Chamber and committees

A mid-year progress report on the implementation of the Change Fund was considered by the Health and Community Care Delivery Group on 6 September 2011. The report identified that by the end of September 2011, Partnerships planned to spend £10.6 million, and a further £47.7 million between October 2011 and March 2012. This position is likely to change as we progress towards year-end.

It is for partnerships to agree locally how to deal with underspend or slippage in 2011-12, the initial year of the Change Fund’s operation, as long as this meets the objectives of their Change Plans. Any agreed underspends will be carried forward to 2012-13 and partnerships will ensure this is spent on Change Fund Plans.

There is no centrally held data on the cost savings of HIV prevention in Scotland specifically, however data exist on cost savings at the UK level.

In 2008, UK data from the Health Protection Agency (HPA) indicated that HIV-related costs would have been reduced by £1.1 billion if those 3,550 HIV infections that were diagnosed in the UK in that year were in fact prevented (HPA, 2009).

Additionally, lifetime costs for HIV treatment are estimated to range between £280,000 and £360,000.

This information is not held centrally.

The Scottish Government do not provide NHS boards with additional funding for HIV treatment costs. NHS boards pay for HIV drug treatments, as with other treatments, from their overall allocations.

In September 2011, partnerships were projecting to spend £58.3 million of the £70 million allocation in year 2011-12, with an overall forecast underspend for that year of £11.7 million. This position is likely to change as we progress towards year-end and is primarily a result of this being the first year of the Change Fund. Overall, good progress is being made by partnerships on implementing the Change Fund.

It is for partnerships to agree locally how to deal with underspend or slippage in 2011-12, the initial year of the Change Fund’s operation, as long as this meets the objectives of their Change Plans. Any agreed underspends will be carried forward to 2012-13 and partnerships will ensure this is spent on Change Fund Plans.

The Care Inspectorate does not collect data on emergency hospital admissions from care homes. The Care Inspectorate will, however, investigate in circumstances where an emergency hospital admission resulted in a complaint which identified concerns about the care practices leading up to that admission. Further, if the admission was notified to the Care Inspectorate as a significant incident in line with the legal requirements on notifications by providers the Care Inspectorate would consider whether additional enquiries were necessary.

More widely, as part of the intelligence-led approach, the Care Inspectorate is currently examining what data, including statistics on overall levels of emergency admissions, should form part of the systematic evidence base that informs the decisions it takes on the planning and handling of inspections.

Since 1 April 2011, the Care Inspectorate logged 992 new complaints.

As of 31 October 2011, 907 complaint investigations had been completed, of which 242 were upheld, 412 were partially upheld, 252 were not upheld and one was withdrawn.

If a care home does not comply with an Improvement Notice, the Care Inspectorate must consider what appropriate action to take. Each Improvement Notice is unique to the service to which it is issued, however options available to the Care Inspectorate include issuing a proposal to cancel registration or, where progress has been made but not completed, allowing additional time for the Improvement Notice to be complied with. At every stage, the Care Inspectorate takes a risk-based judgement on the impact on the health and well-being of the people who use the service.

Local authorities and health boards are fully engaged at the point of consideration of taking any enforcement action. This allows the Care Inspectorate to consider what actions they need to take regarding people who use the service and to consider any support, such as training, they can provide to assist towards improvement.

Statistics on average and maximum lengths of time between inspecting a care home and issuing an improvement notice are not collected. However, service providers are given full oral feedback on any concerns arising as a consequence of inspection or complaint shortly after the inspection visits. Where emergency conditions of registration are imposed, these become effective immediately.

Subject to local agreement on appropriate financial governance arrangements consistent with their Change Plan objectives, it is open to all partnerships to augment their change fund allocations by using supplementary funding from other sources, including local authorities.

The Reshaping Care for Older People Change Fund was established in 2011-12 using a portion of the NHS board uplift resulting from the 2010 Scottish Spending Review. The Fund will continue to be distributed through NHS boards’ baseline funding over its four year lifecycle.