Seòmar agus comataidhean

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 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.

Consultants who have undergone sub specialty training in this area of activity are not identified separately in the national medical workforce statistics, and are classified under obstetrics and gynaecology. Published information showing whole time equivalent and headcount for consultants, broken down by specialty, are available on the ISD website at the link provided below.

http://www.isdscotland.org/Health-Topics/Workforce/Publications/2012-02-28/HCHS_by_specialty_D2011.xls

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.

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.

Prescribing of cancer medicines is the responsibility of the clinician in charge of an individuals care. The most appropriate treatment, be it surgery, chemotherapy or radiotherapy (or a combination of these) will be made in consultation with the individual and based on a number of factors, such as, the type of cancer, stage of disease at diagnosis and the benefits and risks of the treatment being offered.

Information on the number of patients accessing cancer medicines in Scotland is not held centrally. Prescribing data available centrally relate to numbers and cost of items dispensed by community pharmacists and dispending doctors. These data sets exclude the direct supply of medicines to patients from hospital and hospital-based clinics. There are no plans to introduce a central prescribing database.