Seòmar agus comataidhean

Hospitals where Healthcare Environment Inspectorate (HEI) Healthcare Associated Infection (HAI) inspection reports have included requirements that have been (a) repeated and (b) repeated on more than two inspections in inspections carried out since the HEI was established in 2009.

¹The Inspection Report published on 29 October 2013 combined three inspections in one published report. The repeat requirement above was previously identified in November 2011 report.

All published HEI reports can be found at: http://www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/hei_inspections/all_hei_reports.aspx

Hospitals where Healthcare Improvement Scotland (HIS) inspections on the care of older people in acute hospitals have included requirements that have been (a) repeated.

Hospitals where Healthcare Improvement Scotland (HIS) inspections on the care of older people in acute hospitals have included requirements that have been (b) repeated on more than two inspections.

There have been no occasions so far where repeat inspections of the same hospital have been carried out in relation to the care of older people in acute hospitals.

Healthcare Environment Inspectorate (HEI)

(a) A range of actions are taken by the Scottish Government in response to HEI inspection reports. Ministers and senior officials review all HEI reports and NHS Board local action plans. Where a report highlights areas of particular concern, the Scottish Government will instruct Health Protection Scotland to co-ordinate support for the Board to address the issue(s) identified as per the National Framework for support. This framework sets out the requirements for national support and includes drawing on the support of national organisations such as NHS Education for Scotland, Health Facilities Scotland or with Healthcare Improvement Scotland where required.

(b) Since the inception of the Healthcare Environment Inspectorate (HEI) in 2009, there have been three escalations to the Scottish Government:

Aberdeen Royal Infirmary in October 2009

Ninewells Hospital in November 2010

Aberdeen Maternity in October 2013

The HEI can escalate matters of concern via both formal and informal routes. The severity of the issue arising will determine how and to whom the concern will be escalated to. In some circumstances, the HEI may pursue formal escalation of a serious issue without first engaging in informal escalation activity with the NHS board.

The HEI will inform the NHS board on the day of inspection or as soon as possible of its concerns. This is to allow them to take immediate steps to address the issues, and protect the safety and welfare of patients, staff and the wider public.

The HEI’s escalation procedures and definitions can be found at the following link: http://www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/hei_policies_and_procedures/escalation_procedure.aspx

Healthcare Improvement Scotland inspections on the Care of Older People in Acute Hospitals

(a) Follow up inspections noted improvement in the areas identified. Following inspection, an action plan is developed by the NHS board. The Scottish Government expects NHS boards to take urgent action to address the areas identified as requiring improvement.

(b) There have been no formal escalations to local manager/senior clinical staff however, escalation to senior staff at the time of inspection is undertaken by the inspection team.

Under the Tobacco and Primary Medical Services (Scotland) Act 2010, The Sale of Tobacco (Register of Tobacco Retailers) Regulations 2010 came into force on 1 April 2011.

There were no convictions in 2011-12 and one conviction in 2012-13 under Section 20 of the Act, where this was the main offence. 2012-13 is the latest financial year for which data is available data.

Source: Scottish Government Court Proceedings data.

To date no registered tobacco outlets have had their right to sell tobacco removed as a result of selling to people who are underage.

The available information is given in the following tables.

People given non court disposals selling tobacco to underage persons¹, 2009-10 to 2012-13

People convicted in Scottish courts of selling tobacco to underage persons¹, 2006-07 to 2012-13

Source: Scottish Government Court Proceedings database.

Note: 1. where main offence.

Health boards review morbidity and mortality constantly and various local and national means are used to assure and improve the safety and quality of hospital care. NHS boards are responsible for assuring the quality and safety of specific services.

The training of, and support provided to, General Practitioner (GP) trainees is co-ordinated and shared between NHS Education for Scotland (NES) and individual employers, in the following ways.

a. Deprived areas

There are training practices in the East, South East and West Deaneries that are in areas of deprivation. Health inequalities are also taught in the educational day release programmes for GP trainees.

NES is working with NHS Health Scotland and the Deep End group to develop learning on working in areas of deprivation for GP trainees, trained GPs and other primary care professionals.

b. and c. Remote and Rural areas

There are remote and rural training practices across the North of Scotland, and also rural training practices in the West of Scotland in Ayrshire and Dumfries and in the South East in the Borders.

In the North of Scotland NES has a new and innovative Rural Track GP training programme. This programme is offered in addition to existing programmes and is designed to offer an attractive rurally based option around each of the Rural General Hospital systems to achieve not only the competencies required by the RCGP/GMC but also the competencies to live and work in a rural area. In the 2013-14 recruitment six of ten posts have been filled.

NES and the territorial health boards co-fund rural fellowships and in the 2013-14 recruitment all ten posts have been filled.

The Control of Major Accident Hazards Regulations 1999 do not provide for the designation of centres. However, the Regulations, for which Health and Safety Executive and SEPA are the competent authority in Scotland, provide for the preparation of on-site emergency plans by operators and off-site emergency plans by local authorities, and for the review, testing and implementation of these plans. The information to be contained in these plans is set out in Schedule 5 to the Regulations.

Although GPs are independent contractors, they are still given consideration when planning the NHS Scotland workforce. At present the structure and training of all doctors in the UK, including GPs, is under review. The Scottish Government is actively involved in these discussions to ensure that specific service needs in Scotland are addressed.

With regard to health visitors, it is for each NHS board to decide how best to plan and deliver services, including to meet the needs of its population.

We are leading the UK in developing a series of ground breaking Nursing and Midwifery Workload and Workforce Planning Tools that support evidence based decisions in relation to Nursing and Midwifery establishments. These tools are used to determine the number of nurses, including health visitors, or midwives needed for particular clinical areas through measurement of actual workload, as part of a broader approach that incorporates nurses' professional judgment and quality measures. The Workload and Workforce Planning tools have been mandated since April 2013 and we expect all NHS boards to use them to inform local nursing and midwifery workforce planning.

Work in this area is being progressed under the eHealth Strategy, one of the aims of which is to support people to communicate with the NHS in Scotland and manage their own health and wellbeing. Both GP IT systems used in Scotland now offer online appointment booking and ordering of repeat prescriptions. In addition, GP practice websites offer a range of services, such as online registration, downloading of key practice documents, feedback and complaints, and an array of health related information. Work in the next year will look to increase the uptake of current online services, and broaden the range of services offered, based on people's needs.