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The UK Government has not provided sufficient detail on the implementation of its proposed welfare reforms for the financial impact on future Scottish local government expenditure to be known. The Scottish Government has made repeated requests to the UK Government for further detail and will continue to press for this to be made available.

I refer the member to the answer to question S3W-02397 on 22 September 2011. 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/28877.aspx.

The East Ayrshire Community Hospital is an existing PFI project, the contract for which was signed by the former Ayrshire and Arran Community Healthcare NHS Trust in 1998. The proposed dental facility was, therefore, being taken forward as a variation to the existing PFI contract but with capital being provided by NHS Ayrshire and Arran from within the overall capital allocated to the health board by Scottish Government.

The overall project cost for the construction of the dental facility at East Ayrshire Community Hospital was estimated by NHS Ayrshire and Arran to be within their delegated financial limits for capital expenditure and therefore did not require direct Scottish Government approval. Moreover, the proposed dental facility was taken forward as a variation to an existing PFI contract without a requirement for additional debt funding.

The Scottish Government’s guidance on the Procurement of Care and Support Services states that local authorities should take account of the costs associated with good employment practice and a competent and qualified workforce when analysing the costs involved in operating different kinds of care and support services. The level of staff salaries is, however, a matter for individual service providers.

The Scottish Government Health and Social Care Directorate requested that Scottish Futures Trust review the accounting and budgetary classification of the East Ayrshire Community Hospital PFI project contract signed with Cumnock Special Purpose Vehicle Limited. The preliminary assessment under European System of Accounts 1995 indicated that the asset should remain on the government’s balance sheet for national accounts purposes.

Scottish Government officials and Scottish Futures Trust have also assisted by providing advice and opinion at a number of the discussions held between one or more of the parties to the contract variation. The main parties to the discussions have been the board, the Special Purpose Vehicle parent company and the funding bank.

The Scottish Government published comprehensive guidance for local authorities on the Procurement of Care and Support Services in September 2010 after extensive consultation with stakeholders, including service user and carer representative organisations, independent, voluntary and public sector service providers and organisations which procure care and support services. The guidance is available on the Scottish Government’s website:

http://www.Scotland.gov.uk./Resource/Doc/324602/0104497.pdf.

The Scottish Government’s guidance on the Procurement of Care and Support Services recognised the need for commissioning bodies to work in partnership with service providers to make the best use of available funding whilst maintaining the quality of services and meeting service users’ needs and expectations.

The guidance was published following a two-year review of the procurement of social services. In addition, Audit Scotland is currently undertaking a performance audit of the commissioning of social care services in Scotland. Pending the outcome of this work, we do not intend to initiate a further review of the procurement of social care services.

We expect clinicians to follow Scottish Intercollegiate Guidelines Network (SIGN) guidelines in Scotland where clinically appropriate. The guidelines recommend that Sudden Unexpected Death in Epilepsy (SUDEP) should be discussed, except in the minority of circumstances where the clinician may judge that it may cause serious harm to the patient. As no single approach will suit all patients, the discussion about SUDEP is a clinical judgment in the context of individual circumstances, and in agreement with the patient and their carers, where relevant.

If a clinician decides not discuss the risk of SUDEP with patients, the decision should be regularly reviewed and the subject of SUDEP raised at the appropriate time, recording the outcome of discussions in the patient’s clinical records as recommended by the General Medical Council.

We have agreed to provide Epilepsy Scotland with funding to conduct research into the information needs of people with epilepsy regarding SUDEP. The research aims to identify at what point post-diagnosis, individuals would prefer to receive information on SUDEP and in what form. Equally important is to identify who they would prefer to receive the information from; their consultant or epilepsy specialist nurse. The findings of the research will help support healthcare professionals in the vital process of sharing information with people at risk of SUDEP.

Recommendations from the fatal accidents inquiry report should be considered and acted upon by those responsible for delivering healthcare services, such as NHS boards. The Chief Professional Officers Groups at the Scottish Government also consider such recommendations and provides advice to clinicians and boards.

We deeply regret the tragic deaths of Erin Casey and Christina Llia and recognise that measures should be put in place to minimise the risk of Sudden Unexpected Death in Epilepsy (SUDEP). We are currently working with clinicians, pharmacists, Epilepsy Scotland, the Association of Chief Polices Officers in Scotland (ACPOS) and Healthcare Improvement Scotland to take forward the recommendations from the Fatal Accident Inquiry report.

For example, the Scottish Intercollegiate Guidelines Network (SIGN) has produced two guidelines on epilepsy, one for adults and one for children and young people. Both guidelines state that SUDEP should be discussed with patients and if appropriate, their parents or carers as soon as possible after diagnosis. We expect clinicians to follow these guidelines.

SIGN has confirmed that SIGN 70 on the diagnosis and management of epilepsy in adults is due for review next year. As part of that process, SIGN will review the available evidence on information giving on SUDEP.

We have also agreed also to provide Epilepsy Scotland with funding to conduct research into the information needs of people with epilepsy regarding SUDEP. The research aims to identify at what point post-diagnosis, individuals would prefer to receive information on SUDEP, in what form and by whom. The findings of the research will help support healthcare professionals in the vital process of sharing information with people at risk of SUDEP.

In addition, the Association of Chief Police Officers in Scotland (ACPOS) has confirmed that they will make changes to their probationer training in light of the recommendations from the FAI report.