Chamber and committees

Good hygiene can help limit the spread of the norovirus infection, and to ensure best practice in the prevention and treatment of norovirus outbreaks in health boards Health Protection Scotland (HPS) published, on 1 December 2009, revised guidance on norovirus outbreak: control measures and practical considerations for optimal patient safety and service continuation in hospitals. Details are available on their website at: http://www.hps.scot.nhs.uk/haiic/ic/publicationsdetail.aspx?id=43440.

HPS have also published the following guidelines specifically aimed at non health board communities vulnerable to norovirus outbreaks.

14 March 2005: Infection Control In Adult Care Homes: Final Standards.

1 April 2005: The identification and management of outbreaks of norovirus infection in tourists and leisure industry settings. Guide for NHS boards and local authorities.

1 December 2006: Guidance on Infection Control in Schools and other Child Care Settings.

1 August 2007: Guidance for the management of norovirus infection in cruise ships.

NHS boards health protection teams will respond to norovirus outbreaks in the community and give advice, and one of their roles is to exclude other gastrointestinal pathogens. As well as guidance on the prevention and treatment of noroviruses the importance of hand hygiene in preventing infections spreading has been promoted with the following guidance and campaigns:

January 2007: Germs. Wash your hands of them - Scotland''s Hand Hygiene Campaign, Germs. Wash your hands of them, with the aim of reducing avoidable illness amongst staff, patients and the general public.

August 2009 “ the Scottish Government''s national hand hygiene campaign was launched with a campaign pack sent to every nursery and primary school.

1 September 2009: Hand Hygiene - Standard Infection Control Precautions “ HPS publication.

The Scottish Government can confirm that NHS Health Scotland''s corporate communications activity for external audiences is central to their role in disseminating and explaining public health improvement and health inequalities evidence, learning and good practice to professionals. These include professionals who are responsible for delivering campaign messages on the ground “ such as frontline staff and decision-makers in NHS health boards, Community Health Partnerships, local and central government, community and voluntary organisations, Royal Colleges, and health improvement agencies across the UK and internationally “ as well as the media and politicians. They do this through their stakeholder newsletter, briefings and corporate reports. They have budgeted £30,000 for this work in 2010-11.

I refer the member to the answer to question S3W-31550 on 4 March 2010. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

The Scottish Government''s continuing focus on outcomes through the concordat, single outcome agreements and national policies, contribute to the culture change required to realise the ambitions of the Changing Lives report. Working with key stakeholders and partners, we continue to develop and embed tools and approaches which support a confident, competent and valued workforce and the personalisation of services to improve outcomes for individuals, families and communities. This includes supporting the Scottish Social Services Council (SSSC) work with employers to embed the Continuous Learning Framework which focuses on four key areas including the organisational capabilities which describe the culture and conditions in the workplace that enable social service workers to be the best they can be; a self-evaluation guide from the Social Work Inspection Agency focussing on the achievement of outcomes for people who use services, carers and the wider community; driving forward the leadership agenda through collaboration with the SSSC and four Social Services Learning Networks; supporting the Association of Directors of Social Work to take forward the key aspirations of the Changing Lives report, especially in relation to what is needed to deliver personalised support and services and also supporting work they are doing with Local Practitioners Fora.

Social service employers have primary responsibility for skills development in their workforce, linked to requirements set by the Scottish Social Services Council (the council). To support what is done at local level, the Scottish Government has set aside a budget of £30 million in 2010-11. This includes funding for: the council; four learning networks to support delivery of regional learning and development priorities across all sectors of the workforce; four centres for excellence raising skills in key sectors of the workforce; development and promotion of Social Services Knowledge Scotland, an integrated portal providing national access to information and learning resources; development of a Social Services Managed Knowledge Network integrating health and social care learning; work by the Institute for Research and Innovation in Social Services to promote evidence-based practice and personalisation, and finally tools and activity to build effective leadership across the sector. This does not include resources that are provided by other parts of the Scottish Government to support skills development arising from specific policy objectives.

Funding beyond 2010-11 is not known as this will be subject to the next spending review.

The Scottish Government has undertaken a range of activities to support the development of capacity of social care providers.

An example in the third sector is the investment of £4 million over 2009-11 to charities from local, regional and national play organisations, through the Go Play programme, which is being managed and administered by Inspiring Scotland. The aims of the programme are to help the play sector in Scotland grow and offer increased opportunities for play to children aged five to 13 years as well as tackling health inequalities through play, outdoor play and physical activity. Inspiring Scotland will bring in additional resources to build the capacity of the play sector through pro bono support from the private sector. It will also work with organisations to build their funding in the longer term from a variety of sources including local authorities, trusts and foundations and engagement with the broader philanthropic world.

The Scottish Government also awards grants annually to a range of voluntary organisations that contribute to the delivery of our priorities for community care. Over £3 million has been awarded for 2010-11 and many of the grants awarded will contribute to the capacity of the voluntary social care providers concerned. A further £2 million has been awarded for 2010-11 to the voluntary sector for training.

