Chamber and committees

The Scottish Government provides policies, frameworks and resources to NHS Boards to allow them to deliver services that meet the needs of their local populations. It is the responsibility of NHS Boards to ensure that they follow locally agreed and national clinical guidelines on the management of patients with psoriatic arthritis.

The Scottish Intercollegiate Guidelines Network (SIGN), who are part of Health Improvement Scotland, have produced guidelines on psoriasis and psoriatic arthritis (guide 121). The guideline makes clear the importance of annual reviews to ensure that the condition is monitored, and to detect signs of progression. This management may be delivered as shared care between primary care and specialist rheumatology care, involving members of multi-disciplinary teams as needed.

The Scottish Government welcomes the Mental Welfare Commission’s 2015-16 Annual Report, published 8 September 2016. We have noted the six priorities suggested by the Mental Welfare Commission, which are as follows:

To set a new target to reduce the huge disparity in life expectancy between people with mental health issues and the general population.

A call for more to be done for children and young people.

To end the unequal provision of care for people with mental ill health as opposed to physical ill health.

The new mental health strategy to be built around a rights-based approach.

To see services responding better to those who do not fit current health or care approach.

A new approach to workforce development, with a revised set of skills to deliver a modern mental health service.

These priorities were reflected in the Mental Welfare Commission’s written response to our engagement paper “Mental Health in Scotland – a ten Year Vision”. We are considering the Mental Welfare Commission’s views, as expressed in both that written response and in their Annual Report, very carefully ahead of the forthcoming publication of the ten-year Strategy.

The report Prescribing Statistics - Medicines used in Mental Health and the accompanying data sets are published by ISD. ISD have indicated that they are planning on publishing the 2015-16 anti-depressant figures in mid-December.

The data will be published online at: http://www.isdscotland.org/Publications/ .

The Edinburgh Tram Inquiry is independent of Scottish Government.

Lord Hardie and his team are determined to conduct a thorough and wide-ranging investigation into the reasons behind the Edinburgh Tram Project delays and cost escalations and to deliver a report and recommendations to ensure lessons are learned for future major infrastructure projects.

It will take as long as is necessary to get the answers the public wants in relation to the issues surrounding the Edinburgh Trams Project. However, to date, good progress has been made including identifying, retrieving and reviewing more than six million documents and the ongoing gathering of statements from witnesses of interest.

Through additional funding from the Scottish Government, the Scottish Ambulance Service are training an additional 1000 Paramedics over the next five years to provide frontline care in Scotland. This year’s recruitment plan will see 200 candidates undertake a higher education diploma in paramedic practice in the first phase of a 5 year programme that will enhance the clinical skills mix of staff and introduce new ways of working to best meet the needs of patients in all communities.

The Higher Education Diploma in Paramedic Practice is a 12 month course undertaken at the Scottish Ambulance Service Academy at Glasgow Caledonian University and includes 750 hours of practice placement as well a 5 week placement in hospital. 183 candidates have started this course so far in 2016 with 18 further candidates awaiting interview.

The new Paramedics are being trained from the current cohort of around 1,100 qualified Ambulance Technicians, who have already had training in lifesaving procedures and how to interpret ECG results as part of the curriculum for their current qualification. This will be supported by a recruitment drive to backfill those who are moving into the paramedic roles with over 200 new ambulance technicians.

Following a detailed review of NHS Ayrshire& Arran’s adverse event management in the spring of 2012, the then Cabinet Secretary for Health, Wellbeing and Cities Strategy instructed Healthcare Improvement Scotland to develop a national framework and a programme of reviews. In September 2013, following extensive consultation, a National Framework for managing adverse events was published and then refreshed in April 2015.

During Autumn of 2015, Healthcare Improvement Scotland held a series of progress meetings with NHS Boards to understand how they are continuing to implement the national framework. Healthcare Improvement Scotland published their report ‘Learning from Adverse Events’ in May 2016. This report outlined the ways mechanisms for identifying local actionable learning are improving and described the steady increases in the number of national learning summaries shared through the Community of Practice website.

The provisions within the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 for an organisational duty of candour across organisations providing health and social care in Scotland include the publication of annual reports that will provide details of the number and nature of incidents to which the duty has applied and the changes implemented as a result of incidents to which the duty has applied. This will provide a further mechanism for identifying and acting on themes from local learning that are identified in this way.

