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The health and safety of student nurses falls under the governance and care of university occupational health systems.

Student nurses who may be exposed to the flu during placements in NHS boards should receive flu vaccination in line with all other NHS healthcare workers. Each year the Chief Medical Officer and Chief Nursing Officer issue a letter to the NHS setting out arrangements for the flu season. This letter highlights the importance of staff or other individuals who may be at risk of occupational exposure being offered the vaccine by employers. This programme is supported by a range of marketing materials to raise awareness amongst staff, including posters and leaflets.

Each year a significant amount of work is undertaken by the Scottish Government, Health Protection Scotland and NHS boards to ensure that all healthcare staff, including student nurses, have access to detailed and up to date guidance on preparing for and managing norovirus in hospitals and care homes. This includes a temporary suspension visiting (TSV) check list to consider and enable optimal communications with patients and families/visitors before, during and after TSV is used.

When it is the right and appropriate thing to do – to keep staff, patients and visitors safe – wards will be closed. However, closing wards is not a decision that is taken lightly. It is a clinical decision and an outbreak control measure designed to minimise further spread of infection and the impact on staff, patients and relatives.

Health Protection Scotland has led a proactive national communications campaign, funded by the Scottish Government, to ensure public awareness detailing information on norovirus, including prevention and self-care so that everyone can help prevent the spread of the virus. Top tips to help prevent the spread of infection are also published on the Scottish Government’s website including guidance about visiting hospitals and care settings and the importance of effective hand hygiene for everyone.

To prevent the spread of infection in hospitals, the National Infection Prevention and Control Manual, published by Health Protection Scotland, provides detailed guidance on standard infection control precautions. These mandatory precautions are the basic infection prevention and control measures necessary to reduce the risk of transmission of infectious agents and are to be used by all staff (including student nurses), in all care settings at all times, for all patients.

Students also undertake the Cleanliness Champions Programme developed and co-ordinated by NHS Education for Scotland, a key initiative in healthcare professional’s training and education. The programme was written for and is used by a wide range of healthcare staff, and students in medicine, dentistry and nursing. Students are required to undertake all nine modules of this programme throughout their training.

The Scottish Government know that cervical screening can detect cervical changes before they become cancerous and reduces the incidence of cervical cancer. Every woman in Scotland between 20 and 60 years of age is invited to be screened every three years. As well as information on screening, each invitation includes information on how the human papilloma virus causes cervical cancer.

Additionally, through our on-going £30 million Detect Cancer Early programme, we aim to increase the proportion of cancers detected at the early stage through raising awareness of cancers, the importance of knowing about screening programmes and the benefits of earlier treatment.

The Scottish Government fully supports the objective of increasing uptake in the Scottish Cervical Screening Programme and work is already taking place to help address areas of low uptake.

For example, NHS boards have responsibility for publicising screening within their local area and for working closely with their communities to increase screening uptake. Indeed work of this nature is already taking place within NHS boards. Recent local initiatives have included out of hours clinics and sessions specifically designed for regular defaulters. As part of the forthcoming changes to the age range and frequency of the screening programme, some awareness raising work is being developed with NHS Health Scotland and NHS boards

Furthermore, the Scottish Government’s on-going Detect Cancer Early social marketing campaigns aim to raise awareness and encourage participation in the national cancer screening programmes and help people become more confident about recognising and reporting changes in their body.

General Practices (GPs) in Scotland do not directly refer into the national breast screening service. GPs may refer a symptomatic patient to a breast clinic through a routine or urgent suspected cancer pathway.

Data on waiting times from referral to a breast clinic appointment (a) nationally and (b) in NHS Greater Glasgow and Clyde is not held centrally.

Patients who are referred through the urgent suspected cancer pathway are subject to the 62-day standard which covers the whole patient pathway from referral to treatment. Latest published statistics for Quarter 2 (April – June) 2015 show that 97.5% of breast cancer patients across Scotland and 94.6% NHS Greater Glasgow and Clyde received treatment within the 62-day standard (95% standard).

The overall number of consultants in NHS Greater Glasgow and Clyde is up 27.8% under this administration. However, the Scottish Government expects NHS boards to have rigorous recruitment processes in place to ensure that posts are filled appropriately and all NHS boards are expected to ensure they have the correct mix and number of staff to ensure they can provide safe, effective care for their patients.

The Scottish Government meet cervical screening coordinators from all NHS boards on a quarterly basis to discuss a range of issues relating to the national screening programme, including increasing uptake of screening in a number of groups where uptake is low.

On screening issues like this, the Scottish Government is guided by the independent, expert advice provided by the UK National Screening Committee. The committee regularly reviews national screening programmes against international evidence and technology to ensure they remain relevant and fit for purpose.

The committee has not recommended the use of self-testing kits however they are currently reviewing whether to change the primary screening test within the programme to testing for human papilloma virus. If there is any change to the recommendation this will be considered carefully.

Alzheimer Research UK’s latest prediction on the scale of the challenge we face across the world on dementia presumes increasing prevalence of dementia over time primarily because more people are living longer.

Other research, such as by the Medical Research Council in 2013, finds a lower number of people with dementia and concludes that rates of dementia across the UK are falling due in part to a decline in the rates of vascular dementia as a result of improvements in the primary prevention and better management of chronic conditions such as diabetes.

Both factors are in play, meaning it is difficult to accurately forecast what the position on dementia prevalence will be in 80 to 100 years. Irrespective of variable predictions on scale, there is no doubt that dementia is one of the foremost public health challenges world-wide and in Scotland our national work on dementia and health and social care integration is supporting local service re-design to meet that challenge, now and in the future.

Like all sites across Scotland the Queen Elizabeth University Hospital (QEUH) can expect performance to fluctuate from week to week, especially as we head towards winter. However, I remain confident that the staff continue to work hard to ensure the level of improvement we have seen since the support team were on site in June 2015 will be maintained and improved upon.

Performance against the four hour A&E target at the QEUH in the week ending
13 September 2015 was 94.9%, compared to 78.6% in the week ending 14 June 2015 – an overall improvement of over 16 percentage points. While the support team formally disengaged from the site on 26 June 2015 the local teams continue to build upon actions and recommendations made while the support team were on site.

Additionally, since the launch of the new six essential actions approach in May 2015 we have progressed a number of actions. For example, we have:

Recruited the national team in June and July 2015. They have a range of skills and professional expertise to work with local team across Scotland;

Funded NHS boards to recruit local teams dedicated to implementing the six essential actions on each site;

Implemented appropriate site management structure – in essence there is a single manager responsible for all emergency and elective services and targets;

Strengthened structured planning and hospital safety huddles to ensure a whole system focus;

Enhanced use of discharge lounges and discharge hub facilities.

The national team maintain close relationships with the locally appointed teams across Scotland. Amongst other sites, the national team are currently working with staff at the QEUH to help embed the six essential actions, which complements the work of the support team, to ensure sufficient capacity is in place to support flow throughout the hospital as we head into winter.

This is a two year programme that will take time to bring about sustainable benefits across Scotland.