ADHD Support Group at Muirhouse Library

adhdAn informal parents and carers support group for children with ADHD and Autistic spectrum disorders (it doesn’t matter whether your child is diagnosed or not)

*** Every first Wednesday of the month ***

Drop in between 10.15-12pm at Muirhouse Library

Tea, coffee & biscuits will be available

For more details please contact:

Karma (email  karmalennon@hotmail.com)

or Jamie on caitlinkal2003@gmail.com

adhd support group

Britain leading the fight against dementia

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Britain will expand its efforts to combat dementia over the next 5 years, the Prime Minister David Cameron said today as he set out a new, long-term strategy focused on boosting research, improving care and raising public awareness about the condition.

Britain has emerged as the world leader in fighting dementia since 2010 with investment in research doubled, hundreds of thousands of NHS staff given specialist training and 1 million ‘Dementia Friends’ taking part in awareness sessions across the country.

The Prime Minister wants to build on that momentum both in the UK and worldwide. The Prime Minister’s Challenge on Dementia 2020 is the next phase in the country’s effort to combat the condition and includes:

Over £300m invested in UK research

The UK government will invest over £300 million into UK research and medical innovation, backing the country’s world-leading science and medical sectors to lead the way in discovering the next big breakthrough. Annual investment in UK research is expected to double by 2025. Alongside this effort, an international dementia institute will be established in England within 5 years, helping to make the UK a world leader for research on dementia and medical trials. It is hoped the number of people taking part in dementia research will double in that time and a new online and telephone service to facilitate people taking part in dementia research studies will be launched next week.

New global fund on dementia

A separate multi-million pound fund will be launched within weeks to help establish a large-scale, international investment scheme to discover new drugs and treatment that could slow down the onset of dementia or even deliver a cure by 2025. The fund will see investors from the private, public and philanthropic sectors unite under a single scheme to finance a range of research projects identified by scientists as having the best potential for future success.

One million NHS staff trained

All NHS staff – some 1.3 million people – will now be required to undergo training in dementia so that people have the know-how and understanding to provide the best possible standards in care, from hospital porters to surgeons.

Three million more ‘Dementia Friends’

A world-leading call to action on dementia will see 3 million more trained to understand about dementia and how to best support people who may have the condition. Members of the public will be able to take part in free sessions in schools, church halls or their own work places. By 2020 the majority of people in England will be living in towns and cities that have been transformed into dementia-friendly communities , making shops, transport and other public places accessible to people with dementia. Business will play its part, with M&S, Asda, Argos, Homebase and Lloyd’s banking group training staff to become Dementia Friends.

Faster assessments, better care for all

Nationally, initial dementia assessments will take place in an average of 6 weeks, followed by better support post-diagnosis. GP diagnosis rates have increased from 42% to 59% in just 3 years but too many people are waiting up to 6 months for a full assessment, causing worry and uncertainty for people and their families. This will no longer be tolerated. There will also be a greater focus on the support given to people following their diagnosis such as giving people with dementia better information about the services available locally, as well as advice and support for carers.

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Announcing the plan, the Prime Minister, David Cameron, said:

“Dementia is one of the greatest challenges of our lifetime, and I am proud that we are leading the world in fighting it.

“Because of the growing strength of our economy, we can invest in research and drug-development, as well as public understanding, so we defeat this terrible condition and offer more hope and dignity for those who suffer.

“That way, we can help make Britain a country that offers security in retirement for all.”

Dementia is a growing problem. In 10 years it is expected there will be one million people living with dementia in the UK.

The Prime Minister has made it a key priority to overhaul the UK’s approach to dementia, launching the Prime Minister’s Challenge on Dementia in 2012, and hosting the first-ever dedicated G8 event on dementia in 2013 to secure greater global cooperation between leading nations.

Significant progress has been made in improving health and care for people with dementia and carers, creating dementia friendly communities, and boosting dementia research.

