Seòmar agus comataidhean

The Treatment Time Guarantee already outlines that after a diagnosis is determined and treatment agreed, each health board must ensure that patients receive inpatient and day case treatment within 12 weeks. This applies to all treatments and services apart from fertility treatment, obstetrics services, organ and tissue transplantation, direct referrals to Allied Health Professionals, dental treatment provided by undergraduate dental students, direct access referrals to diagnostic services, and mental health services.

The current unprecedented pressures on the NHS means that Health Boards are not currently able to reinstate services to such a degree as to be in a position to meet the existing waiting times standards and targets, which is why we published the NHS Recovery Plan. This includes a focus on providing alternative pathways of care that will allow people to be treated more quickly closer to home, delivering long term sustainability.

At this time, the Scottish Government has no plans to develop any further waiting time targets for cardiovascular disease.

Through our Programme for Government commitments we are already reflecting the aims of the European Stroke Organisation’s Stroke Action Plan for Europe.

In particular the ESO’s target that 90% of all patients with stroke in Europe should be treated in a stroke unit as the first level of care is already reflected within the Scottish Stroke Care Standards (Access to Stroke Unit - 90% within 1 day of admission).

The ESO also recommends ‘national plans for stroke encompassing the entire chain of care’. We already have a national plan on stroke - the Stroke Improvement Plan - which we are in the process of refreshing. To do so, we are developing a progressive stroke pathway document which will set out our vision for what stroke services across Scotland should deliver across the entire patient pathway. Following this, a refreshed improvement plan will support its delivery.

The Scottish Intercollegiate Guidelines Network (SIGN) guidelines on stroke have been withdrawn due to being over 10 years old. SIGN therefore recommend that healthcare professionals look to other up-to-date evidence-based guidelines to inform practice. A good source is the National Institute of Health and Care Excellence (NICE) evidence search that includes trusted sources from a wide range of organisations: https://www.evidence.nhs.uk/

It has been agreed that a four nations approach will be taken to update the Royal College of Physicians Guidelines for Stroke (2016). SIGN is involved in the development process so that the revised guideline will be a collaborative national guideline which will be applicable for use in Scotland.

The Scottish Stroke Care Audit (SSCA) already measures quality of care of Stroke Services in Scotland against the Scottish Stroke Care Standards. Health Boards are provided with reports on a monthly basis. Performance is monitored locally and nationally and actions agreed to improve delivery of stroke care in Scotland. The most recent annual report can be found here: Scottish stroke improvement programme 2021 national report - Scottish stroke improvement programme - Publications - Public Health Scotland

This is similar to the aims of the Sentinel Stroke National Audit Programme (SSNAP) which measures the quality and organisation of stroke care in the NHS across England, Wales, and Northern Ireland.

Further to the answer given to question S6W-04701 I can confirm that the Case Note review carried out by NHS Greater Glasgow and Clyde along with the report of the peer review undertaken by NHS Lothian have both now been shared with Mrs Slorance.

The requested information is not centrally held. Data is published annually, by NHS Education for Scotland on the total medical agency spend by NHS Scotland Boards; and the total WTE hours and cost for Nursing and Midwifery bank and agency staff, but this data does not specify start dates. This information can be found on the following link: NHSScotland workforce | Turas Data Intelligence

Priority 2 within the Heart Disease Action Plan makes clear our commitment to developing nationally agreed pathways of care for all cardiac conditions.

This work is underway. It is led by our recently appointed Heart Disease Improvement Coordinator, who is engaging with clinical colleagues across Scotland to understand service provision, identify needs and collate examples of good practice to inform this programme of work.

All 14 NHS Boards have hospitals providing acute stroke care. A map showing all hospitals that contribute data on stroke unit admission to the Scottish Stroke Care Audit can be found in the Scottish Stroke Improvement Programme report at: https://www.strokeaudit.scot.nhs.uk/index.html . Of those sites shown on the map, Stracathro, Stobhill, Vale of Leven, Queen Margaret, Falkirk Community Hospital and Stirling Community Hospital are shown because they contributed data solely on stroke rehabilitation.

The remaining hospitals provide acute beds for stroke patients, either in a unit which has solely acute beds with offsite stroke rehabilitation units for ongoing care, within an integrated stroke unit (combining acute and rehabilitation beds) or in a hyperacute unit. The seven smallest general hospitals define stroke unit admission as gaining access to the appropriate acute medical ward.

The current Scottish Stroke Care Standards are available at the following link ( https://www.strokeaudit.scot.nhs.uk/index.html)x . At present, they largely relate to acute stroke care.

However, the Scottish Stroke Improvement Programme also includes performance targets which reflect access to rehabilitation in inpatient settings, intensity of provision in stroke units and access to stroke specialist Early Supported Discharge and community teams. The Rehabilitation Sub-Group of the Stroke National Advisory Committee is currently considering future updates to measure rehabilitation service delivery, patient outcomes and experiences within the Scottish Stroke Improvement Programme report.

Further to the answer given to question S6W-04701 I can confirm that the team of reviewers in NHS Lothian were made up of clinical staff at consultant and senior nurse level who are all suitably qualified in their fields and span across various disciplines including Haematology, Microbiology, Infection Prevention and Control and Critical Care.