NHS Scotland’s governance arrangements need to be strengthened to deliver the scale of reform needed across the health service.
NHS Scotland comprises 22 NHS boards, with oversight provided by the Scottish Government. A range of governance groups are in place across NHS Scotland but there are weaknesses within the scrutiny and assurance processes at the Scottish Government level. This risk could be reduced by making greater use of non-executive directors to provide more challenge.
The planning and governance of healthcare in Scotland is becoming more complex, and this limits NHS boards’ ability to drive reform. The mix of local, regional, and national partners makes decision making and accountability difficult.
A new planning framework has been introduced by the Scottish Government and new national strategies for reform are due in 2025. Dealing with this change will be challenging for boards, but it should give them more clarity and help them to work more collaboratively to deliver reform.
NHS boards use a blueprint for good governance that was produced in partnership with the Scottish Government. The blueprint has been well received but there is scope for it to be strengthened to more clearly set out how board governance should be adapted to deliver reform.
NHS Scotland’s governance arrangements need to be strengthened to deliver the scale of reform needed across the health service.
Stephen Boyle, Auditor General for Scotland, said: “The delivery of NHS services must be reformed for Scotland’s health service to remain affordable and sustainable.
“NHS Scotland’s governance arrangements are key to delivering that reform, but they need to be strengthened.
“The planning of healthcare in Scotland is becoming more complex and the Scottish Government needs to ensure lines of accountability and decision-making are clear.”
New paper led by ENU’s Dr Adele Goman is the first randomised control trial of this kind
Hearing interventions such as hearing aids and regular audiology appointments have been linked to a reduction in the number of falls among older adults, according to a new paper led by Dr Adele Goman of Edinburgh Napier University’s School of Health & Social Care.
This research, published today in the Lancet Public Health journal, showed that participants with hearing loss who were randomly assigned best practice hearing care reported an average of 27% fewer falls over the course of three years compared to a control group.
Falls are a leading cause of injury for older people and have rising mortality rates, while hearing loss is highly prevalent among those aged 70 and above. However, existing evidence on the effect of hearing aids on falls is mixed, and limited by the methodology of previous studies.
Goman and her colleagues analysed data from the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study, a three-year, unmasked, randomised controlled trial of adults aged 70–84 years in the USA designed to study the effect of intervention on cognitive abilities and other health outcomes, such as falls.
The ACHIEVE study was funded by the National Institute on Aging, part of the U.S. National Institutes of Health. It was conducted by a consortium of eight universities in the United States and led by researchers at Johns Hopkins University, Baltimore, MD, USA.
The 977 ACHIEVE study participants, all of whom had hearing loss, were randomly assigned to either receive a hearing intervention or to a health education control intervention. Those randomly assigned to the hearing intervention were offered regular one-to-one audiologist appointments, bilateral hearing aids, the option of additional hearing assistive devices, device use support and educational materials. The health education control intervention group received the same number of appointments with a health educator and more broad educational content on healthy aging.
For this paper, participants were asked to report the number of falls they had experienced over a period of three years. Data indicate that participants who received the hearing intervention reported an average of 27% fewer falls over the course of three years compared to a control group.
Dr Goman’s is the first known large-scale randomised control trial that has examined the effect of hearing intervention on falls.
The researchers believe the reduced number of falls among the hearing intervention group could be down to improved auditory input enhancing spatial awareness, or from having to devote less attention to processing auditory input allowing for more attention to be placed on maintaining postural control.
They are now working on a follow-up study with participants to examine the longer-term effects of hearing intervention on brain health, falls, and other health outcomes.
Dr Adele Goman said: “Hearing loss has previously been associated with a greater risk of falling among older adults, but few studies have directly investigated the connection.
“It is possible that the benefit of improved hearing may have enhanced the spatial environmental awareness of these participants, or that the lower demand on cognitive resources for hearing allowed them to focus more on their movement.
