Seòmar agus comataidhean

I refer the member to the answer to question S4W-15368 on 25 June 2013. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

The selection of the appropriate stoma appliance to be prescribed for a particular patient is a clinical matter for the specifying clinician taking into account the needs and preferences of the patient concerned.

Health board joint formularies are in place to assist specifying clinicians in addressing patient needs cost effectively. NHS boards also purchase samples for patients’ own evaluation, and these may include items both on the hospital formulary or not where that item may better meet the requirements of an individual patient.

This is intended to ensure that patients can get access to the samples of products which the clinician has identified as likely to be suitable for them, and avoids NHSScotland having to rely on the provision of free samples which may not be either the most suitable or the most cost-effective for patients’ needs.

All NHS board formularies are advisory, with any variance of usage managed through each individual board’s local arrangements.

All manufacturers wishing to supply stoma appliances to NHSScotland are encouraged to offer products for evaluation and to highlight innovation in their design. Should a supplier then have additional innovative products, these may be added after discussion and review with the clinical group.

The Scottish Government believes that this process assists specifying clinicians to cost effectively meet the needs of their patients from all the products which manufacturers may be making available.

As of 17 June 2013, there were 23 dispensing appliance contractors registered with NHS national procurement as stoma appliance suppliers. In addition, there were 1236 community pharmacy contractors and 47 dispensing practices who were also eligible to provide this service.

I refer the member to the answer to question S4W-15368 on 25 June 2013. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

We are aware of the higher level of unavailability due to no response to an appointment in Grampian. My officials are in discussion with the board to understand their booking arrangements and practices to confirm they are compliant with the current guidance.

We are aware that they a relate to a number of genetic patients who following their GP referral are asked to complete a form providing more information before a decision is made to determine what the most appropriate clinical action is.

My officials are currently in discussion with the Boards to get a better understanding of this and to work with the Board to confirm it is appropriately applying the guidance and that the arrangements they have in place are patient centred.

The vast majority of GP practices in Scotland operate as independent contractors within the NHS and are contracted by local health boards under the terms of a UK negotiated general medical services contract.

As independent contractors, practice partners are free to decide (within the context of the services they must provide under contract with boards) exactly how they set up their operations in terms of employing staff, including pay and conditions. As most practice staff are employees of the practice their employment conditions are agreed with the practice owners, partners or management. Issues relating to particular employee terms and conditions are therefore matters for individual GP ownerships or partnerships.

This also means practices are also free to offer terms and conditions with elements which are more generous, if this is felt appropriate.

The diagnostic waiting time publication is based on an aggregated data return from NHS boards which means that ISD do not receive patient level information. This limits the amount of quality assurance that can be done.

Validation is carried out on submission of the data. NHS boards provide assurance of the data through queries which ISD may ask about the information they have received. These queries will be about patterns/trends or significant changes in numbers. Preview of the publication data is also sent back to the boards to approve, further ensuring accurate figures are submitted and published. As part of any publication, ISD ensure that totals add up to the sum of the parts, and in cases where they don’t, provide commentary to explain differences. This is part of quality assurance section in the publication.

The Scottish Government has no intention currently to ask ISD to undertake an audit of positronic emissions scans at this time as it is not currently part of the diagnostic waiting time standard.

HEAT targets are reviewed each autumn with our stakeholder such as boards and the Royal Colleges. It looks at the range of targets for the year ahead. This may include positronic emissions scans.

There are a number of reasons why patients may be returned to their GP many to do with patient behaviour for example a patient has not attended their appointment or have for the third time cancelled their agreed appointment date. GPs can of course re-refer any patient back to the hospital.

We expect all boards to continue to review their own local arrangements for booking scheduling and managing appointments. For example, if a patient agrees a reasonable offer of appointment some boards are phoning or texting patient to remind them of their appointment in a bid to reduce did not attends.

The Scottish Government will continue to review and monitor this with all boards as part of the normal performance management process.