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Since 1999 the data on the community nursing staff categories, including district nurses, has been subject to a number of reviews.

The number of district nurses by NHS Board, from September 1996 to September 2005,

can be found on the workforce statistics web site:

http://www.isdscotland.org/Health-Topics/Workforce/Historic-Data/WFE01_HB_REG.xls.

In 2006, recording of NHS staff was moved from Whitley to Agenda for Change. As a result statistics presented from 2007 onwards are not directly comparable to information prior to 2006. Information for 2006 is not available as this was a transitional year.

The number of district nurses by NHS Board, from September 2007 to September 2014, can be

found on the workforce statistics web site:

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-09-05/Non-Medical_Trend_J2017.xls.

A review of the data on community nursing staff categories, including district nurses, was undertaken in 2014 to ensure more accurate and consistent reporting for these staff groups. Data prior to the completion of the review is not comparable with data from 2015 onwards.

The number of district nurses by NHS Board, from March 2015 to June 2017, can be found on the workforce statistics web site:

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-09-05/Nursing_and_Midwifery_SIP_J2017.xls.

NHS Territorial Boards continue to make limited use of the independent and private sector for health care services. Total spend decreased from £78.5 million in 2015-16 to £72.0 million in 2016-17.

Spend by each Board for 2016-17 is set out in the following table. Figures for
2006-07 to 2015-16 were provided in response to question S5W-05822.

In developing local approaches, individual GP practices will be consulted by their Health Boards at appropriate junctures.

The Programme is using Managing Successful Programmes (MSP) methodology which includes requirements around risk. A key role of the Vaccination Transformation Programme governance will be to identify and manage risk, undertake equality impact assessments, and establish quality metrics for monitoring the impact of the new delivery model. Local risk assessments will also be carried out as plans progress.

At the heart of any change must be the core principle of patient safety. That is why our planned approach is of a three year transition with changes to services only taking place when it is safe to do so.

The Vaccination Transformation Programme will not mandate how Health Boards will deliver vaccinations in their area. Rather the programme will support Health Boards in implementing local delivery solutions that best suit them, their patients, and their geography. The solutions developed may involve establishing immunisation teams, contracting local GPs, or a combination thereof. As service providers, the local Health Board will ensure that the service they design provides best value for money.

A core principle of the Vaccination Transformation Programme is that services will continue to be delivered to patients in a safe, sustainable and acceptable way. It will be a matter for Boards locally to determine whether or not any change in service provision will warrant consultation with the public, for example if there is a meaningful change in how patients access services, but in many cases this is not likely to be necessary.

In some parts of the country NHS Boards have already taken over responsibility for delivering vaccinations previously delivered by GPs, and all NHS Boards currently deliver school-based vaccinations.

The Vaccination Transformation Programme will support Health Boards to design local solutions to vaccination delivery. Health Boards will be able to make different arrangements in their areas to suit local circumstances. In some areas GPs may continue to deliver vaccination programmes through local agreements.

One of the key principles of the Vaccination Transformation Programme will be to implement new models of delivery that do not adversely impact on uptake rates. While GPs will no longer be responsible for the delivery of vaccinations, it is likely that general practice premises will still be used to deliver vaccinations allowing opportunistic immunisation to continue. Different delivery options and a changing NHS and public health landscape may also provide opportunities and benefits which are not possible within current arrangements. At present local variation in uptake of the flu vaccine across GP practices is monitored closely and appropriate interventions applied to improve uptake. New Primary Care clusters will work closely with HSCPs and make use of intelligence and data to continue monitoring uptake in their areas and provide support as necessary.

The Scottish Care Homes Census published by ISD Scotland provides information on the number of registered Care Homes places in each local authority area in Scotland at http://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Care-Homes/Previous-Publications/index.asp

The number of registered Care Homes places for years 2006-2016 can be found in data table 3 published on 25th October 2016 and for years 2000-2005 in data table 3 published on 29 October 2013.

The extension of free personal care to people under the age of 65 will benefit around 9000 people. We are working with local authorities on preparing for the implementation of the extension of Free Personal Care to under 65s by April 2019. This will involve local authorities assessing people’s needs, and where necessary, conducting financial assessments.