Chamber and committees

A robust governance process is one important aspect of delivering effective care and meeting the Scottish Stroke Care Standards measured in the Scottish Stroke Care Audit.

That is why NHS Board reviews conducted by the Scottish Stroke Improvement Programme explicitly ask NHS Boards to set out their governance structure and any plans to improve this.

We have also asked every NHS Board to nominate an accountable individual to take overall responsibility of stroke care, including meeting the Scottish Stroke Care Standards.

The Scottish Stroke Care Standards are designed to enhance service delivery and improve patient outcomes. Monitoring performance against these standards through the Scottish Stroke Care Audit allows us to identify where challenges are being faced in the delivery of stroke care and implement quality improvements where required.

We recognise the standards are challenging and continue to expect Health Boards to identify aspects of their stroke services which do not meet these standards and to work to improve their standards of care locally to meet the Scottish Stroke Care Standards.

A tool for collection of empirical data relating to various stroke rehabilitation outcomes - such as time to rehabilitation assessment, creation of rehabilitation plans, commencement of rehabilitation, input from various Allied Health Professional specialities and time to commencing community rehabilitation - has been developed. Data collection with this tool is currently being trialled in two NHS Boards, with the aim of using this across Scotland once this has been assessed.

We are in the process of developing a tool to capture and publish patient experience of rehabilitation in each NHS Board.

The Scottish Stroke Care Audit already tracks the number of beds by health board as part of the Scottish Stroke Improvement Programme. This information will be added to the dashboard of the most recent annual report within the next two weeks.

We will continue to work with Public Health Scotland on the most effective methods of capturing and reporting organisational data, including staffing levels.

The revised criteria assessing NHS Boards requires more rigorous reporting on stroke service governance structures and data reporting, and these will take time to fully implement.

I expect NHS Boards to prioritise their stroke governance structures and have scheduled a roundtable meeting with the accountable individuals from all NHS Boards where the importance of service governance will be emphasised.

We expect staff providing care for individuals who have had a stroke to be fully trained in providing stroke care. However, in smaller Health Boards, it is not always possible to maintain a dedicated stroke unit.

A range of online stroke care competency training programmes are available and as part of the Scottish Stroke Improvement Programme review process all NHS Boards are asked to complete an education template highlighting the training stroke staff have undertaken.

We expect staff providing care for individuals who have had a stroke to be fully trained in providing stroke care. However, in smaller Health Boards, it is not always.

The cost incurred to date in relation to the planned National Treatment Centre in NHS Ayrshire and Arran, NHS Grampian, NHS Lanarkshire, NHS Lothian and NHS Tayside is as follows.

Legal advice was provided to individuals in relation to the Scottish Parliament Committee on the Scottish Government Handling of Harassment Complaints. The total costs were £151,811.17 (exclusive of VAT). This information is already published at Cost to Scottish Government of its participation of recent inquiry’s: FOI release - gov.scot (www.gov.scot)

The then First Minister, Nicola Sturgeon did not consult a lawyer of any kind ahead of her evidence session at the Scottish Parliament's Committee on the Scottish Government's Handling of Harassment Complaints.

The Scottish Government set out in June 2021 our plan for implementing the recommendations of James Hamilton’s report, alongside the recommendations of the reports by Laura Dunlop QC and the Scottish Parliament Committee on the Handling of Harassment Complaints. Implementation was delivered through the Continuous Improvement Programme, which was reported regularly to the Scottish Parliament’s Finance and Public Administration Committee. The final report on the Continuous Improvement Programme was provided in January 2023, and with the agreement of the Committee the programme was then concluded and activities absorbed into ongoing work.

The Continuous Improvement Programme, which delivered the Scottish Government’s implementation of the recommendations of the Scottish Parliament Committee on the Handling of Harassment Complaints, was concluded with the agreement of the Scottish Parliament’s Finance and Public Administration Committee in January 2023, with activities absorbed into ongoing work and annual reporting thereafter. The Scottish Government provided a written update to Parliament on ongoing actions on 17 May 2024, ahead of the Permanent Secretary giving evidence to the Committee on 21 May 2024.