Chamber
Meeting of the Parliament 25 June 2013
25 Jun 2013 · S4 · Meeting of the Parliament
Item of business
Specialist Heart Failure Nurse Services
I congratulate Dave Thompson on securing time for this important debate on what remains a clinical priority for NHS Scotland.
I am sure that all members recognise that encouraging progress has been made in recent years, which is underpinned by the 60 per cent reduction in the coronary heart disease premature mortality rate between 1995 and 2010. That shows the degree of improvement in clinical care and the benefits of preventative work in improving outcomes for patients.
We recognise that new challenges are emerging—Dave Thompson set out the challenges very well. More people are living longer with long-term conditions, and more people who have suffered cardiac episodes and heart failure are living with co-morbidities. Supporting such individuals puts pressure on our NHS system. It is important that we ensure that our services can address the needs of the increasing number of patients in Scotland who might suffer from heart failure.
We recognise that heart failure nurses need to be in place to meet the need. The better heart disease and stroke care action plan and the clinical standards for heart disease identify the important role of heart failure nurses in providing safe, effective and person-centred care. The action plan demonstrates our commitment in that regard and sets out how we expect boards to take the issue forward. We expect the recognition that heart failure nurses have an important role to play to inform boards’ workforce planning.
A number of members referred to the SIGN guidelines for heart failure, which were published in 2007 and which recommended that there should be a nurse-led, home-based element of post-discharge care and that patients should be considered for follow-up by a trained heart failure nurse.
The SIGN guidelines are important. They are not from, or directed by, Government, and no Government can claim some form of responsibility for them; they are commissioned and taken forward independently of Government to help inform clinical practice. However, I think that there has been some misunderstanding regarding the ratios that members have referred to, because the SIGN guidelines do not set a minimum standard for staffing provision. I can only assume that members were referring to the British Cardiac Society standards for having one heart failure nurse per 100,000 of the population.
The SIGN guidelines do not specify a specific ratio. It is important, however, that boards ensure that whatever is contained in the SIGN guidelines is taken forward at a local level and that they have adequate staffing levels and the right skills mix in place to meet the local population’s needs.
I am sure that all members recognise that encouraging progress has been made in recent years, which is underpinned by the 60 per cent reduction in the coronary heart disease premature mortality rate between 1995 and 2010. That shows the degree of improvement in clinical care and the benefits of preventative work in improving outcomes for patients.
We recognise that new challenges are emerging—Dave Thompson set out the challenges very well. More people are living longer with long-term conditions, and more people who have suffered cardiac episodes and heart failure are living with co-morbidities. Supporting such individuals puts pressure on our NHS system. It is important that we ensure that our services can address the needs of the increasing number of patients in Scotland who might suffer from heart failure.
We recognise that heart failure nurses need to be in place to meet the need. The better heart disease and stroke care action plan and the clinical standards for heart disease identify the important role of heart failure nurses in providing safe, effective and person-centred care. The action plan demonstrates our commitment in that regard and sets out how we expect boards to take the issue forward. We expect the recognition that heart failure nurses have an important role to play to inform boards’ workforce planning.
A number of members referred to the SIGN guidelines for heart failure, which were published in 2007 and which recommended that there should be a nurse-led, home-based element of post-discharge care and that patients should be considered for follow-up by a trained heart failure nurse.
The SIGN guidelines are important. They are not from, or directed by, Government, and no Government can claim some form of responsibility for them; they are commissioned and taken forward independently of Government to help inform clinical practice. However, I think that there has been some misunderstanding regarding the ratios that members have referred to, because the SIGN guidelines do not set a minimum standard for staffing provision. I can only assume that members were referring to the British Cardiac Society standards for having one heart failure nurse per 100,000 of the population.
The SIGN guidelines do not specify a specific ratio. It is important, however, that boards ensure that whatever is contained in the SIGN guidelines is taken forward at a local level and that they have adequate staffing levels and the right skills mix in place to meet the local population’s needs.
In the same item of business
The Deputy Presiding Officer (Elaine Smith)
Lab
The final item of business is a members’ business debate on motion S4M-06245, in the name of Dave Thompson, on review of specialist heart failure nurse servi...
Dave Thompson (Skye, Lochaber and Badenoch) (SNP)
SNP
The motion was stimulated by a discussion at the cross-party group on heart disease and stroke, of which I am a vice-convener, in March. At that meeting, we ...
Jackie Baillie (Dumbarton) (Lab)
Lab
I pay tribute to Dave Thompson for securing this debate and I commend the British Heart Foundation, the Scottish heart failure nurse forum and Chest Heart & ...
Dave Thompson
SNP
It has just occurred to me that it was remiss of me not to mention that NHS Highland in my area is one of the four health boards that are meeting the target.
The Deputy Presiding Officer (John Scott)
Con
Better late than never.
Jackie Baillie
Lab
That is truly wonderful. We are nothing if not parochial.We have established that heart failure is rising, we agree that we need to try to ensure that servic...
Nanette Milne (North East Scotland) (Con)
Con
I am pleased that Dave Thompson has drawn our attention to the recent “Review of Specialist Heart Failure Nurse Services” and that he has secured the require...
Dennis Robertson (Aberdeenshire West) (SNP)
SNP
I, too, congratulate Dave Thompson on securing a debate on this important subject and bringing it to the chamber. I also thank the organisations, particularl...
Liam McArthur (Orkney Islands) (LD)
LD
I, too, congratulate Dave Thompson on his motion and on securing the debate. I also add my thanks to Chest Heart & Stroke Scotland, to the British Heart Foun...
The Minister for Public Health (Michael Matheson)
SNP
I congratulate Dave Thompson on securing time for this important debate on what remains a clinical priority for NHS Scotland.I am sure that all members recog...
Dennis Robertson
SNP
Will the minister take an intervention?
Liam McArthur
LD
Will the minister take an intervention?
Michael Matheson
SNP
I will give way to Mr McArthur.
Liam McArthur
LD
I am grateful to the minister for giving way. I appreciate what he said in relation to ratios but, as he will have heard, there is no ratio at all in the cas...
Michael Matheson
SNP
I am going to come to Orkney in a minute, when I hope that I can address that point.I am more than happy to give way to Mr Robertson, too.
Dennis Robertson
SNP
I thank the minister for giving way. With regard to the ratios, does the minister share my concern that in Aberdeen there is only one specialist nurse with a...
Michael Matheson
SNP
I will turn to those points on Orkney and Grampian after making a little progress on the wider issue.It is important to recognise that some progress has been...