To ask the Scottish Executive whether the procedures for child screening will (a) remain universal and (b) be undertaken by or under the supervision of a fully trained health visitor for neonates or for infants in the first (i) 10 days, (ii) eight weeks, (iii) three months, (iv) four months, (v) 13 months and (vi) three to five years of life.

Child health screening, surveillance and health promotion will remain a universal service as described in Health for all Children guidance issued by the Scottish Executive in 2005. Contacts outlined in the core programme include neonate, first 10 days of life, six to eight weeks, three months, four months, 13 months and three to five years as well as entry to primary school, primary 7 and at stages within Secondary School. Currently Health Visitors do not supervise or provide the child health screening, surveillance and health promotion programme in its entirety. The programme is provided by a team of appropriately trained practitioners which includes paediatricians, midwives, GPs, health visitors, staff nurses and others with the necessary skills required for each contact. The programme will continue to be provided by an appropriately trained team. A link to the guidance which contains details of the core programme can be found at:

www.scotland.gov.uk/Publications/2005/04/15161325/13269.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what has been done to improve services to people with aphasia, following publication of the report referred to on page 21 of NHS QIS’s Annual Report 2007-2008.

The NHS Quality Improvement Scotland (NHS QIS) annual report refers on page 21 to the report it published in November 2007 on the incidence of aphasia following a stroke, the services currently available, its current management and its impact on individuals and their families. Since then, NHS QIS has published, in June 2008, a response entitled The Road to Recovery , setting out recommendations on raising awareness of the condition and the future development of services for people with aphasia in Scotland.

NHS QIS is currently considering with key stakeholders the holding of collaborative events in Spring 2009. These will enable practitioners and key organisations to come together to review their current practice and identify opportunities for improvements based on the findings from the aphasia in Scotland report and other policy drivers.

We are also considering the actions to improve services for those with aphasia following a stroke which might be included in our revised coronary heart disease and stroke strategy.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what action has been taken by it and each NHS board in response to the NHS QIS report Getting to GRIPS with Chronic Pain in Scotland.

The Scottish Government has made clear, as recommended in the GRIPS report, that we recognise chronic pain as a long term condition, thereby aligning it with the work on long term conditions which we are taking forward in partnership with the Long Term Conditions Alliance Scotland, including implementation of the national strategy for self-management.

NHS boards are being asked by the Long Term Conditions Collaborative to include chronic pain in their long term conditions delivery plans. The North of Scotland Planning Group is considering the development of a pain management service in its area, rather than sending people to the specialist pain management hospital in Bath.

The Scottish Government has provided pump-priming funding for the Chronic Pain Managed Clinical Network that now operates in NHS Greater Glasgow and Clyde. We want to encourage other NHS boards to adopt that model, to promote the systematic integration of pain services across primary, secondary and tertiary care.

NHS QIS will also report on progress with each of the actions in the GRIPS report on a regular basis to the Long Term Conditions Steering Group which the Chief Medical Officer chairs.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive how each NHS board performed in terms of involving patients’ carers and the public in decisions on the planning, design and delivery of care, as reported by the Scottish Health Council.

NHS boards complete a self-assessment of their Patient Focus and Public Involvement (PFPI) activities following discussion with key patient and community groups, including public partnership forums. The self-assessment reports on how they have involved patients, carers and the public. This is then endorsed by the Scottish Health Council as an accurate account of PFPI progress, based on the council’s own discussion with the community. The individual NHS board reports can be found on their respective websites.

An overview report of the NHS boards’ performance in relation to their PFPI activities during 2007-08 will be published shortly by the Scottish Health Council.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what support was given to the Scottish Health Council to improve how NHS boards engage with patients and the public.

The Scottish Health Council is part of NHS Quality Improvement Scotland and is sponsored by the Scottish Government Health directorates. As part of that sponsoring role the Health directorates provide funding and on-going advice, guidance and support for the Scottish Health Council.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive how the Scottish Health Council assists in ensuring that patients, carers and the public can express their views on NHS services.

I refer the member to the answer to question S3W-18171 on 3 December 2008.

At its annual review on 23 September 2008, the Scottish Health Council identified the following approaches it is taking to ensure that patients, carers and the public are able to make their views on health services known:

Support the development of Public Partnership Forums;

Support boards to develop mechanisms that will help them to hear the views of seldom heard groups;

Support patient feedback through the Council’s input to "Better Together", the patient experience programme;

Ensure availability and access to the Independent Advice and Support Service, which is commissioned by boards from Citizens’ Advice Scotland, and

Monitoring how NHS boards are fulfilling their duties to ensure that advocacy services are provided to those who need them.

The annual review process, which is led by ministers, holds all NHS boards to account for their performance and provides an opportunity for patients, carers and the public to express their views on NHS services.

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/Apps2/Business/PQA/Default.aspx.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what data are being collected in order to audit the outcomes of the Counterweight programme.

Counterweight are collecting a range of data to help assess and audit the impact of the programme. This includes:

Numbers of practices/service implementing the programme;

Numbers of patients eligible to take part in the programme (based on body mass index);

Numbers of patients being offered the programme;

Numbers of patients starting the Intervention;

Number of appointments per patient attending the programme;

Numbers dropping out and at what stage, and

Weight change outcomes for patients followed up at three, six,12 and 24 months.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what the evidence base is for the success of the Counterweight programme.

The evidence base for the success of the Counterweight programme is based on the ability of the programme to deliver clinically beneficial weight change.

Clinically beneficial weight change is recognized to be greater than or equal to 5% loss of body weight. The Counterweight programme was designed to assess if this clinically beneficial weight loss could be achieved in a primary care setting, where the Intervention was delivered by busy primary care team as part of other day-to-day activities. Counterweight was originally evaluated from 2000 to 2005 in 65 general practices across the UK. The research demonstrated that 30% of all patients who attend Counterweight appointments achieve greater than or equal to 5% weight loss and this weight loss is maintained at 1 and 2 year follow-up.

The Counterweight programme is seeing similar results in NHS boards to those previously seen during the research.

George Foulkes (Lothians) (Lab): To ask the Scottish Executive what steps it is taking to address the fact that NHS Lothian has the highest number of delayed discharges of any NHS board as of October 2008.

The Lothian NHS/local authority partnership, along with every partnership in Scotland, achieved the target to have no-one delayed outwith the agreed six week discharge planning period at April 2008. This has risen in Lothian, which had 27 such delays at October. This compares with 55 at October 2007 and 119 at October 2006. The figures peaked at July 2002 when there were 319 patients delayed in Lothian for longer than six weeks.

The principal reasons for delay in Lothian were awaiting care home place availability and awaiting social care assessments.

I expect the partners in Lothian, and all partnerships who are not sustaining the zero level, to be back on track at the January census.

The Joint Improvement Team has been invited to help tackle the problem in East Lothian.