Chamber and committees

The Scottish Government expects NHS Boards to provide the best possible care for those who have experienced a stroke, including thrombolysis where considered clinically appropriate.

The Scottish Stroke Improvement Programme (SSIP) report, published on 28 June and available at: https://www.strokeaudit.scot.nhs.uk/index.html , notes a clear effect of the waves of COVID-19 on hospitals.

Stroke admission numbers often fell during the early waves of the pandemic, with patients possibly avoiding seeking medical attention due to the COVID-19 pandemic, and this may help explain the increase in stroke admissions between 2020 and 2021. The trend of increased stroke admissions between 2020 and 2021 is not unique to NHS Lothian and was observed across Scotland.

The proportion of patients who received thrombolysis in NHS Lothian in 2021 (8.9%) was broadly in line with the proportion of stroke patients who received thrombolysis across Scotland (9.1%).

There have been four Gateway Reviews of Scotland’s Deposit Return Scheme. Regular Gateway Reviews are a standard part of the Scottish Government’s project management framework, there is no requirement to notify the Scottish Parliament in advance when a Gateway Review is commissioned.

Since May 2021 the Cabinet Secretary for Justice and Veterans has taken a number of meetings and attended events at which victims/survivors have been present. As people will not always disclose or wish to mention the nature of their experiences, or want these recorded, it is not possible to provide a definitive answer. However, at least 14 meetings and events over the period where victims/survivors have been present have been identified.

As of 19 July 2022 we had issued 79 letters to people receiving Personal Independence Payment to let them know the transfer of their award to Adult Disability Payment has begun. These cases were selected as part of our small Personal Independence Payment to Adult Disability Payment pilot. Once Adult Disability Payment launches nationally on 29 August, we will begin selecting large numbers of Disability Living Allowance and Personal Independence Payment awards for transfer.

We have also developed and are delivering a strategic communication and engagement plan for case transfer. This includes a series of stakeholder roadshows to key stakeholders as well as stakeholder newsletters. We have also included case transfer messaging in our Adult Disability Payment communications such as media releases, opinion pieces, social media posts on Scottish Government and Social Security Scotland channels and paid for marketing campaigns that have run in the pilot areas. Paid for activity has covered radio, social media, digital and print. We will continue implementing this communication and engagement plan as the case transfer process continues.

The guidelines for the diagnosis of thrombosis and similar artery and vein clot conditions are provided by the Scottish Intercollegiate Guidelines Network (SIGN), specifically SIGN 122 for the prevention and management of venous thromboembolism.

The Diagnostics in Scotland Strategic Group (DiSSG) is the national group that holds responsibility for ensuring the continued coherent development and delivery of high quality diagnostic services in Scotland. The DiSSG acts as an advisory board including providing strategic direction and advice on new diagnostic tests.

The NHS Recovery Plan commits to innovation in diagnostic procedures and an increase in capacity over the next 5 years of 90,000 procedures by 2025-26, including diagnostics of thrombosis and similar artery and vein clot conditions.

Case transfer is a joint programme between the Scottish Government and the Department for Work and Pensions. We aim to have safely and securely transferred the awards of everyone living in Scotland in receipt of devolved disability and carer benefits currently delivered by the Department of Work and Pensions to Social Security Scotland by the end of 2025.

From 29 August 2022, adults in Scotland in receipt of Disability Living Allowance will have their awards moved to Adult Disability Payment if they would otherwise have been asked by the Department for Work and Pensions to apply for Personal Independence Payment. Final policy is still being developed on moving the awards of all other adults currently in receipt of Disability Living Allowance.

It is not possible to provide the percentage of individuals admitted to NHS Scotland who are assessed for venous thromboembolism (VTE) as this data is not routinely recorded.

The General/Acute and Inpatient Day case Dataset (SMR01) contains records where pulmonary embolism and phlebitis and thrombophlebitis of the lower extremities are listed as the primary diagnosis.

These conditions are usually recorded in an inpatient setting, on the SMR01. The structure of the International Classification of Disease and Related Health Problems 10 revision (ICD10) does not allow for easy identification of Venous Thromboembolism.

We have undertaken significant engagement with people who have lived experience of energy limiting conditions and organisations which represent them. Adult Disability Payment has been designed to be inclusive and accessible for people with energy-limiting conditions. Applications can be made through a choice of channels and the questions are relevant to people with fatigue and fluctuating conditions. Social Security Scotland makes entitlement decisions based on the individual’s account of the impact of their disability or condition and other supporting information, including from people’s wider support network. This is particularly helpful for people who may have difficulty accessing a diagnosis or treatment.

Consultations between a client and a health and social care practitioner employed by Social Security Scotland will only be held when necessary. Examinations, such as asking clients to touch their toes, will not be used as they do not provide reliable information, especially in relation to energy-limiting conditions. Social Security Scotland case managers also stringently apply the reliability criteria. This means that entitlement decisions must take into account the full impact fatigue has on individuals when completing activities, including any recovery time needed afterwards.

Regular open and constructive engagement with the early learning and childcare sector continues to be a vital part of our approach to policy development. This includes engagement with the sector representative bodies, and through the Childcare Sector Working Group, which last met on 16 June 2022.

Scottish Government and Education Scotland’s ‘Realising the Ambition – Being Me’, the national practice guidance on supporting young children’s learning, was published in 2020. Private providers contributed to its development via sector representative bodies and through a series of consultation events held across Scotland in order to seek the views of practitioners working in the public, private, third and childminding sectors.

All NHS Boards in Scotland already have access to resources to support the early prevention of thrombosis-related deaths. These include SIGN 122, the national clinical guideline for the prevention and management of venous thromboembolism. The implementation of SIGN guidelines is the responsibility of NHS Boards.