performance and outcomes for the people experiencing care. It is a dynamic and continuous process. In the context of Covid-19 it has been supplemented by other steps taken under the enhanced clinical and professional leadership which the Scottish Government has introduced.

Learning from the coronavirus emergency offers an opportunity to strengthen and reflect good practice in relation to infection prevention and control, for future reviews of the Care Inspectorate’s quality frameworks. The Care Inspectorate has amended the quality framework for care homes for adults and care homes for older people to support the assessment of care and support during the Covid-19 pandemic. This includes sections on well being, infection prevention and control and staffing. Specifically this will be used during inspections and support the evaluation of services in response to the pandemic.

I continue to have discussions with the Care Inspectorate on what further changes to its approach it wishes to embed in work going forward.

An Incident Management Team (IMT) was established to investigate and manage the incident at the Nike conference. The IMT is an independent, multi-disciplinary and multi-agency group, which provides a framework, response and resources to enable the NHS board(s) and other statutory agencies to fulfil their remits.

It is part of the IMT’s remit to consider what actions are required following any incident. Each incident is judged individually. On the Nike Conference incident, as all contacts had been identified and contacted, the risk to the public was deemed by the IMT to be low.

Research from the University of Glasgow published on 8 June on viral lineages of the disease concluded that the actions taken to manage the Nike outbreak were successful in containing spread from that incident. This led to the eradication of this particular viral lineage, with no evidence of any wider outbreak associated with it in Scotland since that time.

The IMT will produce its report in due course and within the agreed timescales of within three to six months of the debrief.

There are existing organisations, systems and processes in place in Scotland to identify and manage any concerns patients have with respect to their treatment.

Patients who have experienced an adverse reaction to a therapy or treatment are advised to, first of all, seek medical assistance from their family doctor and/or the relevant clinic where they are being treated. It would then be for the healthcare professional managing their care to determine if an adverse event has occurred and, if so, to report it on the local adverse event reporting and learning system.

Patients who, having spoken to the relevant healthcare professional, remain concerned may then raise a complaint with the appropriate NHS Board. If they are unhappy with the final decision of the NHS Board, they could then pass their complaint to the Scottish Public Service Ombudsman for review.

If the treatment is a medicine or a medical device, there are existing systems in place for adverse events to be notified by healthcare professionals – the Yellow Card Scheme (Scheme) for medicines and Incident Reporting and Investigation Centre (IRIC) for medical devices. Alternatively, public and patients in Scotland can, if they wish, report both medicines and medical device incidents directly through the Scheme, which is used UK-wide.

If the treatment causing concern was bought at a retail outlet, such as a pharmacy, the patient or member of the public should return to the outlet where the product was purchased. Members of the public can also raise concerns with their local trading standards office, in addition to using the Scheme.

If a patient has an issue with a specific therapy or therapist - particularly for services provided in the private sector - they can contact the regulator for that particular profession, such as the General Chiropractic Council; Health and Care Professions Council, who regulate physiotherapists; or Healthcare Improvement Scotland (HIS), who regulate independent healthcare, including independent hospitals, private psychiatric hospitals, independent hospices, and independent clinics, for instance.

As NICE has already begun a comprehensive review and assessment of the most up to date clinical evidence available, we have committed to follow this review closely and will make a decision on updating the Scottish Good Practice Statement on ME once NICE has published its new guideline. This was due to be in 2020, however in light of the COVID-19 pandemic NICE has advised it is reviewing this and we expect to hear a revised timeline in due course.

The Cabinet Secretary and Dr Calderwood appeared before the Public Petitions Committee again last December and also subsequently both replied in writing earlier this year. This reflects our current position on GET and confirms we will review the advice on GET in Scotland when the findings of the NICE research has concluded and the updated NICE guideline on ME/ CFS is published. http://www.parliament.scot/S5_PublicPetitionsCommittee/Submissions%202020/PE1690_VV.pdf .

Ministers did not see resilience partnership plans following exercise Silver Swan. Regional Resilience Partnerships plans are not routinely shared with Scottish Government Ministers.

I refer the member to the answer to question S5W-29482 on 9 June 2020. 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 .