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Health Visitors have full access to the Scottish Women-Held Maternity Record (SWHMR) as it is used as a starting point for their initial assessments. 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.

National guidance to all Alcohol and Drug Partnerships and Drug and Alcohol services within the HEAT A11: Updated Drug and Alcohol Treatment Types publication states the following:

Comprehensive assessment is targeted at drug/alcohol misusers with more complex needs and those who will require structured drug/alcohol treatment interventions. The assessment aims to determine the exact nature of the service user’s drug/alcohol problems, and coexisting problems in the other domains of health (mental and physical), social functioning and offending. A full risk assessment should also be conducted. Comprehensive assessment may be conducted by more than one member of a multidisciplinary team, because different competences may be necessary to assess different areas of service user need (e.g. a doctor needs to assess service users for prescribing interventions involving controlled drugs – a supplementary prescriber may also be involved or a psychologist may need to carry out psychometric assessment).

Comprehensive assessment can be seen as an ongoing process rather than a single event. Comprehensive assessment will be carried out when a service user may:

Require structured and/or intensive intervention

Have significant psychiatric and/or physical co-morbidity

Have significant level of risk of harm to self or others

Be in contact with multiple service providers

Have a history of disengagement from drug treatment services

Be pregnant or have children “at risk”.

Comprehensive assessment provides information that will contribute to the development of a recovery support plan for a service user.

The refreshed Framework for Maternity Care in Scotland sets out how services should be provided to pregnant women with substance misuse issues. It states boards should have evidence that there are effective communication and pathways between maternity service, primary care, public health nursing and other NHS services working with women at risk of poorer outcomes.

NHS boards should also have evidence that maternity care services are integrated with Local Children’s services and vulnerable adult planning mechanisms.

The Scottish Woman Held Maternity Record (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. The Health Plan Indicator or HPI allocated by the health visitor/public health nurse at the initial assessment indicates the level of service required by families following the birth of a baby and can be “core” or “additional”. Pregnant Women, children and families with complex needs or identified vulnerabilities such as alcohol or substance misuse should be allocated an “additional” Health Plan Indicator. The allocation of an HPI requires a structured approach to assessment and any information on the allocation of an HPI should be shared during the hand over from midwife to health visitor/public health nurse.

The responsibility for management of cooling towers lies with each individual company therefore the Scottish Government has no jurisdiction in these matters. Work-related health and safety is a reserved matter for the Westminster Parliament.

The Health and Safety Executive (HSE) publishes an Approved Code of Practice which provides guidance on the control of legionella bacteria in water systems. This sets out what steps should be taken by employers, and those with responsibilities for the control of premises, for identifying and assessing sources of risk, preparing a scheme to prevent or control risk and implementing, managing and monitoring the precautions. It also provides some advice on replacing cooling towers with alternative methods of cooling.

The Scottish Woman Held Maternity Record (SWHMR), was updated in 2011, and is part of a range of actions underway to support NHS boards’ implementation of the Refreshed Framework for Maternity Care (2011), to ensure that care in Scotland is person centred, safe and effective. As set out in the Framework, it is the responsibility of NHS boards to ensure that maternity services gather, record and report on a wide range of information for both local and national purposes, and have IT systems that comply with nationally identified data requirements.

NHS boards received funding in early June 2012, for 2012-13, outlining the government’s continued support with implementation of recommendations in the framework, and this specifically includes data collection. NHS boards recently provided an update on their progress with this, which indicated that they are planning to move towards electronic systems for information collection and analysis.

The Refreshed Framework for Maternity Care in Scotland states that health boards are expected to have evidence that their IT systems comply with nationally identified data requirements.

Figures on entrants studying Medicine at Scotland’s Five Medical Schools broken down by domicile, are provided in the following tables.

Table 1: Number of Undergraduate Entrants to Scotland’s Five Medical Schools: 2008-09

Source: Higher Education Statistics Agency (HESA)

Note: All student numbers are rounded to the nearest five.

Table 2: Number of Undergraduate Entrants to Scotland’s Five Medical Schools: 2009-10

Source: Higher Education Statistics Agency (HESA)

Note: All student numbers are rounded to the nearest five.

Table 3: Number of Undergraduate Entrants to Scotland’s Five Medical Schools: 2010-11

Source: Higher Education Statistics Agency (HESA)

Note: All student numbers are rounded to the nearest five.

Scottish Government policy on this issue will continue to be informed by the latest evidence. We are mindful of the impact that marketing of food high in fat, salt and sugar can have on the nation’s dietary health and obesity levels so our commitment to look for ways to restrict such marketing activity, especially to children, remains.

As this report highlights, product placement is one of many ways in which brands are promoted to viewers. We would strongly urge companies to take a responsible attitude to any such promotion, not only with product placement but also with any sponsorship and advertisements around movies and other media.

Calculating uptake of vaccination by NHS staff is complicated for a number of reasons. NHS boards use different occupational health systems, and some staff will be vaccinated through the core vaccination programme by their GP due to risk factors.

Health Protection Scotland currently collects some high level data from NHS boards on uptake for healthcare workers, and this allows an estimate to be calculated. For the 2011-12 flu season uptake of routine seasonal flu vaccine was estimated at 33%. This figure is based on data provided for all staff and represents a weighted mean value based on the population within each board.

Information for individual clinical staff groups is not held centrally.

There was no pandemic vaccine in 2011-12.

The Office of Fair Trading (OFT) Report identified areas for action. The Scottish Government had already addressed some of these areas prior to publication of the OFT Report, as follows:

1. The National Health Services (General Dental Services) (Scotland) Regulations 2010 already require dentists to provide written treatment plans with costs in specific circumstances.

2. The process for patients to complain about NHS Services has been improved through the Patient Rights (Scotland) Act 2011.

3. The system to inspect private dental practices is currently being agreed with Healthcare Improvement Scotland.

Direct access to dental care professionals is the remit of the General Dental Council and we await their decision.

The Standards of Care for Dementia in Scotland (2011) contain standards on the assessment, provision and design of care environments for people with dementia. It includes a standard on the regular audit of acute general hospital settings and the requirement that adaptations and reasonable adjustments should be made in all settings to support people to remain as independent as possible. The standards signpost services to the Design for People with Dementia: Audit Tool (2008), produced by The Dementia Services Development Centre at The University of Stirling in collaboration with Health Facilities Scotland. Services will also want to consider using any new design tools as appropriate to help them in meeting these standards.

These standards will inform both the advice given to NHS boards by Health Facilities Scotland and any inspections by Healthcare Improvement Scotland (HIS) (including Health Environment Inspectorate) and the Care Inspectorate (CI) into the environmental aspects of dementia care. The current programme of inspections by HIS into the care of all older people, and those with dementia at all ages, in acute general hospital, includes a focus on these issues. The CI Inspection Plan for 2012-13 states that their planned inspections include an alignment with the Scottish Government prioritisation on improving dementia services.

The CI is also designating a network of qualified nurse inspectors to concentrate on the work around the Dementia Standards now being rolled out across care homes and care at home settings. The CI is working closely with the Scottish Social Services Council to develop and raise awareness of the Promoting Excellence dementia skills framework to improve dementia standards of care in care home, care at home and adult day care services.

The forthcoming review of the National Care Standards will include their formal alignment with the Dementia Standards.