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It is generally accepted that junior doctors who are experienced at interpreting electrocardiographs (ECGs) may do so without referring to more senior doctors.

Doctors who are less confident or experienced in interpreting cardiographs may, at any point, ask a more senior doctor for advice.

Good hygiene can help limit the spread of the norovirus infection, and to ensure best practice in the prevention and treatment of norovirus outbreaks in health boards Health Protection Scotland (HPS) published, on 1 December 2009, revised guidance on norovirus outbreak: control measures and practical considerations for optimal patient safety and service continuation in hospitals. Details are available on their website at: http://www.hps.scot.nhs.uk/haiic/ic/publicationsdetail.aspx?id=43440.

HPS have also published the following guidelines specifically aimed at non health board communities vulnerable to norovirus outbreaks.

14 March 2005: Infection Control In Adult Care Homes: Final Standards.

1 April 2005: The identification and management of outbreaks of norovirus infection in tourists and leisure industry settings. Guide for NHS boards and local authorities.

1 December 2006: Guidance on Infection Control in Schools and other Child Care Settings.

1 August 2007: Guidance for the management of norovirus infection in cruise ships.

NHS boards health protection teams will respond to norovirus outbreaks in the community and give advice, and one of their roles is to exclude other gastrointestinal pathogens. As well as guidance on the prevention and treatment of noroviruses the importance of hand hygiene in preventing infections spreading has been promoted with the following guidance and campaigns:

January 2007: Germs. Wash your hands of them - Scotland''s Hand Hygiene Campaign, Germs. Wash your hands of them, with the aim of reducing avoidable illness amongst staff, patients and the general public.

August 2009 “ the Scottish Government''s national hand hygiene campaign was launched with a campaign pack sent to every nursery and primary school.

1 September 2009: Hand Hygiene - Standard Infection Control Precautions “ HPS publication.

The Scottish Government can confirm that NHS Health Scotland''s corporate communications activity for external audiences is central to their role in disseminating and explaining public health improvement and health inequalities evidence, learning and good practice to professionals. These include professionals who are responsible for delivering campaign messages on the ground “ such as frontline staff and decision-makers in NHS health boards, Community Health Partnerships, local and central government, community and voluntary organisations, Royal Colleges, and health improvement agencies across the UK and internationally “ as well as the media and politicians. They do this through their stakeholder newsletter, briefings and corporate reports. They have budgeted £30,000 for this work in 2010-11.

Following discussions with the Thalidomide Trust the Scottish Government has committed £3.4 million to assist the survivors of Thalidomide. This funding is proportionate to the funding committed by the UK, Welsh and Irish Governments, and is based on the 55 thalidomiders living in Scotland.

In response to concerns about the sustainability and fairness of current and future care for older people in the face of financial and demographic pressures, a major work programme “ Reshaping Care for Older People “ is being taken forward in partnership with NHS Scotland and COSLA through the Ministerial Strategic Group on Health and Community Care.

The programme aspires to develop practical ideas for change that are sufficiently radical to meet the changing needs of Scotland''s population by enabling people to stay at home or in a homely setting, with maximum independence, for as long as possible. A key aim is to ensure that appropriate arrangements are in place to enable service providers to respond effectively to future demand for services. An Integrated Resource Framework is also being developed and tested across four sites in Scotland, from which evidence is being gathered about how resources can be used most effectively across health and social care.

So far the programme has focussed on discussion with colleagues with a professional and clinical interest in delivering services for older people. The emerging proposals are moving towards more anticipatory and preventative approaches, more rehabilitation, more re-ablement, and a greater emphasis on self-care and supported self care, with consequential support for unpaid carers and volunteers.

As part of a wider engagement process and to further analyse and develop emerging proposals, the programme will from March 2010 until the summer seek views from the public and from a wider range of stakeholders including patients, service users and service providers.

I refer the member to the answer to question S3W-31541 on 3 March 2010. 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/Apps2/Business/PQA/Default.aspx.

Given the complexity of social care procurement, it is necessary to consider the desirability of national contracts and pricing frameworks on a case-by-case basis. The Scottish Government, COSLA and Scotland Excel (the procurement Centre of Expertise for local authorities) are working together to explore best practice in relation to social care contracts and pricing frameworks. Scotland Excel is currently consulting local authorities on the opportunities for joint commissioning of services.

Local authorities have a duty to commission community care services. They may provide these services themselves directly or they may commission care services in line with their local commissioning strategy. Where they commission, or provide directly, services of a type which is regulated under the Regulation of Care (Scotland) Act 2001, those services are required to be registered with the Care Commission. The commission inspects all registered services against the relevant statutory provisions and the National Care Standards in order to ensure that people using care services receive good quality care.

The Scottish Government is currently consulting on draft guidance on social care procurement which provides a framework and defines a set of guiding principles for social care procurement activity. The draft guidance underlines the need for local authorities to be realistic in specifying requirements and outcomes which can be delivered within available budgets. It also states that local authorities must take account of the need for a skilled and competent workforce.

The consultation documents can be accessed on the Scottish Government''s website:

http://www.scotland.gov.uk/Publications/2010/01/13125045/0.

The consultation period ends on 5 April 2010.

Local authorities have a duty to provide or commission community care services in line with their local commissioning strategy. Accountability for decisions taken in the context of commissioning services therefore rests with local authorities as the commissioning organisations.