Freedom of Information (Scotland) Act 2002 and Environmental Information Regulations 2004

FREEDOM OF INFORMATION (SCOTLAND) ACT 2002 AND ENVIRONMENTAL INFORMATION REGULATIONS 2004

RESPONSES MADE IN FEBRUARY 2012

Request Response

1 Mental health beds and NHS Lanarkshire has been improving the quality of our mental health service by rebalancing our care. inpatient psychiatric units This has resulted in investment in community services which has reduced our need and requirement for inpatient beds. This follows the national policy of rebalancing care to provide services closer to people’s own homes. It also reflects the stated desire of service users and carers for more care to be provided in community settings or at home.

This investment in community services has resulted in new units such as Glencairn at Coathill Hospital and Beckford Lodge in Hamilton, as well as new dedicated mental health facilities at Carluke Community Health Centre, Douglas Street Community Health Clinic, Bellshill Community Health Clinic and the Buchanan Centre in Coatbridge.

There has also been considerable investment in community-based services in line with National Crisis Standards. NHS Lanarkshire also has access to Stobhill Hospital’s Skye House which is a West of Scotland unit for 12-18 years who have mental health problems. We also have access to Rowanbank, also based in Stobhill Hospital, for adults with mental health and learning disabilities who require secure care.

In relation to your questions, the table below includes the total number of beds for Mental Health within NHS Lanarkshire for the years 2006 to 2011.

Year 2006/07 2007/08 2008/09 2009/10 2010/11 Total 585 532 527 497 489

In relation to your second question, I have attached a separate table which gives a breakdown of the total number of psychiatric inpatient units for each of the years requested and their names. Please note that each unit may contain more than one ward. (Appendix H)

2 Consultants, staff, I can advise that information on the total number of consultants and the total number of staff, associate associate specialist, and specialist, and specialty doctors employed by NHS Lanarkshire is exempt in terms of Section 27 of the specialty doctors retirals Freedom of Information legislation as it will be made publicly available within 12 weeks of your request.

The information will be publicly available on 28 February and you may wish to log on to the website at http://www.isdscotland.org/Health-Topics/Workforce/

For your assistance, I can advise that the information on the total number of consultants employed by NHS Lanarkshire, as of 30 September 2011, is available at the following website link: http://www.isdscotland.org/Health-Topics/Workforce/Publications/2011-11 29/Consultant_Staff_In_Post_S2011.xls

In addition, the information you seek in question four on the total number of staff, associate specialist, and specialty doctors employed by the health board as of 30 September 2011 is available through the below links on the ISD website: http://www.isdscotland.org/Health-Topics/Workforce/Publications/2011-11-29/Overall_staff_S2011.xls http://www.isdscotland.org/Health-Topics/Workforce/publications/2011-11- 29/M_and_D_staffinpost_S2011.xls http://www.isdscotland.org/Health-Topics/Workforce/Publications/2011-11- 29/HCHS_by_specialty_S2011.xls

Five consultants have submitted notice that they intend to retire on or before 31 March 2012, none of whom are retiring early.

I regret to advise that I am unable to provide you with details of the total number of staff, associate specialist, and specialty doctors who have submitted notice that they intend to retire on or before 31 March 2012 or the total number of them that are retiring early. To find this information would require a check of individual departments to ascertain the number of people who have given notification of intending to retire. It would then be necessary to carry out a manual check of individual records to confirm whether they would be retiring early. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

3 Deferasirox (Exjade) I can advise that the number of residents of Lanarkshire prescribed deferasirox (exjade) since 2007 is as prescriptions follows:-

2007 2008 2009 2010 2011 Number of Patients 1 2 0 0 2

All of the above requests for deferasirox (exjade) were made under the exceptional requests or individual patient treatment requests process. No requests were refused during this period.

Three patients with MDS have been prescribed deferasirox (exjade) as a direct or supportive treatment. Clinical commissioning Clinical Commissioning Groups are groups of GPs that will, from April 2013, be responsible for deciding 4 groups local health services in England. The CCGs are not due to be established in Scotland. Accordingly, I must advise that in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 the information sought is not held.

5 Hartwood Hospital NHS Lanarkshire has been working with the local authority to address the future disposal of the site which would include the retention (as far as is reasonably practical) of the listed building. However, due to the current UK and world economic climate, there is no foreseeable interest in this site from property developers.

In the meantime, regular security visits are made to the listed buildings on the site to safeguard against risks.

6 Adherence to formulary NHS Lanarkshire records formulary compliance at practice level, locality level and Board level for the at practice/ BNF Chapter therapeutic drug groups listed in the table below. Formulary compliance overall is not recorded for all level drugs in the formulary or at BNF chapter level. The drug groupings in the table are at sub-BNF chapter level.

PAP8 TARGET AREA Green Amber Red Formulary Compliance (% items) Target met within range Not met

Antibiotics > 86% 75 - 86% < 75% Antidepressants > 74% 60 - 74% < 60% Proton Pump Inhibitors > 94% 80 - 94% < 80% NSAIDs 1 > 88% 82 - 88% < 82% ACE inhibitors > 98% 92 - 98% < 92% Angiotensin 2 Antagonists > 98% 92 - 98% < 92% Wound Management Formulary > 75% 60 - 75% < 60% As with any prescribing actions, formulary compliance can be included to meet the requirements of the quality and outcomes framework (QOF) medicines management targets 6 and 10. Practices agree with the prescribing adviser up to three prescribing actions and must show evidence of change. Standard QOF payments apply – there are no other incentives.

Adherence to the Formulary is monitored on a quarterly basis.

The scales are detailed in the green, amber and red categories in the table above. For compliance to be met the target percentages shown in the green column must be exceeded.

I regret to advise that I am unable to provide you with details of percentage adherence for each practice in the overall, gastrointestinal and skin chapters. As stated above, formulary compliance overall for all drugs in the formulary or at BNF chapter level is not recorded. To find this information would require a calculation of the overall formulary compliance for every drug on the formulary to ascertain the percentage adherence for each practice. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

7 Hepatitis-C I attach the preferred pathway for Hepatitis C services in the community and the Hepatitis C Lanarkshire management guideline. The guideline contains prescribing guidelines for Hepatitis C.

There is currently no care pathway for Hepatitis C in Lanarkshire. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought in relation to the care pathway is not held.

