Chamber and committees

Information on numbers of healthcare (a) staff and (b) professions and work times in prison settings is not held centrally. The responsibility and accountability for the provision of health care services to prisoners transferred from the Scottish Prison Service to the National Health Service (NHS) on 1 November 2011. These services are now provided by the respective local NHS Health Boards under the Health Board Provision of Healthcare in Prisons (Scotland) Directions 2011-National Health Service (Scotland) Act 1978.

The Health Board Provision of Healthcare in Prisons (Scotland) Directions 2011 contains the following directions from Scottish Ministers to health boards in relation to standards and training.

Health boards must ensure that the provision of healthcare meets the quality standards set out from time to time in guidance which has been issued to Health Boards by NHS Quality Improvement Scotland or by Healthcare Improvement Scotland.

Health boards must ensure that health care professionals are appropriately registered with the relevant professional body, that their registration is current and that they have such clinical experience and training as are necessary to enable the health care professional properly to perform such services.

Health boards must ensure that for any health care professional there are arrangements in place for the purpose of maintaining and updating the health care professional’s skills and knowledge in relation to the services which the health care professional is performing or assisting in performing.

Health boards must ensure that it affords to each employee in the practice reasonable opportunities to undertake appropriate training with a view to maintaining that employee’s competence.

In addition, the Scottish Prison Service (SPS) and individual prisons are responsible for the training of clinical staff for purposes of working effectively and safely within the prison setting. All NHS staff regardless of their role are required to complete mandatory SPS training. Any additional training is agreed locally between the Governor-in-Charge and NHS health board. The NHS provides staff with training specific to providing health care in a prison environment; this training will vary across each health board. Health boards should be contacted to provide this information.

Information on numbers of healthcare staff at each prison broken down by (a) day of the week and (b) profession is not held centrally.

There are 50 facilities with onsite rest facilities for on-call staff.

In some facilities, if required, additional or adhoc rest rooms are also available for residential on-call staff.

NHS boards and NHS Education for Scotland are responsible for recruiting to junior doctor posts, most through national recruitment programmes.

In response to concerns about Scotland's attractiveness as a place to train and work in medicine, the Strategy for Attracting and Retaining Trainees (START) was launched in April 2013 by NHS Education for Scotland. The overall aim of START is to increase fill rates for junior doctor posts and reduce gaps in training programmes.

The initiative has a number of recruitment goals including increasing fill rates by 5% by 2016 in hard to fill programmes in emergency medicine, general practice and psychiatry.

We have been investing in medical staff and since September 2006 there has been an increase in the number of doctors working in hospitals in NHS Scotland. Junior doctors numbers have risen from 5,336.1 to 5,796.7, an 8.6% increase, Consultant numbers have risen from 3,636.5 to 4,665.8, a 28.3% increase and specialty doctor numbers have risen from 810.3 to 1,042.9, a 28.7% increase.

New guidance on the exclusion from public contracts of companies which engage in blacklisting was launched by the First Minister on 20 November 2013. Compliance with public procurement guidance issued by the Scottish Government is mandatory for Scottish Government departments, its Agencies and Non-Departmental Public Bodies, including the Scottish Futures Trust (SFT). Other bodies in the public sector, including local authorities, are encouraged to follow this guidance, but its adoption is not mandatory.

Hub companies are working with SFT and their partners to implement the new guidance appropriately within the wider hub partnership arrangements.

We are considering ways in which the guidance can be placed on a statutory footing, including through amendment of the Public Contracts (Scotland) Regulations 2012 and through the Procurement Reform (Scotland) Bill, currently before Parliament which contains provisions relating on how a firm’s suitability to bid for contracts is assessed.

We are committed to continuing a constructive dialogue with Trade Unions on this issue and to explore ways in which the guidelines can be further developed.

Under the New Deal Contract, NHS boards are required to monitor the hours of work for junior doctors twice per year.

In this exercise, junior doctors self-monitor by recording the hours they work over a minimum period of two weeks. This information is then analysed by NHS boards and the results reported to the Scottish Government’s medical workforce adviser, as well as to junior doctors involved.

Junior doctors can, at any time, request to be monitored and NHS boards must comply with this request. They can also request that the monitoring itself is independently verified by the medical workforce adviser.

The Scottish Government welcomes the publication of this important national survey as understanding the views of trainees and trainers is essential to monitoring and improving the quality of postgraduate medical education and training.

NHS Education for Scotland (NES) is tasked with quality management of postgraduate medical education and training in Scotland.

Feedback from the National Training Survey (NTS) is triangulated against the NES Scottish Trainee Survey and other data sources and then compared with previous years’ responses. This analysis generates an action plan that is based on either the strength of available evidence about an issue, or the need for further evidence. The action plan comprises either a) visits by training leads from NES that typically focus on specific cohorts of trainees, in particular specialties and in particular locations or b) specific requests for clarification directed typically to the Directors of Medical Education employed in NHSS health boards.

When the issues that have been flagged via the NTS are verified, a specific action plan detailing areas for improvement is shared with the health board (or GP practice) with a timeline for implementation and instructions for evidencing improvement.

Our dedicated medical workforce adviser works with NHS boards to ensure that rotas comply with the required legal and contractual guidelines. No junior doctor rotas in NHS Scotland can be implemented without the approval of this adviser.

NHS boards undertake twice yearly monitoring of Junior Doctors rotas to ensure they continue to comply with the working time directive. In this exercise, junior doctors self-monitor by recording the hours they work over a minimum period of two weeks. This information is then analysed by NHS boards and the results reported to the Scottish Government’s medical workforce adviser, as well as to junior doctors.

We also fund software (Doctors rostering system) which ensures NHS boards have the relevant tools to design legal compliant rotas.

We continue to work with NHS boards and professional bodies to review best practice and how this can be used to improve the working lives of junior doctors, and we meet on a regular basis with the British Medical Association to provide reports on compliance with contracts and the working time regulations.

We have been investing in medical staff and since September 2006 there has been an increase in the number of doctors working in hospitals in NHS Scotland. Junior doctor numbers have risen from 5,336.1 to 5,796.7, an 8.6% increase, Consultant numbers have risen from 3,636.5 to 4,665.8, a 28.3% increase and specialty doctor numbers have risen from 810.3 to 1,042.9, a 28.7% increase.

Since 1 August 2009 all junior doctor rotas in NHS Scotland have been designed to meet the requirements of the working time regulations, which limits working hours to 48 hours per week on average over a 26 week reference period.

Before this, the new deal contract, limited hours to up to 56 per week which was averaged over the course of the agreed rota.