Chamber and committees

I refer the member to the answer to question S4W-02454 on 28 September 2011. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

No specific assessment has been carried out of the risk to people developing drug-resistant tuberculosis as a result of inconsistent supply of antituberculosis drugs. While there is a theoretical possibility that resistant strains of TB can emerge due to inappropriate drug therapy, drug resistant TB can also be spread from person to person. Inappropriate therapy is not the only source of such infection.

Health Protection Scotland data indicates that prevalence of drug resistant TB is low in Scotland (6.9%) and the overwhelming majority of cases on treatment (90.2%) are given at least the standard four-drug regime.

As a direct consequence of shortages of drugs across the UK, the UK Commercial Medicine Unit has taken the lead to establish a group on a four countries basis to consider what actions are necessary to address this issue. Colleagues in NHS National Services Scotland are engaging with this work on behalf of Scotland.

Information on the outcome of TB treatment becomes available one year after initial tuberculosis notification. For this reason, the latest data on treatment outcomes are for cases notified in 2008. Outcomes for cases notified in 2009 will be reported in the 2011 Health Protection Scotland (HPS) annual report.

In 2008, 445 cases of tuberculosis were reported through the HPS Enhanced Surveillance of Mycobacterial Infections (ESMI) system. Outcomes data was available for 387 (86.9%) cases, of whom 294 (76.0%) had successfully completed treatment at 12 months. For cases where data on both treatment outcome and drug resistance are available, 80.7% (184/228) of cases with no drug resistance completed treatment, and 70% (14/20) of those with drug resistance completed treatment.

The most common reason for not completing treatment was death (24 cases; 6.2%), still being on treatment (23 cases; 5.9%) and being lost to follow up (21 cases; 5.4%). The majority of cases reported to still have been on treatment at 12 months were on their initially planned course of treatment (16 cases) or had their treatment changed due to intolerance or poor response (three cases). No data is currently collected as to how many patients were unable to complete treatment due to unavailability of drugs.

While ESMI collects data on both TB treatment outcome and whether strains are drug-susceptible or drug resistant, cross-tabulation of this data was only performed for the first time in the most recent Health Protection Scotland annual report. Analysis of data for previous years is therefore not currently available.

ESMI data requires careful explanation as, for example, multi-drug resistant TB takes longer to treat, so all such cases will be recorded as “still on therapy” for treatment outcome at 12 months. Furthermore, individuals with drug resistant TB may have been non-compliant to previous treatment, for reasons other than lack of drug supply, resulting in drug resistant TB.

No formal assessment has been carried out into these issues in Scotland, but there are difficulties in obtaining supplies of TB drugs across the UK. As a direct consequence, the UK Commercial Medicine Unit has taken the lead to establish a group on a four countries basis to consider what actions are necessary to address this issue. Colleagues in NHS National Services Scotland are engaging with this work on behalf of Scotland.

The National Institute for Health and Clinical Excellence (NICE) manages the process to develop the clinical and health improvement indicators for the Quality and Outcomes Framework (QOF). This includes prioritising areas for new indicator development and recommending whether existing indicators should continue. NICE has not considered QOF indicators on abdominal aortic aneurysm.

However, in line with the advice from the UK National Screening Committee, a national screening programme for abdominal aortic aneurysm will be implemented in Scotland. It is currently envisaged that the programme will be rolled out across the country from autumn 2012.

A national screening programme for abdominal aortic aneurysms is not yet available in Scotland.

It is currently envisaged that the programme will be rolled out across Scotland from autumn 2012.

I refer the member to the answer to question S4W-1672 on 5 August 2011. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/MAQASearch/QAndMSearch.aspx.

I refer the member to the answer to question S4W-01010 on 21 July 2011. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

Such consultations are a matter for Falkirk and West Lothian Council at the appropriate stages in the design and development process.

I refer the member to the answer to question S4W-01010 on 21 July 2011. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.