Chamber and committees

One of the key principles of the Vaccination Transformation Programme will be to implement new models of delivery that do not adversely impact on uptake rates. While GPs will no longer be responsible for the delivery of vaccinations, it is likely that general practice premises will still be used to deliver vaccinations allowing opportunistic immunisation to continue. Different delivery options and a changing NHS and public health landscape may also provide opportunities and benefits which are not possible within current arrangements. At present local variation in uptake of the flu vaccine across GP practices is monitored closely and appropriate interventions applied to improve uptake. New Primary Care clusters will work closely with HSCPs and make use of intelligence and data to continue monitoring uptake in their areas and provide support as necessary.

The Vaccination Transformation Programme will not mandate how Health Boards will deliver vaccinations in their area. Rather the programme will support Health Boards in implementing local delivery solutions that best suit them, their patients, and their geography. The solutions developed may involve establishing immunisation teams, contracting local GPs, or a combination thereof. As service providers, the local Health Board will ensure that the service they design provides best value for money.

A core principle of the Vaccination Transformation Programme is that services will continue to be delivered to patients in a safe, sustainable and acceptable way. It will be a matter for Boards locally to determine whether or not any change in service provision will warrant consultation with the public, for example if there is a meaningful change in how patients access services, but in many cases this is not likely to be necessary.

In some parts of the country NHS Boards have already taken over responsibility for delivering vaccinations previously delivered by GPs, and all NHS Boards currently deliver school-based vaccinations.

Hepatitis C (HCV) prevention remains a priority for the Scottish Government as set out in our Sexual Health and Bloodborne Virus Strategy. All NHS Boards and partners continue to work to prevent new infections, promoting best practice in relation to HCV prevention, diagnosis and treatment.

Monitoring the impact of our investment in prevention and treatment strategies on the incidence of infection remains a challenge as new infection incidents are difficult to measure directly, given that the infection can be asymptomatic and undiagnosed. However, there is evidence to suggest that the prevalence of injecting drug use in Scotland has decreased in recent years, which indicates that the overall number of HCV infections in people who inject drugs is likely to have decreased. In Scotland, HCV is mainly transmitted among injecting drug users.

Despite advertising internationally there were no suitable candidates for the locum surgical post.

National Services Division has advised that the two surgeons will still provide the current service and ensure that patients are being managed within clinical protocols. NHS GG&C has confirmed that the surgeons are content with this position and are now supported by a full team of specialist nursing and administrative staff.

The current service will continue to be monitored by NHS GG&C to ensure patients are being managed appropriately and that the impact on the surgeons is being assessed accordingly. This approach is ensuring that all patients receive time appropriate surgery.

This information will not be available until after the publication of the Scottish Local Government Finance Statistics 2016-17 in February 2018.

The Scottish Government Hepatitis C Treatment and Therapies Group has established a Short Life Working Group to generate guidance on how best to identify hepatitis C infected people who are either undiagnosed, diagnosed but never in follow up, or diagnosed and lost to follow up. The Group will report back to the Scottish Government in mid 2018. it will also make recommendations on new models of care and treatment for infected people in the context of the highly effective and safe therapies for hepatitis C now available.

This table contains the data available by calendar year to 31 December 2016 regarding the number of people reported to be diagnosed hepatitis C positive in Scotland.

¹ ‘NHS Board’ refers to the person's NHS Board of residence, or where this is not known, the NHS Board of source of referral.

This table contains the data by financial year for people initiated onto hepatitis C treatment in Scotland to 2016-17.

Hepatitis C treatment data by NHS Board has only been reported routinely since 2011-12.

*2011-12 initiations are based on the NHS Board where treatment was administered, however 2014-15, 2013-14 and 2012-13 initiates are based on NHS Board of residence where known.

The Orkney/Shetland/Western Isles data are summarised as a collective total and proportion in a combined Island NHS Board field.

NA - not applicable. There are no specialist HCV services available in these NHS Board areas.

Minutes of a meeting of Scottish Government officials with Chief Officers and Chief Finance Officers of a number of Integration Joint Boards, along with COSLA to discuss the implementation of Free Personal Care for under 65's, which took place on 26 October 2017, will be published on the Scottish Government website in the near future. Membership of this group will be expanded to form an implementation advisory group for the extension of free personal care. Minutes from this group will also be published on our website.

The 2017 Pulmonary Rehabilitation survey, published by Chest Heart & Stroke Scotland in partnership with the Scottish Pulmonary Rehabilitation Action Group notes that completion of pulmonary rehabilitation is a well-recognised challenge for a number of reasons, including the unpredictable nature of respiratory health.

Overall completion rates in Scotland are similar to those reported elsewhere in the United Kingdom.

Through the Respiratory National Advisory Group we would encourage the sharing of best practice from areas with higher completion rates and recommend that other solutions, such as digital are explored to help overcome some of the barriers highlighted in the survey.