Seòmar agus comataidhean

Sharing appropriate information is an essential component of child protection and care activity. Local data sharing agreements and procedures will vary but local areas and agencies should ensure that there are robust information-sharing protocols in place and that practitioners understand their responsibilities in relation to the sharing, storing and retrieving of information.

Professor Ian Diamond was asked to prepare an expert think piece on options to ensure continuity in research funding in an post independent Scotland. Professor Diamond's former position with the Economic and Social Research Council and with Research Councils UK provided him with experience necessary to develop such expert advice. Given this expertise, Professor Diamond was not constrained with a detailed remit in undertaking this piece of work.

The Scottish Government has no plans at present to commission research to assess the use of illegal drugs through the use of biomarkers in raw sewage. However, we continuously monitor any developments in the evidence base on substance misuse and note with interest any new approaches to detecting illegal drug use.

Since 2007, the Scottish Government has invested significantly in building the evidence base on substance misuse in Scotland, so that we can better understand substance misuse in Scotland and how best to respond.

The following studies are funded by the Scottish Government to estimate the prevalence of drug use in Scotland. The Scottish Crime and Justice Survey: Drug Use is a household survey which provides information on the experiences and prevalence of illicit drug use amongst the general adult population in Scotland. The most recent data available is for the year 2010-11, published 27 March 2012.

The prevalence of problem drug use in Scotland is provided by the study Estimating the National and Local Prevalence of Problem Drug Use in Scotland. This study provides estimates of the problematic use of opiates (including illicit and prescribed methadone use) and/or the illicit use of benzodiazepines. The most recent data available is estimates for the year 2009-10, published 29 November 2011.

The prevalence of drug use amongst schoolchildren across Scotland (13 and 15 year olds) is provided through Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) a school survey looking at drug, tobacco and alcohol use. The most recent data is for the year 2010, published 20 December 2011.

I have asked NHS Information Services Division to provide an update on electronic SMR25 submissions and they have provided this response. They have reported that over the past year, progress has been made in increasing the electronic submission of SMR25 forms as outlined below for each of the services:

(a) Statutory (includes all NHS and Local Authority services) Drug Treatment Services:

Approximately 95% of all SMR25 submissions from statutory services are now made electronically compared with 70% in March 2011.

As of September 2011, all submissions for statutory and voluntary drug treatment services are expected to be completed electronically. Paper forms are no longer accepted from statutory drug treatment services, unless they are in the process of transitioning to electronic submissions. Following the roll out of a new IT system (completed March 2012) in parts of Glasgow, all services within Glasgow City now have the facility to submit data electronically and ISD expect that electronic submissions will be received by December 2012.

ISD send monthly compliance reports to Alcohol and Drug Partnerships (ADPs) to enable them to identify those services who are not submitting SMR25 data electronically and also to ensure data quality. ISD continue to work with ADPs and services to ensure that all services who should be submitting SMR25 data are doing so electronically.

(b) Scottish Prison Service

Since 1 April 2010, drug treatment services within all 13 publicly funded Scottish prisons make electronic SMR25 submissions.

ISD are engaging with the two Health Boards containing private prisons with the aim of receiving electronic SMR25 data. Kilmarnock prison is expected to collect electronic SMR25 data in late 2012. ISD will continue to work with the Addiewell prison to progress electronic submission.

(c) Primary Care Providers (including GPs)

Currently, no electronic SMR25 submissions are received from primary care providers, however 94 general practices submitted SMR25a paper forms to ISD in 2010-11.

There is no requirement for primary care providers to submit SMR25 forms electronically in order to receive a fee. Any fees associated with providing drug and alcohol treatment services are received as part of the enhanced services contract which is managed locally by NHS boards. In 2010-11, approximately 400 practices received payments for providing drug treatment services.

As of 1 October 2011, there are approximately 1,000 GP practices in Scotland. However, it should be noted that not all of these practices will provide drug treatment services.

Children can be referred to the Reporter up to the age of 16 (or 18 if they are already on supervision). This is a matter for the Principal Reporter, however I can confirm that Scottish Children's Reporter Administration (SCRA) does not centrally record whether those children have children of their own. Any such information would be held on individual case files. Referrals to the Children’s Reporter are only made in respect of children, not adults.

SCRA does not hold centrally the numbers of children where parental drug misuse is a factor in their referral. However, SCRA has published a number of research reports, which include examination of the extent and impact of parental drug misuse on children and young people referred to the reporter. These reports are available on the SCRA’s website www.scra.gov.uk.

<>Funding for the provision of smoking cessation services is allocated to NHS health boards. Individual boards are then responsible for design and delivery of high quality, intensive, evidence-based services tailored to the needs of the local population. These services should be in line with the definitions and recommendations set out in the NHS Health Scotland and ASH publication A Guide to Smoking Cessation in Scotland 2010 (http://www.healthscotland.com/documents/4661.aspx).

This guidance does not specifically promote text messaging but concentrates on longstanding and robust evidence around behavioural support and pharmacotherapies in line with NICE guidance.

The guidance does, however, recommend that other types of public health interventions such as the national smoking helpline Smokeline and support website www.canstopsmoking.com should be used where appropriate to support NHS Smoking Cessation effort. The www.canstopsmoking website offers free text support which aims to provide encouragement, advice and motivation to quit and stay quit, and to help the client cope with cravings and withdrawal symptoms. In addition, some NHS boards offer their own text service in support of local specialist smoking cessation services.

A new Tobacco Control Strategy, which will focus on prevention and cessation, is due to be launched later this year. The strategy will set out plans for reviewing smoking cessation services across Scotland. In the light of this review, we will consider whether any modification to current guidance is required.

Information on the “off-licence” use of medicines broken down by age group and type of use is not held centrally.

Prescription data which is collected centrally relates to prescribed items dispensed in the community by community pharmacists and dispensing doctors. These data are not patient specific and do not identify if the item is prescribed outside the terms of the marketing authorisation (off-licence).

Whilst UK medicines legislation does allow for the use of licensed medicinal products being used outside the terms of the marketing authorisation, the decision to recommend the use of a medicine in this way is a matter for clinical judgement by the prescriber concerned involving full consultation with the patient.

A number of additional health data collections record substance use information during and post maternity. Scottish Morbidity Record 02 (SMR02) is a prenatal and antenatal episode based patient record relating to all inpatients and day cases discharged from obstetric specialties. Substance use information recorded on SMR02 includes smoking behaviour, drug use during pregnancy and typical weekly consumption (SMR02 may include data entered from the Scottish Woman-Held Maternity Record, SWHMR). Information Services Division (ISD) publishes annual data on maternities recording drug misuse at Scotland, NHS board and local authority level. Scotland and NHS board data on smoking is also published on the ISD website; information on alcohol consumption during pregnancy is not routinely published but is available on request.

The Scottish Drug Misuse Database (SDMD) is a key national information source on the use of drugs in Scotland. The initial assessment (SMR25a) and follow up assessments (SMR25b) ask whether the client presenting for specialist drug treatment or their partner is pregnant, and whether the client has dependent children under the age of 16. Information on the percentage of “new clients” who report at their initial assessment that they have dependent children is published annually by ISD in Drug Misuse Statistics Scotland. The first release of information collected by the SDMD at follow-up assessment, including that on dependent children, will be published by ISD in December 2012.

The Scottish Birth Record (SBR) is a web-based system developed to ensure that every child born in Scotland has one record, which will act as the foundation for future information collection. SBR includes information relating to alcohol and smoking use: smoking history, smoking during the pregnancy; alcohol intake pre-pregnancy; current alcohol use, and whether the mother was referred for alcohol problems. This data may come from SWHMR or be entered directly on to the system at birth. In addition, diagnostic codes covering alcohol, drugs and tobacco relevant to the baby can be recorded on SBR. Neonatal discharges recording drug misuse for Scotland, NHS boards and local authorities are published by ISD; the SBR alcohol and smoking information is not routinely published but is available at both national and local level.

The Scottish National Smoking Cessation Services Database was established in 2005 to capture information on people presenting to NHS services in Scotland for help to stop smoking. This web-based system includes information on quit attempts made by pregnant women; these data is published in the smoking cessation statistics annual report.

Evaluation of the programme is key to assessing its success. The programme will be continually monitored, using agreed quality control measures, to ensure measurable outputs are met.

To date there have been two interim reports published on the evaluation of the Family Nurse Partnership programme in NHS Lothian which are available on the Scottish Government website.

First interim evaluation report – pregnancy phase (published July 2011) http://www.scotland.gov.uk/Publications/2011/07/28142203/0.

Second interim evaluation report – late pregnancy and postpartum phases (published June 2012) http://www.scotland.gov.uk/Publications/2012/06/1551/0.

A further interim report (infancy phase) is due to be published in late 2012 with the full evaluation report due to be published in the spring of 2013. We will consider how we report future evaluation of the programme across Scotland following publication of the full evaluation report.

The SWHMR guidance for Professional Version 6 sets out how the information gathered in the SWHMR should be used by maternity care services to assist in the process of early communication and care planning for families with complex needs or identified vulnerabilities. Any pertinent information should be shared during the hand over from midwife to health visitor/public health nurse.

The SWHMR is held by the woman during her pregnancy and therefore Health Visitors, Midwives and other relevant professionals will have access to the data it contains during this period and the initial postnatal period. By being in the woman’s possession rather than a particular health board, this ensures the woman will receive informed maternity care wherever she may be.