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The Rail Noise Assessment “ Stirling “ Alloa “ Kincardine Rail Link Report published on 26 May 2009 were undertaken prior to the publication of the World Health Organisation Night Noise Guidelines for Europe. The WHO Night Noise Guidelines for Europe provides guidance on converting between noise metrics and mitigation thresholds reported are in line with the WHO Night Noise Guidelines for Europe. Claims for compensation, in relation to noise and disruption are considered under Part 1 of the Land Compensation (Scotland) Act 1973, and are managed by Network Rail. In determining claims Network Rail has taken into consideration the age and location of properties and it has been determined that only properties adjacent to the new railway line qualify.

As of 14 July 2010, the Medicines and Healthcare Products Regulatory Agency (MHRA) has received a total of 327 reports of suspected adverse reactions (ADRs) associated with the use of human papilloma virus (HPV) vaccine (including Cervarix and brand unspecified reports) from Scotland, covering 1,002 ADRs. 77 of these reports were considered serious by the reporter and only 35 reports contained information on medical history.

The number and nature of suspected ADRs received so far is very much in line with what the MHRA expected to receive at this time and no serious new risks have been identified. Following administration of at least 4 million doses across the UK since September 2008, the balance of risks and benefits of Cervarix remains positive.

Documents which summarise the reports of suspected adverse reactions received by the MHRA in association with HPV vaccine are placed on the MHRA''s website at www.mhra.gov.uk/HPVvaccine.

The Scottish Government may be entitled to consequentials from the UK in respect of the announcement for expanding respite care for disabled children in England in the 2010 Budget depending upon how this is dealt with in the Comprehensive Spending Review. Any consequentials will be contained within the overall Comprehensive Spending Review Settlement 2010 which is due for publication on 20 October 2010.

It is the responsibility of Scottish ministers to decide how additional consequential funding should be allocated and the Scottish Government will be looking at all budgets as part of its own spending review process.

NHS boards are responsible for ensuring the quality, safety and effectiveness of the services they provide. The Scottish Government ensures that all complaints upheld by the Scottish Public Services Ombudsman are followed-up rigorously by NHS boards through established governance arrangements including consideration by Clinical Governance Committees.

The Scottish Government''s food, health and education policies all contribute to successful delivery of our national outcomes that we live longer, healthier lives and improve the life chances for children, young people and families at risk. These are Scottish outcomes to address Scottish issues.

Curriculum for Excellence will play an important part in promoting the health and wellbeing of children and young people. In particular, the food and health experiences and outcomes provide learners with a variety of opportunities to apply their knowledge and skills to plan and safely prepare dishes for a healthy balanced diet meeting their needs and those of others.

We are also ensuring the new national courses involving catering, being developed under Curriculum for Excellence at SCQF levels 4 and 5, draw on the experiences and outcomes. This will ensure the key requirements of health and wellbeing, for example lifestyle, food and nutrition, are included in the new courses.

Meanwhile, all existing national courses that involve aspects of catering, such as college delivered SVQs, skills for work, HNCs and HNDs, already include elements of nutrition and healthy eating. This is either through specific units studied as an integral part of the course or by embedded clearly identifiable nutrition and healthy eating themes.

The NHS in Scotland has invested significantly in new ways of working to support the reduction in hours for doctors in training which has come as part of the implementation of the New Deal Contract and Working Time Regulations. Hospital at Night (H@N) has become the main focus of this, with investment in a multidisciplinary team working in the out of hours period providing care to the majority of inpatients within the hospital.

Safe and effective handover is key to ensuring the success of H@N and shift working, the safety of patients and the quality of care received. As such, NHS Boards have reviewed handover procedures to ensure they are as safe and effective as possible, and some have invested in new technologies such as a the Salisbury Handover Tool to aid this. The Scottish Government has made all NHS boards aware of this tool, and of any good practice across the country.

There is a significant amount of evidence which supports H@N as a safe and sustainable clinical model, and it is shown to improve the overall patient experience, improve clinical outcomes and reduce overall length of stay. Such is the success of H@N within NHS Scotland (and across the UK), it is now being extended to cover the daytime periods in a large number of areas across the country. More information on H@N can be found at:

http://www.healthcareworkforce.nhs.uk/hospitalatnightand247/

Training grade doctors are also complimentary of the H@N environment, stating that they feel supported within the team, with the necessary clinical support available at all times. There is again documented and published evidence (by NHS Greater Glasgow and Clyde) to show that H@N helps doctors in training achieve curriculum competencies at foundation year level.

Both patient safety and staff welfare are critical issues for health boards and they are constantly seeking to improve both. All rotas are designed to meet the minimum contractual and legal guidelines around hours of work, rest and breaks which ensure that doctors are not over tired or unsafe to work. Our WTR Adviser also works with NHS Boards to review working patterns, ensuring that any pattern implemented meets the minimum standards required.

The implementation of H@N has helped reduce the amount of out of hours work done by doctors in training, particularly during the night, with some posts now being required to work night shift one week in every six months. Previous to implementation of H@N, all specialty areas provided individual cover, which meant  that night working was significantly higher in a large number of specialties than it is now. This reduction in night work means more time can be spent working in daytime hours.

The Scottish Government and NHS Scotland have implemented where possible the BMA''s recommendations around splitting night shift working from a week of nights to two individual periods of four nights on and three nights on with extended periods of rest after each.

The Scottish Government is also pursuing a policy of reshaping the medical workforce by moving to a health service predominantly delivered by trained doctors and to reduce the reliance on doctors in training for front-line service delivery. A trained doctor delivered service will ensure better health and higher quality healthcare services for patients resulting in improved patient outcomes and clinical safety. It also supports the continued development of excellence in medicine by giving us the opportunity to enhance the capacity of NHSScotland as a trained doctor''s capacity to deliver is far greater than a doctor in training.

These developments ensure that the welfare of doctors and the safety of patients is always a priority for NHSScotland boards.

While the Scottish government has no current plans to ban trans fats in hospital food, we do recognise it is vitally important that when people are in hospital their nutritional needs are a priority and a balanced diet is tailored to assist each person''s recovery. Over 95% of NHS hospital canteens now have the Healthyliving Award which helps food outlets prepare and promote the sale of healthier food options to staff, visitors and patients.

We are committed to working jointly with industry and retailers to make healthy choices easier for everyone. The food industry has successfully taken voluntary steps to reformulate many products and as a result the average intake of trans fats has been significantly reduced. However, we will keep our position under close review, actively monitoring outputs of ongoing work and new research, in Scotland, the UK and internationally.

The Scottish Government has consulted with the Food Standards Agency (FSA) Scotland. FSA Scotland advise that there is no scientific evidence to suggest that take-away food outlets serve food with a disproportionately high trans fat content.

We will continue to keep trans fats levels under close review, actively monitoring outputs of ongoing work and new research in Scotland, the UK and internationally, and will support action to protect consumer health that is evidence based.

The ePharmacy Programme has introduced electronic prescribing for GPs, who generate 90% of all prescriptions. In relation to other types of prescriptions:

(a) information prescriptions do not currently exist in Scotland.

(b) prescriptions for minor ailments are electronically generated by community pharmacists as part of the Minor Ailment Service (MAS).

(c) and (d) currently the ePharmacy Programme does not support non medical prescribers which includes pharmacist prescribers. We are considering the future scope of the programme and non medical prescribers are part of that review.