Chamber and committees

The Oral Health Improvement Plan identified a range of actions, some of which have been completed. The current programme of work comprises two key highlights.

The introduction of new arrangements for dentists to provide enhanced domiciliary care in care homes. A second cohort of dentists are currently in training and the intention is for further cohorts to be rolled out next calendar year.

We have also launched an Oral Health Community Challenge Fund for Third Sector organisations to work with families living in areas of multiple deprivation to design and lead oral health improvement initiatives. The Fund comprises 22 projects throughout Scotland running from 1 July 2019 to 31 March 2022.

The incidence for cancer of the oral cavity by NHS board over the previous five years is shown in the following table.

Table 1. Caner of the Oral Cavity – Number of Registrations

Vaccination policy in Scotland, as with the rest of the UK, is based on recommendations from the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI is an independent, expert group which considers a full range of available evidence before providing advice on all aspects of vaccination.

In line with the Committee’s recommendation, this year, individuals aged 65 years and over will receive either the adjuvanted Trivalent Inactivated Vaccine (aTIV) (Fluad ®) or the cell based Quadrivalent Inactivated Vaccine (QIVc) (Flucelvax Tetra®). The aTIV vaccine contains an adjuvant and protects against three strains. The QIVc vaccine protects against four strains without an adjuvant. On the basis of the available evidence on vaccine effectiveness the JCVI considers both these vaccines to be equally effective in those aged 65 and over. In line with this, Health Protection Scotland worked with Immunisation Coordinators within each of the NHS Boards on the distribution of both flu vaccines.

a) Shona Robison, the former Cabinet Secretary for Health and Sport, met with the Caithness Health Action Team (CHAT) on 7 February last year to discuss health services in Caithness, and the Chief Medical Officer also visited Caithness to discuss the issues they raised. I am pleased to note that CHAT continues to engage with NHS Highland and will of course consider any request for a meeting with health services user representatives.

b) It is vital that all pregnant women in Scotland receive safe, high quality service and care. The decision to change the status of the Caithness Maternity Unit from an obstetric unit to a midwife-led unit was made on the basis of safety following a report conducted by Hugo Van Woerden, Director of Public Health at NHS Highland, available via the following link: https://www.nhshighland.scot.nhs.uk/News/PublicConsultation
/CaithnessRedesign/Documents/Caithness%20Report.pdf .

There are a range of reasons why patients may be inappropriately admitted to hospital. This can include admissions due to a lack of suitable community support to keep an older, vulnerable patient safe in their own home. Delays in hospital discharge, and the assessment of long-term care needs within an acute ward are also an inappropriate use of hospital services, and a poor outcome for the individuals concerned.

The Day of Care Survey is carried out twice yearly and identifies the number of patients who do not meet criteria for continuing care in an acute or community bed. The last survey in May 2019 identified 21% patients in an acute bed and 39% in a community bed could be cared for in an alternative setting or discharged home.

This government has made clear our commitment to ensuring every patient who arrives in A&E is treated in a timely way and that the care they receive is safe, person-centred and effective. Scotland’s A&E departments have outperformed those in the rest of the UK for more than 4 and a half years. Figures released in September show that this year we have seen more patients within four hours than in any year since 2012.

However, we recognise more needs to be done to improve and sustain A&E performance. We continue to work with Boards to ensure implementation of the six essential actions and that good practice is shared nationally. We have also put in place an intensive performance support team to work with those hospitals facing the greatest challenges to ensure immediate improvements.

To ensure resilience over winter, on 4 November we announced an additional £10 million would be allocated to health boards to help ensure that appropriate levels of staffing are in place across the whole system so patients are cared for at the right place at the right time and as close to home as possible. This is in addition to the £6.4 million already allocated towards improving unscheduled care.

The following table shows the mean and median waiting time by NHS Board for the year ending September 2019 and Scotland as a whole. The figures include both Emergency Departments and Minor Injuries Units.