This includes:

  • introducing the first-ever World Dementia Envoy, spearheading a global approach to the fight against dementia, driven through the G8 dementia summit in 2013
  • over 437,920 NHS staff have already received dementia training and more than 100,000 social care workers have received dementia awareness training, more than any other country worldwide
  • there are now 1 million dementia friends and 82 areas across England have signed up become dementia-friendly communities
  • diagnosis rates in the UK are the highest in the world, increased from 42% to 59% and on track to reach two thirds, ensuring more people than ever before get the care and support they need.
  • the UK has doubled research funding since 2009 to over £66m in 2015. This investment includes major research on issues that matter to people with dementia and their carers, such as the world’s largest – £20 million – social science research programme on dementia. It also includes Dementias Platform UK (DPUK), a 5-year £53 million public private partnership led by the Medical Research Council, the world’s largest dementia population study.
  • we have achieved a world-leading 52% fall in the level of prescribing of antipsychotic medication to people with dementia.

The number of people living with dementia worldwide today is estimated at 44 million people, set to almost double by 2030.

The cost to healthcare is huge, with dementia now one of the greatest pressures on healthcare systems around the world. It costs an incredible estimated £370 billion (US $604 billion) – about 1% of the world’s GDP. And, without urgent action this is set to rise.

However, global spending on dementia is at 5 times below research on cancer, with only 3 new drugs making it onto the market in the last 15 years.

The World Dementia Envoy, Dennis Gillings, said: “We have momentum. Awareness of dementia is increasing and action is being taken, and that will ensure the condition is managed far better in our society. More treatments are on the horizon but we must continue to invest in research and drug development. David Cameron’s outstanding leadership is having huge effect.”

Simon Lovestone, Professor of Translational Neuroscience, University of Oxford, said: “Dementia is the biggest single problem facing health services today. Worldwide, it poses an enormous challenge and demands an urgent and substantial response from governments and from the research community.

“In the UK we are rising to this challenge and with the Alzheimer’s Research UK Drug Discovery Alliance, launched this week, with the Dementias Platform UK launched at the beginning of the year and with the network of Biomedical Research Centres and Units for dementia funded by the NIHR, together with this commitment for substantial increased in funding for research and innovation, we are in a good position to lead, collaboratively across Europe, North America and beyond, a substantial fight against this terrible disease.

“The opportunity, which I think we have a realistic chance of delivering on, is novel therapies for dementia that will slow down, and perhaps even prevent Alzheimer’s and similar diseases.”

Hilary Evans, Charity Director, Alzheimer’s Research UK, said: “Over the past three years we’ve seen the Prime Minister’s Challenge play a pivotal role in creating a heightened focus on dementia and boosting the case for more research. Alzheimer’s Research UK is proud to have spearheaded the research challenge and successfully launched a number of pioneering global initiatives that will bring us ever closer to finding a cure.

“Since 2012, we’ve launched a £100 million fundraising campaign which, in addition to our existing research projects, will see a pioneering new Stem Cell Research Centre, a powerful network of world-class Drug Discovery Institutes to fast-track new treatments and a Global Clinical Trials Fund to allow new treatments to reach people sooner.

“Today represents an opportunity to reflect on the progress made so far, but we owe it to the 850,000 people in the UK with dementia to build on this work with even bolder commitments. It is vital that we continue to energise a movement across society to improve the lives of people with dementia and that research into the condition continues to be a priority.”

Jeremy Hughes, Chief Executive of Alzheimer’s Society, said: “Our researchers, staff and volunteers who are delivering support to people with dementia nationwide now sit as part of a national movement more than a million strong.

Dementia Friends is truly changing attitudes and capturing the public’s attention. Together we are transforming lives today and reaching out for preventative treatments and a cure tomorrow. This government has rightly prioritised dementia. We would all acknowledge the work that remains to be done, but the PM deserves credit for the phenomenal achievement in getting dementia on the national and global agenda and this has resulted in significant progress.”

 

Western General patient tests negative for Ebola

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A patient admitted to the Western General Hospital after recently returning from west Africa has tested negative for Ebola.

The age and sex of the patient is not yet known, although the patient is understood to be a woman.

The patient was admitted to the regional infectious diseases unit at the Western General Hospital yesterday but NHS Lothian confirmed late last night the patient had tested negative for the virus.

Sign up to help cure the stigma of dementia

‘We need the whole community to get on board and help us make Edinburgh a dementia friendly city’ – Cllr Ricky Henderson

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A new awareness campaign has been launched today (Monday 16 February) to highlight the stigma associated with dementia, and the little things we can all do to help.

Devised in conjunction with Edinburgh residents who have dementia and their relatives, the campaign is part of ongoing work by the City of Edinburgh Council, NHS Lothian and Alzheimer Scotland to make Edinburgh a dementia friendly city.