“As this is the first study of its kind, more research is needed to establish our conclusion that hearing intervention may reduce the overall average rate of falls. Our ongoing follow-up will also aim to tell us more about the effect over a longer period of time.
“We hope that these findings have the potential to inform researchers and health professionals, and address a leading cause of injury among older people.”
In Scotland, 38% of melanomas in men are found on the torso and 36% in women are found on lower limb, according to new analysis from Cancer Research UK.
Melanoma skin cancer cases expected to rise again this year, with a projected 1,800 cases in Scotland in 2025.
Cancer Research UK urges people to stay safe in the sun as the weather gets warmer, and to go to their doctor if they notice any unusual changes to their skin.
New analysis by Cancer Research UK suggests that clothing choices may influence where skin cancer develops.
The latest data for Scotland (from 2018-2021) shows that 38% of melanomas in men were diagnosed on the torso (back, chest and stomach) – more than any other part of the body. This translates to around 280 cases every year.
However, in women, the most common location is the lower limbs (from the hips to the feet) – with more than a third of cases (36%) diagnosed here – around 270 cases every year.
The charity says people’s behaviours in the sun, like what they wear or how much sunscreen they use, could be influencing where skin cancer develops on their bodies. For example, men might be tempted to go without a shirt, while women might wear shorts or skirts as the weather gets warmer. Surface area could also be playing a role as men’s torsos are typically bigger than women’s and women’s legs take up a larger proportion of their body surface area.
Although wearing less clothing in hot weather can help people stay cool, it also means that more skin is exposed to the sun’s ultraviolet (UV) rays, which can damage the DNA in cells and cause skin cancer.
In fact, 81% of melanoma cases in Scotland – that’s around 1,300 each year – are caused by overexposure to UV radiation, which is why it’s so vital to take steps to stay safe while enjoying the sun and avoid using sunbeds.**
Fiona Osgun, head of health information at Cancer Research UK, said:“As the weather gets warmer, it’s really important to look after yourself in the sun.
“Getting sunburnt just once every couple of years can triple your risk of melanoma skin cancer, compared to never being burnt.
“And it’s not just the hot, sunny days you need to watch out for – UV rays can be strong enough to cause skin damage between mid-March and mid-October in the UK, even when it’s cloudy or cool.
“That’s why we encourage people across Scotland to take some simple steps to stay safe. Try to stick to the shade between 11am and 3pm when the sun is strongest, wear clothes that help cover up your skin, with a hat and sunglasses, and use a sunscreen with at least SPF 30 and 4 or 5 stars. The key is to apply it generously – and remember to top it up regularly, especially if you’re sweating or in water.”
Nearly 100 years ago, Cancer Research UK helped prove that UV radiation can cause skin cancer. Since then, the charity has learnt more about how skin cancer starts and spreads and is pioneering ways to prevent, detect and treat the disease.
UK melanoma survival has doubled in the last 50 years and, today in Scotland, more than 9 in 10 adults diagnosed will survive their disease for five years or more.
But rates continue to rise, with a projected 1,800 cases in Scotland in 2025 – the highest on record. Since the early 1990s, melanoma skin cancer rates have doubled in Scotland.
In women, rates have increased by almost three quarters and in men, they’ve increased by two and half times (157%).
Cancer Research UK’s chief executive, Michelle Mitchell, said:“Improvements in skin cancer survival rates highlight the remarkable progress driven by our research. But the growing number of people diagnosed with melanoma in Scotland is still concerning, especially when we can see that rates are rising faster in men.
“If you notice anything different on your skin like a new mole, a mole that’s changed in size, shape, or colour, or any patch of skin that looks out of the ordinary – don’t ignore it, speak to your GP. We want to beat skin cancer for everyone, no matter who they are or where they’re from – early diagnosis is key and could make all the difference.”
With the weather getting warmer, more people will head outside on high UV days, so Cancer Research UK and NIVEA Sun are – in partnership – urging the public to protect their skin and enjoy the sun safely.
