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As part of the childhood immunisation programme, children are routinely offered one dose of MMR vaccine at around 12 to 13 months of age, and a second dose from three years four months of age. The level of uptake of MMR vaccine required for population cover (herd immunity) is 95%.

Uptake rates are shown in the information provided for the answer to question
S4W-14433 on 9 May 2013. These figures show:

Uptake of one dose of MMR vaccine by 24 months of age in Scotland reached 95% for the first time in 2012 (Table 1).

Uptake of one dose of MMR by five years of age in Scotland exceeded 95% in 2009, 2010, 2011 and 2012. Uptake rates at five years of age are available from 2006 (Table 2a).

Uptake of the second dose of MMR by five years of age has been below 95% since monitoring at this stage began in 2006 (Table 2b).

Uptake rates by 24 months of age by Scottish Index of Multiple Deprivation (SIMD) quintile are available from 2006 and are shown in Table 4 of PQ answer S4W-14433. SIMD quintile 1 relates to the most deprived areas and SIMD quintile 5 relates to the least deprived areas. Uptake rates in SIMD quintile 4 exceeded 95% in 2012. Uptake rates exceeded 95% in SIMD quintile 5 (least deprived) in 2011 and 2012.

We have no plans at present to commission any research which specifically looks at the effects on children of exposure to the promotion of drink and retail food establishments in films and on TV.

There is a lot of existing academic research conducted here and abroad which looks at the effects of marketing through film, TV and other media in relation to the purchase and consumption of food and drink. We continue to ensure that such research, where relevant, is used to inform policy on how we can best protect dietary health through the responsible marketing of food and drink.

Under the Scotland Act 1998, all broadcast marketing is reserved to Westminster.

The following is a list of published research on suicide and self harm which has been funded or part funded by the Scottish Government since the launch of Choose Life in 2002. The list includes research funded by the Choose Life programme, which is fully funded by the Scottish Government; and research about projects related to, but not solely about, prevention of suicide and self-harm.

Confidential Inquiry into Suicide and Homicide by People with Mental Illness (on-going)

http://www.hqip.org.uk/national-confidential-inquiry-into-suicide-and-homicide/

Suicide and Suicidal Behaviour: Establishing the Territory for a Series of Research Reviews (2004)

http://www.scotland.gov.uk/Publications/2004/10/20090/45184

Evaluation of Phase 1 of Choose Life (2006)

http://www.scotland.gov.uk/Publications/2006/09/06094657/0

The Epidemiology of Suicide in Scotland 1989-2004: An Examination of Temporal Trends and Risk Factors at National and Local Levels (2007)

http://www.scotland.gov.uk/Publications/2007/03/01145422/20

Risk and Protective Factors for Suicide and Suicidal Behaviour: A Literature Review (2008)

http://www.scotland.gov.uk/Publications/2008/11/28141444/0

Effectiveness of Interventions to Prevent Suicide and Suicidal Behaviour: A Systematic Review (2008)

http://www.scotland.gov.uk/Publications/2008/01/08094005/0

Evaluation of Phase 2 of Choose Life (2010)

http://www.scotland.gov.uk/Publications/2010/03/30174735/0

Scottish Suicide Information Database

Report 2011:

http://www.isdscotland.org/Health-Topics/Public-Health/Publications/2011-12-20/2011-12-20-Suicide-Report.pdf

Report 2012:

http://www.isdscotland.org/Health-Topics/Public-Health/Publications/2012-12-18/2012-12-18-ScotSID-2012-Report.pdf

Evaluation of the Breathing Space Telephone Advice Line and Signposting Service for People Experiencing Low Mood or Depression

Christine Sheehy et al. 2006

http://www.scotland.gov.uk/Resource/Doc/114404/0027945.pdf

An in-depth qualitative exploration of the links between self-harm and attempted suicide in young people

Dawn Griesbach et al. 2007.

http://griesbach-research.co.uk/wp-content/uploads/2011/09/FINAL-REPORT-JUL07.pdf

The Use and Impact of Applied Suicide Intervention Skills Training (ASIST) in Scotland: An Evaluation

Rona Dolev et al. 2008

http://www.scotland.gov.uk/Resource/Doc/223482/0060182.pdf

Breathing Space Telephone Advice Line: Omnibus Survey Evaluation of Public Awareness (2009)

http://www.scotland.gov.uk/Publications/2009/01/30112003/0

Impact evaluation of the Choose Life training programme

Dawn Griesbach et al. 2011

http://www.healthscotland.com/uploads/documents/17217-ChooseLifeImpactEvaluation.pdf

In addition, the Scottish Government commissioned Professor Stephen Platt of the University of Edinburgh to undertake research on Development of a Framework to Capture and Monitor Trends in Completed Suicide and its Determinants in Scotland, 1979-2010. This is currently unpublished.

Currently, MMR vaccination uptake rates in Scotland are very high, with rates reaching 97.1% in children up to the age of five years. This figure exceeds the World Health Organisation target of 95%.

Since the introduction of the MMR vaccination in 1988 the uptake rates in Scotland on average did not drop below around 85%. Although the risk level is significantly lower in Scotland than in Wales or England, Health Protection Scotland (HPS) has further assessed the risks in Scotland including an analysis of work already carried out by NHS boards over the last 18 months. An HPS risk assessment at that time recognised the need for some action to target 10-17 year olds and NHS Boards were asked to vaccinate on an opportunistic basis when visiting secondary schools to deliver the existing S3 booster. This action, along with our childhood immunisation uptake rates, have placed us in a better position than other parts of the UK.

Average susceptibility rates are also very low in Scotland. However, evidence has shown that there are likely to be some pockets of coterminous small areas, particularly in urban areas, where susceptibility in 10-17 year olds may be higher. The catch up campaign for the MMR vaccine announced on 25 April is therefore a precautionary measure.

All NHS boards are being asked to identify an executive lead for innovation, where one does not already exist. It is the decision of boards which senior colleague they appoint to the innovation role. There are no plans to ask Boards to seek input to the selection process from outside groups.

A Health Innovation Fair for Scotland is being planned. The proposed NHS innovation awards will be included in the Fair’s programme.

Healthcare Improvement Scotland (HIS) would routinely ask for this information on arrival at the hospital being inspected. This provides inspectors with a current list of patients that, if necessary they can look at further to assess suitability, i.e. cognitive ability, and time moved etc.

Boarding information is considered on the day of the inspection so that it is considered in a timely manner. If it had been submitted in advance as part of the self-assessment process, it would be out of date by the time of the inspection. HIS is currently exploring opportunities to further enhance the data and intelligence it collects and receives to support and underpin inspections.

Membership of the strategic engagement group is still to be finalised.

We welcome the Royal College of Physicians report as it provides further context and information towards our understanding of the many factors that impact on the provision of high quality, safe and effective care in our health services.

We are determined to continue to build upon Scotland’s excellent record in delivering safe and effective care services, in line with the ambitions of the Healthcare Quality Strategy and the 2020 Vision. Effective partnership working is integral to the success of our ambitions and to this end, we have instigated a series of regular meetings with the Royal Colleges, and the Academy of Medical Royal Colleges in Scotland to ensure we address such issues collaboratively. This engagement includes meetings with Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh.

There is a great deal of activity already underway in Scotland to address the issues highlighted within this report. In March 2013, we announced £50 million will be invested over the next three years as part of our Unscheduled Care Action Plan to help meet the growing demand on accident and emergency and other unscheduled care services, and there will be further investment in frontline staff. An expert group is now making sure that the best medical, nursing and other advice is contributing to the delivery of the action plan, and each health board has been asked to produce its own local version of the action plan to deal with the pressure points each faces.

We are also aware that that there are difficulties in recruiting to some medical specialities and welcome the launch, on 1 May, of the Strategy for the Recruitment and Retention of Trainess in Scotland, as this will enable NHSScotland to better understand career choices that medical trainees make, and thus consider ways to tackle recruitment and retention issues in a more systematic way.

We acknowledge that doctors in training posts make a substantial and valuable contribution to the delivery of patient care, including within out of hours care. It is NHS Education for Scotland(NES) which has responsibility for ensuring that all training programmes are delivered in such a way as to meet GMC quality standards. The GMC surveys all doctors in training on an annual basis, and this survey includes the collection of information on working hours, workload and work intensity, and the impact on training. NES also collects a wide range of additional information on the quality of training, and undertakes regular visits to training units to meet with trainees and trainers. Where NES identifies concerns about the quality of training, it works with health boards to put in place action plans to address these. All of this work is reported annually to the GMC, which has responsibility for approving training programmes across the UK.

We also await the recommendations from Prof. David Greenaway’s independent Shape of Training review, due later this year, as that is likely to lead to fundamental changes in the future shape of medical training across the UK. This will require careful scrutiny to understand the impact on Scotland’s health services of any change to future medical training programmes.

The remit of the strategic engagement group will be finalised soon after the first meeting of the group which is due to be held on 15 May 2013.