Chamber and committees

Guillain-Barr© Syndrome (GBS) affects approximately 1,500 people in the UK every year. The trend in the number of new cases of GBS diagnosed in Scotland does not show a statistically significant increase between 1999 and 2008. Complete data for 2009 is not yet available.

The National Advisory Group for Breast and Cervical Screening advice is to maintain the current age range for the Scottish Breast Screening Programme.

The group will consider any new evidence provided by the age extension in England and provide further advice on the age range in Scotland in due course.

The Scottish Ministers accept the recommendation directed at the Scottish Government relating to the use of the care programme approach (CPA). Guidance was issued on the use of CPA in CEL 13 (2007) and CEL 19 (2008). The guidance indicated that whilst CPA is mandatory for restricted patients, CPA should be used for cases where there are concerns about the risk to others posed by a patient. Health boards were asked to identify a senior manager responsible for providing the assurances on the quality of the operation of the care programme approach.

It is our intention to write shortly to health boards asking them to provide evidence that a senior manager has been appointed, that an audit into the use of the CPA has been carried out and will also ask for a copy of the results of that audit.

Information on the numbers of wards closed to admissions or visitors due to infection control measures in general is not available centrally.

Health Protection Scotland monitors ward closures due to norovirus outbreaks via management information derived from the Scottish HAI Outbreaks Reporting System (SHORS) however:

SHORS does not include counts of wards with visitor restrictions and

SHORS data is not collected at individual hospital level.

The number of wards closed in NHSScotland due to presumed or confirmed Norovirus outbreaks, broken down by individual health boards, for each Monday in 2008 and 2009 (Monday Point Prevalence) are available from the Scottish Parliament Information Centre (Bib. number 49977).

It should be noted that:

Reporting to SHORS is voluntary and not all single ward outbreaks are necessarily included in the tables,

The prevalence data is management information and relates to the number of wards closed at any time on a Monday. It is not possible, therefore, to provide an annual total of ward closures from this source,

Outbreaks resulting in ward closure starting on a Tuesday (or later) and finishing on a Sunday (or earlier) are not included in the prevalence data,

Ward closures occurring on a Monday that are still ongoing the following Monday will be counted twice even though they relate to a single outbreak.

Yes, the Scottish Parliamentary Corporate Body does allow paid time off for employees to attend the mobile blood transfusion service when it visits the Parliament.

All NHS boards publish reports on their websites using the HAI reporting template introduced in January 2009. The content and substance of each report varies by board but, as a minimum, all NHS boards publish Clostridium difficile and Staphylococcus aureaus Bacteraemia data by month and by hospital.

A short-life working group has been established by NHS Scotland to review the structure and presentation of the HAIRT and to consider what changes are necessary in order to make the information, as presented, more consistent across NHS boards and easier to understand. This group will report the outcomes of its finding in the New Year. I expect their recommendations to be adopted and implemented in full by all NHS boards. It is anticipated that the revised mandatory template will be rolled out from March 2010.

The Scottish Parliamentary Corporate Body is aware of this good practice and already allows its staff paid time off to attend the mobile transfusion service when it visits the Parliament.

The review of the role of the senior charge nurse (SCN) was completed in 2008, with the key aim of creating a modern role which maximised the SCNs contribution to delivering safe and effective care. Leading Better Care, launched in June 2008, established a national role framework for SCNs working in hospital settings across NHS Scotland. The framework for the role includes four core responsibilities:

Ensuring safe and effective clinical practice (including responsibilities for tackling healthcare associated infection),

Enhancing the patient experience,

Managing and developing the performance of the team and

Contributing to the delivery of the organisation''s objectives.

The national progress reporting process is demonstrating that Leading Better Care is providing NHS Scotland with SCNs who are visible, approachable and empowered clinical leaders, who are being supported in fulfilling their role as guardians of care quality and clinical standards. SCNs also have a key role in implementing clinical quality indicators (CQIs) for nursing and midwifery which cover food, fluid and nutrition, falls, pressure ulcer prevention and in monitoring of infections within their clinical area “ a key element of Scotland''s patient safety programme.

Leading Better Care set out the aim that the framework for SCNs and the CQIs should be fully implemented within NHS boards by December 2010.

Efficiency savings are a key component of financial plans contributing to the overall financial performance of NHS boards. All boards have savings plans and all boards continue to forecast either breakeven or an underspend in 2009-10. The following table provides an analysis of in-year efficiency savings (2009-10), broken down by NHS board.

Every penny of the efficiency savings made by NHS boards is retained and reinvested by the board in frontline patient care.

Efficiency Savings (2009-10)

NHS Boards	Forecast (£m)
Ayrshire and Arran	11.3
Borders	5.1
Dumfries and Galloway	4.8
Fife	10.1
Forth Valley	9.0
Grampian	17.3
Greater Glasgow	49.4
Highland	15.6
Lanarkshire	15.8
Lothian	24.8
Orkney	1.7
Shetland	1.2
Tayside	14.1
Western Isles	1.8
NHS Boards Total	181.8
NHS Special Health Boards
Scottish Ambulance Service	6.9
National Services Scotland	5.6
NHS 24	1.2
The State Hospital	1.3
National Waiting Times Centre Board	0.8
NHS Education Scotland	0.9
NHS Health Scotland	0.4
Quality Improvement Scotland	0.1
NHS Special Health Boards Total	17.2
Grand Total	199.0

 

Efficiency savings are a key component of financial plans and contribute towards overall financial performance. NHS Scotland boards are currently forecasting delivery of additional efficiency savings of £199 million for 2009-10, exceeding the in-year target of £159 million by £40 million.

All boards are projecting either financial breakeven or an underspend in 2009-10.

Every penny of the efficiency savings made by NHS boards is retained and reinvested by the board in frontline patient care.