Stigma and lack of understanding are major barriers for people with dementia according to 66% of people who responded to a recent Alzheimer’s Society survey. The research also revealed that 35% of people with dementia only go out once a week or less.

The new campaign includes a radio advert featuring people affected by dementia and a poster campaign for bus shelters, shops, pubs, clubs and pharmacies. It aims to tackle the stigma often associated with dementia and encourage people to be more aware of the condition. It also highlights how we can all play our part to make Edinburgh a dementia friendly city.

Six key ways to help a person with dementia and help them to feel included have been summarised as part of the initiative:

  • Learning more about the facts;
  • Show patience, for example if someone is having problems with their words;
  • Include them in conversations;
  • Being kind and show respect;
  • Helping them to join in;
  • Be a friend.

Health, Social Care and Housing Convener, Councillor Ricky Henderson, said: “With the numbers of people with dementia in Edinburgh continuing to rise, it’s important to address some of the myths about dementia which can lead to people feeling excluded from the community.

“There are little things that everyone can do to support and encourage people with dementia so that they feel confident enough to continue with day-to-day activities such as shopping and getting out and about. This may be a friend with dementia or someone that they meet in the course of their job or in their local neighbourhood.  We need the whole community to get on board and help us make Edinburgh a dementia friendly city.”

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Helen Hay, Regional Manager of Alzheimer Scotland, added: “Many people don’t understand dementia and think that a diagnosis means that a person is immediately incapable of working or carrying on with their daily routine.

“The campaign will help break down some of the barriers people face when they tell others they have dementia. Simple things like being included in the conversation and being asked to take part in social activities like going to the theatre can make a big difference to a person’s quality of life.”

A number of activities will take place in the city throughout the campaign, including dementia awareness sessions with retailers, councillors, Council and NHS staff. Members of the public are also being urged to become more dementia aware by signing up to Alzhiemer Scotland Dementia Friends programme, www.dementiafriendsscotland.org

A ‘dementia friendly’ performance of Plutôt La Vie theatre company’s production ‘Clean Sweep’, co-hosted with the Festival Theatre, is one of the events planned.

It will be attended by people with dementia, their friends and family and is specifically designed to provide an accepting environment and relaxed atmosphere for people with dementia.

Cerin Richardson, Learning and Participation Manager, Festival City Theatres Trust, said: “The Festival and Kings theatres have been developing work for children and young people with additional needs through their Relaxed Theatre programme and are delighted to be expanding their participation work to include people living with dementia and their families, so that they can take full advantage of the performances in our theatres.”

Find out more about the campaign at www.edinburgh.gov.uk/dementiastigma

Another patient tested for Ebola

WesternGeneralA patient is being tested for Ebola at the Western General Hospital after feeling unwell on returning from West Africa. The patient, who has not been named, was admitted to the specialist unit at the Western earlier today.

The test results are likely to be known later tonight or early tomorrow morning.

NHS Lothian Nurse Director Melanie Johnson said: “A patient who recently returned to Scotland from West Africa has been admitted to our Regional Infectious Diseases Unit (RIDU) at the Western General Hospital after reporting a raised temperature.

“The patient will be screened for possible infections and as a precaution will be kept in isolation. We have robust systems in place to manage patients with suspected infectious diseases and follow agreed and tested national guidelines.”

Pauline Cafferkey went out to Africa to assist in the Ebola aid effort and became the first Scot to be diagnosed with the disease when she returned to Glasgow in December. Transferred from the Western to London’s Royal Free Hospital after tests proved positive, the nurse was in a critical condition at one point but has since made a strong recovery.

Extra £2m for ambulance service

ambulancesThe Scottish Government is to invest an additional £2 million in the Scottish Ambulance (SAS) next financial year. The cash has been earmarked to progress service developments that will improve patient care.

The extra funding will be used to help the ambulance service deliver their refreshed strategy, Towards 2020: Taking Care to the Patient, that will support the overall vision for the health service to provide more care to patients at home or in the community and help to avoid unnecessary hospital admissions.

To achieve this, more investment will be targeted at developing the clinical skills of the current ambulance service workforce to operate to the full scope of their practice, as well creating new roles with enhanced skill sets.

Health Secretary Shona Robison said: “The Scottish Ambulance Service play a vital role in the delivery of NHS care for patients, often being the first to attend to a patient who is unwell. They have a key part to play in this Government’s vision for a health service that works around the needs of a patient and delivers the right care, in the right place, at the right time.

