Chamber and committees

The asset management system will be rolled out to NHS boards on a phased basis between 19 January 2010 and 31 March 2010.

Guillain-Barr© syndrome (GBS) usually develops quickly, over a few days, but can sometimes develop gradually over a period of up to four weeks. Symptoms first appear one to three weeks after a minor infection, such as a cold or sore throat.

Initial symptoms tend to start in the feet and hands and include tingling, numbness, unsteadiness and progressive muscle weakness. These symptoms soon spread up the limbs, affecting the legs and arms a few days later. Some people only have a mild form of the condition and their symptoms do not get any worse than a general feeling of weakness.

In some cases, the muscle weakness progresses to temporary paralysis of the legs, arms and face, temporary paralysis of the respiratory muscles that control breathing, difficulty with eye movement and speech, difficulty with chewing or swallowing, difficulty with bladder control or digestion and slow heart rate or low blood pressure.

The extent of paralysis varies with each case of GBS but the most serious cases can paralyse respiratory muscles and stop the patient from breathing.

The Medicines and Healthcare Regulatory Agency (MHRA) monitor all reports of side effects and publish weekly reports outlining these cases. There have been two suspected cases of Guillain-Barr© syndrome (GBS) reported in the UK to-date following H1N1 vaccination. Further information is awaited in order to fully assess diagnostic certainty. There is no evidence across Europe of any vaccine associated risk of GBS.

The current condition of the two patients is unknown, however these cases were reported as not fatal. Eight in 10 people with GBS make a full recovery within a few weeks or months. One in 10 people become wheelchair-bound, or have permanent weakness or numbness. There is a 5% mortality rate from GBS.

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.

Two cases of suspected Guillain-Barr© syndrome (GBS) have been reported to the Medicines and Healthcare products Regulatory Agency (MHRA), following H1N1 vaccination in the UK to date. There is no evidence across Europe of any vaccine-associated GBS. GBS is a naturally occurring condition and it is inevitable that cases will occur not long after vaccination, without the vaccine playing a role. This is particularly so over the winter period when pathogens that may cause GBS are circulating.

The MHRA does not provide information on the location of these cases, given the very small numbers may mean that individuals could be identified.

The number of new cases of Guillain-Barr© syndrome (GBS) diagnosed in acute hospital care in Scotland in the last 10 years is as follows. Information on the number of cases of GBS is only available until year ending 2008.

1999	92
2000	99
2001	86
2002	95
2003	97
2004	111
2005	71
2006	88
2007	110
2008	109

 

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.

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.