Chamber and committees

Guidance for the procurement of palliative and end of life services, including those provided by independent adult hospices, is set out in Chief Executive Letter, CEL 12 (2012). The CEL makes clear that funding of mutually agreed specialist palliative care services should be reached by NHS Boards and independent adult hospices on a 50% calculation of agreed costs.

Last year we announced funding of £30 million over five years to address the specific issue of support for children and young people’s palliative and end of life care needs. This investment brings funding for children's hospice services in line with that provided for adult hospice services.

This information is not centrally held.

The Scottish Atlas of Palliative Care, which was published in September 2016, provides Scotland specific data on levels, location and types of specialist palliative care services across Scotland which has previously been subsumed within UK data. The Atlas can be found at: https://www.gla.ac.uk/media/media_486122_en.pdf

Additionally, the Children's Hospice Across Scotland (CHAS) published the Children in Scotland requiring Palliative Care (CHiSP) study in October 2015. This study sets out the numbers of children and young people in Scotland with palliative care needs and generated evidence to support the planning and delivery of paediatric palliative care in Scotland. The CHiSP study can be accessed at: http://www.cen.scot.nhs.uk/wp-content/uploads/sites/24/2017/02/ChiSP_report.pdf

Training places for social care are not centrally controlled. Demand for places is assessed through colleges working in partnership with employers to meet the needs of local labour markets.

The information requested is not held centrally.

I receive requests from NHSScotland staff on a regular basis to discuss a wide range of matters. All meeting requests are considered on a case by case basis but are not recorded by the employment or whistleblowing status of the individual requesting the meeting.

The recording of requests from NHSScotland staff to meet Healthcare Improvement Scotland and the Care Inspectorate are matters for these bodies to determine.

Under the Public Interest Disclosure Act 1998, prescribed bodies or persons are independent bodies or individuals who whistleblowers can approach to make a ‘protected disclosure’ rather than their employer. Depending on the nature of the concern, these are usually scrutiny or legislative bodies and include Healthcare Improvement Scotland.

Health and Safety is a reserved matter under the terms of the Scotland Act (1998). The duty holders in NHSScotland under the Health and Safety at Work etc. Act 1974 (HSWA) and relevant regulations, are NHS Boards, as they are separate legal entities to the Scottish Government. Individual NHS Boards are responsible for Health and Safety within their own areas.

Through Healthcare Improvement Scotland and NHS Boards the Scottish Government and its officials ensure that the HSAW act is adhered to. In addition, the Health and Safety Executive (HSE) can and does enforce health and safety legislation within NHS Boards in accordance with its policy on patient safety.

HSE’s role in patient health and safety is explained in the Letter of Understanding between Health and Safety Executive and Healthcare Improvement Scotland and is available at http://www.hse.gov.uk/aboutus/howwework/framework/letter-of-understanding-his.pdf

Reducing Healthcare Associated Infections (HCAI) is a key priority for the Scottish Government. Health Protection Scotland provide the Scottish Government with quarterly and annual reports, which are used to measure the progress in tackling HCAI across NHSScotland. The information also highlights areas of good practice, which is shared across all Health Boards to ensure they continue to drive forward improvements in this area.

Information on the number of Managed Access Schemes for drugs in each year since 1999 is not held centrally by the Scottish Government.

A recommendation contained within Dr Montgomery’s Review of Access to New Medicines was to explore Managed Access Schemes. We are working with stakeholders to take this work forward, in consideration of the interdependencies with implementation of a conditional acceptance provision.

The Best Start recommends that "NHSBoards should redesign maternity services with a focus on local care, built around the concept of multidisciplinary community hubs, with the majority of women being offered routine care and services through these hubs." This is in line with the national strategic direction to deliver multidisciplinary patient centred care as outlined in the National Clinical Strategy and Realistic Medicine. Scottish Government will work with NHS Boards locally to implement the recommendation from the Best Start however it is for NHS Boards to determine where the hubs are located, what services are provided within these hubs and how these are managed to ensure that they offer safe, high quality services to all pregnant women. We expect boards to involve staff and patients in these discussions.

This information is not held centrally. Information Services Division routinely publish statistics on the three national cancer screening programmes: Breast Cancer Screening, Bowel Cancer Screening and Cervical Cancer Screening. This information can be found at: http://www.isdscotland.org/Publications/index.asp

Most people who use mental health services receive treatment without being subject to an order or certificate under the Mental Health (Scotland) (Care and Treatment) Act 2003. For some individuals however, compulsory treatment is used to provide the person with medical treatment to alleviate suffering and for the protection of both the person and others. Compulsory treatment is only allowed under mental health legislation in Scotland in very strict circumstances.

Firstly, certain criteria must be met before an order or certificate can be granted. For a 28 day short-term detention certificate (STDC), this includes that an approved medical practitioner considers it likely that the patient has a mental disorder (as defined by the 2003 Act) and that the patient’s decision making ability is significantly impaired by their disorder and without treatment the patient could be of significant risk to their own health, safety and welfare, or to the safety of others. The patient can appeal the granting of an STDC to the independent Mental Health Tribunal. A longer term order can only be granted by the Tribunal, and the application must have the support of two doctors who agree that the criteria for the order are met.

Secondly, treatment under the 2003 Act is governed by a range of safeguards. For certain treatments, including medication given for more than two months, a Designated Medical Practitioner, an experienced psychiatrist appointed by the Mental Welfare Commission, must agree to the treatment.

In addition to this, the 2003 Act is based in rights and principles and contains tools to support patients in expressing their will and preferences. The principles include that any function should be carried out for the maximum benefit of the patient, with the minimum necessary restriction on the freedom of the patient and having regard to the views of the patient and of any carer. Under the 2003 Act, any service user has the right to support from an independent advocate, the right to appoint a named person to represent their interests and the right to make an advance statement setting out how what treatment they would and would not like to receive when unwell. We have made changes to ensure that people with a mental disorder can access effective treatment quickly and improved legislation through the Mental Health (Scotland) Act 2015 to strengthen support for decision making and promote rights.

I refer the member to the answer to question S5W-11345 on
27 September 2017. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx