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The role of the Scottish Government in such matters is to set out policies and guidance for NHS boards to implement.

When considering a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) instruction, we expect the clinicians responsible for a patient’s care to follow the guidance set out in the NHSScotland Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Integrated Adult Policy (2010). The policy encourages communication with the patient and their relevant others if CPR is judged to be appropriate should cardio-respiratory arrest occur.

I refer the member to the answer to question S4W-12051 on 22 January 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/39875.aspx.

This is a matter for individual GP contractors as employers. The information requested is not held centrally.

The Scottish Government has no plans for a review of the use of the Liverpool Care Pathway by NHS boards.

We are in close contact with our Department of Health counterparts concerning their review, and will study their findings carefully for relevance to Scotland.

There is no centrally held information to facilitate monitoring of outcomes for patients diagnosed with cancer who breach the cancer access targets, nor is there centrally held information on the relationship between cancer stage and point of treatment on cancer access pathway. Survival rates by stage of cancer vary between tumour types but, in general, increased five year survival rates tend to occur in patients whose cancer is diagnosed and treated at an earlier stage.

Tumour types differ in biological behaviour and characteristics (including the rate at which they spread) and there is a lack of clinical evidence to suggest that treatment within 62 days of referral or 31 days of a decision to treat influences survival outcomes in all cancer cases. However, data indicate that the earlier a cancer is diagnosed, the greater the chance of longer survival. This is the rationale behind the Scottish Government’s Detect Cancer Early Programme. Whilst there is no centrally held data to demonstrate a direct relationship between stage of diagnosis and compliance with cancer access standards, the Detect Cancer Early Programme aims to ensure that those patients requiring the most urgent treatment have swift access to the full range of services they need from the NHS. Additional treatment capacity is being made available from the £30 million funding behind this programme in order that cancer access standards can continue to be met.

However, we know that awaiting the results of cancer tests and awaiting treatment for cancer is an anxious time for patients and families and the introduction of cancer access standards and improvement in performance against these standards will help reduce this period of anxiety.

All GP practices in Scotland have access to IT systems that can provide online services for patients. England is pursuing this work through proposed changes to GP contracts, but in Scotland this is being delivered through the person-centred eHealth Strategy, which will encourage GP practices to switch on this functionality, and to focus initially on booking appointments and ordering repeat prescriptions.

Scottish Government is in the process of procuring a public sector wide broadband services contract. Referred to as the Scottish Wide Area Network (SWAN) programme it will be a “dual stacked” communications system. This means that as SWAN delivers network services, it will be able to support applications which use either IPv4 or IPv6 addressing concurrently. When considering new services and applications, the ability to provide a migration path from IPv4 to IPv6 or go straight to IPv6 is an important consideration.

The Scottish Government is currently not involved in taking steps to support the use of Internet Protocol version 6 in the private sector.

NHSScotland is committed in its eHealth Strategy to a “paper-light” approach to information and records management and in time to eliminate paper based exchanges between care providers.

The preference is for email to be managed digitally while it is in the mailbox and digitally when it is moved out of the mailbox and into the corporate or clinical records system. However, there are particular business transactions where this is not practical and printing is the only option. Record managers in each board provide advice in such circumstances.

European Court of Human Rights Judgment 20511/03 makes clear the measures that need to be in place to protect the confidentiality of health data relating to staff as well as patients. In relation to clinical portals, health boards have chosen solutions with comprehensive access permissions and audit trails.

Furthermore, the Scottish Government has funded a national contract for a privacy breach detection tool that can work across multiple applications. This tool is already operational in some boards, and due to be released in all the territorial boards. These technical measures are backed up with an overall policy on accessing records on patients and staff, as well as training and guidance.