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Whilst the British MedicalJournal report referred to focused on GP IT systems used in England, and whichaccount for less than 20% of those used in Scotland, the issues identified willbe reviewed by the clinical information sub-group of the department’s eHealth programmeboard. A commentary in the report makes clear, however, that computers already helpmore effective prescribing and have reduced medication errors by as much as 60%simply by ensuring that prescriptions are legible, complete and in a standard format.

The department is already workingwith all GP IT system suppliers active in Scotland on a programme of functionality enhancements, which hasbeen agreed with GP representative bodies, to meet the ongoing needs of NHS Scotland,and which is supplementary to the existing accreditation standards. As part of thisprocess, we will be reviewing the prescribing support arrangements in individualsystems and requiring any improvements, which the clinical information sub-groupdeems to be necessary, to be put in hand.

At present, as part of the dispensingprocess, community pharmacists are professionally responsible for checking prescriptionsfor accuracy, accurate dosage and any potential significant drug interactions beforethey are dispensed. Additionally, and as part of the migration path towards a newcommunity pharmacy contract, new arrangements are being phased in to give communitypharmacists an enhanced role to work with GPs in the management of patients withchronic but stable conditions. These arrangements are intended to improve the effectivenessof current repeat prescription arrangements.

Once the clinical informationsub-group has considered the report, the Chief Medical Officer will write to allGPs to make them aware of the report’s findings and any action required by the Scottish Executive Health Department. In addition, GPs will be encouraged to review their existingprescribing practice on an ongoing basis so that they make best and safest use oftheir IT system. NHS board prescribing and IT advisers are already in place to helpGPs do this.

The health department iscurrently developing an Equality and Diversity Strategy for the NHS and hasentered into a partnership with the Disability Rights Commission Scotland tolook at the requirements of the Disability Discrimination Act on the NHS. Thispartnership will support and advise NHS boards in developing a disability strategywhich will highlight accessibility issues as part of the approach to deliveringpatient-centred and responsive services.

The audit looks at access relatedto premises and property and may not impact directly on the needs of deaf and hard-of-hearingpeople. However, the good practice guidance on access to services Equality fordisabled people in the NHS in Scotland (Bib. number 7233) provides support and guidance forstaff in meeting the needs of deaf and hard-of-hearing people. This guidance isbeing updated in partnership with NHS Health Scotland to ensure that the supportmechanisms are available for staff to apply the guidance.

Thetraining will be available for use by all NHS providers by the end of 2004, andis suitable for use in standard induction training for all clinical and non-clinicalstaff. The training can include a short practical assessment to ensure traineeshave reached a level of competency in using appropriate strategies when communicatingwith deaf people.

the Scottish Executive Health Department has made available £1.5 million tohelp raise awareness amongst primary care contractors of the needs of disabled people.Such training has been shown elsewhere to be effective in improving services andto be valued by patients with particular needs.

Number and Percentage of GP Practices Prescribing Methadone

The table does not present the full picture of methadone prescribing services across Scotland, since specialist drug services also prescribe methadone, both in community and residential settings.