Seòmar agus comataidhean

I refer the member to the answer to question S4W-14689 on 20 May 2013. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/58157.aspx.

We expect clinicians to adhere to relevant clinical standards and guidelines when planning an individual’s diabetes care.

SIGN Guideline 116: Management of Diabetes makes it clear that all patients with diabetes should be screened in a timely manner to assess their risk of developing a foot ulcer. This is supported by the inclusion of a diabetes foot screening indicator in the new Quality Outcomes Framework (QOF) 2012-13.

This will ensure that all people with diabetes have their feet checked and foot risk score recorded as an integral part of their diabetes care and will reduce the number of lower limb amputations.

Through the work of the Scottish Diabetes Group, we have supported the introduction of a foot risk stratification system.

This allows clinicians to assess the major risk factors which may lead to foot ulceration, record them appropriately to calculate a foot risk score and then arrange for the appropriate treatment to be provided. This system of risk stratification ensures that all patients who are at risk of developing a foot ulcer (which if left untreated can lead to amputations), will receive the most appropriate treatment in a timely manner.

Work is progressing through our Scottish Diabetes Foot Action Group to improve access to multidisciplinary foot care, provide structured education for all people with foot complications and raise awareness with staff in hospitals to the importance of foot care for in-patients with diabetes.

Our Scottish Diabetes Foot Action Group (SDFAG) is working closely with Diabetes UK to raise public awareness of foot complications for people with diabetes through the “Put Feet First” campaign.

During the foot screening process, clinicians are expected to make the patient aware of the risk factors that contribute to ulceration and amputation and provide information tailored to the patient’s individual need. This advice is also emphasised through appropriate written information.

This information is available on the NHS National Services Scotland (NSS) Information Services Division (ISD) website. The most up to date figures available are for the financial year 2011-12. These are reproduced in the following table:

The Scottish Diabetes Survey collates data submitted by all 14 NHS Scotland Boards on the number of people with diabetes.

The 2011 report can be found at: http://www.diabetesinscotland.org.uk/Publications/SDS%202011.pdf

Information in the report (Table 69) reported that in Scotland

Percentage of people with diabetes (type 1 and type 2 combined) who had a record of ever having had a foot ulcer was:

Information in the report (Table 71) reported that in Scotland

Percentage of people with diabetes (type 1 and type 2 combined) who had a record of ever having had a lower limb amputation,

Both Ministers and Scottish Government officials regularly discuss matters of local importance, including the forthcoming clinical services review, with NHS Greater Glasgow and Clyde.

Information is not recorded for specific conditions and services.

The Scottish Health Service Costs (the Costs Book) is the only source of published cost information for NHSScotland. This provides a detailed analysis of how board operating costs reported in board annual accounts, have been spent on patient care within NHS Scotland.

The Costs Book is published on the ISD website: http://www.isdscotland.org/Health-Topics/Finance/Costs/

Data on neurorehabilitation services broken down by individual NHS board is not held centrally. Information for condition specific services is not recorded.

While policies, frameworks and resources are provided by the Scottish Government, individual boards are responsible for planning services in their area. This includes securing the range of staff to deliver services to make sure the services meet the needs of patients.

Standard 4.6 of the Neurological Standards states that NHS boards should provide designated rehabilitation services specifically for people with neurological symptoms.

While policies, frameworks and resources are provided by the Scottish Government, individual NHS boards are responsible for planning services in their area and for securing the staff (including specialisms) to deliver them. It is for NHS boards to determine their workforce requirements, including training, based on the clinical needs and services developments in their area.

Our priority for people living with neurological conditions is to ensure that the Neurological Standards published by Healthcare Improvement Scotland are implemented, they offer the best mechanism for achieving safe, effective and person centred care.

The standards will help ensure people get the earliest and most appropriate treatment locally, but with access to specialist services when needed. That’s why we previously provided boards with £1.2million, to develop improvement groups as the main vehicles to take them forward.

Standard 4.6 of the states that NHS boards should provide designated rehabilitation services specifically for people with neurological symptoms.