“That is why we are supporting the vision set out in this strategy with this additional funding which will help accelerate the pace of change and mean patients will start to benefit sooner. I know how committed and dedicated ambulance staff are to delivering high quality patient care day in and day out, and it is important we ensure they are equipped with the appropriate skills, training and clinical support to be able to deliver more care in the community.

“Our vision for a health service that meets the changing needs of our population, also needs our local services to evolve. With this vision, and investment, the ambulance service will be better prepared to meet the needs and the challenges of the future, working with local services.”

Over the course of the five-year strategy, the SAS aims to decrease A&E attendances by around 12 per cent by taking high quality care to people in the community and bringing those who need it directly to specialist care, rather than having to be admitted through emergency departments.

It also outlines plans to take forward investment in new technology to enhance diagnostic capacity and clinical decision support to frontline staff, as well as making further improvements to pre-hospital cardiac care by leading a national programme of improvement for out of hospital cardiac arrest.

ambPauline Howie, Chief Executive, Scottish Ambulance Service said: “Our strategy recognises the principle that care should be appropriate to need, so we will continue to respond rapidly to serious emergencies while developing care pathways that are integrated with other health and social services in local communities to enable patients to be treated safely at home or in their community when appropriate.

“Last year over 77,000 patients avoided attendance at A&E after being treating safely at home by our teams and we continued to improve cardiac arrest survival rates.

“Our strategy is supported by a programme to develop our staff to meet the changing needs of patients within the new landscape of integrated health and social care in Scotland.”

Towards 2020: Taking Care to the Patient, A Strategic Framework for 2015-2020, is available at:

http://www.scottishambulance.com/UserFiles/file/TheService/Publications/Strategic%20Plan_Online%

Contracts signed for new Sick Kids hospital

RHSC and DCN view from above alt_jpgConstruction of a major new healthcare facility is set to start after the financial contracts were agreed yesterday. The new £150 million building will see services from the Royal Hospital for Sick Children, Department of Clinical Neurosciences and Child and Adolescent Mental Health Service brought together in a modern and high-quality setting at Little France.

Construction works will start over the next few weeks and the new building, which will adjoin the Royal Infirmary of Edinburgh, is expected to open in autumn 2017.
The six storey building (including basement) will have a large atrium with a shop and café, a stunning skylight linking both hospital entrances, a helipad on the roof and a link building adjoining adult and paediatric emergency departments.
It will also bring with it an increase in single rooms with ensuite facilities and a range of new technology.
Health Secretary Shona Robison said: “This is a momentous date for this project and I’m personally very pleased that work will soon be about to begin on the new co-located Royal Hospital for Sick Children and Department of Clinical Neurosciences.
“The new development brings paediatric care, specialist neonatal care, neurosciences and adult and children’s emergency departments all together in one place, making access to services much easier for patients and health professionals alike.
“The Scottish Government is investing over £2 billion in Scotland’s health infrastructure over the spending review period, with this development being one of many that demonstrate the Scottish Government’s commitment to continually improving health services. The investment in this development will ensure the hospital campus at Little France can continue to develop as a modern hub of research and medical practice.”
Susan Goldsmith, Finance Director, NHS Lothian said: “We are delighted to have reached this point and now look forward with anticipation to seeing the new facility taking shape over the coming years.
“This is an extremely exciting time in the proud history of the Royal Hospital for Sick Children, along with the Child and Adolescent Mental Health Service and Department of Clinical Neurosciences, which will find a high-quality new home at Little France from 2017.
“The building designs have been heavily influenced by staff, patients and families and, in addition to offering a modern, light and spacious environment, will also enhance the clinical services we deliver.”
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Mark Bradshaw, IHS Lothian and Macquarie Capital said: “We are excited that construction will soon start on The Royal Hospital for Sick Children and Department of Clinical Neurosciences. This state-of-the-art facility will allow the delivery of quality healthcare services to the people of the Lothian region and beyond for decades to come.
“It has been a pleasure to partner with the Lothian NHS Board and the Scottish Futures Trust to develop an innovative and competitive financing structure that will ensure value for money over the next 25 years.”
Peter Reekie, Scottish Futures Trust, deputy chief executive and director of investments said: “This is a fantastic deal for NHS Lothian and its partners, bringing investment into the Lothians and allowing construction to start on a great new building which will support many hundreds of jobs as it is built.”
Some key features of the new facility include:
  • 233 beds and 10 theatres. 154 beds in the Royal Hospital for Sick Children, 67 beds in the Department of Clinical Neurosciences and 12 beds in the Child and Adolescent Mental Health Service.
  • 11 beds will be added to the critical care department within the Royal Infirmary of Edinburgh.
  • The specifically designed family hotel will mean that the experience for families whose child has to spend time in hospital is more homely.
  • Conjoined children’s and adult Emergency Departments will mean that the most appropriate services are available to teenagers who currently do not always fit well into either service.
  • Patients in the Child and Adolescent Mental Health Service suffering from physical illness and mental health problems will benefit from the immediate availability of both specialities.
  • The Department of Clinical Neurosciences will make neurology and neurosurgery available to all age groups on a single site, meaning potentially quicker treatment is available. One advantage will be that patients who present to the Emergency Department at Royal Infirmary of Edinburgh and who subsequently turn out to need neurosurgery will no longer need to be transferred to the Western General Hospital.
  • The most modern imaging equipment within the Department of Clinical Neurosciences along with its adjacency to the Anne Rowling Regenerative Neurology Clinic and the Clinical Research Imaging Centre will allow the Department of Clinical Neurosciences to further enhance its position as a leading clinical and academic neurosciences centre.

