Chamber and committees

Healthcare Improvement Scotland (HIS) is not a special health board. HIS was set up under the terms of the Public Services Reform Act (2010) as a health body, independent of the organisations it inspects (both NHS and non NHS) and reports independently of Scottish Government.

This is an operational matter for the Scottish Ambulance Service, the information requested is not held centrally.

The Scottish Ambulance Service have advised that they do not use private ambulance services, or other private sector transport (including taxis), in place of ambulances or patient transport.

The Scottish Ambulance Service has a Memorandum of Understanding with the British Red Cross Society (BRCS), which helps the Service respond to patient needs, for example, during adverse weather. The BRCS make ambulance vehicles available should these be required. The Service also works with the BRCS during periods of anticipated high demand, such as the festive period and other key dates during the year such as pay days. This arrangement delivers an additional layer of resilience and support at times of peak demand.

The Service works with approximately 200 volunteer car drivers across the country, who undertake patient transport journeys where this is clinically appropriate, particularly in remote and rural areas.

Please note that specific coding for transvaginal mesh implant procedures was introduced in 2006. Annually complete data is only available since 2007-08.

The Medicines and Healthcare Products Regulatory Authority (MHRA) has not issued any medical device alert on transvaginal mesh products. However, MHRA commissioned the University of York Health Economics Consortium to conduct a systematic review of the available literature.

The report of the review together with advice and information for patients and clinicians was published on 22 November 2012 and is available at the following website:

http://www.mhra.gov.uk/Safetyinformation/Generalsafetyinformationandadvice/Product-specificinformationandadvice/Product-specificinformationandadvice%E2%80%93M%E2%80%93T/Vaginalmeshforpelvicorganprolapse/

This information is not held centrally.

The most frequently reported side effects have included mesh exposure, pain, sexual problems, mesh erosion and occasionally injury to nearby organs such as the bladder or bowel.

Information is not held centrally on the number of women who have been affected by side effects.

The information requested is not held centrally.

Officials are in regular contact with colleagues in the Medicines and Healthcare Products Regulatory Agency (MHRA’s) about a range of issues including transvaginal meshes. This topic has been the subject of discussions at the MHRA’s Committee on the Safety of Devices, committee papers are available from the following website:

http://www.mhra.gov.uk/Committees/Devices/index.htm

In addition to discussions within the last month, there was also discussion in November 2012 when the University of York Health Economics Consortium produced its report on Summaries of the Safety/Adverse Effects of Vaginal Tapes/Slings/Meshes for Stress Urinary Incontinence and Prolapse which is available at the following web-site:

http://www.mhra.gov.uk/Safetyinformation/Generalsafetyinformationandadvice/Product-specificinformationandadvice/Product-specificinformationandadvice%E2%80%93M%E2%80%93T/Vaginalmeshforpelvicorganprolapse/

National Procurement, which is part of NHS National Services Scotland, has confirmed that it supplies some transvaginal mesh devices to health boards through the National Distribution Centre. These devices are not included in a national contract but are supplied in response to catalogue requests from NHS boards for specific makes and type of device.

As the value and volume of products supplied through National Procurement is relatively low there are no plans to move this to a National Contract.