I can advise that a care pathway is due to be developed later this year as part of a review of the existing Hepatitis C pathway. (Appendix I) 8 Medical records I can advise that requests of this nature are exempt in terms of Section 38 of the Freedom of Information (Scotland) Act 2002. Your request for information can be dealt with under the terms of the Data Protection Act 1998 as a subject access request. I have passed your request to Craig Tannahill, Information Governance Manager, Kirklands, Fallside Road, Bothwell G71 8BB (Tel: 01698 858079) who will process the matter further.

9 NHSL carers information I can advise that the publications you request can be obtained from the NHS Lanarkshire website. It is the strategy, annual report case that the documents are otherwise reasonably obtainable and that the information you seek falls with and accounts 2010/2011, a ground of exemption in terms of Section 25 of the Freedom of Information (Scotland) Act 2002 annual report 2009/2010, inasmuch as it is information which can reasonably be obtained other than by requesting it under the a Picture of Health freedom of information legislation. The website is www.nhslanarskhire.org which you may find of use. progress, carers leaflets, Links to the specific documents you require are as follows:- other publication, leaflets or survey results on Carers Information Strategy - carers. http://www.nhslanarkshire.org.uk/Hospitals/Carer%20Information/Pages/CarersInformationStrategy.aspx

Annual report and accounts 2010/2011 and Annual report 2009/2010 – http://www.nhslanarkshire.org.uk/publications/Pages/default.aspx?let=A

A Picture of health progress – http://www.nhslanarkshire.org.uk/boards/2011-board-papers/Pages/January-2011.aspx

Carers leaflets and publications – http://www.nhslanarkshire.org.uk/Hospitals/Carer%20Information/Pages/default.aspx

1 Handling enquiries I attach the Customer Care Policy Statement and Standard that details the process to be followed within 0 NHS Lanarkshire when dealing with enquiries about patients. This document is in the process of being revised. I also attach the telephone and reception guidance for use by staff when giving information pertaining to the whereabouts of patients whilst in the hospital care system.

Police requests are dealt with in line with the data protection legislation.

I can advise that there is no specific written policy for handling enquiries about patients in Accident and Emergency. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held.

In accident and emergency, information is provided to next-of-kin and every GP is advised as appropriate. For patients under 16 years of age, the public health nurse is also included. (Appendix J and K)

1 Patient on patient attacks Please find below a table that gives the number of patient on patient attacks, and the location where that 1 incident took place, that occurred within NHS Lanarkshire in each of the years requested.

The attacks recorded include slapping, scratching, punching, pushing, grabbing and the throwing of objects/liquids.

Location 2007 2008 2009 2010 2011 Airbles Road Centre * * * * 0 Beckford Lodge 0 0 0 0 7 Caird House 0 0 0 * * Carrickstone House/Day unit * 0 0 0 0 Cleland Hospital 0 * 19 20 Coathill Hospital 9 * 6 15 22 Cumbernauld Care Home 17 15 0 * * Hairmyres Hospital 8 15 9 9 8 Hartwoodhill Hospital 18 10 33 8 * Hattonlea Nursing Home 0 0 0 0 46 Holehills Clinic * 0 0 0 0 Kello Hospital 0 8 0 0 0 Kirklands Hospital * * * * * Lockhart Hospital 0 * 0 * 0 Monklands Hospital 9 * 6 9 8 Newmains Health Centre 0 0 * 0 0 Stonehouse Hospital 0 * 0 0 0 Udston Hospital 21 30 19 20 23 Victoria Memorial Cottage 0 0 * 0 0 Wester Moffat Hospital 0 0 0 * 0 Wishaw General Hospital 34 67 65 27 30 TOTAL 125 160 148 119 173

* There was five or fewer patient on patient attacks at this location during this year. I cannot provide any of the additional information requested as the Scottish Government’s Code of Practice on Protocol on Data Access and Confidentiality states that all figures released should not identify either explicitly or inexplicitly any individual who is the statistical subject. Disclosure of the information would contravene the Data Protection principles that constitute grounds of exemption as referred to in Section 38 of the Freedom of Information (Scotland) Act 2002.

The highest proportion of patient on patient attacks occurs within older people’s services, mental health and learning disabilities. Wishaw General is the largest NHS Lanarkshire hospital and has a higher number of patients within these services than the other acute hospitals.

NHS Lanarkshire has mandatory training for staff of all professions and grades to enable and equip them to manage violent or potentially violent patients and staff are actively encouraged to report incidents. We also actively work with colleagues in NHS Scotland groups to share best practice to improve and enhance staff ability to manage violent and aggressive incidents. NHS Lanarkshire does not specifically record the number of occasions the police attended these incidents or if they resulted in prosecutions and, accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 the information sought in this regard is not held.

However I can advise that our records show that the police were called to attend two of the incidents in the table above.

1 Joint health improvement I attach the health and wellbeing action plan which covers the North Lanarkshire Community Health 2 plan Partnership (CHP) area, and the latest version of the joint community care plan – South Lanarkshire 2008/2011 which covers the South Lanarkshire CHP area. (Appendix L and M)

1 Medical Certificate of the Firstly, the family would contact the practice. When a patient dies at home, in normal hours the GP 3 Causes of Death practice would be contacted. Outwith the hours of 8am to 6pm Monday to Friday, the out of hours (OOH) service would be contacted. When the patient’s own regular GP is not available and a locum is taking that GP surgery, a similar process would be followed although individual practices will have their own process in place.

The doctor (or locum) is required to confirm life extinct, by visiting the patient. Whether or not the MCCD is issued is dependent on the information available to the doctor. In the case of the locum, or indeed any doctor, the accurate completion of MCCD is important and does not need to be done at the same time as PLE (pronounced life extinct). It may be necessary to examine medical records closely to get accurate information for the death certificate, and hence there may be a delay.

There is no requirement to see the patient before death as the information available to that practice gives adequate ability to fill in the medical certificate and the cause of death. The locums can pronounce life extinct and then complete the medical certificate if they have enough information to do so.

A doctor can refuse to issue an MCCD when the doctor does not have sufficient information to do so, or has specific concerns about the circumstances of the death, or a specific requirement to notify the procurator fiscal.