Table 1 Mean and Median Waiting Time (minutes), Year Ending September 2019

The Scottish Government welcomes this report led by the Glasgow City Health and Social Care Partnership, and recognises the importance of ensuring that children and young people who are looked after are afforded the same opportunities as their non-looked after peers.

Increasing digital participation for all is a priority for the Scottish Government. We are committed to ensuring that everyone in Scotland is able to enjoy the social, cultural and economic benefits of the internet - and that includes looked after children. Access to the internet at home has increased to 87%, however we acknowledge that some young people still experience digital inequality, and that quality of access and levels of digital awareness and engagement across Scotland varies. We have invested £1.5 million in the Digital Participation Charter Fund, which aims to provide funding for organisations to assist digitally excluded people, including young people, to gain or improve basic online skills.

Across Scotland it is up to individual local authorities to decide how best to meet the needs of children and young people in all care settings. However this is defined, it must ensure that children and young people who are looked after by a local authority receive high quality care which reflects their rights, needs, views and best interests. The 2015 Standard for Residential Child Care, produced by the Scottish Social Services Council (SSSC), outlines the principles expected of all care staff in performing their duties to the young people in their care. This includes respecting a young person's right to communicate and access information about themselves, using their preferred methods of communication and language and encouraging them to be healthy, active and achieving. The Standard for Foster Care, published in 2017 by SSSC, also emphasises the importance of providing young people with an environment which supports inclusion, diversity, safety and social justice.

As Corporate Parents, local authorities have a responsibility to safeguard the young people in their care and carers must achieve a balance between supporting young people to access information, and ensuring that they are protected online. As stated in our National Action Plan on Internet Safety for Children and Young People (2017), the Scottish Government will engage with parent and carers organisations across Scotland to host a series of events aimed at empowering them to support their children’s online activity. Activity is also underway across primary schools to host a series of awareness-raising sessions aimed at parents and carers, providing them with the tools needed to keep children and young people safe online.

The Scottish Government welcomes this report led by the Glasgow City Health and Social Care Partnership, and recognises the importance of ensuring that children and young people who are looked after are afforded the same opportunities as their non-looked after peers.

As part of our approach to digital inclusion across Scotland we have invested £1.5 million in the Digital Participation Charter Fund. This fund provides funding for community digital participation projects throughout the country; helping those who are digitally excluded, including young people, to improve their skills. We have also committed to ensuring our children and young people are safer online, and are working to enable both parents and carers to support safe online activity.

In exercising their duties as Corporate Parents, local authorities have a responsibility to promote the rights and interests of young people, provide those children and young people with opportunities to participate in activities designed to promote their wellbeing, and be alert to matters which, or which might, adversely affect their wellbeing. This should extend to an awareness of the issues covered in the report.

The Health and Social Care Delivery Plan: Progress Report was published on the Scottish Government’s website today ( http://www.gov.scot/ISBN/9781839603389 ).

The Report sets out the good progress that has been made to date across our ambitious reform programmes. It commits to update the Delivery Plan by early 2020 to focus intent and sharpen activity on the remaining actions by 2021. The National Programme Board will continue to ensure reform progress remains on track.

The Scottish Government published guidance on the education of children and young people unable to attend school due to ill health in June 2015. This guidance provides advice on the roles and responsibilities of local authorities, hospital and other services to ensure that children and young people can continue to learn whenever possible. Hospitals should ensure that appropriate accommodation is provided so that education can be delivered.

The Food in Hospitals guidance covers catering services for children and young people, the guidance is detailed and outlines the complexity of ensuring that children and young people receive the required nutritional diet whilst in hospital. Boards are required to provide evidence of their compliance with the guidance, alongside their description of how they achieve compliance, or any actions required to meet the requirements. Live self-assessment will commence early next year, with a full national assessment and report available by the end of 2020.

Decisions about admittance to hospital wards are a matter for local NHS Boards, taking into account locality, available services and the diagnosis and circumstances of each individual child or young person.