Chamber and committees

I refer the member to the answer to question S5W-29244 on 29 May 2020. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx .

We welcome the report facilitated by Epilepsy Scotland on the impact of Covid-19 on people with epilepsy in Scotland.

We recognise this is a worrying and distressing time for everyone, including those with specific health and social care needs. In order to assist people with long-term conditions to understand the risks of Covid-19 and to signpost them to resources that can provide support, we have published guidance available at https://www.gov.scot/publications/coronavirus-covid-19-tailored-advice-for-those-who-live-withspecific-medical-conditions/ . This includes information about the national helpline (0800 111 4000) that enables people to access wider support such as food and medicine deliveries, and emotional wellbeing.

We remain committed to improving neurological care and support in Scotland, as set out in the National Framework published at the end of last year. Over the past few months we have kept in regular contact with stakeholders including the many third sector neurological organisations that represent the neurological community in Scotland, and a newly established clinical network across all Health Boards. This has helped us monitor activity and understand the priorities and challenges. While non-urgent elective appointments have been postposed, services have dramatically increased the use of telephone and/or Near Me video consultations to ensure people continue to be able to access care throughout the pandemic. Other digital healthcare innovations have included the use of the vCreate cloud-based service, which enables transfer of short recorded video in healthcare settings. This new service was deployed to all Scottish intensive care units during Covid-19 and has been adapted to enable patients and carers to share seizure videos for remote clinical interpretation and management advice. The Chief Nursing Officer also asked Nursing Directors to ensure they prioritise community support for the most vulnerable. We are now working with Health Boards as they consider how all services can be safely and incrementally re-mobilised.

We are listening to experiences such as those highlighted by Epilepsy Scotland and using these views to inform ongoing decisions about our response to the current public health emergency, as set out through the Framework for Decision Making and more recently Scotland’s Route Map through and out of the crisis. This includes understanding more about the harms from Covid-19, harms from disruption to non-Covid-19 health and social care, and harms from the introduction of physical distancing and impact of loss of wider freedoms on wellbeing and lifestyles.

We are therefore working with partners across the UK, through the National Institute for Health Research, and also through investment in 55 rapid research projects via our Chief Scientist Office in Scotland, to better understand the impact of Covid-19. Further information is available at https://www.cso.scot.nhs.uk/rapid-research-in-covid-19-programme/ .

This information is currently not available. NRS plan to publish more detailed analysis of COVID-19 deaths, including information on pre-existing conditions mentioned on the death certificate, in due course.

a)

During the first year of the Perinatal and Infant Mental Health Programme, as set out in the Perinatal and Infant Mental Health Programme Board Delivery Plan 2019/20 , we have focused on a set of initial actions to implements the Perinatal Mental Health Managed Clinical Network’s Delivering Effective Services: Needs Assessment and Service Recommendations for Specialist and Universal Perinatal Mental Health Services recommendations. As part of this work, we have invested in community services in the North of Scotland which will inform the development of a model that can be adapted and rolled out across Scotland in 2020-21 and beyond.

Work to roll out this model across Boards in the current financial year has had to be paused due to Covid-19 pressures.

However, we are now recommencing this work where possible, and the Chair of the Board will shortly meet each health board to agree guidance and protocol for wider roll out of expanded specialist community perinatal teams as well as funding to support these developments.

The Perinatal and Infant Mental Health Programme Board Delivery Plan for 2020-21 will be published in the coming weeks and will set out further actions to implement the recommendations in the Delivering Effective Services Report, as well as additional actions the Programme Board considers necessary to ensure women, babies and families receive the support they need.

This data is centrally held by Public Health Scotland (PHS). The following tables present the number of admissions to Mother and Baby Units in Scotland in the period 2017 – 2019 (up to and including December 2019), broken down by treatment unit and year of admission in Table 1 and then further broken down by patient health board of residence in Table 2.

Table 1. Number of admissions to Mother and Baby Units by Year, 2017-2019.

The Perinatal and Infant Mental Health Programme Board (PNIMH-PB) agreed to undertake a review of access to MBU inpatient care for women with the most severe perinatal mental illness. A Short Life Expert Working Group (SLWG) was established to address three distinct areas:

- To articulate the evidence of need for additional MBU inpatient capacity.

- To consider the current impact on other mental health services when patients are not cared for in an MBU.

- To make recommendations to the PNIMH-PB regarding appropriate next steps.

The consensus from the professionals of the SLWG, including representatives from the Managed Clinical Network who made the original recommendation, was that there was not currently sufficient evidence to suggest need for additional beds. Additionally, there may be a number of sustainability and safety concerns with establishing a third MBU. Before undertaking a formal options appraisal, the SLWG advised that community perinatal mental health specialist teams needed to be established in order to see what impact that had on services and demand initially.

Once initial work to establish community specialist teams is underway, the Programme Board will consider the need to commence a formal options appraisal, which might also consider alternative models of specialist support for women with acute perinatal mental health needs. We will also take into consideration the views of women and families when considering the options for additional MBU provision.

This will be a key priority in the forthcoming Programme Board Delivery Plan for 2020-21.

Yes, the Perinatal and Infant Mental Health Programme Board has commissioned the Perinatal Managed Clinical Network to carry out this review, in conjunction with The Robertson Trust.

There are two Mother & Baby Units (MBUs) in Scotland. These are at Leverndale in Glasgow and St John’s in Livingston.

NHS Greater Glasgow & Clyde has contractual arrangements with: NHS Ayrshire and Arran, NHS Dumfries and Galloway, NHS Highland (Clyde), NHS Lanarkshire and NHS Western Isles. Patients from these Boards are routinely admitted to Leverndale.

NHS Lothian has contractual arrangements with: NHS Borders, NHS Fife, NHS Highland, NHS Tayside, NHS Orkney and NHS Shetland. Patients from these Boards are routinely admitted to St John’s.

NHS Grampian and NHS Forth Valley do not hold contractual arrangements with either MBU but are able to access either resource on a case by case basis, in accordance with clinical need.

Please see answer to S5W-28880 on 18 May 2020 for information on additional Mother and Baby Units. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: http://www.parliament.scot/parliamentarybusiness/28877.aspx

I refer the Member to the answer to question S5W-28877 on 18 May 2020. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: http://www.parliament.scot/parliamentarybusiness/28877.aspx

In addition, we are investing £825,000 for additional specialist staffing at the two Mother and Baby Units in Scotland (St John’s Hospital in NHS Lothian and Leverndale Hospital in NHS Greater Glasgow and Clyde), enabling them to become centres of expertise which will help support development of specialist community teams.