When the sun is strong, they recommend three simple steps to reduce cancer risk:
Spend time in the shade, especially between 11am and 3pm in the UK.
Cover up with clothes, a wide-brimmed hat and UV-protection sunglasses
Apply sunscreen with at least SPF 30 and 4 or 5 stars generously and regularly.
Mum of two Michelle Harris understands the impact of a skin cancer diagnosis all too well.
Complex needs teacher Michelle who was diagnosed with melanoma in November 2019 was on a family holiday to Finland when her husband Alistair Harris, 45, first flagged that a mole on her back had changed shape and was growing larger. Michelle had also noticed the mole had become itchy.
She visited her GP and was referred to University Hospital Monklands in Airdrie for tests which confirmed she had cancer. Breaking the news to her children Abby, 17, and Kaden, 13, was tough.
Michelle, 38, of Motherwell said: “Cancer turns lives upside down, steals precious moments and affects far too many of us.
“I was very matter of fact and open when I told the children I had cancer. I explained that doctors had told me it was stage 2b melanoma so they had got the cancer early. Although I had to go through an operation I was going to be okay. I just had to get on with things. It was good the NHS were there to look after me so well and my GP was fantastic.”
Michelle had day surgery on 30 November 2019 to remove the mole as well as lymph nodes from under her arm. She recovered well but has regular check ups on other areas of her body where there are moles.
Michelle said: “I think it’s really important to raise awareness about skin cancer. I have a lighter skin tone and I take extra care in the sun, make sure I’m covered up and I seek shade when the sun is at its strongest.”
TO coincide with Dementia Action Week (May 19 – 25), the Specsavers Home Visits team in Edinburgh has taken vital steps to support its customers living with dementia.
The full team has recently become qualified Dementia Friends, after completing a training course to professionally care for the eye health and hear care of customers who have the condition.
The Specsavers Home Visits team provides care to customers who, due to a multitude of reasons, are unable to pay a visit to a high street store to receive eye health and hearing services.
Lynne Seebaluck, director at Specsavers Home Visits that covers Edinburgh, the Lothians and the Scottish Borders, said: “By becoming Dementia Friends, our team feels more confident to ensure any customers living with dementia feel safe and are looked after in a sensitive way.
“We’re always keen to go the extra mile and support our local community, especially as we’re out visiting those directly in it.”
For more information about the Specsavers Home Visits team, visit:
Yesterday (Tuesday 20 May) pupils met at the Scottish Parliament for a special space-themed walk for Living Streets’ Walk to School Week.Pupils from Royal Mile Primary School in Edinburgh dressed as astronauts for Living Streets’ Walk to School Week (19-23 May).
Joined by representatives from City of Edinburgh Council they embarked on a space-themed walk to Dynamic Earth and Planetarium, enjoying discovering facts about the solar system and how walking and wheeling to school can help protect our planet. Pupils also enjoyed a visit to Dynamic Earth and Planetarium, the only science centre and planetarium in Edinburgh.
During Walk to School Week, pupils across Scotland are encouraged to walk, cycle, scoot, or wheel to school each day during the week, to feel the benefits of getting active before the school day.
This year’s Walk to School Week theme, The Great Space Walk, has inspired thousands of children to travel actively to school each day of the week, with over 250,000 pupils already signed up for the challenge.
Chris Thompson, Programme Manager, Living Streets Scotland said: “Walk to School Week is a fantastic opportunity to celebrate the extraordinary steps pupils across Scotland are taking to make their journey to school more active, which is better for individuals, communities and the planet.
“By choosing to walk, they’re showing how small actions lead to big impacts, such as easing congestion, improving air quality, and creating cleaner, healthier streets. We hope this week inspires others to walk and wheel to school and discover how easy it can be to make their daily commute truly ‘out of this world’.”
Mrs Black, Head Teacher at Royal Mile Primary School said:“It is wonderful to see how much our children enjoy participating in the WOW challenge, and having their hard work acknowledged in this way is incredibly rewarding.