I can advise that the Crown Office and Procurator Fiscal Services provide information and guidance for medical practitioners. Section 6 details categories of death that have to be reported to the procurator fiscal. The link to that information is as follows:-

http://www.copfs.gov.uk/publications/1998/11/deathandthepf

Doctors at all times should be sensitive to the specific religious practices and funeral requirements in responding to a request to issue MCCD, but must comply with the legal framework.

I attach guidance produced by the General Medical Council in relation to personal beliefs and medical practice which may be of assistance to you.

The OOH service uses a medical verification of death (VOD) form when pronouncing life extinct. The service also has current clinical guidelines in place. Both of these are attached.

The OOH service is not involved in the issuing of death certificates. Their role is purely to provide the VOD form. The case will then be referred either to the patient’s own GP on the next working day or to the Police if there are any concerns.

The locums are employed by the individual practices and will follow the procedures in place in that practice. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought on instructions given to locums is not held. (Appendix N, O and P) 1 Building primarily used Please find in the below table the information you requested: 4 as office space for employees Building Area Staff Tenure Rental costs Operational costs Law House, ML8 5ER 3,644 126 Freehold n/a £152,457 Kirklands HQ, G71 8BB 5,150 335 Freehold n/a £495,599 Beckford Street 2,361 201 Freehold n/a £318,019 Netherton House, ML2 0DZ 454 50 Initial term of PFI contract expires 2028 There are no lease breaks, however, under the PFI contract NHS Lanarkshire can declare areas surplus to requirements Held by PFI* 257 Main Street Bellshill 294 29 Leased £45,900 lease break 18/11/12 £82,368 Corporate Services Building, Monklands, ML6 0JS 2,820 63 Freehold n/a The costs are not split between this building and main hospital building.

I must advise that the operation of Netherton House comes under the Private Finance Initiative contract for Wishaw General and the associated operational costs are included within this payment. The operational costs for the Corporate Services Building at Monklands Hospital are not separated from the overall operational costs of the whole hospital. In addition, while we record the total number of staff for each building, the number of full time equivalent staff is recorded by department, not by site. Accordingly, I must advise that in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 the information sought on the operational costs of Netherton House and the Corporate Services Building, and how many FTE staff work in each site, is not held.

1 Augmentative and Provision of augmentative and alternative communication (AAC) equipment is based on a professional, 5 alternative independent assessment of need. communication devices The majority of adult patients who require AAC equipment are those with progressive neurological disorders whose speech and voice deteriorates over time as the disease process progresses. During the lifetime of their disorder, patients may require more than one piece of equipment as what is suitable early in the course of the disease may not be suitable some months/years later as the disorder increases in complexity and severity. Timely authorisation of the equipment purchased and delivery is essential due to the time sensitivity.

The children and young people within NHS Lanarkshire who require access to AAC systems tend to have a physical and/or learning disability.

NHS Lanarkshire purchases equipment from companies directly but also purchases equipment through the Scottish Centre for Technology for Communication Impairment (SCTCI).

AAC equipment has been directly purchased by NHS Lanarkshire as follows:-

Year Equipment Type 2010/2011 1 x Light writer 2009/2010 2 x Light writer 1 x Vantage lite 2008/2009 7 x Light writer

Information for 2006/2007 and 2007/2008 is held on an older recording system that is no longer in use. NHS Lanarkshire does not have access to this system at present. Attempts are being made to fix the problem but it is unlikely to be resolved in the near future. Accordingly, in terms of Section 17 of the Act I must advise that the information you seek for the years 2006/2007 and 2007/2008 is not currently held.

In addition, NHS Lanarkshire has a contract with SCTCI which operates a loans system for specialist communications equipment. It has been identified that records of AAC equipment purchased within this contract have in the past not been kept centrally in sufficient detail to identify what type of equipment is being provided. Systems are now in place to record the information in more detail. I cannot, therefore, provide details of the devices supplied or purchased through the SCTCI for the full period that you request. I can advise, however, that referrals to SCTCI and the number of loans of high-tech equipment to NHS Lanarkshire since 2007/2008 is as follows:-

Year Number of Referrals Number of Loans of High Tech Equipment 2007/2008 17 31 2008/2009 24 26 2009/2010 17 29 2010/2011 18 12

I can also advise that the following AAC requests made since June 2011 are as follows:-

Number of items Equipment

3 Lightwriter SL40 2 Eyegaze system Tobii P10 1 Eyegaze Tobii C8 1 Servox artificial larynx 1 Step by step computer 2 Vantage Lite 1 Springboard Lite 3 Servox intone 3 ipad tablets with voice applications

To obtain details of the AAC equipment purchased prior to the last year would involve a manual trawl through our records. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002. I do hope, however, that what has been provided is of assistance to you.

1 Overseas testing of blood I can advise that NHS Lanarkshire does not provide overseas testing of blood samples. 6 samples

1 Needle stick injuries to Please find in the below table the total number of needle stick injuries to staff and patients in the last 7 staff or patients five years.

Staff Patients Total Number of incidents 485 12 497

I must advise that the information you seek in relation to the incidents and their outcomes constitutes personal data in respect of which disclosure would contravene the data protection principles and that this constitutes a ground of exemption in terms of Section 38 of the Freedom of Information (Scotland) Act 2002.

As you can see from the above table the vast majority of needle stick injuries occur to staff. To minimise the risks of needle stick injuries NHS Lanarkshire has clear guidelines in place for the safe use and disposal of all sharps, and for the management of exposure to blood or bodily fluids. Most needle stick injuries are similar in how they occur. The types of needle stick injuries included those which occurred during: stitching, re-sheafing of needle, working with intravenous lines, surgery, immunisation, administering of injections, taking blood, moving sharps box, using clinical waste bins and handling needles.

When a needle stick injury occurs staff follow the guidelines and procedures for the management of exposure to blood or bodily fluids. The appropriate action would be carried out whenever a needlestick injury occurs. Action following a needle stick injury includes:

• Squeezing the area around the cut to encourage bleeding • Washing the surrounding area with soap and water • Performing necessary first aid • Obtaining medical assistance from nearest site nurse or hospital with accident and emergency department • Informing nurse in charge of area • Reporting incident to supervisor • Contacting Occupational Health department • Complete infection control forms and send to relevant departments (Salus Occupational Health department)

While the risk of acquiring a blood-borne virus following a needle stick injury is small, testing for blood-borne infections following a needle stick injury is carried out where appropriate.

