Chamber and committees

There are no specific upper or lower age limits for bariatric surgery. It is not generally recommended in children or adolescents, but may be considered in exceptional circumstances. Decisions to treat will be jointly made between clinicians and patients, taking account of relevant guidance and the patient’s individual circumstances, including their fitness for surgery.

Clinical guidelines on the appropriate use of antipsychotics to help manage stress and distress symptoms exhibited by all people with dementia are contained in the Scottish Intercollegiate Guidelines Network national clinical guideline for the management of people with dementia (SIGN 86).

Revised polypharmacy guidance published by the Scottish Government in March 2015 reinforces the principles on the appropriate review and reduction of the use of antipsychotics in people with dementia and identifies three groups which practitioners should prioritise for review: people in care homes, those with vascular dementia, and those with dementia who also have a history of cardiovascular disease, cerebrovascular disease or other vascular risk factors.

The Scottish Government’s first Standards of Care for Dementia in Scotland (2011) set out clear standards on responding to stress and distress in people with dementia in all care settings. Managing symptoms should involve the development of a multidisciplinary and integrated care plan and psychoactive medication should only be used where there is no appropriate alternative and where there is clear benefit to the person receiving the medication.

The Education (Additional Support for Learning) (Scotland) Act 2004 provides the framework for individual support which underpins young people’s access to educational opportunities in Scotland. This framework enables authorities to provide support for learning, for any reason, in the short or long term. Patterns of attendance and absence often provide indicators of the need for support.

The attendance rate in Scottish schools has remained steady at just over 93% in recent years with pupils' rate of attendance increasing from 93.1 per cent in 2010-11 to 93.6 per cent in 2012-13. However, the Scottish Government recognises that more needs to be done to promote good attendance at school. Making sure pupils are included, engaged and involved in their education is fundamental to achievement and attainment in school. Absence from school, whatever the cause, disrupts learning.

To support this we have developed, with key stakeholders, Included, Engaged and Involved Part 1: attendance in Scottish schools. This document provides guidance to schools, communities and local authorities on how to promote engagement and motivation, including among those who may be at risk of poor attendance.

NHSScotland boards disclose private patients’ income in their annual accounts. The following table details income received from private patients in each year since 2006-07. The income from private patients represents only 0.05% of boards’ net operating costs.

Income from Private Patients (£ million)

Source: NHSScotland boards’ annual accounts

The Scottish Government has provided over £0.5 million to the National Deaf Children’s Society (2011-16) to support families with a deaf baby. The first phase of the project developed resources to help parents understand how to communicate with their deaf baby or toddler from birth through to starting school, so they can get the best start in life.

The second phase (from May 2013) is supporting families with deaf children aged 0-8 years, providing language skills for the child at a critical age and developing the sign language and communication skills of the rest of the family as well as providing good parenting skills so that the child is nurtured and has the best possible chance of emotional well-being and academic success. Services include one-to-one and telephone support, sign language and audiology training courses and parenting courses as well as peer support networks. In the first 18 months of the award, the project has directly supported a total of 181 parents from 130 families across 6 local authority areas.

The Scottish Council on Deafness (SCOD), which chairs the British Sign Language and Linguistic Access Working Group has recently completed a report setting out progress in key areas and concludes that “since 2009, many of the desired outcomes in the roadmap have been achieved, if not in their entirety, then at least in part”. While some progress has been made towards gathering data on deaf people, for example the inclusion of a question on British Sign Language in the 2011 census, there is currently no baseline and no performance indicators in place to measure performance in most areas highlighted in the roadmap.

However, the Equality and Access for Deaf People project funded by the Scottish Government and hosted by SCOD since 2012 has started to build a picture of current need and provision for deaf and deafblind people across the public sector. This work will be further developed through Scottish Government funding in 2015-16.

The roadmap, developed by the British Sign Language and Linguistic Access Working Group, was designed as a resource for central and local government and other public bodies, to enable them to make informed judgements about linguistic access in a policy context. It sets out a vision for what needs to be in place to improve linguistic access for deaf and deafblind people and identifies eight long-term aims; one of these is that all public services are deaf and deafblind aware.

The Scottish Government does not collect information on deaf and deafblind awareness in public bodies but has taken steps to address this in a variety of settings. Since 2009, the Scottish Government has undertaken a range of activities to address the exclusion and discrimination which deaf and deafblind people face. For example, during 2014 we ran deaf awareness sessions for two key groups of staff to support them in understanding the issues faced by colleagues and customers with hearing loss. NHS Education for Scotland (NES) have commissioned a deaf awareness training pack and course, to be co-delivered by an approved deaf trainer and a member of NHS staff. NHS 24 provide an e-learning deaf awareness course for all their staff, call centre staff as well as HR and senior management so that deaf and hearing colleagues can enjoy the same levels of support as well as those who use the services provided.

In 2014, the Scottish Government published the Sensory Impairment Strategy, which recommends that “Local partnerships should audit their skills base in relation to awareness of sensory impairment in the workforce and take steps to address any deficits identified.”

Yes but currently only a few schools offer pupils continuous British Sign Language (BSL) learning of this kind. However the 1+2 policy will offer opportunities as local authorities introduce wider language learning in schools and BSL will be part of this landscape of growing provision. Schools and local authorities will plan which languages to offer based on a range of factors including teacher skills, relevance to young people in a particular cluster of schools, local circumstances such as links to business and job opportunities and the availability of opportunities to progress and obtain qualifications. The Scottish Qualifications Authority already has a suite of national qualifications units in BSL at various levels, and as with other languages this provision may develop further in coming years.

NHS 24 delivers safe and effective services to more than 1.5 million people a year. Its performance is measured against an access service level which aims to achieve 90% of calls answered within 30 seconds. NHS 24 achieved 97% in 2013/14 and consistently exceeds this target.

Since the introduction of 111 in April 2014, NHS 24 has seen a sustained increase in demand for its unscheduled care service. NHS 24 is responding to this in its Workforce Plan through recruitment of additional call handlers and clinical staff who deliver clinical governance of the unscheduled care service. The challenges in recruiting nursing staff are being addressed through innovative trials aimed at attracting a more diverse range of nursing backgrounds.

NHS 24 staffing increased by 4.6% between September 2014 and December 2014 and under this government, NHS 24 staffing levels have increased by 9% (from 924.3 whole time equivalent in September 2006, to 1,010.3 in December 2014).

The need for a national eligibility framework was originally identified in 2008 in reports on Free Personal Care published by Audit Scotland and subsequently by Lord Sutherland’s Independent Review of Free Personal and Nursing Care in Scotland.

The Free Personal Care Access and Entitlement to Services Group was asked to establish proposals for consistent and transparent eligibility criteria and waiting times.

Joint guidance on Eligibility Criteria for free personal and nursing care was issued by the Scottish Government and COSLA on 28 September 2009.

Local authorities were asked to confirm by 1 December 2009 that their local arrangements were compatible with the guidance. All 32 local authorities have confirmed that this is the position.