public health – Page 11 – The NEN

Dermatology: Funding to bring down outpatient waiting list

£1.8 million for new national service

A new national digital dermatology programme will be launched to help speed up treatment and reduce waiting lists.

By capturing quality digital images of a patient’s skin concern when they visit their GP or primary care provider the programme will, where clinically appropriate, allow a senior dermatologist to triage, diagnose and assess some skin conditions without the need for patients to attend an appointment.

People will then either be treated by their GP, directed to a more suitable service for their skin concern like an acne clinic or be offered a face-to-face appointment at a dermatology clinic, with those who need it directly scheduled for treatment or surgery.

Dermatology is one of the biggest outpatient specialties with over 46,000 patients on the waiting list for a first appointment at the end of March 2023. This new programme, backed by £1.8 million of funding, could potentially reduce demand for outpatient dermatology appointments by up to 50 per cent with the potential for up to 90 percent of referrals across Scotland to include a digital image.

Health Secretary Michael Matheson said: “The Scottish Government is determined to reduce waiting times across all specialities, and we know that dermatology is one of the busiest when it comes to demand for outpatient appointments. This new programme will lead to a better and quicker service for patients – allowing clinicians to see patients in the right place sooner. It has the potential to significantly reduce waiting times.

“Innovation like this is vital for the future of our healthcare service and I am excited to see the real benefits that will come from programmes like this in the years to come.”

Fiona Macdonald, Consultant Dermatologist and Centre for Sustainable Delivery (CfSD) Clinical Lead for Dermatology said: “Managing referrals during the pandemic highlighted to Dermatologists how important a good quality image is to a Dermatology referral.

“It can help us prioritise the most urgent referrals, choose the right treatment pathway or offer advice to support care provided in Primary care”.

Dr Stuart Sutton, GP and clinical lead for primary and secondary care interface working, said: “Having a fast, effective and secure way for Primary Care teams to send images of our patient’s skin conditions to specialist colleagues will ensure more rapid and most appropriate advice and treatment is available – a picture provides a level of detail that cannot be conveyed in a traditional referral letter.”

Boyack: Two-tier dental crisis is failing the most vulnerable patients

The Scottish Government was unable to answer a parliamentary question regarding the number of NHS dentists who require a deposit to be paid before registering with them.

In response to a question submitted by Sarah Boyack MSP, the Minister for Public Health and Women’s Health, Jenni Minto, said that the information requested “is not held centrally by the Scottish Government,” raising concerns about the scale of the problem and the number of people it affects.

Earlier in May, the Scottish Labour MSP for Lothian, Sarah Boyack discovered that 75% of NHS Dentists in Edinburgh and Lothians are no longer accepting new NHS patients and some of those that are accepting new patients, are charging patients to do so.

The Lothian MSP has recently released findings showing that more than 3 in 4 Dental Practices serving patients in Musselburgh are no longer accepting NHS Patients.

This comes amid concerns over dentistry services failing to recover from the pandemic and fears that NHS dentists are becoming increasingly inaccessible.

Commenting Sarah Boyack, Labour MSP, said: “How can the Scottish Government get a grip of the crisis facing our NHS Dentists if they have no clue about how it is working?

“Following concerns from constituents in Edinburgh and the Lothians, that they are unable to register with an NHS Dentist I conducted research on the state of NHS Dentistry in Lothian and the finding were shocking.

“When asked about this, the Scottish Government admitted they have no clue and do not hold any information about this.

“The SNP have created a two-tiered healthcare system that prioritises those who can afford to pay over anyone else.

“It is a disgrace that in a cost-of-living crisis the SNP/Green Scottish Government knows nothing about the added costs being placed on patients, which has been caused by their managed decline of the NHS and lack of support for dentists.

“People deserve better than a botched two-tiered system that fails the most vulnerable.”

