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Specialist NHS inpatient care is provided by the Eden Unit at the Royal Cornhill Hospital Aberdeen which serves north of Scotland NHS boards and under contract with the independent providers at The Priory, Glasgow and Edinburgh Huntercombe Hospitals which serve west and east of Scotland NHS boards.

There are currently no waiting lists for NHS patients to access services at these facilities.

The NHS Quality Improvement Scotland''s Eating Disorders in Scotland Recommendations for the Management and Treatment highlight the importance of both tailored physical assessments and the need for DXA scans to estimate bone density which can be an indicator of osteoporosis to be carried out on individuals with anorexia nervosa.

The Scottish National Blood Transfusion Service (SNBTS), which organises and collects blood donations, currently works with a number of, but not all, public authorities, including fire and police organisations, local councils, universities, colleges and hospitals.

Data on whether staff from the relevant organisations who give blood are paid is not collated centrally. However, SNBTS believes that this is the case.

The SNBTS Accessibility Group is expanding as much as possible the blood donation collections that take place with other NHS bodies.

All NHS board areas provide a range of specialist inpatient and community-based care for people with anorexia nervosa, either directly or through arrangements with the independent sector.

The Eden Unit, which is a specialist NHS eating disorder inpatient unit at the Royal Cornhill Hospital, serves the north of Scotland NHS boards. In other board areas, NHS specialist inpatient care is provided in NHS hospitals or under contract with the independent sector at The Priory, Glasgow and Edinburgh Huntercombe Hospitals.

All NHS boards keep arrangements and services under review and are working towards improved access and outcomes for service users based on prevention, appropriate intervention and sustained recovery.

NHS boards in the south east are currently considering proposals for a 12 bed inpatient unit to be based at St John''s Hospital, West Lothian. Decisions are expected early next year.

Decisions on treatment options rest primarily with the clinician, in consultation with the individual, and where appropriate, the carer and family. Treatments will be based on a through assessment and tailored to the needs of the individual to achieve the best possible outcomes.

Medication may be used to treat co-morbid conditions with anorexia nervosa such as osteoporosis. However, all healthcare professionals should be aware of the risk of using drugs for co-morbid conditions that prolong the QTc interval. All patients with a diagnosis of anorexia nervosa should have an alert placed in their prescribing record concerning the risk of side effects. ECG monitoring should be undertaken if there is a prescription of medication that may compromise cardiac functioning.

Patients with anorexia nervosa are routinely given vitamin and mineral supplements in an oral form during both inpatient and outpatient weight restoration and this may improve bone density. Hormonal treatment using oestrogen or dehydroepiandrosterone (DHEA) does not have a positive impact on bone density and oestrogen is not recommended in children or adolescents due to the risk of premature fusion of the bones.

Other treatment for osteoporosis can have harmful cardiac and or renal side effects and have to be used with care, particularly in young people.

My previous answer to the question S3W-27821 on 28 September 2009, has been revised as there had been new supply shared equity completions in Argyll and Bute in 2007-08 and 2008-09. In 2007-08, there were 39 new supply shared equity properties completed. In 2008-09, there were 20 new supply shared equity properties completed. The letter sent to you on the 21 October 2009, noting the amendment, has been placed in the Scottish Parliament''s Information Centre (Bib. number 49491), and S3W-27821 will be changed on the official record.

Scottish Government Officials are in contact with NHS Highland to monitor the situation and expect to receive an update from NHS Highland in the next few weeks.

The Scottish Government Health Directorates will issue a Chief Executive Letter (CEL) in late 2009 to reinforce the recommendations for implementation contained in the Health for all children 4: Guidance on Implementation in Scotland.

The work to address the variation in implementation of certain aspects of health for all children 4 across Scotland continues. This includes NHS Highland. The Scottish Government Health Directorate will issue a Chief Executive Letter (CEL) in late 2009 to reinforce the recommendations for implementation contained in Health for all children 4: Guidance on Implementation in Scotland.

A significant amount of guidance has been issued to NHS boards regarding working with schools and parents on young people''s health. This includes guidance, which may not be primarily addressed to NHS boards but requires them to work in partnership with local authority children''s services and education authorities.

All guidance published by the Scottish Government is available at:

http://www.scotland.gov.uk/Publications/Recent.

As stated in my previous answer, a date has not been specified. The NHS boards who have not yet introduced an orthoptist pre-school screening programme are working towards doing so, or towards introducing a programme supervised by an orthoptist or an optometrist.

The Scottish Government Health Directorates will issue a Chief Executive Letter (CEL) in late 2009 to reinforce the recommendations for implementation contained in Health for all children 4: Guidance on Implementation in Scotland.