However, I regret to advise that I am unable to provide you with details of whether the result of subsequent testing, following a needle stick injury, resulted in any blood-borne infections to the injured persons and what these infections were. To find this information would require a manual check of each individual’s personnel or patient record to ascertain whether testing had identified a blood-borne infection caused by a needle stick injury. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

Response to follow up question - I have to advise that the information we provided in the original response is exempt as it constitutes personal data.

However, I can expand on the examples provided on the types of needle stick injuries which occur. Please find more information in the below table:

Needle stick occurred during and Example Stitching - While suturing a wound sustained needle stick injury Re-sheafing of needle - Re-sheafing needle when it pricked skin on hand Working with intravenous lines - While doing line procedure needle sustained needle stick injury Surgery - Individual using needle during procedure punctured finger Immunisation - After giving immunisation sustained needle stick injury Administering of injections - Patient moved while administering injection causing needle stick injury Taking blood - withdrawing needle from patient sustained needle stick injury Moving sharps box - Moving sharp box needle protruding from box pierced skin Using clinical waste bins - Jabbed finger when disposing needle in clinical waste Handling needles - accidentally colliding with medical staff or patient and sustained needle stick injury

1 The number of people Please find below a table which gives the number of patients attending NHS Lanarkshire A&E 8 recorded as being treated departments after attacks or injuries by the specified animals from January 2008 to December 2011. for attacks or injuries relating to animals Animal Number of patients Squirrel 6 Fox 3 Seagull 1 Badger 0 Horse 105 Cow 11 Sheep 2 Monkey/Ape 5 Snake 9 Rodent 23 Total 165

I cannot provide any of the additional information requested as the Scottish Government’s Code of Practice on Protocol on Data Access and Confidentiality states that all figures released should not identify either explicitly or inexplicitly any individual who is the statistical subject. Disclosure of the information would contravene the Data Protection principles that constitute grounds of exemption as referred to in Section 38 of the Freedom of Information (Scotland) Act 2002.

However, I can advise that for the figures in the table above 52 people were kicked by a horse, 40 were bitten by a horse, 12 were stood on by a horse, eight were kicked by a cow and three were crushed or knocked over by a cow.

Please find below the quarterly figures for the total number of patients attending A&E departments after attacks or injuries by the specified animals

Jan - Mar 2008 - 12 Apr – Jun 2008 - 5 July - Sep 2008 - 11 Oct - Dec 2008 - 8 Jan - Mar 2009 - 2 Apr – Jun 2009 - 21 July - Sep 2009 - 16 Oct - Dec 2009 - 9 Jan - Mar 2010 - 8 Apr – Jun 2010 - 9 July - Sep 2010 - 12 Oct - Dec 2010 - 10 Jan - Mar 2011 - 8 Apr – Jun 2011 - 13 July - Sep 2011 - 8 Oct - Dec 2011 - 13

1 New consultant All new consultant appointments are appointed on the basis of 9:1 following the Management Steering 9 appointments Group guidance which was discussed with the British Medical Association (BMA) and Local Negotiating Committee (LNC).

The guidance states “that all Health Boards adopt a standard approach that on appointment or at any time thereafter supporting professional activities (SPA) time can be negotiated for specific, clearly identified SPA duties. These activities would have to be agreed with the individual and the Board. Health Boards should be clear that any SPA activity agreed with new and existing consultants must be capable of being performed within the allocated SPA time, and consultants must be able to demonstrate that they are fulfilling their allocated SPA duties. Consultants may wish to keep diaries and either the Board or the consultant can of course, seek a job plan review should, in their view, the job plan be unrealistic and undeliverable.”

NHS Lanarkshire has agreed that the job plan will be dependent on the successful candidate’s subspecialty, training and interests. A minimum of one SPA will be included in the job plan.

Additional SPAs (up to 2.5 in total) can be incorporated into the job plan depending on the time required to support the successful candidate’s professional activities and the needs of the service.

On taking up the post the Job Plan will be agreed between the person appointed and the Clinical Director/Associate Medical Director. The job plan will be reviewed after three months in post and then again after six months in post.

2 Contact details for person As indicated in my letter of 1 December 2011, NHS Lanarkshire has a DVT clinic in the A&E 0 responsible for the DVT Department at Hairmyres Hospital. The clinical management of patients who attend is done through the clinic in Hairmyres. site emergency and medical team. The overall management responsibility sits with Judith Park, the site general manager. Judith can be contacted by email at –

[email protected]

2 Antibiotic treatments The prescribing of antibiotics within primary care is undertaken by individual GP practices. I can advise 1 that NHS Lanarkshire does not collect information in relation to the effectiveness of first, second or third course antibiotic treatments for 2011 from General Medical Practices within Lanarkshire. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held. I can advise that GP practices are subject to the Freedom of Information legislation in their own right and you may wish to put your questions to GP practices direct. A full list of practices in Lanarkshire is available on our website via the following link. http://www.nhslanarkshire.org.uk/servicefinder/GPs/Pages/gp.aspx

I regret to advise that I am unable to provide you with details of the effectiveness and the number of occasions when first, second or third course antibiotic treatments have been prescribed for 2011 in relation to acute settings. To find this information would require a manual check of each individual patient record to ascertain who had been prescribed antibiotics, on how many occasions and whether a prescription was in relation to a condition that the patient had previously been prescribed antibiotics for. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

The Scottish Medicines Consortium (SMC) reviews all new medicines and provides recommendations to NHS Boards about the appropriate use of new medicines in NHS Scotland. Further information on NHS Lanarkshire’s policies for prescribing antibiotics in both primary care and acute settings is available at this link: http://www.medednhsl.com/sites/prescribing/resources.asp

2 Backlog maintenance Please find attached NHS Lanarkshire’s full submission to Audit Scotland for the January 2009 Asset 2 costs Management in the NHS in Scotland publication.

I must advise, however, that this submission does not include details on the particular sites within NHS Lanarkshire that these costs refer to. Due to moving from a local database system to a national system in 2010/11, and changes in personnel, we are unable to provide a full breakdown of the costs by site. Accordingly, I must advise that in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 the information sought, on which particular sites the backlog maintenance costs refer to, is not held. (Appendix Q) 2 Fascia iliaca I can advise that there are three acute hospitals within Lanarkshire. Hairmyres and Monklands Hospitals 3 compartment block do not perform fascia iliaca blocks in their A&E department.

