Chamber and committees

Data from 2016-17 is provided below, data from the financial years 2012-13 to
‎ 2015-16 was provided in the answers to questions S5W-08627 on 24 April 2017 and S5W-08983 on 10 May 2017.

As highlighted in the answer to questions S5W-08627 and S5W-08983, there are issues around the quality of this data. This means that accurate comparisons between local authorities and between years cannot be made. A lack of consistency in how local authorities have broken down the information to primary, secondary and special categories means that this data does not consistently represent the levels of spending in different categories of schools in local authorities.

Table 1 shows gross revenue expenditure on additional support for learning education from 2016-17 split by Pre Primary, Primary, Secondary and Special Education

Source: Local Financial Returns – Education (LFR 1) statistical return provided by local authorities to the Scottish Government.

Table 2 shows the percentage of total gross revenue expenditure on education by local authorities which is accounted for by spending on additional support for learning in 2016-17.

Source: Local Financial Returns – Education (LFR 1) statistical return provided by local authorities to the Scottish Government.

Table 3 shows the average per-pupil spending on additional support for learning by local authority. This data shows gross revenue expenditure on additional support for learning in primary, secondary and special education from the local financial returns, divided by the number of pupils identified as having additional support needs recorded in the 2016 Pupil Census

Sources:

1. Local Financial Returns – Education (LFR 1) statistical return provided by local authorities to the Scottish Government.

2. Pupil Census – published annually - for further details go to; http://www.gov.scot/Topics/Statistics/Browse/School-Education/dspupcensus

A short-term detention certificate (STDC) should be the usual route into hospital for someone who needs compulsory treatment. The STDC offers several safeguards for the person. Before granting the certificate, the doctor must consult a mental health officer (MHO) and get their agreement. In deciding whether to agree to the certificate, the MHO should speak to the patient in person, unless there is a good reason why they cannot do this.

A patient’s views and wishes about treatment should be taken into account by everyone involved in their care, including where these views and wishes are expressed in an advance statement. Additionally, people with a mental disorder have a legal right to access independent advocacy.

Mental health law in Scotland is based on rights and principles and offers patients significant safeguards where compulsory treatment is necessary. These safeguards include an independent Mental Health Tribunal which grants and reviews orders for compulsory treatment.

The patient or the patient’s named person can appeal to the Mental Health Tribunal for Scotland to have the STDC revoked. This could be because the patient or named person do not think an STDC is needed, or because the patient or named person is of the view that the patient's condition has improved sufficiently that it is no longer necessary.

The Mental Welfare Commission for Scotland is the independent body which monitors the use of Scottish mental health law, including compulsory treatment. The Commission has the power to intervene in particular cases if there is evidence of improper care, treatment or practices.

There is no test of capacity set out in the Mental Health (Care and Treatment) (Scotland) Act 2003. In some circumstances different provisions and safeguards of the 2003 Act apply if the patient does not have capacity to make a certain decision in relation to treatment at a certain time.

A person has a Significantly Impaired Decision Making Ability (SIDMA) when a mental disorder affects the person’s ability to believe, understand and retain information, and to make and communicate decisions. All adults are assumed to have a decision-making ability or capacity as a starting point. A person with a mental disorder who retains unimpaired ability to take treatment decisions cannot be treated compulsorily under the 2003 Act.

The medical practitioner must believe there are sufficient grounds before deciding it necessary to grant an order for a patient who is refusing to accept treatment on a voluntary basis.

• The patient has a mental disorder.
• The patient has significantly impaired decision-making ability with respect to medical treatment for mental disorder, as a result of his or her mental disorder.
• Detention in hospital is necessary to determine what medical treatment is required and to provide that treatment.
• Significant risk exists to the health, safety and welfare of the patient or to the safety of others if the patient is not detained.

Mental health law in Scotland is based on rights and principles and offers patients significant safeguards where compulsory treatment is necessary. These safeguards include an independent Mental Health Tribunal which grants and reviews orders for compulsory treatment. The patient or the patient’s named person can appeal to the Mental Health Tribunal for Scotland to have an order allowing compulsory treatment revoked.

The General Medical Council (GMC) is the statutory regulator of the medical profession in the UK. The Chief Executive of the GMC is the registrar for the medical profession. Further information can be sought from the GMC annual report: State of Medical Education and Practice in the UK: 2017 Report, accessible at the following link https://www.gmc-uk.org/publications/somep2017.asp .

The Scottish Government does not collect specific data on how much each NHS Board spends on staff overtime. It is for Boards to manage service provision locally, including the use of overtime where appropriate.

The Scottish Government has committed to £10m additional funding to increase, over the term of this Parliament, the provision of insulin pump therapy for adults and Continuous Glucose Monitoring (CGM).

The first £2 million was allocated to NHS Boards in financial year 2017-18.

A further £2 million will be made available to NHS Boards in financial year 2018-19.

Funding for subsequent years will be agreed as part of the Spending Review and Budget Bill processes for those years, which will be subject to approval by the Scottish Parliament.

The decision to invest further in CGM and insulin pumps was made on the basis of robust analysis of clinical evidence by NICE and SIGN. Effectiveness of these technologies is considered over the lifetime.

The Scottish Diabetes Survey enables us to track improvement over time against a range of important indicators including glycaemic control and the complications of diabetes. The Survey shows a developing trend of improvement in glycaemic control in the Scottish type 1 diabetes population over the wider period of investment in insulin pumps.

I would remind the Member that the decision to offer a CGM or insulin pump is a clinical one, and the results for the individual will be monitored by their clinical team. Where the expected outcomes are not being realised, clinicians will consider clinically appropriate changes to the care regime.

Scotland’s health workforce benefits enormously from the contribution made by overseas staff. The Scottish Government has consistently signalled that we need to remain an open and welcoming destination for international medical graduates, both from the EU and further afield.

We support initiatives being led by the service to encourage former practitioners return to practice, alongside activity to promote the appeal of NHS Scotland to fresh international talent. NHS National Education Scotland currently operates a successful GP Returner Programme, for former practitioners who have had a career break of who have been practising abroad. Additionally, the service operates an Enhanced GP Induction Programme for overseas GPs, to facilitate their transition to practise in the UK.

Registration and licensing is undertaken by the General Medical Council (GMC), which is the statutory regulator of the medical profession in the UK. The chief executive of the GMC is the registrar for the medical profession; this information is not held by the Scottish Government.

Data on doctors who are registered and/or licensed to practice in the United Kingdom can be found in the GMC’s annual report on the “State of medical education and practice in the UK”, accessible online at: https://www.gmc-uk.org/static/documents/content/SoMEP-2017-final-full.pdf

The Scottish Government actively supports initiatives being led by the service to encourage practitioners to return to practice in known areas of need. The GP Returner Programme for instance, provides a supported opportunity for practitioners who are eligible to practice, but otherwise not practising, to safely return to general practice in Scotland.

Equally, we are actively supporting activity to encouraged qualified doctors who are settled migrants or refugees to work within NHS Scotland. Through the Bridges Programme, doctors from overseas living in Scotland can access a rolling programme of clinical placements during their pre-registration period and access linguistic support for the Professional and Linguistic Assessments Board examination, which is a pre-requisite of full registration with the General Medical Council.