Chamber and committees

The Scottish Government has been fully consulted by the Department for Transport as part of the InterCity East Coast refranchising process, and has presented its requirements of the new franchise, in partnership with the department, at the Bidders’ Awareness Day, marking the commencement of the franchising process.

Scottish Government officials have also completed discussions with all companies bidding for the InterCity East Coast franchise, and will have further consultation with the Department for Transport on the content of those companies’ bids as they relate to Scotland.

Since the Railways Act 1993, several UK Government administrations have had the opportunity to reverse the decision to privatise the railways but have failed to do so.

The Scottish Government has made numerous representations to the UK Government about the unfairness of its rail franchise legislation which prevents UK public sector organisations bidding whilst allowing those from Europe and elsewhere. Those representations have not been heeded.

Following discussion with the UK Government, the invitation to tender for the InterCity East Coast franchise requires the franchisee to provide services to and from Scotland to, at least, their current levels.

The Scottish Government has discussed in detail with the UK Government the continuing need for the provision of services to and north of Edinburgh and notes that the specification of the InterCity East Coast franchise included within the invitation to tender requires the franchisee to provide services to and from Scotland to, at least, their current levels.

a) Integration of health and social care will play a key role in ensuring the ongoing quality and sustainability of health and social care in Scotland.

We are integrating health and social care services in order to improve the quality and consistency of care, and to ensure that our systems of health and social care support people with the right care, in the right place at the right time. Integrated budgets, under the control of the new Integration Authorities established via the Public Bodies (Joint Working) (Scotland) Act 2014, will enable local integrated health and social care partnerships to put in place strategic plans for service provision that support local needs and priorities effectively and efficiently.

b) The government’s investment in the NHS has continued to increase. £757 million was invested directly in primary medical services in 2012-13, an increase of 10% since 2006-07. I announced on 14 March 2014 a further increase in investment for general practice for 2014-15 of £6 million, reflecting the invaluable contribution that general practice can make in improving outcomes through more effective integrated care and management of patients.

In addition, for the first time this year, health boards are also required to complete a ‘strategic assessment of primary care’ as part of the annual Local Delivery Plan process. Within health boards these assessments will inform the measurable resource shift necessary to innovate in and strengthen primary care, recognising that across Scotland, health boards have different priorities, reflecting their geographic situation, current infrastructure and health needs.

The Scottish Government recognises the importance of providing accurate, quality assured information to cancer patients and their carers. This includes pancreatic cancer. In April 2014, we launched the Patient Experience Quality Performance Indicators (QPIs). These QPIs place a responsibility on health boards to provide appropriate information to patients and their carers in order to promote maximum understanding and to assist coping mechanisms. Access to written materials, computerised information and a named nurse should be readily available at all stages of disease management.

The QPIs recommend that healthcare professionals explore the patient’s preferences about the level and type of information they want. Based on this, the patient (and their family members and/or carers if appropriate) should be given clear, consistent, evidence-based, contextualised, and tailored information throughout all stages of their care.

In addition to the QPIs, NHS24 will continue to work to develop the Cancer Zone on NHS inform to provide a trusted source of on-line tailored cancer information that supports the patient at whatever stage they are in their treatment process. This development includes the facility for GPs to produce leaflets for patients which are tailored for their specific needs.

The role of the Scottish Government is to provide policies, frameworks and resources to NHS boards in order that they can deliver services that meet the needs of their local population. Within this context, the actual planning and provision of healthcare services is the responsibility of local health boards, taking into account national guidance, local service needs and priorities for investment. This includes deciding how best to utilise funding, facilities and staff.

We expect NHS boards to plan their facilities and workforce to deliver these services and to have robust processes in place to ensure the provision of safe, effective and high quality patient care, which is delivered by the right professional at the right time. NHS boards have fully delegated powers to recruit and deploy their workforce to meet their service provision responsibilities and to deliver high quality, safe and sustainable services to meet the needs of their population.

Whilst recognising that it is NHS boards’ responsibility to plan and deliver services, including specialist nursing services, taking account of national priorities and local need, there is awareness within the Scottish Government of the increasing prominence of the issue of specialist nursing services.

The Chief Nursing Officer therefore wrote to all NHS boards asking Nurse Directors to consider the implications of the recent reports on this issue by our third sector partners in terms of their current approach, future plans for provision and potential solutions to any common challenges identified.

The Scottish Government commissioned NHS Education for Scotland to host three regional workshops to provide opportunities for specialist nurse groups and other stakeholders to explore current provision and the future direction of specialist nursing in Scotland.

Early diagnosis of pancreatic cancer remains challenging as symptoms are initially often vague and non-specific. The most common presenting feature is obstructive jaundice but may also include weight loss and abdominal pain. Specifically in relation to management of patients who present with jaundice, the General Medical Council approved curriculum for general surgical training details that trainees need to be “competent to manage, including referral for radiological and endoscopic investigation, patients who present with jaundice” and need to be “competent to manage patients who present with malignant disorders including pancreatic cancer … within a multi-disciplinary team with other surgical, medical and clinical oncology colleagues”.

NHS Education for Scotland ensures delivery of these approved curricula through quality managed training programmes and an annual review of competency progression for each trainee.

New technologies for patients require careful evaluation of the safety, efficacy and clinical and cost-effectiveness prior to use.

The National Institute for Health and Care Excellence (NICE) publishes Multiple Technology Appraisals (MTAs) which are then reviewed in Scotland by Healthcare Improvement Scotland (HIS) who consider the suitability of the NICE MTAs for Scotland. HIS then issues advice to all NHS boards identifying any contextual differences.

NHS boards are expected to follow HIS advice on technologies in the planning and provision of its services, and clinicians are expected to follow their professional judgement, working within the management structure of their boards.

For medicines, the Scottish Medicines Consortium assesses all new medicines and makes recommendations for their use in NHS Scotland.

The Scottish Government is committed to improving survival rates from cancer. The Detect Cancer Early Programme was formally launched in February 2012. The tumour types covered by the programme are breast, colorectal and lung, chosen because these tumours account for over 45% of new cancer cases in Scotland.

Using these three tumour types, which have a large numbers of cases, will demonstrate the impact of the programme more effectively and the learning can then be used to inform initiatives for other tumour types in the future. The Detect Cancer Early Programme board is currently undertaking work to look at the inclusion of additional tumour types into the programme.

The Scottish Cancer Coalition (SCC) is a partnership of 21 voluntary sector organisations which plays a continuing role in the implementation of Better Cancer Care, an Action Plan (2008), providing the Scottish Government with collective views and feedback on what is required in Scotland to support people living with and beyond cancer.

Representatives from the SCC attend the Scottish Cancer Taskforce, the group tasked with overseeing the overall delivery of the action plan. The SCC is also represented by member organisations on the various sub-groups taking forward specific areas of action, such as the National Cancer Quality Steering Group, that has undertaken a programme of work to develop clinical quality performance indicators for all main cancer types, including pancreatic cancer.