Chamber and committees

Information on numbers of healthcare (a) staff and (b) professions and work times in prison settings is not held centrally. The responsibility and accountability for the provision of health care services to prisoners transferred from the Scottish Prison Service to the National Health Service (NHS) on 1 November 2011. These services are now provided by the respective local NHS Health Boards under the Health Board Provision of Healthcare in Prisons (Scotland) Directions 2011-National Health Service (Scotland) Act 1978.

HMP Addiewell holds an average of 680-700 prisoners.

There are 12 registered general nurses, 8 registered mental health nurses covering mental health & addictions, 7 healthcare support workers, 4 senior manager positions, 2 pharmacy technicians and 2 admin staff.

In addition, a GP is on duty Monday to Friday, am and pm and on Saturday mornings; a psychiatrist works there one day a week. A physiotherapist serves the prison inmates and there is a dental service and a smoking cessation service.

NHS standards for health care provision now apply to the provision of care within the prison setting.

Although there are clear contextual differences between prison and the community in terms of the way healthcare is delivered, the expectation is that the quality of care in prisons, and health care professionals' obligations in this regard, is equivalent to that available in the community and is based on assessed needs and the provision of safe, efficient and appropriate care which offers the best possible outcomes for individuals. Health boards must ensure that in the provision of such services the practice meets the quality standards set out from time to time in guidance which has been issued to health boards by NHS Quality Improvement Scotland or by Healthcare Improvement Scotland.

There are 50 facilities with onsite rest facilities for on-call staff.

In some facilities, if required, additional or adhoc rest rooms are also available for residential on-call staff.

New guidance on the exclusion from public contracts of companies which engage in blacklisting was launched by the First Minister on 20 November 2013. Compliance with public procurement guidance issued by the Scottish Government is mandatory for Scottish Government departments, its Agencies and Non-Departmental Public Bodies, including the Scottish Futures Trust (SFT). Other bodies in the public sector, including local authorities, are encouraged to follow this guidance, but its adoption is not mandatory.

Hub companies are working with SFT and their partners to implement the new guidance appropriately within the wider hub partnership arrangements.

We are considering ways in which the guidance can be placed on a statutory footing, including through amendment of the Public Contracts (Scotland) Regulations 2012 and through the Procurement Reform (Scotland) Bill, currently before Parliament which contains provisions relating on how a firm’s suitability to bid for contracts is assessed.

We are committed to continuing a constructive dialogue with Trade Unions on this issue and to explore ways in which the guidelines can be further developed.

NHS boards and NHS Education for Scotland are responsible for recruiting to junior doctor posts, most through national recruitment programmes.

In response to concerns about Scotland's attractiveness as a place to train and work in medicine, the Strategy for Attracting and Retaining Trainees (START) was launched in April 2013 by NHS Education for Scotland. The overall aim of START is to increase fill rates for junior doctor posts and reduce gaps in training programmes.

The initiative has a number of recruitment goals including increasing fill rates by 5% by 2016 in hard to fill programmes in emergency medicine, general practice and psychiatry.

We have been investing in medical staff and since September 2006 there has been an increase in the number of doctors working in hospitals in NHS Scotland. Junior doctors numbers have risen from 5,336.1 to 5,796.7, an 8.6% increase, Consultant numbers have risen from 3,636.5 to 4,665.8, a 28.3% increase and specialty doctor numbers have risen from 810.3 to 1,042.9, a 28.7% increase.

Since 2009 the Scottish Government has been advising NHS boards to eliminate the practice of junior doctors working seven nights in a row. Over 97% of rotas in Scotland have now eliminated this practice, with the remainder under review to identify alternative patterns.

The Scottish Government welcomes the publication of this important national survey as understanding the views of trainees and trainers is essential to monitoring and improving the quality of postgraduate medical education and training.

NHS Education for Scotland (NES) is tasked with quality management of postgraduate medical education and training in Scotland.

Feedback from the National Training Survey (NTS) is triangulated against the NES Scottish Trainee Survey and other data sources and then compared with previous years’ responses. This analysis generates an action plan that is based on either the strength of available evidence about an issue, or the need for further evidence. The action plan comprises either a) visits by training leads from NES that typically focus on specific cohorts of trainees, in particular specialties and in particular locations or b) specific requests for clarification directed typically to the Directors of Medical Education employed in NHSS health boards.

When the issues that have been flagged via the NTS are verified, a specific action plan detailing areas for improvement is shared with the health board (or GP practice) with a timeline for implementation and instructions for evidencing improvement.

Under the New Deal Contract, NHS boards are required to monitor the hours of work for junior doctors twice per year.

In this exercise, junior doctors self-monitor by recording the hours they work over a minimum period of two weeks. This information is then analysed by NHS boards and the results reported to the Scottish Government’s medical workforce adviser, as well as to junior doctors involved.

Junior doctors can, at any time, request to be monitored and NHS boards must comply with this request. They can also request that the monitoring itself is independently verified by the medical workforce adviser.

The working hours of junior doctors are set and controlled by the new deal contract and the working time regulations, both of which set limits of the number of hours a doctor can work, and ensure that minimum periods of rest and time off are adhered too.

The Scottish Government has a dedicated medical workforce adviser who works with NHS boards, the British Medical Association (BMA) and junior doctors to ensure working hours limits are enforced and regularly monitored.

We also meet regularly with the BMA to discuss junior doctor working conditions and address any concerns they have.