Data collected by the office of Sarah Boyack MSP on 5^th May 2022 for 39 NHS Dentists in Edinburgh

Practice Name	Accepting Patients	Status on NHS Inform
Meadowbank Dental Practice	No	Open
Holyrood Dental Care	No	Open
Parkside Dental Practice	No	Open
Abbeymount Dental Care	No	Open
Easter Road Dental Practice	No	Open
University Dental Care	No	Open
Bupa Dental Care Prestonfield	No	Open
Montgomery Street Dental Practice	No	Open
Hope Park Dental Practice	No	Open
Vitality Dental Care	No	Open
LW Dental	No	Open
Barbour Dental Care	No	Closed
Edinburgh Dental	Yes	Open
Annandale Dental Care	Yes	Open
Craigmillar Dental Centre	No	Open
Pilrig Dental Practice	No	Open
Duddingston Dental Practice	No	Open
KF Dental Care	No	Open
Citrus Dental Practice	No	Open
Marchmont Dental Care	No	Open
Bellevue Dental Practice	Yes	Open
Leith Walk Dental Practice	Yes	Open
Southside Dental Care	No	Closed
Edinburgh Gums and Teeth	No	Open
Newkirkgate Dental Care	No	Open
Meadows Dental Clinic	no	Closed
Frederick Dental Care	Yes	Open
Lauriston Dental Care	No	Open
Duddingston Park	No	Open
NinetyfiveDental	No	Open
City Health Clinic	No	Open
Gilmore Dental Practice	No	Open
Great Junction Dental Practice	No	Open
Edinburgh Orthodontics	No	Open
Mydentist Portobello	No	Open
Portobello Dental Clinic	Yes	Open
Dental Express	No	Open
Craigentinny Dental Care	No	Open

Question submitted:

Sarah Boyack (Lothian) (Scottish Labour Party): To ask the Scottish Government what information it holds on how many NHS dentists require patients to pay a deposit before registering with them.

S6W-17895

Jenni Minto: This information is not held centrally by the Scottish Government.

Scots want to see more done to limit tobacco sales and use

A report published yesterday by Healthcare Improvement Scotland finds that people want more to be done to limit the sales of tobacco products.

The survey, commissioned by the Scottish Government, asked questions which will form part of a refreshed plan to be published this autumn, to support a tobacco-free Scotland.

The Citizens’ Panel survey, which ran between November 2022 and February 2023, found that of the 667 people who responded to the survey, 75% want more action to be taken to further limit who can sell tobacco products, and while 63% agreed the legal age to buy them should be raised from 18 to 21, 25% were opposed.

Some 65% agreed that Scotland should increase the legal age of the sale of nicotine vaping products from 18 to 21 years.

In addition, the survey found that 80% of respondents said that they either strongly agreed or agreed that action should be taken to further limit who can sell nicotine vaping products. Just 9% either disagreed or strongly disagreed.

In addition, 67% felt packaging, in pack information and the appearance of cigarettes should be made more unappealing. Some 64% agreed that taxes on tobacco and vaping products should be raised, but nearly a quarter of respondents (23%) disagreed with this.

There was also wide agreement that the smoking ban should be widened to create more smoke-free areas where children congregate, such as outside schools and play parks, with almost nine in ten respondents (86%) in agreement. Just 8% disagreed.

The report recommends that the Scottish Government considers including all the measures that have the strongest public support in its Tobacco Action Plan 2023.

It adds that the Scottish Government should then consider further around more punitive measures, such as raising the age of purchase and raising taxation on tobacco and vaping products. After assessing the impact of these measures, these could also be implemented following a staged approach.

Clare Morrison, Director of Community Engagement at Healthcare Improvement Scotland said: “As Scotland looks to become tobacco-free in the near future, this shows that the majority of people believe more should be done to limit access for younger people to tobacco and vaping.”

Visit our Community Engagement website to access the full report.

Majority of Scots will take COVID-19 vaccines in the future

A report published yesterday by Healthcare Improvement Scotland finds that the majority of Scots will take COVID-19 vaccines in the future, based on their experiences with COVID-19.

The survey, commissioned by the Scottish Government, asked questions about people’s motivations around vaccination as we move away from the pandemic.

Uptake of the COVID-19 vaccine has been high and the survey asked people if they would take up new offers of COVID-19 vaccination, or, if not, to understand their reasons why.

The Citizens’ Panel survey, which ran between November 2022 and February 2023, found that of the 667 people who responded to the survey, the majority of respondents (72%) said they would take up the offer of the COVID-19 vaccine in the future. The survey also found that of those who will take up the offer of the COVID-19 vaccine in future, their main reasons were to protect themselves (88%) and to protect others (82%).

One respondent said: “If I can do this to help myself and others, and know the vigorous testing the vaccines have gone through, then why wouldn’t I accept the vaccine?”

