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Scottish participation in the UK National Cardiac Audit Programme (NCAP), managed by the National Institute for Cardiovascular Outcomes Research (NICOR), was previously enabled through the Healthcare Quality Improvement Partnership (HQIP).

The Scottish Government had been working with HQIP since November 2018 to identify a mutually agreeable legal basis that would support Scotland’s continued participation in a number of UK wide audits, including the NCAP programme. It was not possible to identify one and as a result, throughout 2020/21 there was a phased withdrawal of Scottish Government participation in HQIP associated audits as an appropriate point was reached in each.

As replacement for the NCAP, in April 2021 we commissioned Public Health Scotland (PHS) to develop the Scottish Cardiac Audit Programme. PHS have been actively seeking data submissions from all sites across Scotland which previously contributed to the NCAP.

PHS are currently working with clinicians and patients across Scotland to undertake further development of the audit programme.

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.

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.

Where it is clinically appropriate to do so, patients of all ages will be examined with a stethoscope to listen for breathing and heart sounds. They may also have ECG electrical recordings of their heart rate, blood tests and have access to other investigations such as Echocardiograms, rhythm monitors and blood pressure recordings, should these be required.

Primary care professionals have access to multiple sources of education and update regarding heart valve disease and management both at undergraduate and postgraduate level. Through local interface groups local pathways to support diagnosis and management have been developed at board level with opportunities for specialist advice and rapid referral where required.

Scottish Government has no current plans to carry out a public awareness campaign on heart valve disease.

Digital stethoscopes can be purchased by any clinician.

The Heart Disease Action Plan recognises the need to ensure timely and equitable access to diagnostics, including echocardiography.

As set out within the plan, we are working to address key workforce issues relating to cardiac physiology. Cardiac Physiologists are healthcare professionals who are vital to the delivery of many aspects of cardiac care, including the provision of echocardiography.

Furthermore, we have also recently provided funding for the delivery of a pilot project to improve access to echocardiography. The learning from this will support us in understanding how best to further support improvement across Scotland.

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.

Employers with ten or more staff are eligible to participate in the workplace asymptomatic testing programme. The programme allows participating organisations to offer COVID-19 testing to any individuals who work at the location, including employees, volunteers, contractors and agency staff. Agencies which meet the criteria can also enrol in the programme to provide their staff with tests. This includes agencies providing staff to the health and social care sectors.

If an employer or agency does not provide workplace testing, lateral flow device test kits are widely available to individuals through the universally accessible testing offer. Kits can be collected from test sites, pharmacies and local authority collection points, or ordered online for home delivery.

Further to the answer given to question S6W-04701, I can confirm that one of the seven clinicians who undertook the peer review was an experienced Haematology consultant who has expertise in the care of haematological malignancies and the associated protocols.