Chamber and committees

The national response time target for category A calls (life threatening) across mainland Scotland is that, by March 2009, 75% of all incidents should be reached within eight minutes.

The national response time target for category B calls (serious but not life threatening) across mainland Scotland is that, by March 2009, 95% of all incidents should be reached within 14, 19 or 21 minutes depending on population density. For the locations requested, the target is 21 minutes.

The information requested has been provided by the Scottish Ambulance Service for 2007-08 and is set out in the following tables.

Station	Cat A Demand	Cat A Performance	Cat B Demand	Cat B Performance
Arrochar	115	10.4%	144	50.7%
Helensburgh	773	54.6%	1702	92.3%
Vale of Leven	1,396	61.7%	2,488	94.6%

 

Station	Urgent Demand	Urgent Performance
Arrochar	61	88.3%
Helensburgh	986	89.5%
Vale of Leven	1,275	88.9%

Notes:

1. The figures provided are for activity recorded against Arrochar, Helensburgh and Vale of Leven Stations.

2. Urgent performance is measured by the service as the crew being at the patient within 15 minutes of the agreed time in 95% of cases. The time is agreed with the GP or hospital at the time of the call request and is determined by the needs of each patient.

The Scottish Government has already announced a record level of investment of £54 million over three years to tackle all healthcare associated infection, including Clostridium difficile.

In addition, all NHS boards have been instructed to ensure that they have an antimicrobial management team in place, and £520,000  has now been released to enable NHS boards to establish antimicrobial pharmacist posts which will support high quality prescribing.

The Scottish Government regularly reviews and updates the information that is made available on their website. Information about Clostridium difficile was last reviewed and updated following the publication of the independent review on 7 August 2008.

The review report was referred to the Lord Advocate because she is responsible for the investigation of deaths in Scotland. The Procurator Fiscal has a duty, on behalf of the Lord Advocate, to investigate all sudden, suspicious, accidental, unexplained and unexpected deaths, as well as deaths which give rise to serious public concern.

The majority of these deaths were not reported to the Procurator Fiscal at the time but when the full extent of the situation at the Vale of Leven Hospital became known, I ordered a review. In the circumstances, it was appropriate for the Procurator Fiscal to await the outcome of the independent review before considering what further action was necessary. However, the number of deaths at the Vale of Leven hospital has clearly given cause for concern within the community and it is therefore appropriate for the area Procurator Fiscal to conduct an independent inquiry into the circumstances of those deaths in the first instance.

If a medical practitioner knows the cause of death he/she can complete a death certificate. If not, the case should be discussed with the Procurator Fiscal who may decide there is enough information available to sanction the completion of a death certificate, or alternatively instruct further enquiry, which may include a postmortem. The NHS undertakes hospital postmortems with proper authorisation from the deceased person''s relatives, if a clinician wishes to learn more about the cause(s) of death. Postmortems very often reveal that a patient has more than one medical condition, some of which may not have been evident in life. Equally, the cause of death is still on occasion unknown, even following a postmortem. There is no legal requirement for a postmortem in cases of Clostridium difficile, and this condition is diagnosed by microbiological tests on stool samples in life.

The Scottish Ambulance Service (SAS) have advised that they intend to take forward the recruitment of an additional member of staff for the Arrochar station. In addition, this additional crew member will support the elimination of single-rostered crewing in this area.

The Scottish Government is committed to ensuring that the SAS continues to provide sage, efficient and effective services to patients across Scotland, including those in remote and rural area. It is also important that patients have confidence in the SAS''s ability to respond to emergencies.

While this presents particular challenges in remote and rural locations, the service seeks to improve performance for all patients and remains keen to seek local solutions that meet the needs of those communities. In addition, the SAS has appointed a first responder co-ordinator in this area to develop and support first responder schemes.

It is important to ensure that performance targets are challenging but deliverable. On that basis, the national performance target for responding to category A calls was revised to be achieved across mainland Scotland by March 2009, rather than within each individual NHS board area.

We recognise that achievement at a Scotland-wide level will mean that there may be some communities where this target is not routinely being met. That is why the Scottish Government is looking for the Scottish Ambulance Service (SAS) to demonstrate that across all parts of Scotland it is working to secure continuous improvement, particularly in remote and rural areas.

The Scottish Government and the SAS are committed to ensuring safe, efficient and effective health services across all parts of Scotland, including remote and rural areas. The SAS will continue to work with local partners to achieve this.

I refer the member to the answer to question S3W-12770 on 15 May 2008. 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/webapp/wa.search.

The Scottish Ambulance Service and NHS 24 have provided the following tables of information. It is not possible to give an absolute definition of the catchment area for the Vale of Leven Hospital as it relates to these organisations so the tables set out the postcode sectors that have been used to capture the information.

(a) Emergency Incidents Attended by the Scottish Ambulance Service

Postcode Sector	Area	2007-08	Quarter 1 2008-09
G60-5	Bowling	307	77
G82-1	Dumbarton	498	126
G82-2	Dumbarton	455	104
G82-3	Dumbarton	478	114
G82-4	Dumbarton	573	136
G82-5	Cardross	499	98
G83-0	Alexandria	1,210	276
G83-7	Arrochar	131	42
G83-8	Luss	611	181
G83-9	Arrochar	509	133
G84-0	Roseneath	276	72
G84-7	Helensburgh	512	120
G84-8	Helensburgh	602	166
G84-9	Helensburgh	171	46
PA248	Lochgoilhead	42	13
PA258	St Catherine''s	4	1
PA268	Cairndow	17	2
PA328	Inverary	135	30
Total		7,030	1,737

 

(b) Calls to NHS 24

Postcode Sector	Area	2007-08	Quarter 1 2008-09
G60-5	Bowling	1,401	311
G82-1	Dumbarton	1,021	191
G82-2	Dumbarton	1,573	314
G82-3	Dumbarton	1,391	309
G82-4	Dumbarton	1,569	408
G82-5	Cardross	1,358	341
G83-0	Alexandria	2,111	530
G83-7	Arrochar	193	47
G83-8	Luss	1,727	443
G83-9	Arrochar	2,387	574
G84-0	Roseneath	819	185
G84-7	Helensburgh	1,314	319
G84-8	Helensburgh	1,250	312
G84-9	Helensburgh	1,083	259
PA248	Lochgoilhead	103	39
PA258	St Catherine''s	4	3
PA268	Cairndow	15	0
PA328	Inverary	63	27
Total		19,382	4,612

Notes:

*Cowal Peninsula has not been included as it is assumed to be within the catchment for Inverclyde Royal.

**Areas north of Tarbert (on the Loch Lomond side) are not included as these are assumed to go to Glasgow or Stirling.

***Ambulance Service systems report incidents attended rather than numbers of calls. This is, for example, because there can be duplicate calls for one incident.

Health Protection Scotland is part of National Services Scotland, and NHS Quality Improvement Scotland is a special health board. National Services Scotland and NHS Quality Improvement Scotland are accountable to Scottish ministers who hold annual reviews in public.