“We are extremely proud of our pupils for their enthusiasm to walk and wheel to school in all weathers. We’ve also seen a real difference in the number of cars outside the school gates, making the roads safer for pupils and the wider community.”
Cllr Stephen Jenkinson, Transport and Environment Convener at the City of Edinburgh Council, said:“Walking, wheeling and cycling to school has such a positive impact on young people. It helps build independence, improves road awareness, and helps pupils start the day feeling energised and ready to learn.
“From ambitious active travel projects like the City Centre West to East Link (CCWEL) and Roseburn to Union Canal along with traffic calming and road safety measures – we’re committed to making people feel more comfortable walking, wheeling, and cycling, whilst creating more liveable and inclusive streets and neighbourhoods.
“Congratulations to the pupils and staff at Royal Mile Primary School for their outstanding commitment to travelling to school in safer, healthier, and more sustainable ways.”
The pupil-led initiative encourages students to log their active journeys to school using the interactive WOW Travel Tracker. Pupils who walk, cycle, scoot, or wheel to school once a week for a month are rewarded with a special collectible badge.
You can find out more about Living Streets, Walk to School Week and WOW – the walk to school challenge at Home | Living Streets.
Members of the public are being encouraged to stay safe in the sun as the current warm weather is expected to continue into this week.
NHS Greater Glasgow and Clyde (NHSGGC) advised people to ensure they are protected from the sun, and to take care when barbecuing to prevent food poisoning.
It also highlighted the importance of getting the right care in the right place if help is needed for a health concern.
Common health conditions during nicer weather can include sunburn, food poisoning, bites and stings.
NHSGGC also highlighted the importance of keeping items like over-the-counter medicines, a first aid kit and an ice pack at home to help manage minor cuts, bruises, sprains and strains.
During Sun Awareness Week, NHSGGC is asking people to consider the following:
Sunburn and sunstroke – Always cover up in the sun to protect yourself and your family from burns and heat exhaustion. This includes wearing a high-factor sunscreen and appropriate clothing and spending time in the shade.
Food poisoning – Barbecuing can lead to food poisoning if it is not done correctly. Ensure meat is cooked thoroughly and evenly, and keep cooked and raw food separate.
Medicines – Make sure you have over-the-counter medicines at home for common illnesses including paracetamol or ibuprofen, remedies for bites and stings and antihistamines for allergies.
First aid – Keep a first aid kit in your home with plasters, bandages and antiseptic wipes for cuts, and an ice pack for minor strains or sprains.
For those requiring support or medical treatment for non-life-threatening conditions, there is a range of services available to help, and NHSGGC continues to ask people to ‘think ABC’ before attending A&E:
Ask yourself: Do I need to go out? For information on keeping yourself well and treating minor illnesses and injuries from home, visit the NHS Inform website or download the NHS24 app.
Be aware: There is help for many conditions right on your doorstep. Your local GP, pharmacy, dentist or optician offer a range of services. This could include directing you to a Minor Injuries Unit.
Call 111: If it’s urgent, or you’re not sure, call NHS24 on 111. They’ll make sure you get the help you need.
If you think your condition or injury is very urgent or life-threatening, you should call 999 or go to A&E immediately.
Dr Emilia Crighton, NHS Greater Glasgow and Clyde’s Director of Public Health, said: “This is a great time to get outside and enjoy warmer weather and longer days with friends and family.
“Please enjoy the good weather safely by covering up when in the sun, staying hydrated and making sure food is properly cooked if barbecued”.
“For those who do require support over this period, we want people to be aware that there are many services available to them other than emergency departments.
“By using NHS 24’s digital resources and through 111, people who need care can be seen by the most appropriate staff in the most appropriate setting.
“We ask everyone to think ABC before A&E. This will ensure you get the right care in the right place, will help reduce waiting times, and free up capacity for those who need it most.”
What do you do to boost your mental wellbeing?