Romance? Give a card or a kiss – not a cold sore!

PEOPLE in Scotland are being reminded to take some time to think of their health this Valentine’s Day …

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As people’s thoughts turn to celebrating love and romance (Eh? – Ed), Scotland’s national telehealth and telecare service is urging people to take some simple steps to avoid passing on any unwanted gifts on February 14th.

Professor George Crooks, NHS 24 Medical Director, said: “Many people mark Valentine’s Day by exchanging cards with their loved ones. Make sure the only thing you share with your partner this Valentine’s Day are these type of romantic moments and not a cold sore or other infection.

“If you have a cold sore, it is important to avoid kissing until they have completely healed and always wash your hands before or after touching the affected area. The online health library at NHS inform also includes helpful advice and tips about preventing halitosis or bad breath. Practising good hand hygiene will also ensure that you don’t pass on any unwanted germs to your loved one.

“You could also give your partner the gift of stopping smoking this Valentine’s Day. As well as preventing bad breath, there are many benefits to quitting, from lowering the risk of cardiovascular and respiratory diseases to saving money which you could use to buy flowers or chocolates for that someone special in your life.

“Take some time to think about your health this Valentine’s Day and remember there is a wealth of health advice and information available at your fingertips at www.nhsinform.co.uk

nhs 24

Find us at www.twitter.com/nhs24 and www.facebook.com/nhs24

Let’s talk about Dementia

DementiaSTARTING this month, Alzheimer Scotland – Action on Dementia is launching a Let’s Talk about Dementia campaign. The campaign aims to open up more discussion on the subject of dementia and to raise awareness of the importance of early diagnosis.

Stigma, negative perceptions of people with dementia and perceptions that there is little or no help available are some of the reasons which prevent people from seeking help sooner rather than later. The negative perceptions also create fear and worry meaning that many families avoid talking about dementia.

The worry that you or someone close to you may have dementia is one of the most difficult conversations we may have. The Let’s Talk about Dementia campaign hopes to raise awareness and get families talking to each other and medical professionals so that more people living with dementia can get the help and support they need in place to ensure they have the best quality of life possible.

Alzheimer Scotland’s Let’s Talk about Dementia campaign will offer detailed information, support on the organisation’s website (www.alzscot.org/conversation) and via the Dementia Helpline (0808 808 3000) which is free to call and available 24 hours a day, 365 days a year.

