Seòmar agus comataidhean

To support GPs in Scotland to refer patients with suspected cancer as early as possible, the Scottish Government published referral guidance in 2007, called the ‘Scottish Executive Health Department Letter (2007) 9: Scottish Referral Guidelines for Suspected Cancer’.

Healthcare Improvement Scotland have been leading on a review of these Scottish Referral Guidelines for Suspected Cancer. Review groups have been established for each tumour group, with membership of each including clinicians from secondary and primary care, members of the Scottish Cancer Coalition and patient representatives. The lung cancer review group produced draft guidelines for suspected lung cancers, which were sent out for wide clinical, patient and public consultation prior to being published in October 2013.

To support effective communication and implementation of the revised guidelines a series of primary care education session were held in autumn 2014 in partnership with Roy Castle Lung Cancer Foundation. These sessions are now available for primary care professionals to view online.

The remaining guidelines are under review and all guidelines will be published by late summer 2014.

A further sub-group has being convened to support the effective dissemination and implementation of the revised guidelines with support from Macmillan Cancer Support.

The Detect Cancer Early (DCE) Programme aims to increase the proportion of Scots diagnosed in the first stage of cancer, initially focusing on breast, colorectal and lung cancer. Survival rates from cancer are often poorest in those living in the most deprived communities and uptake of the cancer screening programmes is lowest in these areas.

The DCE social marketing campaigns are targeted to the most hard to reach groups and include targeted TV, radio and press adverts, translated materials as well as extensive field marketing and road shows. Indeed, over 75% of this target audience have reported high levels of awareness of the DCE social marketing campaigns through an independent evaluation.

In addition we have introduced a two year primary care initiative to support informed uptake of the national bowel screening programme in areas of poorest uptake and have recently launched a targeted breast screening campaign aimed at women over 50 who do not currently take up the offer to screen.

Information on the number of qualified nurses can be found through Information Services Division.

Due to the multidisciplinary nature of the role, a qualified nurse may work in more than on specific speciality, however only one specialist area is recorded for each nurse.

Heart failure services are covered by the Scottish Government 18 weeks to referral to treatment waiting time standard. To deliver this standard all parts of the patient pathway, outpatient consultation, diagnostic test and treatment, must be as short as possible. If a patient goes on to inpatient and day case treatment they will also be covered by the 12 weeks legal treatment time guarantee. However, within the standard and guarantee we would expect that the more urgent patients will be seen much quicker.

There are no waiting time targets for follow up appointments as the timing of such appointments need to reflect each individual patients condition and treatment. We would expect clinicians to keep patients fully informed of their care and the frequency of any follow-up care.

The Scottish Government does not centrally hold the cost of a brain natriuretic peptide test.

The 2012-13 Scottish Health Service Costs (Costs Book) publication provides a cost per examination for ultrasonics (£42.87) and for ‘other radiology’ (£54.79), which includes conventional x-rays:

http://www.isdscotland.org/Health-Topics/Finance/Costs/Detailed-Tables/Radiology.asp). The cost of chest x-rays is not separately identified.

The Detect Cancer Early Programme has an associated HEAT target to increase the proportion of people with stage 1 disease at diagnosis by 25% (as a proxy indictor of survival outcome) for the three most common cancers in Scotland, lung, breast and colorectal cancer and is due to be met by end December 2015.

The social marketing campaigns are continually being reviewed and are evaluated through an independent research agency. In addition the impact on the uptake of the national bowel and breast screening programme is being assessed. The initial evaluations of the social marketing campaigns have been encouraging however the direct impact of public awareness campaigns and other components of the Detect Cancer Early Programme will not be fully apparent until the cancer staging data for 2013-2014 is available.

Professor Henry Dargie completed an audit of heart failure services in Scotland in 2008-09.

This was undertaken as part of NHS QIS (HIS) Heart Disease Improvement Programme, the report of which was published in September 2011.

This work helped to inform the development and subsequent implementation of a Heart Failure Care Bundle which is an integral part of the current Acute care workstream of the Scottish Patient Safety Programme.

Healthcare Improvement Scotland published the Heart Disease Services: Take Heart – A National Overview in September 2011. This publication covers heart failure and the development and subsequent implementation of a Heart Failure Care Bundle. This is an integral part of the current acute care work stream of the Scottish Patient Safety Programme.

This information is not held by the Scottish Government.

Information on numbers of qualified nurses, which increased in this government by 4%, or by 1654.4 whole-time equivalent (WTE) to 42,680.6 WTE, is available via ISD Scotland.

Due to the multidisciplinary nature of the role, a qualified nurse may work in more than one specific specialty, only one of which is recorded by ISD Scotland for each nurse.