Within Wishaw General Hospital A&E two consultants are trained to perform these blocks. They are performed by landmark method and are performed by consultants in the emergency department only.

I attach the protocol for the nurse-led fascia iliaca catheter block service in place within Hairmyres Hospital. The fascia iliaca block is not routine practice outwith this protocol and although it was described as nurse-led, many of the blocks are delivered by medical staff within the anaesthetic department. This has been rolled out since 2010 and agreed by all anaesthetic, orthopaedic and accident and emergency clinicians. Blocks are usually carried out on the ward and the service is available between 9am and 5pm for patients who will be delayed more than 6 hours to operative intervention.

Fascia iliaca blocks are not carried out within the orthopaedics wards in Wishaw General Hospital and Monklands General Hospital. Within Monklands Hospital the procedure is carried out within the theatres. (Appendix R)

2 Voluntary early I can advise that within the staff categories that you request, that is administrative services and senior 4 retirement or compulsory managers, there have been no voluntary early retirals or compulsory redundancies recorded between 1 redundancy January and 31 December 2011.

2 Hospital meals returned NHS Lanarkshire hospitals, with the exception of Wishaw General Hospital, use a ‘cook chill and cook 5 uneaten freeze’ food service model for preparing meals. Wishaw General Hospital provides a plated meal service. In addition, Wishaw General Hospital and Hairmyres Hospital are PFI sites and their figures are calculated separately. I hope that what has been provided is of assistance to you.

I can advise as follows:- Hairmyres Hospital

Year Number of meals served % waste Cost 2010/2011 353,519 2.74 N/A 2009/2010 354,201 3.15 N/A 2008/2009 364,915 3.81 N/A 2007/2008 368,903 7.00 N/A 2006/2007 370,210 7.00 N/A

Wishaw General Hospital

Year Number of meals served % waste Cost £

2010/2011 524,186 8.20 66,194.00 2009/2010 582,547 8.20 73,562.00 2008/2009 591,997 8.90 79,820.00 2007/2008 608,122 8.30 84,384.00 2006/2007 604,705 8.30 90,904.00

All other hospitals

Hospital 2008/09 £ 2009/10 £ 2010/2011 £ Cleland 2.0 36,489 1,532 2.3 25,523 1,593 3.0 50,625 2,673 Coathill 3.4 156,677 11,186 2.6 146,196 7,412 3.3 107,235 6,228 Hartwoodhill 4.5 66,172 6,253 3.3 54,225 3,489 2.7 31,914 1,516 Kello 2.0 17,140 719 2.0 19,498 760 1.8 17,278 547 Kirklands 3.0 15,584 981 3.6 9,231 648 3.5 8,553 527 Ladyhome 2.0 16,152 678 2.3 20,375 913 1.9 18,224 609 Lockhart 2.6 20,275 1,107 1.7 23,130 766 1.8 24,317 770 Roadmeetings 2.4 26,620 1,314 2.2 23,948 1,067 2.9 23,335 1,191 Stonehouse 2.3 27,467 1,326 1.7 32,181 1,066 2.0 40,188 14,145 Udston 3.0 108,626 8,896 2.0 112,692 4,394 1.8 110,162 322 Kilsyth 2.6 15,109 824 2.2 16,323 700 2.0 15,710 552 Monklands 3.4 543,449 23,096 2.9 531,050 18,634 2.5 536,948 19,867

NHS Lanarkshire does not have the breakdown of all other hospitals for 2006/2007 and 2007/2008. I can advise, however, that the total meals prepared were 1,572,477 in 2006/2007 and total meals 1,198,430 in 2007/2008 with 7% of those meals uneaten in both years. The breakdown of these figures has not been kept and accordingly, in terms of Section 17 of the Act I must advise that the information sought for 2006/2007 and 2007/2008 is no longer held.

In addition I can advise that Hairmyres Hospital does not specifically record the cost of food wastage. Accordingly in terms of Section 17 of the Act I must advise that the information sought in this regard is not held. I do hope, however, that what has been provided is of assistance to you.

I can advise that the figures for food waste have been recorded in accordance with the Health Facilities Scotland Catering Group guidelines. The percentage of unused meals at all NHS Lanarkshire hospitals is within the Audit Scotland target of 10%.

2 Hartwood hospital NHS Lanarkshire has not retained many records pertaining to Hartwood Hospital and particularly not 6 dating as far back as the late 1960s. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the particular information sought is not held.

Some records have been retained including a site plan and building layout of Hartwood Hospital dating back to 1980. I attach these documents which I hope will be of assistance to you in your area of study. (Appendix S and T) 2 Hartwood Hospital NHS Lanarkshire has not retained many records pertaining to Hartwood Hospital and particularly not 7 dating as far back as the 19th century. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the particular information sought is not held.

Some records have been retained including a site plan and building layout of Hartwood Hospital dating back to 1980. I attach these documents which I hope will be of some assistance to you in your area of study. (Appendix S and T)

2 AAC devices purchased I can advise that the problem with accessing this particular system was due to a faulty server which our 8 internal IM & T department were unable to repair. A solution was identified and an external supplier approached to make the repair. The repair has now been carried out and access to the system has now been restored.

I can advise that AAC equipment that has been directly purchased by NHS Lanarkshire is as follows:-

Year Equipment Type 2010/2011 1 x Light writer 2009/2010 2 x Light writer 1 x Vantage lite 2008/2009 7 x Light writer 2007/2008 8 x Light writer 1 x Dynavox 5 x Go Talk Devices 2006/2007 1 x Interact

I hope this is to your satisfaction and apologise for the delay in providing you with the information for the years 2007/2008 and 2006/2007. If you have any further queries on this please do not hesitate to contact me. 2 Car washing in car park I am advised that car washing was carried out in the car park connected to the GP surgery within 9 of Rutherglen Health Rutherglen Health Centre on 8 February 2012. NHS Lanarkshire does not own the building and does Centre not pay electricity for that element.