Some 12% said they would decline the offer and 17% were not sure. Where respondents did not want it, the most common reason given was concern over possible long-term side effects of the vaccine.

In addition, all respondents were asked if their decision about getting the COVID-19 vaccine has changed over time. The majority said that their decision has not changed (82%). Some 16% said they wanted it at first, but now they don’t, and just 2% said that they didn’t want it at first but now they do.

The survey asks if people are more or less likely to take up the offer of other vaccines, such as flu or childhood vaccines, based on their COVID-19 vaccine experiences, with 36% saying more likely, 56% saying it’s made no difference, and just 7% saying they are less likely.

Simon Watson, Medical Director at Healthcare Improvement Scotland, said: “Vaccination is an absolutely essential element of our response to COVID-19 including future variants. It is vital to protect individuals, their families and the wider population of Scotland.”

Clare Morrison, Director of Community Engagement at Healthcare Improvement Scotland, said: “The findings around vaccination motivations highlight the positive public attitudes towards vaccination, as well as potential areas for improvement, mainly around the need to develop clear and accessible information about vaccine side effects and the benefits of vaccination including their effectiveness against serious illness.”

The report recommends the Scottish Government should continue to consider how to ensure positive and accessible vaccination experiences for all.

It also notes the Government should consider exploring people’s concerns further and their experiences around side effects. Developing further clear and accessible messaging around side effects, and the benefits and effectiveness of vaccination against serious illness may help address this.

Visit our Community Engagement website to access the full report.

Facemasks: Return to pre-pandemic advice for health and social care

People in health and social care settings will no longer be advised to wear facemasks from Tuesday next week (16 May).

The return to pre-pandemic guidance means that mask use will be based on clinical need based on infection prevention and control advice, meaning staff, patients, service users and visitors will not be routinely asked to wear facemasks in health and social care settings.

It follows a review of the guidance introduced during the Covid-19 pandemic to protect staff, patients, service users and visitors, and recognises that Scotland has entered a calmer phase of the pandemic.

Chief Nursing Officer Alex McMahon said: “Due to the success of vaccines in protecting people, and the availability of treatments, now is the right time to revise the advice on wearing masks in health and social care settings and return to pre-pandemic guidance.

“We recognise that some staff may have concerns around the withdrawal of this guidance and would expect organisations to undertake individual occupational health assessments and risk assessments as appropriate.

“We continue to be vigilant in our response to Covid-19 and encourage everyone to make sure they are up to date with the boosters available to them. We are grateful for the tireless work of health and social care teams during these challenging times and to everyone who has helped them by adhering to the guidance.”

No time to delay: RCEM calls for meeting with new Health Minister

‘The Emergency Care system is not functioning as it should’, RCEM says as Emergency Department performance drops

Responding to the latest Emergency Department performance figures for Scotland for March 2023 Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said: “The data show another drop in performance. This means more patients facing longer waits, more delays to care and more harm.

“We cannot continue to see this occur, we need to be seeing improvements in performance and a reduction in delays to care. This is a signal that the current interventions and actions are not having the time critical impact that we need to be seeing.

“The Scottish Government needs to understand that hesitancy to take the necessary actions will impact on the safety of patients and their care. Emergency care is not functioning as it should, no patient should face a 12-hour wait in an Emergency Department.

“We know what needs to be done: ensuring social care is responsive and able to support the timely discharge of patients; expanding acute bed capacity across Scotland; retaining existing staff while recruiting more staff into Emergency Medicine. These are the solutions laid out in our campaign Five Priorities for UK Governments for #ResuscitatingEmergencyCare.

“We would welcome an opportunity to meet the new Cabinet Secretary for Health and Social Care, Michael Matheson MSP, to put forward these solutions and the means to tackle the crisis in Emergency Care. We cannot consider this to be winter pressure anymore; this is year-round, and it continues to cause harm. We must do better for patients and staff, there is no time to delay.”

