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The Care Inspectorate does not routinely examine how often GPs review antipsychotic medication prescribed to care home residents and its recording. Both might be examined by the Care Inspectorate’s pharmacy advisers if there are specific concerns in a care home about overuse of psychoactive medication. In addition, during complaints investigations, review of psychoactive medication might be looked at if relevant to the complaint.

We have a specific commitment in the national dementia strategy to reduce the inappropriate prescribing of psychoactive medication. We are currently considering the findings and recommendations of an academic report we commissioned into time trends in the prescribing of antipsychotic and other psychotropic medications to older people with dementia between 2001-11 and the report will inform a commitment to reduce inappropriate prescribing of psychoactive medication to be finalised this year.

On publication, a copy of the report will be placed in The Scottish Parliament Information Centre (Bib. number 53915).

This information not held centrally.

We are currently considering the findings and recommendations of an academic report we commissioned into time trends in the prescribing of antipsychotic and other psychotropic medications to older people with dementia between 2001-11. The report will inform a commitment to reduce inappropriate prescribing of psychoactive medication to be finalised this year.

On publication, a copy of the report will be placed in the Scottish Parliament Information Centre (Bib. number 53915).

This information is not held centrally.

The dementia standards state that NHS boards must ensure that systems are in place to ensure that capacity to consent to treatment (including the prescribing of psychoactive medication) is considered and that appropriate documentation is in place, in line with Part 5 of The Adults With Incapacity (Scotland) Act 2000.

They also state that services must demonstrate knowledge of whether the person with dementia has appointed someone as their welfare power of attorney or if there is a welfare guardian; and that any challenging behaviour must always be addressed by means of an integrated assessment to establish the cause and put a care plan in place to manage it, in line with the relevant SIGN clinical guidelines.

We have a specific commitment in the national dementia strategy to reduce the inappropriate prescribing of psychoactive medication, in recognition of the fact that this is a key driver in helping the reconfiguration of service provision and the range of response in this key area – and ensuring that care is at all times safe, appropriate and person-centred. We are currently considering the findings and recommendations of an academic report we commissioned into time trends in the prescribing of antipsychotic and other psychotropic medications to older people with dementia between 2001-11 and the report will inform a commitment to reduce inappropriate prescribing of psychoactive medication to be finalised this year.

The report shows that, based on its sample and methodology, since 2009 there has been a decline in the initiation of new antipsychotics and a moderately decreasing trend in antipsychotic use. The report shows that in the first quarter of 2011 the rate of older people with dementia being prescribed an antipsychotic is the lowest level over the entire 2001-11 period.

On publication, a copy of the report will be placed in Scottish Parliament Information Centre (Bib. number 53915).

An initial draft health and environment sustainability framework - Towards Healthier and More Environmentally Sustainable Food and Drink in Scotland - was published in December 2011. The framework was developed to explore ways to join up decision making on health and environmental sustainability in food and drink. This concept is at an early stage and, consequently the framework was published as a draft to seek views on the approach taken. Comments received on the draft were due by 30 April. The views received on the draft framework will be used to inform the way forward for the document’s development.

National dietary and sustainability targets and goals are integral to Scotland’s National Food and Drink Policy and underpin the draft framework – Towards Healthier and More Environmentally Sustainable Food and Drink in Scotland. During development of the next iteration of the framework, ways in which to communicate the dietary and environmental sustainability goals will be considered along with the views received from an online survey that closed on 30 April 2012.

It is hoped that decision makers will use the framework and see the business benefits of integrating health and environmental sustainability in their decision making. In doing so, use of the framework may help to contribute towards health and environmental targets and goals.

The vaccination of NHS staff against seasonal influenza is an occupational health responsibility of NHS boards. This responsibility is supported through government activity to raise awareness of the vaccination amongst NHS staff each year, including through the production of a healthcare professionals information leaflet, and the provision of information online.

The Chief Medical Officer (CMO) writes to the NHS prior to the start of the seasonal flu programme each year, and within this letter health professionals are reminded about the importance of staff vaccination for those directly involved in patient care. Last year the Chief Medical Officer included specific additional advice to NHS boards on a range of issues around staff vaccination, including detail on the rationale for vaccination of staff, and guidance on how to deliver a staff vaccination programme.

The CMO also advised that NHS boards should seek to ensure that front line staff were vaccinated as priority, and that particular efforts should be made to ensure that staff working in areas where patients might be at high risk (paediatric, maternity, care of the elderly, haematology and ITUs) are vaccinated. The government will shortly undertake a sample survey across NHS boards to determine the levels of uptake achieved in one such high-risk clinical area. The results of this survey will inform planning for the up-coming flu season.

Ultimately seasonal flu vaccination of staff is not mandatory, and it is a matter for each individual member of staff to decide whether or not they should be vaccinated. That decision should be informed by the information and evidence available.

The Scottish Government has made funding available which will allow the programme to continue until the end of this year.

A report from the CAYA programme will then allow us, working with the University of Glasgow and the Scottish Football Association to consider the next steps.

While this is underway, I can confirm that the Cardiac Assessment of Young Athletes programme (CAYA) has no plans to issue provisional redundancy notices to its staff.

Clinical decisions on ward placements and moves will be informed by best practice and by relevant standards and guidelines, including the standards of care for dementia published last year.

I asked the Chief Nursing Officer to undertake a programme of work with health boards and others to give greater assurance on the quality of the organisation and delivery of care and treatment for older people in acute general hospitals. To complement this initiative, earlier this year Healthcare Improvement Scotland began a programme of inspections into the care of older people, including those with dementia, in acute general hospital settings.

The Final Report is not due to be published until early August 2012, subject to successful peer review. We will consider the findings, once the final report is published, to help us ensure that eye care policies continue to meet the needs of the people of Scotland.

Boards will, as part of monitoring performance against the NHSScotland Staff Governance Standard, be required to identify timescales within which their local employment policies will be compliant with each new/revised partnership information network (PIN) policy and, subsequently, to evidence compliance within that identified timescale. The results of such performance monitoring are used to inform Board Annual Reviews. Timescales for compliance can also be monitored through the national and local NHSScotland partnership structures.