Seòmar agus comataidhean

I refer the member to the answer to question S6W-14393 on 9 February 2023. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

This information is not held centrally. However, the Scottish Diabetes Education Advisory Group (SDEAG) has been working with undergraduate medical education partners in order to ensure that appropriate education on diabetes is included in the curriculum. The Inpatient Sub-Group of the Scottish Diabetes Group has also been working to improve the ‘Think, Check, Act’ training module hosted by Healthcare Improvement Scotland.

The Type 2 Prevention Framework has also provided opportunities for several professional groups to participate in continued professional development, including training on trauma informed care and the psychological impact of overweight and obesity on diabetes management.

As part of the Scottish Diabetes Group, we have a sub-group focusing on Education. This group is currently working towards a ‘Once for Scotland’ pathway for both Type 1 and Type 2 diabetes – both of which will have pregnancy specific content and support.

The Framework for the Prevention, Early Detection and Early Intervention of Type 2 Diabetes indicates that for those diagnosed with gestational diabetes, structured education for the prevention of Type 2 diabetes should be offered post-partum and, where appropriate, referral to a weight management programme after pregnancy. Through investment, some NHS Boards have developed enhanced options for pregnant women for treatment of gestational diabetes in pregnancy. These involve education and clinical support provided by specialist midwives and dietitians.

Most women with pre-existing diabetes, be it Type 1 or Type 2, can anticipate a successful pregnancy and birth of their baby. However, having diabetes does require careful planning before conception and extra appointments throughout pregnancy due to higher risks involved for both mother and baby. Some NHS Boards already offer counselling within Combined Diabetic Antenatal Clinics (CDANC), and we have established networks for diabetes specialist teams and health psychologists to share good practice in this area.

Data to determine rates of improvement is held on SCI Diabetes. Discussions are ongoing to determine whether this should become part of future annual Diabetes Surveys.

As part of the Scottish Diabetes Group, we have a Scottish Diabetes Foot Action Group (SDFAG) which is comprised of clinicians from across the country with an interest in diabetic foot complications. We have also funded a part time role of National Diabetes Foot Co-ordinator.

SDFAG has worked closely with the SCI-Diabetes team to develop an Ulcer Management System to record and manage all episodes of Foot Ulceration occurring in individuals with Diabetes. The SDFAG supports teams to record all episodes of new foot ulceration , by completing a series of mandatory fields.

These mandatory fields must be completed, as a minimum requirement, for every new diabetic foot ulcer at first presentation. Standards across Scotland ensure that every individual with diabetes who develops a new foot ulcer should be seen within a multidisciplinary foot clinic or by a Podiatrist within 2 working days and must be recorded on the SCI-Diabetes system. This pathway is known to reduce the risk of major amputation.

As part of the Scottish Diabetes Group, we have a sub-group working specifically on pregnancy related projects. The pregnancy group are working closely with SCI-Diabetes leads to develop specific measures for the dashboard. These will help us to identify where and when improvements are being made and ensure we utilise the data to identify future opportunities or risks.

There are three types of tribunals which operate in Scotland. Scottish tribunals which deal with devolved issues and have specific jurisdiction in Scotland (such as the First-tier Tribunal for Scotland) and tribunals which deal with reserved issues but have specific Scottish jurisdiction and structures (such as the Pensions Appeal Tribunal for Scotland), these are administered by the Scottish Courts and Tribunal Service. Other tribunals exist which deal with reserved issues and have Great Britain wide structures administered by His Majesty’s Courts and Tribunals Service (such as the Employment Tribunal). The Scottish Government can only comment on those administered by the Scottish Courts and Tribunal Service.

As at 1 February 2023, the Scottish Courts and Tribunal Service administer the Scottish Tribunals (consisting of the First-tier Tribunal for Scotland and the Upper Tribunal for Scotland), the Mental Health Tribunal for Scotland, the Lands Tribunal for Scotland, and the Pensions Appeal Tribunal for Scotland. The First-tier Tribunal for Scotland is split into six Chambers.

The respective funding, staffing and year established for each of these tribunals is listed in the following table.

Raising awareness of Type 1 diabetes in Primary Care is a commitment within the Diabetes Improvement Plan. The Scottish Diabetes Group (SDG) has a sub-group focusing on Type 1 Diabetes and this group has representation from Primary Care clinicians. The sub-group will focus on development of a Diabetic Ketoacidosis (DKA) prevention campaign across primary care, using the well-established ‘Think, Check, Act’ communications material.

Various other strands of the Diabetes Improvement Plan programmes will influence the delivery of this commitment, including the development of a ‘Once for Scotland’ education pathway, which will highlight diagnostic routes and risk factors that clinicians in primary care should be aware of.

This information is not held centrally.

As part of the implementation of the Diabetes Improvement Plan, we funded a Diabetes Improvement Lead post. The primary aim of this role was to support the sub-group chairs and key stakeholders to utilise data from the diabetes dashboard and implement quality improvement methodology across their programmes of work.

One example of this is the development of the quality index scoring system to enable teams to share learning and make best use of the SCI-Diabetes data. Other examples include mapping of current education processes across Scotland and ongoing tests of change to identify ‘Once for Scotland’ pathways for the delivery of diabetes education.