I can advise that GP practices are subject to the Freedom of Information legislation in their own right and NHS Lanarkshire cannot answer on their behalf. You may wish to put your questions to the GP practice direct. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held.

3 How to examine, I can advise that all doctors are taught how to examine wrist injuries, who to X-Ray and how to treat 0 document and treat wrist these patients as part of their basic medical training and as part of their induction when starting work in injuries. A&E.

There is no specific documentation on examining, documenting and treating wrist injuries in A&E. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the documentation sought is not held.

3 Hip replacements and I attach details of all hip and knee replacement operations carried out in Lanarkshire hospitals in 2011, 1 knee replacements broken down by procedure and hospital. (Appendix U)

3 Server and virtualisation The server and virtualization support/maintenance contracts held by NHS Lanarkshire are detailed 2 support/maintenance ICT below:- contract Contract - Server Virtualisation Users - 8,000 Supplier - Northgate Server Hardware make - HP Operating System - Solaris/AIX Number of servers - 20 Number of Virtual Servers - 170 Contract Value - £90,000 Contract duration - 3 years Contract review date - 31/03/2013 Contract Description - VMware Server Virtualisation system Internal contact - Gavin Cox, Head of IT Infrastructure Email: [email protected] Telephone: 01698 858008

Contract - Dell Server Support Users - 6,000 Supplier - Northgate Server Hardware make - Dell Operating System - Windows Server Number of servers - 38 Number of Virtual Servers - 0 Contract Value - £8.5k + VAT p/a Contract duration - 3 yrs Contract review date - 31/03/2012 Contract Description - Server Maintenance Internal contact - Gavin Cox, Head of IT Infrastructure Email: [email protected] Telephone: 01698 858008

3 Health records I can advise that requests of this nature are exempt in terms of Section 38 of the Freedom of Information 3 (Scotland) Act 2002. Your request for information can be dealt with under the terms of the Data Protection Act 1998 as a subject access request. I have passed your request to Ina Tainsh, Health Records Manager at Wishaw General Hospital (Tel: 01698 366789) who will process the matter further. 3 People with dementia No individual with dementia has been housed in a short stay assessment unit while waiting for a suitable 4 hospital place over the last 12 months. Only those patients with dementia and who have a clinical need are cared for in a short stay unit to undergo assessment, treatment, and rehabilitation to allow them to be discharged to their own home or an appropriate specialist care environment.

No dementia patient has had to wait for a hospital place in any of the years requested as NHS Lanarkshire does not place dementia patients within hospital settings. Patients with dementia are discharged from the short stay assessments units to their own homes, a care home of their choice or to NHS Lanarkshire contracted beds which are also within care homes.

The table below give details of the number of patients who have been admitted to a short stay assessment ward which is not in their hospital catchment area. The three hospital catchment areas cover the whole of Lanarkshire and are: • Airdrie, Coatbridge and the North localities • East Kilbride and Hamilton localities • Bellshill, Clydesdale, Motherwell and Wishaw localities. The table also includes non dementia patients and patients who reside in a neighbouring health board. Year 2006/07 2007/08 2008/09 2009/10 2010/11 Total 20 15 14 19 11

I am unable to provide you with information on the distance of the unit in which they are being cared for from their home as we do not record this information. Accordingly, I must advise that in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 the information sought on the number of miles a short stay unit is from a patient’s home is not held.

3 Antibiotic treatments The prescribing of antibiotics within primary care is undertaken by individual GP practices. I can advise 5 that NHS Lanarkshire does not collect information in relation to the effectiveness of first, second or third course antibiotic treatments for 2011 from General Medical Practices within Lanarkshire. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held. I can advise that GP practices are subject to the Freedom of Information legislation in their own right and you may wish to put your questions to GP practices direct. A full list of practices in Lanarkshire is available on our website via the following link. http://www.nhslanarkshire.org.uk/servicefinder/GPs/Pages/gp.aspx

3 NHS Continuing I attach the following documents currently in use within NHS Lanarkshire:- 6 Healthcare • Continuing Care in NHS Lanarkshire • Information for patients/carers – NHS continuing care • Information for patients/relatives – interim care • Information for patients/relatives – temporary move to await community care assessment • Finding the care that is right for you

The continuing care in NHS Lanarkshire document follows CEL 6 guidance, explains what makes a patient eligible for NHS continuing care and provides clear, concise information on the eligibility and assessment process. The information sheets can be provided to patients, carers or relatives. These documents are, however, not seen as a substitute for good face-to-face communication with the relatives by staff.

There are forms attached to the continuing care document for medical staff to complete that document the completion of rehabilitation. In some instances these are completed in the acute site but may be completed offsite if no clear decision has been reached and the patient is moving for interim care.

In terms of discussing when rehabilitation is complete the relatives are not given written information. This is dealt with on an individual basis.

There is no specific documentation in relation to an appeals process and accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the documentation sought in this regard is not held. NHS Lanarkshire uses the guidance provided to Boards in the CEL 6 (2008) circular. The Medical Director for NHS Lanarkshire is responsible for the review process.

NHS Lanarkshire is not aware of any formal documentation being in place prior to the issue of this guidance on NHS continuing care. The consultants dealing with patients requiring NHS continuing care dealt with the cases on an individual basis in consultation with partner agencies. (Appendix V, W, X, Y and Z)

3 Eating disorders Lanarkshire patients with an eating disorder can be treated in a wide variety of settings including GPs, 7 practice nurses, public health nurses in schools or counsellors. They can also be referred to a psychologist, a community psychiatric nurse or an occupational therapist who work alongside our specialist eating disorder dietitians in our community mental health teams. Under 16s are seen by our Child and Adolescent Mental Health Service (CAMHS). We also have a multi-disciplinary specialist team which treats patients with severe eating disorders. This team can refer patients for inpatient treatment. I regret to advise that I am unable to provide you with details of the total number of people treated by these services for the years requested as the information is not centrally recorded. To find this information would require a manual check of each individual patient record for these services to ascertain who had been treated for an eating disorder and in what year. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

However, the table below gives the number of adults who have been referred to the multi disciplinary specialist team for the years listed.

Year Total 2009 (Feb-Dec) 27 2010 32 2011 16

I can also inform you that the total number of new patients who were seen our specialist eating disorder dietitians in 2010/11 was 55. For the months April to January 2011/12, the total is 35.

