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NHS boards are required annually to provide workforce projections for all staff groups including radiographers. The workforce projections are used to identify supply and demand requirements across NHSScotland and also to inform education needs. NHS boards are also required to publish their workforce plans on an annual basis.

The Scottish Government expects all NHS boards to have robust processes in place to ensure the provision of safe, effective and high quality patient care which is delivered by the right professional at the right time.

This information is not held centrally.

NHS boards are expected to plan, fund and deliver services to meet the needs of their local populations and the totality of a person’s healthcare needs rather than on an individual condition basis. Accurate estimates for the overall cost of foot ulcer and diabetes related amputations are therefore difficult to establish due to the involvement of numerous disciplines as well as the variable social and rehabilitation costs associated with amputations.

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

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.

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.

The Higher Education Statistics Authority produces statistics for students in higher education institutions. The latest information for Scotland is for the academic year 2011-12. Data for academic year 2012-13 will be available in 2014.

In 2011-12, 120 students (rounded to the nearest 5) obtained a higher education qualification in Radiography.

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.

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,

The total amount spent by NHSScotland on clinical negligence claims since 2007-08 is detailed in the following table:

Fluctuations in the sums paid from year to year are due to the number of high value settlements occurring in any one year. These tend to relate to birth cases where the sums paid can be substantial. In 2010-11 there were 25 claims paid that were in excess of £1 million compared to 16 in 2009-10.

SCOTTISH GOVERNMENT