The latest performance figures for March 2023 for Emergency Departments across Scotland show:

There were 110,446 attendances at major Emergency Departments
64.5% of patients were seen within four-hours at major (Type 1) Emergency Departments
- This is a decrease of 1.9 percentage points from the previous month, and a decrease of 3.9 percentage points when compared with March 2022
- 39,253 patients waited over four-hours in major Emergency Departments, this is an increase of 22.3% from the previous month
In February 2023, 13,750 (12.4%) patients waited eight-hours or more in an Emergency Department
- This is an increase of 33.9% from the previous month, February 2023, and the highest figure so far this year
- When compared with March 2022, this figure has increased by 24.8%
- This is equal to more than one in eight patients waiting eight-hours or more in a major Emergency Department
5,739 patients waited more than 12-hours before being seen, admitted, discharged, or transferred
- This figure has increased by 25.6% from the previous month, and an increase of 39% compared with March 2022

ASH Scotland: Sign up and support the Charter for a Tobacco-free Generation

What do we want?

Reduce the harms caused by smoking!

How can we achieve this?

Support Scotland’s Charter for a Tobacco-free Generation.

Find out more here https://bit.ly/3McxIkL

England’s smokers urged to swap cigarettes for vapes in world first scheme

Pregnant women will also be offered financial incentives to help them quit as part of a sweeping package of measures to cut smoking rates in England

One million smokers will be encouraged to swap cigarettes for vapes under a pioneering new “swap to stop” scheme designed to improve the health of the nation and cut smoking rates.

As part of the world-first national scheme, almost one in five of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smokefree by 2030 – reducing smoking rates to 5% or less. Local authorities will be invited to take part in the scheme later this year and will design a scheme which suits its needs, including deciding which populations to prioritise.

In a speech today, Health Minister Neil O’Brien will also announce that following the success of local schemes, pregnant women will be offered financial incentives to help them stop smoking. This will involve offering vouchers, alongside behavioural support, to all pregnant women who smoke by the end of next year.

The government will also consult on introducing mandatory cigarette pack inserts with positive messages and information to help people to quit smoking.

Additionally, there will be a crackdown on illicit vape sales as part of measures to stop children and non-smokers take up the habit – which is growing in popularity among young people.

Health Minister Neil O’Brien will say: “Up to two out of three lifelong smokers will die from smoking. Cigarettes are the only product on sale which will kill you if used correctly.

“We will offer a million smokers new help to quit. We will be funding a new national ‘swap to stop’ scheme – the first of its kind in the world. We will work with councils and others to offer a million smokers across England a free vaping starter kit.”

The new policies will deliver the UK Government’s three aims to help more adults quit smoking, stop children and non-smokers from taking up vaping, and using vaping as a tool for established adult smokers to quit.

For those who quit, the risk of heart attack is halved after one year of quitting, ultimately halving the likelihood of ending up in a hospital bed or worse.

Supporting more women to have a smokefree pregnancy will reduce the number of babies born underweight or underdeveloped with health problems requiring neonatal and ongoing care. It will also reduce the risk of miscarriage and stillbirth.

Cutting smoking rates reduces the number of smoking-related illnesses needing to be treated, in turn reducing the pressure on the NHS, helping to deliver on our priority to cut NHS waiting lists.

NHS figures for 2021 showed that 9% of 11- to 15-year-old children used e-cigarettes, up from 6% in 2018.

In recognition of the sharp increase, Minister O’Brien will launch a Call for Evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products – and explore where government can go further.

Working with enforcement agencies and learning from the government’s work with Trading Standards on illicit tobacco, £3 million of new funding will also be provided to create a specialised ‘illicit vapes enforcement squad’ to enforce the rules on vaping and tackle illicit vapes and underage sales.

As part of the measures, HMRC and Border Force will also be publishing an updated strategy this year to tackle illicit tobacco. It will lay out strategically how we continue to target, catch and punish those involved in the illicit tobacco market.

Smoking prevalence in England in 2021 was 13% – the lowest on record thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services

In 2021-22, £68 million of public health grant funded was spent on stop smoking services by local authorities and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million has been committed to the NHS this year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

However, 5.4 million people in England smoke tobacco which remains the single biggest cause of preventable illness and death. Up to two out of three lifelong smokers will die from smoking and recent data shows one in four deaths from all cancers were estimated to be from smoking.

Last year an independent smoking review led by Javed Khan proposed a range of measures to help people stub out the addiction, which has informed the measures set out today.

