Chamber and committees

Management information shows the following number of practices were closed to new patient registrations in each NHS board:

No-fixed abode also includes individuals with a mobile lifestyle, such as travellers, and people with multiple residences, or those living temporarily with friends or family.

Analysis is based on the number of discharges. Individual patients may appear a number of times in a calendar year and in more than one year.

In 2012 a review of SMR01 data quality, only 67% of the discharge/transfer to code was found to be correct at a Scotland Level, therefore this data should be treated with caution.
(See https://www.isdscotland.org/Health-Topics/Hospital-Care/Publications/
2012-05-08/Assessment-of-SMR01Data-2010-2011-ScotlandReport.pdf ).

The total number of discharges with a discharge/transfer to code of 'No Fixed Abode' in Scotland each year between 2007 and 2018, reported to NHS Information Services Division is detailed in the following table:

Information on the number of people who have been prescribed methadone is not held centrally.

NHS Information Services Division (ISD) publish figures on the Scottish Public Health Observatory (https://www.scotpho.org.uk/behaviour/drugs/data/treatment-for-drug-misuse/ ) on drugs used for the treatment of opioid dependency in Scotland, which includes dispensing of methadone hydrochloride. Published figures show that over the ten year period 2007-08 to 2017-18, the number of dispensed items for Methadone has reduced by 14%, from 492,908 dispensed items to 423,656.

Data for 2007-08 to 2017-18 can be seen in the following table:

In 2014 the Heart Disease Improvement Plan was published, the purpose of which was to ensure that priorities remain current and that in Scotland we continue to strive towards improved prevention, treatment and care of heart disease. At its meeting on 28 April the National Advisory Committee for Heart Disease (NACHD) it was recognised that as it was five years since the Heart Disease Improvement Plan's publication, it was timely to discuss the potential for its next steps. Officials will consider if a review is required, and NACHD will discuss this at its next meeting in the autumn.

There are a number of specialist cardiac services and provisions for children with heart conditions in Scotland. These include:

• a paediatric cardiology centre, which includes a nationally commissioned neonatal and Paediatric Cardiac Service, at the Royal Hospital for Children in Glasgow
• a paediatric cardiology centre at the Royal Hospital for Sick Children in Edinburgh.

There are also paediatricians with an interest or expertise in cardiology at the Royal Aberdeen Children's Hospital, Ninewells Hospital, and in most district general hospitals that are not in remote or rural areas. Outreach is also provided by cardiologists from Glasgow and Edinburgh to other NHS Boards.

Scottish Specialist Transport and Retrieval (SCOTSTAR) support transfer of sick neonates or children to Glasgow. Other paediatricians and neonatologists are able to perform ultrasound scans of children's hearts and send/discuss these with a cardiologist in Glasgow or Edinburgh, which is especially useful for emergency presentations.

Paediatric cardiac services are arranged as a national service so that skills and expertise can be concentrated to maximise outcomes for the smaller patient numbers. This is in line with the Scottish Government's National Clinical Strategy that some services be planned on a population basis to ensure the greatest clinical expertise and the best outcomes. Services are regularly reviewed.

Standards for both adult and paediatric specialist congenital cardiac services were issued in 2018.

Clinical nurse specialist roles provide support to people living with a range of conditions across the life spectrum and operate across hospital and community settings. The First Minister announced on 7 January 2015 that up to an additional £2.5 million recurring funding would be made available across Scotland to enhance clinical nurse specialist provision and care, with £700,000 allocated to enable the number of specialist motor neurone disease nurses to be doubled, and funded from public funds.

NHS Boards across Scotland have benefited from the additional investment. The Scottish Government's Report on the Specialist Nursing and Care Fund, published in September 2017, shows how this investment has been used by NHS Boards to increase the number of clinical nurse specialists by 31.35 whole time equivalents. Some NHS Boards have used a proportion of this funding to invest in training.

The majority of Lyme disease cases can be diagnosed and treated in primary care without the need for specialist input, however where specialist input is needed such cases would be cared for by Infectious Disease Consultants.

Increasing awareness amongst the public of ticks and Lyme disease is an on-going priority for the Lyme Borreliosis group which is part of the Scottish Health Protection Network. The group has produced a number of educational resources for the public which can be accessed at: https://www.nhsinform.scot/bugs-and-germs .

This information is not held centrally. Figures on violence and aggression towards NHS Scotland staff are collated by Health Boards, in line with the relevant policies and procedures.

The following table, from Justice Analytical Services provides data on convictions between 2008-09 and 2017-18 under the Emergency Workers (Scotland) Act 2005.

Since 2015, the Scottish Government has provided additional financial support to NHS Boards of over £2.4 million to enhance clinical nurse specialist provision and care. The report on the specialist nursing and care fund, published in September 2017, outlines the additional clinical nurse specialist capacity in NHS Boards resulting from the funding that they received. The report can be accessed here: https://www.gov.scot/publications/report-specialist-nursing-care-fund/ .

Reports from NHS Boards in May 2017 showed that specialist nursing capacity had been enhanced through this additional investment alone by 31.35 whole time equivalents.

Information on which drugs are currently available through NHS England but not in Scotland, and vice versa is not readily available.

The Scottish Drug Tariff list those items which are reimbursable to community pharmacies if presented with a prescription form. The English Drug Tariff lists the reimbursement prices for prescribed medicines in England and Wales.

Local prescribing formularies are put in place by each NHS Board in Scotland and will be based on range of issues including general population, prevalence, cost effectiveness, clinical decisions and appropriateness for the patient concerned. Each NHS Trust and Clinical Commissioning Group in England will have similar processes in place.

With regard to (b), the current list of “all-UK” specialist services is published by National Services Division, a division of NHS National Services Scotland : NSD list of Nationally funded services .

Guidance on the prescribing, and the reviewing of prescriptions, of methadone, and other opioid substitute therapies is available to all NHS Boards through the 'Drug Misuse and Dependence: UK guidelines on clinical management' (2017 Clinical Guidelines). These guidelines were commissioned by the Chief Medical Officers of England, Scotland, Wales and Northern Ireland and updated in 2017.

The 2017 Clinical Guidelines were designed to guide clinicians and commissioners in the provision of the right balance of interventions, which have the greatest likelihood to produce individual benefit and public good.

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 .