Chamber and committees

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.

The Scottish Government expects NHS Boards to ensure that information is provided to children and families about their stay on the ward, either prior to admission if the admission is planned or as part of the admission process. Nursing staff routinely involve children, their families and carers in conversations about what matters to them as part of developing the child’s plan of care, and we would expect further information about ward routines, and any other specific information that would be helpful to that particular patient, to be provided as part of these conversations.

In the 2018-19 Programme for Government we committed to having person-centred visiting on all wards by 2020. This approach is further supporting staff on paediatric wards to have person-centred conversations with children and families on the ward, and for families to be given access to as much information about their child as possible so they can be partners in care.

In June 2019 the Scottish Government published the revised Charter of Patient Rights and Responsibilities, which summarises what everyone is entitled to and what is expected of them when they use NHS services and receive NHS care in Scotland. The Charter includes information about people’s rights in relation to confidentiality, consent, complaints, access to health records and communication with NHS staff. Further information about people’s health rights in Scotland is available on the NHS Inform website, which also provides information about consent and confidentiality developed specifically for young people under 16.

The Patient Rights (Scotland) Act 2011 requires that NHS Boards make copies of the Charter available to patients, staff and members of the public free of charge, taking account of people’s needs when considering the appropriate format.

The Maternal and Infant Quality Improvement Collaborative, part of our Scottish Patient Safety Programme, has maternity, neonatal and paediatric work streams and is rolled out in all NHS Boards in Scotland. The programme, which is now in its 6th year of operation has focussed on improving safety in maternity care, and improving outcomes for mothers and babies.

Work is underway to deliver recommendations made in The Best Start: A Five Year Forward Plan for Maternity and Neonatal Care in Scotland to ensure all pregnant women have timely access to specialist advice when needed. The Maternal Medicine sub-group of The Best Start is leading work with the Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow to improve collaborative working in maternity care between physicians and obstetricians in the acute and chronic settings. This work has the support of both college presidents and priorities are strongly influenced by the MBRRACE-UK findings.

The Scottish Government recognises that it is essential to ensure that pre-eclampsia is diagnosed and treated as soon as possible. As part of developing an evidence base in this area, NHS Lothian intends to take part in a trial which will look at the benefits of repeated placental growth factor (PlGF) testing in the care of pregnant women. Work on developing a Women’s Health Group is also progressing and will prioritise the testing for pre-eclampsia in its workplan, looking at recent evidence.

Information on the number of cases of pre-term births, stillbirths and maternal deaths attributed to pre-eclampsia, eclampsia and HELLP syndrome recorded in each territorial Health Board is not collected centrally. I have asked my officials to explore whether it is possible to collate this information from various relevant sources and I will write to you following receipt of this information. However, the MBRRACE-UK Saving Lives, Improving Mothers’ Care 2016 report notes that less than one woman in every million who gives birth in the UK now dies from pre-eclampsia.