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The A8 and Gogar Roundabout do not form part of the Trunk Road Network and therefore this is a matter for City of Edinburgh Council as Local Roads Authority.

The Scottish Government has committed £20 million as part of the Edinburgh and South East City Region Deal to improving public transport infrastructure in West Edinburgh. Although the specific proposals have yet to be finalised, the Scottish Government understands that improvements to the A8 at Gogar Roundabout and the Maybury Junction are both being considered by City of Edinburgh Council.

The information requested is not held centrally.

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.

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 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.

The Information requested is not reported centrally, but the tables show the number of patients for whom dehydration and related conditions were the main diagnoses recorded as the reason for hospital admission (table 1) or one of the diagnoses recorded (table 2). Because dehydration is reported together with other conditions such as hypovolaemia (low blood volume), the figures given are likely to overestimate the number of cases. Where dehydration and related conditions were the main reason for hospital admission, the most common other conditions recorded included vomiting, kidney disease and diabetes.

Table 1: Number of people who had at least one admission to hospital during the year because of a primary diagnosis of volume depletion, including dehydration or related condition; by Health Board of treatment; 1999 – 2016

Table 2: Number of people who had at least one admission to hospital during the year because of any diagnosis of volume depletion, including dehydration or related condition; by Health board of treatment; 1999 – 2016

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 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.