Social care provision is often delivered jointly across health and local authorities involving a range of service providers. Working with stakeholders, the Community Care Outcomes Framework was developed in answer to calls from local partnerships who wanted an outcome-focussed approach to monitoring and improving joint performance in community care. By focussing on six complementary themes, the framework emphasises improving whole system performance across the broad spectrum of community care services. Midlothian Community Care Partnership has been funded to develop an independent Scottish Community Care Benchmarking Network, using the Framework to scrutinise and compare local performance. All Community Care Partnerships are choosing to use some or all of the Community Care Outcomes Framework so that they can understand their own performance better, and compare it with relevant benchmarking partners in order to identify opportunities for improvement.

To help improve the capacity to meet the needs and expectations of the Scottish public, and also contribute to improved health and social care outcomes for people using services, an Integrated Resource Framework (IRF) is being developed by the Scottish Government, NHSScotland and COSLA. This seeks to shift the balance of care and improve outcomes for people by working in a more integrated way within the NHS and across health and social care. Through identifying what resources are currently being spent and where, and whether or not this could be improved, local partners will be better placed to arrange the optimum configuration of future health and adult social care.

A joint capacity building programme is being developed by the Scottish Government and the Improvement Service to assist and support Community Planning Partnerships in delivering the local outcomes in SOAs, with a particular focus on achieving a shift towards early intervention and prevention in the delivery of public services. This programme will build on existing approaches, tools and techniques.

The Scottish Government also supports building capacity of providers in more indirect ways. For example, in June 2008 the National Care Standards Awareness Raising Campaign was launched. The campaign focuses on making older people aware of the Standards and how they are used. It fulfilled the commitment in the All Our Futures: Planning for a Scotland with an Ageing Population. The campaign included TV and radio ads and a touring theatre production explaining the importance of the Standards which visited care homes and day centres. The final phase is running now and is aimed at people who receive care in their own homes and the care services that provide their care. Although not directly targeted at social care providers'' capacity, it should contribute indirectly to them improving the quality of service they provide.

Similarly the establishment of the Multi-Agency Resource Service, the Scottish Child Care and Protection Network and the National Coordinator for Child Protection Committees increase the resources, skills and experience available to service providers and practitioners as do the wide range of activities to develop a confident, competent and valued workforce.

I refer the member to the answer to question S3W-31550 and S3W-31552 on 4 March 2010 which also provide relevant information. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

In response to concerns about the sustainability and fairness of current and future care for older people in the face of financial and demographic pressures, a major work programme “ Reshaping Care for Older People “ is being taken forward in partnership with NHSScotland and COSLA through the Ministerial Strategic Group on Health and Community Care.

The programme aspires to develop practical ideas for change that are sufficiently radical to meet the changing needs of Scotland''s population by enabling people to stay at home or in a homely setting, with maximum independence, for as long as possible. A key aim is to ensure that service providers can respond effectively to future demand for services, and this work will have far-reaching and important implications for the workforce as a whole and for those who design, deliver and manage these services. An Integrated Resource Framework is also being developed and tested across four sites in Scotland, from which evidence is being gathered about how resources can be used most effectively across health and social care.

So far the programme has focussed on discussion with colleagues with a professional and clinical interest in delivering services for older people. As part of a wider engagement process and to further analyse and develop these proposals, the programme will from March 2010 until the summer seek views from the public and from a wider range of stakeholders including patients, service users and service providers.

Because so many of Lord Cullen''s recommendations have practical implications for the Scottish Court Service and the Crown Office and Procurator Fiscal Service, the Government is involved in discussions with these bodies in identifying how the recommendations should be implemented. It is not possible at this stage to provide a timescale for implementation.

I refer the member to the answer to question S3W-31678 on 3 March 2010. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

Core participants can already be represented at fatal accident inquiries (FAI) and bereaved families may receive legal aid if they cannot afford to pay for that representation.

The purpose of a fatal accident inquiry is to investigate the circumstances of death in the public interest - to try to avoid similar incidents in future.

Procurators fiscal have a public duty to fulfil at the inquiry, including leading evidence to establish the cause of death. The fiscal will meet with the family to discuss the conduct of the FAI. They will inform the family as to the witnesses and evidence they intend to produce and what line of questioning they intend to pursue. Often the fiscal will ask the family if there are any particular questions or issues that they wish raised.

In some circumstances, however, the families may have questions that the fiscal does not feel it would be appropriate to ask in the public interest. Families may wish to ask questions intended to establish whether there are grounds for civil proceedings following the fatal accident inquiry. In such cases the families may instruct their own legal representative.

If the family cannot afford to pay for legal representation, they may be eligible to receive legal aid. The Scottish Legal Aid Board can make legal aid available where a person entitled to be represented at a fatal accident inquiry can show that they have concerns which the procurator fiscal is not going to raise at the Inquiry.

Any application for legal aid will be subject to the usual statutory tests of financial eligibility, probable cause and reasonableness, that is, whether it is reasonable in the particular circumstances of the case that legal aid should be provided.

Lord Cullen has recommended that relatives of the deceased should not have to justify the reasonableness of the granting of legal aid for their representation at the FAI and that Scottish Ministers should consider increasing the limit for legal aid in FAIs and the extent to which legal aid is available within that limit. Scottish Ministers will consider this proposal in conjunction with the Scottish Legal Aid Board.