Chamber and committees

There has been no specific funding made available to NHS boards to fund the removal of surgical mesh implants for the treatment of pelvic organ prolapse. It is for individual boards to carry out this type of surgery from within existing budgets.

Part 2 of Schedule 5 to the 2004 General Medical Service Regulations sets out the requirements that GP Practices and Health Boards must follow in managing patient lists, including closure of patients lists.

Boards should find ways to either support the practice to once again take on patients or to agree a formal, usually time limited, closure, informing other local practices in the area. This safeguards patient access and allows the Board to monitor the situation more fully and to take any further appropriate action.

NHS Boards have provided the following information.

The Scottish Government established the short life working group in December 2013.

Membership of the short life working group includes:

Four Scottish Government staff, three clinical staff and one providing secretariat support;

Two patient representatives;

Five NHS clinical and research staff;

One NHS healthcare planner (member selected by NHSScotland); and

Two other patient representatives who have been consulted separately regarding the patient information and consent leaflet (selected by the clinical staff on the Group).

Except where noted, members were selected by the Deputy Chief Medical Officer, Dr Frances Elliot.

The performance measure is monitored through results of an access survey, which directly measures patients’ experience of getting access to their General Practice, within 48 hours, on the basis of clinical need. The percentages shown are calculated from the results of national surveys of GP practice patients and reflect the views of randomly sampled patients who responded to the survey in each year. They are not based on an evaluation of all appointment records/all patients in each practice.

Latest available figures, published in May 2012, show that 92.6% of patients were offered the opportunity to see or speak to a doctor or nurse within 48 hours – above our target of 90%. 85% of patients were able to see or speak to a doctor or nurse within two working days, 8% were offered an appointment, but the person they wanted to see was not available or the time was not convenient and 7% were unable to get access.

Any woman who is worried, or is experiencing adverse side effects, should contact their surgeon or GP for advice.

An expert group is developing a revised patient information and consent leaflet that will go into use in NHSScotland and new care pathways for those women who decide to go ahead with a mesh procedure and for those who have suffered complications.

The Chief Medical Officer wrote to all GPs, through Medical Directors, on 11 July 2013 and 20 December 2013 regarding the investigation and management of patients being treated for urinary incontinence and pelvic organ prolapse, including the management of patients with vaginal mesh and tape products. The Scottish Government will be writing again to Medical Directors once the expert group has concluded its work developing the documents and new care pathways.

The Scottish Government will write to NHS Inform following the publication of these documents. NHS Inform provides a health information service and is able to respond to enquiries regarding transvaginal mesh surgery. They can be contacted online at www.nhsinform.co.uk or by using their helpline number: 0800224488.

Between September 2011 and March 2013 a total of 10,902 new users accessed the Life Begins at 40 website.

An evaluation was carried out by Ipsos MORI between August 2011 and February 2012. This showed that only 8% of those invited to access the service chose to do so. Fewer than half (48%) of those who logged on between February and June 2011 completed each section of the online questionnaire.

The Scottish Government does not hold this information centrally.

The budget allocation to NHS 24 for the delivery of the Life Begins at 40 programme was £670,000 between October 2010 and December 2012.

In 2014-15, part of the budget has been allocated to redeveloping the website to provide a more accessible service targeted at working age people in collaboration with the Scottish Centre for Healthy Working Lives. This is expected to go live in 2015. Additional funding has been provided to programmes providing targeted support for people in communities with high levels of inequalities in health.

Regulation of medical devices, including implants, is a reserved matter dealt with by the UK Government.

I have written to both the Medicines and Healthcare products Regulatory Agency (MHRA) and the European Commission asking that they urgently consider the US Food and Drug Administration’s proposed reclassification of surgical mesh for treatment of pelvic organ prolapse.

The European Commission is seeking further research and expert opinion. I have asked for assurance that it will act quickly once the research is available to reclassify these devices if the evidence points to that requirement.

The Life Begins at 40 programme was discontinued at the end of March 2013. The decision was taken by me in January 2013 on the basis of advice on the conclusions from the evaluation of the programme that showed low levels of uptake and completion, and no evidence of benefits to health.

The Life Begins at 40 website is included in a scoping exercise to develop a web-based resource for working age people that will provide a range of advice for employees, employers and GPs on health and wellbeing in the workplace and on managing and returning to work from sickness absence.