Chamber and committees

There are no plans to introduce a HEAT target in relation to chronic pain services this year. The Scottish Government reviews HEAT targets on an annual basis with decisions on new targets based on evidence and impact.

The Scottish Intercollegiate Guidelines Network (SIGN) are currently developing a guideline for the management of chronic pain, with a public consultation event scheduled in December 2012. Following publication of the SIGN guideline consideration can be given as to whether HEAT can support improvement / delivery.

<>Information on how many pain consultants there are in multidisciplinary chronic pain teams in each NHS board area for (a) adult and (b) children services, is not held centrally. However, I would like to refer the member to the Benchmarking Report published by Healthcare Improvement Scotland on 26 October2012. http://www.healthcareimprovementscotland.org/programmes/long_term_conditions/chronic_pain/chronic_pain_update_report.aspx.

The audit has identified the current resources available in relation to NHS Board populations and provides up to date information on the provision of pain management services in each NHS Board area. This information will assist NHS Boards to identify any gaps and variation in local services and provides recommendations to inform planning and assist in the implementation of the Scottish Service Model for Chronic Pain.

The National Chronic Pain Steering Group continues to work closely with NHS Boards to seek updates on the progress in implementing the Scottish Service Model for Chronic Pain. NHS Boards that have or are establishing service improvement groups/Managed Clinical Networks for Chronic Pain will report regularly to the National Steering Group on their progress.

However, it is also for NHS Boards to ensure that the work of these groups/networks do deliver improvements and that their work feeds into local reporting and governance arrangements.

The Lead Clinician and the National Chronic Pain Steering Group are currently exploring a range of options for the provision of specialist chronic pain services. These will be discussed at a meeting scheduled with National Services Division of NHS National Services Scotland in early December 2012.

The Public Services Reform (Scotland) Act 2010, which established the Care Inspectorate, came into force on 1 April 2011.

The Care Inspectorate has expedited powers, to apply to the sheriff, under s65 of the 2010 Act for cancellation of the registration of a care service (including care homes) on the basis that unless the order is made “there will be a serious risk to the life, health or wellbeing of persons”. An order to cancel a service would have the effect of closing the service.

The sheriff has the power to make an interim order, which may include an order suspending registration pending a full hearing. If necessary, the Care Inspectorate can also impose an emergency condition of registration, which becomes effective immediately and remains in place until removed or successfully challenged on appeal.

The Care Inspectorate has made one application to the sheriff under section 65. In this case interim suspension was sought by the Care Inspectorate but this was refused. A date for a full hearing was fixed by the court, however by the time the case called, the action was no longer necessary as the service had improved and the action was therefore dismissed.

Lothian and Borders Police have confirmed that they are in the final stages of completing their report for the Crown Office and Procurator Fiscal Service in relation to the Elsie Inglis Care Home Inquiry. It is anticipated that this will be complete within the next fortnight.

As I announced on 11 September, I have taken the decision to introduce a Transcatheter Aortic Valve Implantation (TAVI) service in Scotland. This decision was based on the advice of the TAVI Short Life Group, who recommended that there should be a single centre providing TAVI for patients across Scotland, and that centre should be in Edinburgh.

The new service will be closely monitored over the next six to 12 months, and consideration will be given to expanding the provision of TAVI elsewhere in Scotland, as required.

As the national Transcatheter Aortic Valve Implantation (TAVI) service is now operational, NHS boards are able to routinely refer patients to the national service in Edinburgh. All new referrals should therefore be directed to the national TAVI service at the Royal Infirmary Edinburgh.

However, there may be some patients who have been assessed as requiring TAVI who had an existing individual patient treatment request approved prior to the launch of the national TAVI service. For these patients, it will be a matter for the patient, their clinician and the national TAVI service to make a judgement on whether it is appropriate for the individual to have the procedure in Edinburgh, or whether this should be carried out in another UK TAVI centre as previously planned.

The Scottish Government has worked together with NHS Scotland, through the National Planning Forum (NPF), to gather expert advice and evidence from clinicians, health professionals and planners from Scotland and elsewhere in the UK on the potential provision and location of a transcatheter aortic valve implantation (TAVI) service in Scotland.

On 11 September, I announced the decision to introduce TAVI in Scotland, based on the advice of the TAVI Short Life Group, who recommended that there should be a single centre providing TAVI, and that centre should be in Edinburgh.

The Care Inspectorate has confirmed that in 2011-12, 1 quality of care related improvement notice was not complied with. As a result, registration of the care service was cancelled.