Please note that the totals above do not include patients from the Rutherglen/Cambuslang area who are treated by NHS Greater Glasgow and Clyde.

I am unable to provide you with a breakdown of eating disorder groupings as we do not categorise all patients with an eating disorder in this way. Accordingly, I must advise that in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 the information sought on the breakdown of eating disorders into groupings is not held. I can tell you that those patients with a severe eating disorder who are referred to our multi-disciplinary specialist team, are given a categorised diagnosis which will be either Anorexia Nervosa or Eating Disorder not otherwise Specified.

3 Blood-borne virus I attach details of how the blood-borne virus funding has been spent between the years 2007/2008 and 8 prevention funding 2011/2012. (Appendix AA) 3 Recruitment NHS Lanarkshire does not have a structure of all hiring managers and accordingly, in terms of Section 9 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held.

Executive Directors authorise the filling of posts within their divisions. I attach a structure chart showing the corporate management team within NHS Lanarkshire which I hope will be of assistance to you. This details the executive directors that are on the establishment.

I can advise that £64,197.92 was spent on recruitment in 2010/2011.

I can advise that this expenditure was all related to recruitment advertising costs.

I attach a table showing the companies used for publicity and advertising over this period.

I can advise that £47,486.01 was spent on recruitment in 2011/2012 (up to January 2012).

I can advise that this expenditure was all related to recruitment advertising costs.

I attach a table showing the companies used for publicity and advertising over this period. One item has been removed from the table. This did not relate to spend on publicity and advertising.

I regret to advise that I am unable to provide you with details of the budget for recruitment for 2012/2013. Recruitment spend is included within a wider budget heading relating to HR services. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held.

NHS Lanarkshire has issued no tenders for recruitment in the last 24 months.

I can advise that as at 30 September 2011, the latest figures available, NHS Lanarkshire employed 9,809.80 (wte) staff. In line with Scottish Government guidelines, NHS Lanarkshire is currently working on staff workforce estimates for the financial year ending 31 March 2013. These projections will not be concluded until late June 2012. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held. (Appendix AB, AC and AD)

4 MMR vaccination I can advise that, following receipt of Scottish Government Health Department circular CMO(2011)12 0 on 7 October 2011, NHS Lanarkshire developed a business plan to offer MMR vaccination to school pupils in S3 to S6. This offer of MMR vaccination will take place in secondary schools during March 2012, with specific school MMR catch-ups timetabled for the same day as female S2 pupils are scheduled to receive the HPV vaccine.

This year the MMR catch-up will coincide with the third HPV vaccine dose. NHS Lanarkshire had completed around a quarter of secondary school boosters (S3) by the time the Scottish Government circular was issued and another 25% were timetabled for weeks 2-4 in October 2011. In future years, the offer of MMR vaccine will be ongoing for those in S3, along with their secondary school booster

NHS Lanarkshire has not been in recent discussions with universities and colleges about the uptake of MMR immunisation. As recommended in the Chief Medical Officer’s letter, GPs have been alerted to the HPS measles risk assessment and the advice on completing MMR vaccination and provide advice when the opportunity arises.

NHS Lanarkshire maintains an active vigilance for confirmed cases of measles, mumps or rubella and, if an outbreak was identified, vaccination would be offered to those at risk within the institution affected.

4 CAMHS referrals From referral to Child and Adolescent Mental Health Services (CAMHS) to being assessed by a 1 member of the CAMHS team for the years i) 2009-2010 (ii) 2010-2011 and (iii) 2011-2012. The table below gives a breakdown of the information you require measured in weeks.

Year 2009/10 2010/11 2011/12*April to December Shortest Less than one week Less than one week Less than one week Average 11 12 9 Longest 60 61 34

I regret to advise that I am unable to provide you with details of the shortest, average and longest waits for the years requested for those referred or assessed by CAMHS for talking psychological talking therapy and the start of their treatment as this information is not centrally recorded. To find this information would require a manual check of each individual patient record to ascertain who had been referred and assessed by CAMHS for psychological talking therapy and measure the length of time from their assessment or referral to receiving treatment. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

4 Pain consultants NHS Lanarkshire employs two consultant anaesthetists - one whole time equivalent (WTE), 0.3 WTE 2 nurse consultant, one WTE clinical nurse specialist, one WTE clinical psychologist, one WTE specialist physiotherapist and 1.5 WTE administrative support with a responsibility for chronic pain.

This multidisciplinary team approach has shown to be both clinically effective and cost effective and is in line with the national chronic pain service model and the NHS Lanarkshire long term conditions strategy.

NHS Lanarkshire does not have a managed clinical network for chronic pain however it does have a service improvement group which links with the very successful musculoskeletal pathway to ensure patients receive the right level of multidisciplinary support and self management education as early as possible. At the time of writing 35 patients were waiting for a first appointment with a pain consultant.

Appointments are allocated at the discretion of the consultant and are based on the individual needs of the patient. However, this information is not recorded centrally and gathering this information would be prohibitive in both terms of time and cost. To provide this information would involve a manual trawl of patient records and the cost of complying with this part of your request would exceed the amount prescribed in the Regulations made by the Scottish Ministers. This constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002.

NHS Lanarkshire’s chronic pain service offers a pain management programme that aims to restore, to as normal as possible, the lives of those affected by persistent pain.

The pain management programme offers psychological and physical support and is run by a clinical psychologist and physiotherapist with input from other members of the chronic pain team.

The programme uses a mix of psychological techniques from cognitive behavioural therapy and different physiotherapy exercises to treat people with chronic pain.

This type of therapy works well for people with both physical and emotional difficulties, as it tackles how they think in relation to pain, how they feel about it and how they behave in relation to pain.

Patients are taught the techniques in the group and are expected to practice at home etc. to become expert in their application. The aim of the programme is to help patients reduce the disability and distress caused by chronic pain.

The pain management programme runs for ten consecutive weeks, with each session lasting half a day. Patients can be referred either by their GP or their hospital consultant.

In line with the national service model for chronic pain NHS Lanarkshire has had in place for some years, a Service Level Agreement (SLA) with Pain Association Scotland. This SLA provides formal self management support programmes and four ongoing self-management maintenance groups. NHS Lanarkshire has worked closely with Pain Association Scotland since 1995.

