Seòmar agus comataidhean

I refer the member to the answer to question S4W-06539 on 23 April 2012. 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 Scottish Medicines Consortium published advice on 12 March 2012 to confirm that fingolimod for the treatment of highly active relapsing remitting multiple sclerosis is not recommended for use within the NHS in Scotland.

Further information about the SMC advice can be found on their website:

http://www.scottishmedicines.org.uk.

Nhs boards are expected to take full account of SMC advice. However, NHS boards have arrangements in place for clinically-led consideration of medicines which have not been accepted for use by the SMC, for individual patients in certain circumstances.

Information on the number of patients who have been given access to cancer medicines that were approved by the Scottish Medicines Consortium under a patient access scheme since 2011 broken down by (a) NHS board and (b) medicine is not held centrally.

Information on SMC advice for medicines accepted with a patient access scheme is available on the SMC website via the following link:

http://www.scottishmedicines.org.uk/Submission_Process/Submission_Guidance_and_Templates_for_Industry/Patient-Access-Schemes.

In its response to the Scottish Parliament Public Petitions Committee in relation to PE1108 regarding the availability on the NHS of cancer treatment drugs, the Scottish Government advised that its focus was to improve access to all newly licensed medicines and not just those to treat cancer. On that basis, no assessment was made of the use of the quality adjusted life year (QALY) health economics tool specifically for small cohorts of poor prognosis patients.

Instead the Scottish Government advised the Committee that the use of QALYs is currently the accepted method in health economics used by both the Scottish Medicines Consortium (SMC) and the National Institute for Health and Clinical Excellence (NICE) to compare between very different medicines and patient groups.

It also clarified that QALYs provide the basis for discussion about individual medicines by the SMC, the QALY alone does not determine the decision.

Training in community sexual and reproductive health is a specialty training programme designed to produce consultants who would be specialists in community sexual and reproductive health. The training places would therefore be for junior doctors in training rather than consultants.

Training in community sexual and reproductive health is a relatively recent development. The medical speciality of community sexual and reproductive health was formally established in 2009, under the auspices of the faculty of sexual and reproductive healthcare of the Royal College of Obstetricians and Gynaecologists.

Prior to the development of the speciality of community sexual and reproductive health, training was available to doctors training in obstetrics and gynaecology who wished to sub specialise in sexual and reproductive healthcare. The sub speciality training programmes in sexual and reproductive healthcare were developed from around 2006, and training in this sub specialty has been provided in Scotland. Doctors training as sub specialists in sexual and reproductive healthcare gain a certificate of completion of training in obstetrics and gynaecology, but with recognition that they are sub specialists in this area.

Until November 2011 there were three doctors training in this sub specialty in Scotland. With two having achieved their Certificate of Completion of Training (CCT) there is currently one trainee undergoing training in this sub specialty area in Scotland. This training is not situated in an individual board, but is based in the West of Scotland region.

While there are currently no doctors training in the new specialty of community sexual and reproductive health in Scotland, we would expect to advertise training posts in this specialty programme from 2013.

The Sexual Health and Blood Borne Virus Framework is outcomes focussed. It does not seek to mandate how NHS boards and others should deliver outcomes, and does not set expectations on staffing levels within NHS boards. The framework encourages local needs-assessments to be undertaken to establish what resources are required to deliver on framework outcomes. Staffing levels are therefore entirely a matter for NHS boards. We are not aware of any staffing issues that will compromise delivery of the framework.

The government undertakes annual local area visits to monitor progress of the framework outcomes. These visits will involve detailed discussion on issues of concern in each area and this will provide an opportunity for any staffing issues to be raised. These visits are commencing this month.

The Sexual Health and Blood Borne Virus Framework is outcomes focussed. It does not seek to mandate how NHS boards and others should deliver outcomes, and does not set expectations on staffing levels within NHS boards. The framework encourages local needs-assessments to be undertaken to establish what resources are required to deliver on framework outcomes. Staffing levels are therefore entirely a matter for NHS boards. We are not aware of any staffing issues that will compromise delivery of the framework.

The government undertakes annual local area visits to monitor progress of the framework outcomes. These visits will involve detailed discussion on issues of concern in each area and this will provide an opportunity for any staffing issues to be raised. These visits are commencing this month.

The chemotherapy electronic prescribing and administration system is one that supports safe prescribing and administration practices for chemotherapy. It does not record the amount spent on cancer medicines.

The most recent meeting via teleconference across the four UK administrations was held in November 2011.

The Draft UK Plan on Rare Diseases was launched for public consultation by the Department of Health on Rare Disease Day, 29 February 2012.

The consultation document and accompanying equality analysis can be found on the Department of Health (England) website at:

http://www.dh.gov.uk/health/category/publications/consultations/.

The National Planning Forum will consider both the updated guidance from the National Institute for Health and Clinical Excellence (NICE), and the health technology assessment (HTA) on TAVI commissioned by the National Institute for Health Research as soon as they are published.

NICE has indicated that it expects the Interventional Procedures Programme (IPP) guidance on TAVI to be published before the end of March 2012.

The National Institute for Health Research has indicated that the HTA has been extended in scope to also examine the cohort of people who are eligible for surgery, but are considered high risk. As a result, the HTA is now expected to be published later this summer.

As indicated in the answer to question S4W-03307 on 2 November 2011, the Scottish Health Technologies Group has robust processes in place for monitoring and reviewing publications relating to TAVI.

In the interim, NHS boards continue to ensure that local arrangements are in place so that people with severe aortic stenosis get access to appropriate clinical treatment. As part of those arrangements, where it is considered clinically appropriate by their doctors, people can get access to TAVI treatment through consideration by an individual case panel.

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.