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The preliminary date for the National Institute for Clinical Excellence (NICE) to issue guidance to the NHS on the clinical and cost effectiveness of trastuzumab (Herceptin) is March 2002. As with all NICE appraisals consultees have the right to appeal against these recommendations. If an appeal is lodged the timelines may be extended in order to consider the appeal. Details of the schedule are published on the institute's website at nice.org.uk.The Health Technology Board for Scotland (HTBS) will consult with experts to determine if there are any important differences to be considered in Scotland. HTBS will then issue authoritative guidance for NHSScotland in the form of an HTBS Comment, six to 10 weeks after NICE publishes its guidance.

The total number of out-patients waiting for an out-patient appointment at the Scottish National Sleep Centre at the Royal Infirmary of Edinburgh, from all health boards, is approximately 1,000. The number of Continuous Positive Airway Pressure (CPAP) assessments carried out each month, involving overnight studies, is approximately 50. Not all patients whose cases are studied in this way are assessed as suitable for CPAP treatment. Funding by NHS Lothian in 2000-01 for the service was £172,000. In 2001-02 this was increased by £109,000, following the review of the service in June 2001. Final details of next year's funding have not yet been agreed. In addition, the National Sleep Centre receives substantial funding from a number of other NHS boards.

The Scottish Health Plan, Our National Health: A plan for action, a plan for change, reinforces the requirement of NHSScotland to meet the specific needs of people with physical disability by giving a commitment to "improve physical access to health services, meetings and offices, by carrying out an accessibility audit of all NHS premises". This commitment is consistent with the legal obligations which require NHS bodies to comply with the statutory requirements of section 21: Access to Goods and Services, of the Disability Discrimination Act 1995 (DDA). The provisions of section 21 are being phased in over the period October 1999 to December 2004.To assist NHS Holding Bodies the Scottish Executive Health Department (SEHD) and the NHSScotland Property and Environment Forum have issued comprehensive guidance on both compliance with section 21 of the DDA and on accessibility audits. Responsibility for implementing measures to ensure compliance with these legal obligations rests with NHS Holding Bodies, e.g. NHS trusts, and to inform the process accessibility audits are currently on-going.Having issued this guidance SEHD and the NHSScotland Property and Environment Forum are considering what monitoring mechanisms need to be put in place to assess the progress of compliance. It is anticipated that appropriate monitoring arrangements will be in place in the near future.

Of existing plans, 27 of the 32 councils include brain injury as a separate section. Plans for the 2001-04 period are presently being reviewed and, of 16 received to date, 12 include a separate section.

Progress on implementing good practice on staff issues relating to disability will be made through the Staff Governance Standard which I launched on 25 January at the Scottish Partnership Forum Conference. The Standard requires NHS employers to ensure Partnership Information Network guidelines such as the Equal Opportunities Guideline which includes disability are implemented and progressed. In addition, a self assessment audit on the implementation of "Learning Together", the Strategy for Education and Lifelong Learning for NHSScotland staff to ensure all staff are appropriately trained, will be undertaken by the local partnership forum.

The commitment to establish an Information Task Group was reaffirmed in Cancer in Scotland: Action for Change launched in July last year. The group has now been set up and met for the first time on 23 January 2002.Mr Ian Gibson, Director for Scotland and Northern Ireland, Macmillan Cancer Relief and a member of the Scottish Cancer Group, is chairman of the group. Its membership also includes patient, voluntary sector and regional cancer clinical network representatives from a variety of professions and disciplines. The group will report to the Scottish Cancer Group.

We have set up a dedicated team to implement single shared assessment for older people in the first instance and a reference group to advise it. More directly, we issued guidance in setting out the key steps to implementation and the essential infrastructures we expect to be in place by 1 April 2002. And to promote and support implementation locally, we held regional seminars and are currently visiting every local authority area. Single shared assessment will be extended to the rest of community care in the course of 2002-03.

A range of leadership development programmes have been supported by the Executive and delivered in local NHS organisations since the publication of the Scottish Health Plan. In addition, the National Leadership Programme, Xceed, launched in April 2001, is currently providing leadership to a range of NHS personnel including doctors, nurses administrative and other staff engaged in managerial functions. The programme has been well received and demand for places has been, and continues to be, very high.

I launched the Staff Governance Standard on 25 January at the Scottish Partnership Conference. A copy of the Standard is available on the Health Department website.

Cancer in Scotland: Action for Change was published in July 2001. The Framework for Mental Health Services in Scotland was issued in September 1997 and has subsequently been updated. The Executive established a CHD/Stroke Task Force which reported in September 2001. Following consultation, which is now complete, the strategy for Coronary Heart Disease and Stroke is expected to be ready for publication this spring.