Chamber and committees

The Scottish Government welcomes the Royal College of Paediatrics and Child Health's State of Child Health report which reaffirms the work currently underway across government to improve child health. The Scottish Government is carefully considering all of the recommendations in the report to identify any further work needed.

Many of the report's recommendations are already being taken forward in Scotland including: rolling out the Family Nurse Partnership to reach every eligible teenage mother in Scotland by the end of 2018; prioritisation and expansion of the health visiting service provided to families; bringing forward a Child Poverty Bill for Scotland; maintaining our commitment to support people in Scotland affected by the UK Government's welfare cuts; providing a Baby Box for all newborn babies; progress in achieving the UNICEF UK Baby Friendly best practice standards; placing relationships, sexual health and parenthood education at the centre of the school curriculum; achieving the target of halving exposure to second hand smoke through the Take it Right Outside campaign five years early; investing in a range of programmes to support and encourage healthy eating; investing in free school meals for all primary one to three children; investing in physical education in schools; exceeding our target of delivering 150 Community Sport Hubs across all local authorities; working on a new Mental Health Strategy which will focus on the earliest and most effective interventions to prevent children and young people from becoming ill; and committing to producing an overarching child health and wellbeing strategy to consolidate all of the actions.

Through substantial financial investment and the implementation of successive strategies to improve diagnosis and treatment pathways, Scotland has achieved one of the most effective whole-system approaches to Hepatitis C in the world.

The success of our approach is demonstrated by the decline in Hepatitis C Virus-related liver failure in Scotland from 156 cases in 2014 to 121 in 2015, a 22% reduction. If this trend continues, the Scottish Government is on track to achieve its strategic goal to reduce such disease presentation by 75% by 2020.

Any prescribing or referral for psychological therapies treatment is a clinical decision for a patient’s doctor in discussion with the patient and in terms of anti-depressants there is good evidence that GPs assess and treat depression appropriately. All GPs prescribing is monitored and discussed individually through annual appraisal. Audit of prescribing in mental health commonly occurs involving Health Board pharmacy departments. There is National annual reporting of prescribing patterns and trends which are carefully considered by Government and other agencies.

Data is published by Information Services Division on the number of people referred to psychological therapies and starting treatment each quarter, Psychological Therapies Waiting Times In NHSScotland, as well as on the level of prescribing for mental health published on an annual basis, Medicines used in Mental Health, which includes the level of prescribing for anti-depressants. These reports are available online at http://www.isdscotland.org/Publications/. The Scottish Government has also published “Key Information on the use of Antidepressants in Scotland” which can be found online at: http://www.gov.scot/Resource/0045/00456540.pdf.

The National Clinical Strategy is the Scottish Government’s blueprint for health and social care over the next 15 years. It’s one of the key drivers that will help deliver transformational change across our NHS.

Its foundation is to provide care as locally as possible through a whole-team, community-based approach which is vital to the future of the NHS, allowing people to continue to be treated close to home, or in their home, in the majority of cases.

The National Clinical Strategy sets out why the NHS in Scotland needs to adapt in the face of increasing and changing demand, along with significant constraints in terms of workforce and finances. The National Clinical Strategy sits alongside the Health and Social Care Integration and GIRFEC to ensure that there is a comprehensive approach to both improving the health of the population, and the healthcare available.

The Scottish Government has supported and funded Crohn’s and Colitis UK in the production of “Scotland Leading the Way - a National Blueprint for Inflammatory Bowel Disease in Scotland”, which seeks support NHS Boards in improving care and treatment for all people living with inflammatory bowel disease in Scotland.

The information relating to which hospitals do not have dedicated transition services from paediatric to adult care is not centrally held.

The Scottish Government expects NHS boards to have well-structured transition arrangements in place, which meet the needs of their local population, regardless of where in Scotland the young person lives.

The national policy regarding age appropriate hospital care for children and young people was outlined in Better Health, Better Care: Hospital Services for Young People in Scotland published on 5 May 2009. The national policy considered the importance that transfer from paediatric to adult services should be the culmination of a period of planned transition care and emphasises the need for good transition arrangements for young people moving into the adult care sector across all specialities.

The Scottish Government has supported and funded Crohn’s and Colitis UK in the production of “Scotland Leading the Way - a National Blueprint for Inflammatory Bowel Disease in Scotland”, which seeks support NHS boards in improving care and treatment for all people living with inflammatory bowel disease in Scotland.

The Blueprint makes a number of recommendations for NHS boards in relation to the care of treatment and young people and including the need to have standardised transition to adult services.

Work is underway to plan for implementation of the recommendations in The Best Start. We will take this planning work forward in partnership with boards, including the Scottish Ambulance Service to develop a comprehensive understanding of the resource implications of the recommendations.

The Scottish Ambulance Service, through funding from the Scottish Government and NHS boards, deliver the ScotSTAR (Scottish Specialist Transport and Retrieval) Service. The service undertakes all neonatal transfers providing a safe and dedicated transport service for a group who, because of their clinical condition, may require an augmented clinical team during transport.

The Scottish Government expects NHS boards to have well-structured transition arrangements in place, which meet the needs of their local population, regardless of where in Scotland the young person lives.

The national policy regarding age appropriate hospital care for children and young people was outlined in Better Health, Better Care: Hospital Services for Young People in Scotland published on 5 May 2009. The national policy considered the importance that transfer from paediatric to adult services should be the culmination of a period of planned transition care and emphasises the need for good transition arrangements for young people moving into the adult care sector across all specialities.

The Scottish Government has supported and funded Crohn’s and Colitis UK in the production of “Scotland Leading the Way - a National Blueprint for Inflammatory Bowel Disease in Scotland”, which seeks support NHS Boards in improving care and treatment for all people living with inflammatory bowel disease in Scotland.

The Blueprint further reinforces the need makes a number of recommendations specific to this area. A number of trials have taken place across Scotland including virtual and telephone clinics, the trial has meant that patients can avoid long journeys to physical clinics, also ensuring the necessary care could be provided in the appropriate timescale to support the patient.

The latest Health Protection Scotland estimate from 2015 is that there were 35,900 people in Scotland living with chronic hepatitis C.

Approximately 8,600 people have been initiated on Hepatitis C Virus therapy since the launch of Scotland’s Hepatitis C Action Plan Phase II in 2008. This has contributed to a significant fall in the total number of infected people in Scotland, a reduction from a peak of 39,000 in 2009.

It is for NHS boards to plan and deliver clinical services and ensure that they have the correct staff in place to meet the needs of their services and ensure high quality patient care. As part of this we expect them to have robust workforce plans and recruitment and retention policies in place which take account of health visitor vacancies and retirements.

In addition the Scottish Government has committed to delivering an additional 500 Health Visitors by 2018, and we have invested £3.3 million since 2014 to support additional training.

Record keeping of an individual’s care is an important aspect of a nurse’s role and contributes to ensuring quality of care. As part of their role nurses and midwives must keep clear and accurate records relevant to their practice. This requirement is set out in the revised Nursing and Midwifery Council’s Code, which came in to effect from 31 March 2015, and further details of the requirements can be found at - https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf

In addition as part of our Excellence in Care work programme, led by our Chief Nursing Officer, we will be including work on record keeping.