UK Government crackdown on illegal sale of vapes

‘Bold new measures’ to combat rising levels of youth vaping to be announced this week

A new ‘illicit vapes enforcement squad’ – backed by £3 million of government funding – to be formed to enforce rules on vaping and tackle illegal sales of vapes to under-18s
Call for Evidence also launched to identify opportunities to stop children vaping

The UK Government is expected to unveil tough new measures to combat the illegal sale of vapes to under-18s as part of its plans to reduce smoking and tackle youth vaping in England.

In his speech at Policy Exchange on Tuesday 11 April, Health Minister Neil O’Brien is expected to announce a new ‘illicit vapes enforcement squad’ – backed by £3 million of government funding – to enforce the rules on vaping and tackle illicit vapes and underage sales.

Working across the country, the enforcement squad led by Trading Standards will share knowledge and intelligence across regional networks and local authorities.

It will undertake specific projects such as test purchasing in convenience stores and vape shops. It will also produce guidance to help build regulatory compliance, and will have the power to remove illegal products from shops and at our borders.

The minister is also expected to announce the launch of a Call for Evidence to identify opportunities to reduce the number of children accessing and using vapes, while ensuring they remain available as a quit aid for adult smokers.

It will explore topical issues such as the marketing and promotion of vapes and the environmental impact of disposable products.

Health Minister Neil O’Brien said: “Smoking kills, so our priority is to prevent people smoking, and support them to quit. We remain committed to our ambition to be smokefree by 2030.

“However, while vaping is a preferable alternative to smoking for adults, we are concerned about the rise in youth vaping, particularly the increasing use of disposable vaping products.

“The new illicit vapes enforcement squad will work across the country and clamp down on those businesses who sell vapes to children – which is illegal – and get them hooked on nicotine. Our Call for Evidence will also allow us to get a firm understanding of the steps we can take to reduce the number of children accessing and using vapes.”

Smoking prevalence in England in 2021 was 13.0%, the lowest on record, thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services. In 2021-22, £68 million of funding from the public health grant was spent on stop smoking services by local authorities, and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million was committed to the NHS last year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

Children aged 6 months to 4 years in a clinical risk group to be offered a Covid vaccine

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that clinically vulnerable children aged 6 months to 4 years should be offered a coronavirus (COVID-19) vaccine.

Although young children are generally at low risk of developing severe illness from COVID-19, infants and young children who have underlying medical conditions are over 7 times more likely to be admitted to paediatric intensive care units.

Over one million children aged 6 months to 4 years in the US have received at least one dose of the Pfizer-BioNTech COVID-19 vaccine since June 2022. Data from the US showed the most common side effects reported were similar to those seen with other vaccines given in this age group, such as irritability or crying, sleepiness, and fever.

In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) first authorised use of the Pfizer-BioNTech vaccine for children aged 6 months to 4 years on 6 December 2022.

Following that authorisation, the JCVI has advised that children aged 6 months to 4 years who are in a clinical risk group should be offered the vaccine. The JCVI does not currently advise COVID-19 vaccination of children aged 6 months to 4 years who are not in a clinical risk group.

Eligible children should be offered 2 doses of the vaccine, with an interval of 8 to 12 weeks between the first and second doses.

NHS England has confirmed it will begin offering vaccinations to those eligible in England from mid-June. Parents should wait to be contacted before coming forward.

Professor Wei Shen Lim, Chair of the JCVI’s COVID-19 Committee, said: “For the vast majority of infants and children, COVID-19 causes only mild symptoms, or sometimes no symptoms.

“However, for a small group of children with pre-existing health conditions it can lead to more serious illness and, for them, vaccination is the best way to increase their protection.”

Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “COVID-19 is still in circulation, with thousands of new cases reported every week.

“The extra protection offered by the vaccine could be important for young children in clinical risk groups, who are at greater risk of severe illness. The virus is not going away so I would encourage all parents to bring their child forward if they are eligible. Parents should wait to be contacted by their local health professionals.”

Health and Social Care Secretary Steve Barclay said: “Children are at very low risk of harm from Covid. However, there are a very small number of children with health conditions which make them particularly vulnerable, and for those children we want to give parents the choice as to whether they wish to vaccinate their at risk child or not.

“I have accepted advice from the Joint Committee on Vaccination and Immunisation on vaccinating children aged from 6 months to 4 years who are in a clinical risk group. It is a parental decision, and this advice is simply to enable parents of children with medical conditions to choose if they wish to have the protection.”

Scotland is expected to follow suit.