Alzheimer Scotland will be promoting the campaign on radio, in print and through social media (Facebook and Twitter). Social media is particularly important, as these difficult conversations are often intergenerational; involving partners, adult children, grandchildren, other family members and beyond. We want people to share their own experiences of these often difficult conversations and if, in hindsight, they would have handled things differently. Alzheimer Scotland will also be sharing real life case studies, information and advice via its Facebook page and Twitter feed.

www.facebook.com/AlzheimerScotland

www.twitter.com/alzscot

“I wish I’d trusted my instincts about dad earlier. Got us to sit down as a family and discuss it. If I had the chance again, that’s what I’d do.” Ian

“I knew there was something wrong with me and I kept asking questions until I found out what it was. My family and friends have been wonderful – they support me in so many ways and I’m glad I can talk openly to them. Nobody should have to face dementia alone. Never be afraid to ask: ask people, ask questions and ask for help.” Anne

“Nobody’s happy to get a diagnosis of dementia, but it was so much better than the not-knowing. It gave mum, and me, a way of dealing with the changes that were happening in her life.” Donna

‘Simply unacceptable’: Western’s cleanliness standards slammed

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Standards of cleanliness at The Western General Hospital have been severely criticized in a report (see below) by official watchdog The Healthcare Environment Inspectorate (HEI). NHS Lothian chiefs have said they have already acted to respond to concerns.

Chief Inspector Susan Brimelow said: “We carried out an unannounced inspection to the Western General Hospital on Tuesday 18 and Wednesday 19 November 2014. Due to significant concerns about the cleanliness of patient equipment and the environment, we escalated our findings to senior management in the hospital.

“We requested that NHS Lothian take immediate action to address these issues and produce an improvement action plan. We returned unannounced on Thursday 27 November 2014 to assess progress against the improvement action plan and found that significant improvements had been made. NHS Lothian must address the requirements and make the necessary improvements as a matter of priority.”

In a full statement issued earlier today the HEI said:

We previously inspected the Western General Hospital in February 2013. That inspection resulted in four requirements and five recommendations. The inspection report is available on the Healthcare Improvement Scotland website.

We carried out an unannounced inspection to the Western General Hospital on Tuesday 18 and Wednesday 19 November 2014. Due to significant concerns about the cleanliness of patient equipment and environmental cleanliness within the Western General Hospital, we escalated our concerns to senior management in NHS Lothian on 18 November and then again on 19 November 2014. On ward 52/53, we also raised concerns about the lack of working macerators and the procedures in place to reduce the risk of cross-infection to patients, staff and visitors. Macerators break human waste down into slurry so it can be sluiced effectively. We requested that immediate action be taken on these issues and an improvement action plan produced to show how these issues would be rectified.

We returned unannounced on Thursday 27 November 2014 to assess progress against the improvement action plan at ward and departmental level. Significant improvements had been made although we still noted some issues with the cleanliness of patient equipment and the environment.

We assessed the hospital against the NHS Quality Improvement Scotland (NHS QIS) healthcare associated infection (HAI) standards and inspected the following areas:

  • ward 2 (oncology)
  • ward 4 (oncology)
  • ward 15 (winter ward)
  • ward 20 (ICU)
  • ward 26 (general medicine)
  • ward 27 (colorectal)
  • ward 43 (regional infectious diseases unit)
  • ward 50 (stroke unit), and
  • ward 52/53 (gastroenterology).

Overall, we found evidence that NHS Lothian is not complying with the NHS QIS HAI standards to protect patients, staff and visitors from the risk of acquiring and infection.

In particular we found:

  • the standard of cleanliness of the patient environment was poor
  • the standard of cleanliness of patient equipment was poor, and
  • a lack of appropriate risk assessments, for example for out-of-order macerators.

The report highlights areas of strength and weakness as well as areas for further improvement, including requirements and recommendations.

This inspection resulted in eight requirements and one recommendation.
NHS Lothian must address the requirements and make the necessary improvements within the stated timescales.

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Responding to the report, Melanie Johnson, executive nurse director at NHS Lothian, said staff had acted on the inspectors’ findings as ‘a matter of urgency’.

Ms Johnson said: “We recognise that some standards were below those we would expect and I apologise to any patients who may have been affected. I would also like to reassure them that those areas have been rectified – since the first of the visits in November, immediate changes were put in place to address all areas that were singled out for improvement.

“A detailed action plan was drawn up and all points have been completed. Many of these significant improvements were proven during the subsequent unannounced visit by inspectors as is detailed in the report.”

Commenting on the ‘extremely disappointing’ findings, Health Secretary Shona Robison said: “The report shows that standards have fallen well short of what the public and patients expect. The inspectors have uncovered simply unacceptable levels of cleanliness and infection control in certain wards, and I will be meeting the chair of NHS Lothian to reiterate my desire to see standards immediately improve. The improvement plan in place must be delivered urgently.”

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