4 Maternity services The total spend on maternity services is as follows:- 3 Financial year Spend 2009/2010 13,429,663 2010/2011 14,167,904 2011/2012 (up to 31 December 2011) 14,248,864

The number of midwives on the staffing establishment is already published by the Information Services Division of NHS Scotland (ISD). This is Scotland’s national organisation for health information, statistics and IT services.

It is the case that the information is otherwise reasonably obtainable and that the information you seek falls with a ground of exemption in terms of Section 25 of the Freedom of Information (Scotland) Act 2002 inasmuch as it is information which can reasonably be obtained other than by requesting it under the freedom of information legislation. The link to the workforce report is:- http://www.isdscotland.org/Health-Topics/Workforce/Publications/2011-11-29/2011-11-29-Workforce- Report.pdf?15838259459

The information for the quarter ending 31 December 2011 will be made publicly available on the ISD website on 28 February 2012 and you may wish to log on to the website at the link detailed above.

In line with Scottish Government guidelines, NHS Lanarkshire is currently working on staff workforce estimates for the financial year ending 31 March 2013. These projections will not be concluded until late June 2012. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought on the forecast for the number of midwives on the establishment for 2012/2013, 2013/2013 and 2014/2015 is not held.

NHS Lanarkshire does not have targets for bed occupancy rates. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held.

I can advise that the maternity bed occupancy at Wishaw General Hospital is as follows:- Financial year % Occupancy 2009/2010 56 2010/2011 58 2011/2012 60

I can advise that during this period there were no recorded maternal deaths directly related to childbirth and/or labour within NHS Lanarkshire.

The recorded child deaths during this period is as follows:- Financial year Still births Early neonatal deaths 2009/2010 35 4 2010/2011 25 11 1 April 2011 to 31 December 2011 13 5

I attach the number of recorded maternal injuries for 2009/2010, 2010/2011 and 2011/2012 (up to December 2011).

I regret to advise that I am unable to provide you with details of the obstetric anaesthetic complications for the years 2009/2010 and 2010/2011. The information was not collected until this financial year. To find this information would require a manual check of each individual patient record over this period. This information gathering would exceed the charging threshold prescribed in the Regulations made by the Scottish Ministers which constitutes a ground of exemption in terms of Section 12 of the Freedom of Information (Scotland) Act 2002. I do hope, however, that what has been provided is of assistance to you.

I can advise that there are no obstetric claims settled for incidents occurring during the period 2009/2010, 2010/2011 and 2011/2012. I can advise that there is only one maternity unit in Lanarkshire comprised of wards 21, 22, 23 and 24 at Wishaw General Hospital. There are also maternity day assessment units at Monklands Hospital, Hairmyres Hospital and Lanark Health Centre. (Appendix AE)

4 GPs in the OOH service I can advise that all doctors carry adrenaline 1:100 in 1ml ampoules in the Out of Hours period. 4 carrying adrenaline When pre-loaded, intact, in date adrenaline is available, it is reasonable for a GP to utilise this and no specific permission is required from NHS Lanarkshire to do this.

GPs are autonomous practitioners and are responsible for their clinical actions and decisions. Thus, equally, a GP may decide to use adrenaline that he/she holds in his/her medical bag.

The guidelines on the management of anaphylaxis are summarized in section 3.4.3 of the British National Formulary. It should be noted that the medical (as opposed to lay person) management of anaphylaxis can also include use of injectable antihistamines and corticosteroids and establishment of IV access.

The British National Formulary can be obtained at the following link:- http://bnf.org/bnf/index.htm

4 Financial monthly I attach the financial monthly monitoring returns submitted to the Scottish Government for October, 5 monitoring return November and December 2011. I can advise that the first return required by the Scottish Government submitted to the Scottish Health Department was for June 2011. You have already received the returns submitted to the Scottish Government Government for June, July, August and September. These were provided to you in my letter of 15 December 2011. (Appendix AF, AG and AH) 4 Cleland Hospital I can confirm that inpatient care will continue to be provided within the Parkside Unit on the Cleland 6 Hospital site.

The remaining surplus land will be disposed of in due course in line with the disposal procedures laid down in the NHS Scotland Property Transaction Handbook to ensure that the NHS receives an appropriate market value.

4 Prescribing formulary I can advise that the NHS Lanarkshire Joint Formulary is the key document in relation to prescribing 7 and wound care formularies active in NHS Lanarkshire. The formulary can be obtained on the NHS Lanarkshire website formulary at:- http://www.medednhsl.com/meded/NHSL_Formulary/

This document is updated regularly as soon as a change is agreed. The next update is expected in March 2012. The Lanarkshire formulary is used by acute and primary care prescribers in NHS Lanarkshire but it is not used by other organisations. The Lanarkshire Area Drugs and Therapeutics Committee is responsible for updating the formulary.

The NHS Lanarkshire wound management formulary is also available on the NHS Lanarkshire website. The link to the document is as follows:- http://firstport/sites/tissueviability/wmf/default.aspx

4 Records about a I can advise that requests of this nature are exempt in terms of Section 38 of the Freedom of Information 8 complaint. (Scotland) Act 2002 as this is your own personal information. Your request can be dealt with under the terms of the Data Protection Act 1998 as a subject access request. I have passed your request to Craig Tannahill, Information Governance Manager at Kirklands Hospital (Tel: 01698 858079) who will process the matter further.

4 Assisted conception I attach the NHS Lanarkshire criteria for acceptance for level 3 fertility treatments (IVF and ICSI). The 9 NHS Lanarkshire criteria follows guidance on infertility treatment from EAGISS, the expert advisory group on infertility services in Scotland. Their guidance states:-

NHS-funded assisted conception should be available to couples who meet all of the following eligibility criteria:- • Infertility with an appropriate diagnosed cause, of any duration or • unexplained infertility of at least three years duration • Female partner aged <38 years at the time of treatment • Neither partner previously sterilised • No child living with the couple in their home • Less than three previous embryo transfers funded from any source

Any requests for review of a decision would be dealt with on an individual basis.

I can advise that NHS Lanarkshire does not have a policy on assisted conception or written exceptions to the criteria for assisted conception. Accordingly, in terms of Section 17 of the Freedom of Information (Scotland) Act 2002 I must advise that the information sought is not held. (Appendix AI)