The following table shows the number of funded places allocated to each medical school from 2006-07 to 2016-17.

Funded places are not allocated separately for Scottish and EU students. The places can be used for Scottish, rest of UK (RUK) and other EU students. Since 2012-13, rest of UK students pay the deregulated tuition fees.

As the deregulated fees were phased in, i.e. only applicable to RUK students who started from 2012-13 onwards, there has been a phased reduction in the funded places to reflect the levels of RUK students at each medical school.

The funded places will continue to be revised to reflect the latest information on levels of RUK students in the actual intakes and to reflect updated information on course year-to-year progression rates, which are used to derive funded places for the second and later years of the course.

Funded Places for Undergraduate Medicine for the Scottish Medical Schools for 2006-07 to 2016-17

Source: Scottish Funding Council (SFC)

Numbers are Full-time equivalent (FTE)

Notes

(I) In 2007-08 in response to the Calman review of medical education the Scottish Government funded an additional 55 places at the University of St Andrews. The Scottish Government continued to fund these additional places at St Andrews in 2008-09 and 2009-10 as the cohort progressed to years 2 and 3 of the programme. In AY 2010-11 the Scottish Government continued to provide funding for the 55 student places as the cohort progressed from St Andrews to complete their clinical training at one of the other Scottish medical schools. In AY 2011-12 in addition to this initial cohort of 55 FTEs the Scottish Government funded a second cohort of 55 FTEs as they entered their clinical years at one of the four clinical schools. In AY 2012-13 the Scottish Government funded a third cohort of 55 FTEs. These 165 additional places have been maintained since then.

(II) In 2012-13 the Scottish Government reduced the intake target for new medical students, which covers Scottish, rest of UK and other EU students, by 50 from 834 to 784. This reduction was maintained up to and including 2015-16, and would have effected the pre-clinical funded places from 2012-13 onwards and the clinical funded places from 2014-15 onwards. In 2016-17 the Scottish Government increased the intake target by 50, with the additional places aimed at Scottish domiciled or other EU students who satisfied criteria relating to widening access.

(III) In 2012-13 new students from the rest of the UK (RUK) were charged deregulated tuition fees. As funding from the Scottish Funding Council (SFC) does not support the provision of RUK students paying deregulated tuition fees SFC reduced the funded places to reflect the levels of RUK students at each medical school. As the deregulated tuition fees were phased-in, with only RUK students who started from 2012-13 onwards paying these tuition fees, the reduction in funded places has also been phased in. Funded places will continue to be revised each year to reflect the level of RUK students in the actual intakes in previous years, and to reflect changes in course year-to-year progression rates.

(IV)Medical students typically begin by studying pre-clinical medicine, before progressing to clinical medicine.

Students at St Andrews can only study at the pre-clinical level and have to move to another institution to complete their medical training.

I refer the member to the answer to question S4W-04703 on 23 November 2016 which sets out the work the Scottish Government is currently undertaking to enhance rights-based practice under the Mental Health (Care and Treatment) (Scotland) Act 2003. 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

Health and Social Care integration takes a person centred approach to developing local services with the involvement of the people who use those services. The Scottish Government is currently considering the strategic way forward on co-production including how we support health and social care partnerships to extend this approach. This will build upon work delivered through the Scottish Co-Production Network, the Health and Social Care Alliance’s People Powered Health and Wellbeing programme, and the many good examples highlighted through the recent Co-Production Week.

Ensuring that people to have sufficient knowledge, understanding, confidence and skills to cope with the complex demands of modern health care is key to delivering person-centred care. Scotland’s Chief Medical Officer used her 2014-15 annual report to start a conversation with doctors about Realistic Medicine and how to support people in making decisions about their care. A conversation with the public about Realistic Medicine will begin next year. CMO’s next annual report to be published in 2017 will provide an update on progress in realising Realistic Medicine.

The Scottish Government has issued guidance on the Roles, Responsibilities and Membership of the Integration Joint Boards (IJBs) which is applicable to Integration Joint Monitoring Committees (IJMC). The guidance states that the IJB's and IJMC must ensure that appointed stakeholder members, including service users, are given specific training and supported to contribute effectively, where such training is required. This is takes place locally in a range of ways, for example through one-to-one mentoring sessions as well as wider Board development events.