Seòmar agus comataidhean

The matter of energy procurement is one which is devolved to NHS boards to determine under the auspices of the Scottish Government Health Directorates Environmental Management Policy for NHSScotland [NHS HDL(2006)21].

NHSScotland bodies are already investigating the use of renewable energy generation and other energy saving initiatives as part of their commitment to the Scottish Government''s sustainable development objectives under direction of the Health Directorates policy.

Guidance, direct help and assistance is provided by Health Facilities Scotland on a broad range of measures and initiatives to assist NHS boards to improve their energy efficiency and reduce their CO₂ emissions. Within this guidance the Carbon Trust is identified as the main source of help in identifying efficiency projects including renewables. However, it is the responsibility of individual NHS boards to procure the required plant and services and secure the necessary funding or grants.

A breakdown of assets owned by the NHS decommissioned, planned for decommissioning and land for which no NHS use is planned is not held centrally. The information requested is currently being sourced from NHS boards. A full tabled reply will be placed in SPICe when a consolidated response has been compiled. (Bib. number 49884).

An exercise is currently being conducted by Health Facilities Scotland on behalf of the Scottish Government to collect data from NHSScotland bodies on a number of aspects on the NHSScotland estate. This exercise will be the basis of a baseline report to be produced by the end of March 2010. The data collected will incorporate an analysis of assets surplus to requirements and planned for disposal.

An Asset Management System has recently been purchased for implementation across NHSScotland. This system will allow regular local and national reporting and will for the first time ensure that all estates data is held in a single and consistent form across the whole of NHSScotland.

The information requested is not held centrally.

The rapid testing system in NHS Tayside is currently being evaluated by the board as part of its overall approach to managing Clostridium difficile Infection (CDI).

Independent of this, the Scottish Microbiology Forum (SMF), Health Protection Scotland and the Scottish Clostridium difficile Reference Laboratory Service have produced a new testing algorithm for Clostridium difficile which will be available for the diagnostic laboratories before the end of December 2009. Whilst this guidance recognises that Polymerase Chain Reaction (PCR) testing for toxin B may have a role as part of the combination of tests employed in a two-step diagnostic algorithm, the expert consensus of opinion, both in the UK and the rest of Europe, does not currently support its use as a stand alone test, and that there are alternative test combinations which can be used as part of that algorithm.

Any case for the implementation and roll out of a specific rapid testing system for the whole of Scotland would require evidence that a single solution could be applied and would be cost effective for all laboratory situations. It would also require evidence that the system is at least as effective as other methods available and improves the turnaround of results with a positive impact on patient care. Such evidence is currently lacking.

It remains the case that best practice in infection control management and control of potential outbreaks and incidents should be handled as explicitly stated in the Scottish Guidance for the management of CDI.

The derogations apply to the following numbers and grades of doctors in training:

NHS Scotland board	Hospital	Specialty	Number and Grades of Training Posts
NHS Ayrshire and Arran	Ayr Hospital	Emergency Medicine	1 x ST3+
NHS Borders	Borders General Hospital	Paediatrics	5 x ST3+
NHS Fife	Forth Park Maternity Hospital/ Victoria Hospital	Paediatrics	10 x ST3+
NHS Lanarkshire	Hairmyres Hospital   Monklands Hospital   Wishaw Hospital   Wishaw Hospital	Accident and Emergency Accident and Emergency Accident and Emergency Neonates	2 x SpR 1 x ST4 3 x ST4 1 x ST5 2 x ST4 4 x ST3+

 

Some of these rotas may be partially staffed by staff and associated specialist grades and the numbers of doctors in training may fluctuate as vacancies occur and are filled.

As employers, NHS boards are required to maintain such records as are adequate to demonstrate that each employee is compliant with the regulations. In addition to guidance covering record keeping issued in 2003 (NHS HDL (2003) 3), more recently we have issued CEL 14 2009 which provides good practice guidance on the sort of records that NHS Scotland boards could keep to measure compliance with the Working Time Regulations (WTR) for doctors in training. These include:

New Deal monitoring (two week monitoring information);

Template rota information, in particular extending all rotas over 26 weeks to ensure compliance over this reference period, and

Clinical activity analysis.

Our WTR Adviser continues to work with NHS boards to ensure that employers are aware of their obligations around record keeping. Following these suggestions will enable NHS Scotland boards to gauge the working hours of doctors in training to ensure they comply with the WTR.

Under the New Deal contract, all rotas in NHS Scotland have to be approved by the New Deal Manager/WTR Adviser before implementation. This approval ensures that all working patterns meet the required legal and contractual guidelines, including hours of work and associated rest/time off requirements. If these requirements are not met, rotas cannot be implemented.

Following the recommendations set out in the NHS QIS reports, the national HAI Task Force established a short life group to review the membership and terms of reference for both the task force and the national HAI Stakeholder Group.

This group has met twice and will report its findings at the 8 December meeting of the task force. Its remit has been to ensure the terms of reference and membership for both groups support the provision of advice to the Scottish Government on the appropriate operational and policy response/approach for reducing HAI in Scotland.

This review will also ensure that the professional interests involved in supporting delivery of the infection control agenda are fully represented in overseeing both policy development and operational delivery at national level.

In the event of an incident or outbreak, all NHS boards are required to complete an incident and outbreak reporting template. This is used to inform key contacts at both the Scottish Government and Health Protection Scotland. I have asked the HAI Task Force at its next meeting on 8 December to review the arrangements in place for notifying the public of incidents/outbreaks. I have also asked that any changes support a consistency of approach across the NHS; are based on the principle of a single point of contact between the Scottish Government and the NHS board and preserve the absolute priority of protecting the interests of patients and their families at all times.