Chamber and committees

We are aware of the PWC research compiled by the Local Data Company and whilst we are concerned at the reported number of shop closures in Glasgow we welcome the news that retail closures are slowing down in Scotland, and that Paisley, Dundee and Falkirk have all witnessed a growth in the number of retail units.

The Scottish Government recognise that help is needed to re-invigorate our high streets which is why Scotland’s Town Centre First Principle, together with the range of measures in our Town Centre Action plan, is designed to tackle key issues such as empty shops, and to improve the vibrancy of our town centres.

We will continue to use all levers at our disposal to ensure Scotland remains an attractive place to do business. We are maintaining a competitive business rates package in Scotland including cutting the rates poundage, limiting the extent of the large business supplement and expanding the Small Business Bonus so that it lifts 100,000 properties out of rates altogether. We have also gone beyond the recent Barclay Review recommendations with new measures to drive investment. In addition to the growth accelerator, which will mean businesses pay no rates increases for the first year on new and improved properties, we will ensure every new build property does not pay a penny in rates until it is occupied for the first time. Further detail will be confirmed in the Draft Budget later this month.

We recognise the challenges faced by people living with all forms of diabetes. Through our Mental Health Strategy, which sets out our ambition for the next 10 years, we seek to improve access to psychological therapies and to prevent and treat mental health problems with the same commitment and drive as we do for physical health problems.

We are committed to expanding our focus on early intervention and prevention as key to minimising the life time impact of mental illness and aiding recovery.

The number of specialist eating disorder beds for adults is shown in the following table:

Source: Scottish Government

In other Board areas, NHS inpatient care is provided in general or adolescent psychiatry in mental health hospitals or in acute care, with specialist in-patient treatment also available through referral if appropriate to the independent sector.

Children and young people with an eating disorder will normally be referred to Child and Adolescent Mental Health Services (CAMHS) with only a very small number requiring treatment in an inpatient facility. Where hospital admission is appropriate, this would be to one of the 3 regional CAMHS inpatient units shown in the following table.

Source: Scottish Government

Suicide prevention training is provided by NHS Health Scotland which is fully funded by the Scottish Government. Data on suicide prevention training of NHS staff is not held centrally by the Scottish Government.

Mental health is an absolute priority for this government and we have already increased mental health spending by 40% between 2006-07 and
2015-16.

Our mental health law is based on rights and principles and offers protection for patients where compulsory treatment is necessary. Any increase in compulsory treatments may represent the effects of more people coming forward for treatment and increased awareness and response to mental ill health. It’s also important to note that the largest proportion of people subject to compulsion are for short term orders rather than long term orders. We will continue to work with the Mental Welfare Commission and stakeholders both to ensure these orders are correctly used and to promote patients rights more generally. Patient rights are a key part of our legislation and the new Mental Health Strategy.

The Scottish Government is considering how best to use data in mental health and this includes the important information which the Mental Welfare Commission provide about the use of compulsion.

Curriculum for Excellence is the national approach to learning and teaching for young people aged 3 to 18 in Scotland. It provides significant flexibility, within broad national guidelines, for teachers to develop lessons which best meet the needs of individual learners. Teachers, head teachers and other professional educational practitioners are best placed to decide what is taught in Scotland’s schools. Schools are encouraged to focus on the individual interests of classes and pupils to make lessons more relevant and therefore more rewarding.

‘Conduct of Relationships, Sexual Health and Parenthood (RSHP) Education in Schools’ provides guidance for teachers on the conduct of teaching RSHP education within the health and wellbeing organiser of Curriculum for Excellence. RSHP education is an integral part of the health and wellbeing area of the school curriculum in Scotland. The curriculum is not statutory and it is for local authorities and schools to decide how to deliver the curriculum based on local needs and circumstances. However, we are specific about the need for children and young people to gain knowledge appropriate to their age and stage of education. This aspect of the curriculum is intended to enable children and young people to build positive and safe relationships as they grow older and should present facts in an objective, balanced and sensitive manner within a framework of sound values and an awareness of the law.

Information on how many under 16 and 16 to 18 year-olds diagnosed with a mental and physical health condition admitted to an adult/non-adult inpatient ward is not held centrally. It is not possible to distinguish between an adult and a non-adult inpatient ward from the information received from NHS Boards.

The Mental Welfare Commission publishes an annual report showing the number of young people under the age of 18 who were admitted to non-specialist mental health beds http://www.mwcscot.org.uk/publications/statistical-monitoring-reports/. This includes where children and young people have been admitted to a non-mental health paediatric ward for mental health reasons, but the report does not cover physical health admissions. In 2015-16 (the latest year for which data is published) the number had decreased compared to previous years.

There are some reasons why it may not always be possible for a young person to be admitted to a specialist child and adolescent bed – for example, a crisis admission out of hours where there are concerns for the young person’s safety, or where a specialist facility might be a considerable distance from family support that could help recovery.

Most of these admissions are among young people aged 16 or 17 where an adult facility might in certain cases be clinically judged to be the more appropriate setting, but nevertheless it is expected that almost all children and young people admitted to adult wards be discharged quickly or transferred to Child and Adolescent Mental Health Services (CAMHS).

Scottish Government intends to publish the findings of the audit of child and adolescent mental health services (CAMHS) rejected referrals within 12 months. Preliminary work has now taken place and the audit will commence shortly. This will consist of two parts, quantitative analysis by NHS Information Services Division and qualitative data from parents, carers and young people gathered in partnership with the third sector. The timeframe of the audit will mirror the planned Audit Scotland CAMHS audit to ensure coordination of activity.

This Government has committed to and is undertaking a review to consider whether the provisions of the Mental Health (Care and Treatment) (Scotland) Act 2003 fulfil the needs of people with Learning Disability and Autism.

The work to lay the foundations of the review are complete and I am hopeful that a formal announcement regarding the appointment of a Chairperson will be made shortly, with the work commencing before the end of October.

We have been clear from the outset that we do not wish to place an artificial timeline on the review. In order to deliver an inclusive and credible review there is a need to ensure that all perspectives are covered equally therefore evidence will need to be gathered from a wide range of sources. It will have to get to the heart of differing opinions so that the real issues can be fleshed out and then considered on an evidence led basis. The Chairperson will therefore determine a realistic timeline however we expect a duration for gathering evidence, consultation and writing of around 2 years.

The Scottish Government is working closely with the local team at the Queen Elizabeth University Hospital (QEUH) to support improvements.

While performance at the QEUH over the summer months (June and July) improved to over 90%, performance against the four hour A&E target over the last few weeks has dipped. There have been a number of issues impacting on performance at the QEUH including the level of attendances; with the exception of May 2017, August saw the highest level of attendances since the hospital opened in 2015. This high level of attendances has been consistent throughout September - despite this no patients have been delayed over twelve hours.

My officials are in regular contact with the senior Executive Team at NHS Greater Glasgow and Clyde and have had a number of discussions around actions in place to support improved performance. The national team are on site working with the local team to strengthen the principles of the unscheduled care six essential actions and support the specific actions that have been put in place, including:

• Opening additional capacity

• Additional staffing in place in the A&E department at peak times

• Focused approach to maximising appropriate daily discharges to create capacity throughout the day

• Golden hour on all medical wards to support early discharges

We will continue to work with the Board and monitor improvements over the coming weeks.