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The NHSScotland Staff Governance Standard already places a specific obligation on NHS boards, as employers, to ensure that all staff have access to communication channels which offer the opportunity to give and receive feedback, either directly or via their trade union/professional organisation, on organisational and service delivery issues at all levels.

The NHSScotland Partnership Information Network (PIN) policies, which underpin the Staff Governance Standard, provide a minimum standard of practice in employment, helping to ensure fair and consistent management of staff which meets both current legislative requirements and best employment practice. These policies, which are promoted locally, and accessible via a range of mediums, cover, amongst other things, whistleblowing and bullying and harassment.

The National Standards for Clinical Governance and Risk Management, published in 2005, set out the requirement for NHS boards to self-assess their arrangements for clinical governance and risk management to support the delivery of safe, effective and person-centred care and services.

The Scottish Government published the in 2013. This sets out the respective roles and responsibilities of the Scottish Government, NHS board chief executives, NHS board chairs and non-executives and all staff and includes recommended actions in respect of risk management to support the oversight, planning, and delivery of healthcare services.

In addition, the , published by Healthcare Improvement Scotland in April 2015, includes risk assessment and prevention actions for boards to minimise risks in order to provide high quality care.

The Scottish Government recognises the importance of ensuring a high quality future supply of senior managers within the NHS and that is why future planning for ‘Effective Leadership and Management’ is one of the five priority areas for action in Everyone Matters, our 2020 vision for the NHS workforce. Within that priority area, we are supporting delivery of specific leadership and management focus areas, and a leadership advisory board has been established to provide strategic leadership and advice.

Led by NHS Education Scotland’s (NES) National Leadership Unit, there are several initiatives that enable NHS staff to undertake appropriate training to progress into senior management positions. For example, the, ‘Delivering the Future’ development programme aims to identify senior strategic clinical leaders and prepare them for future roles at board, regional and national level. The programme was developed to address a perceived gap in recruiting to the most senior strategic clinical leadership roles.

NES has also developed a flexible range of resources including the Leadership and Management Programme which offers leadership and management development to all Scottish medical trainees in higher training, as part of a conceptual framework which also includes the Management Trainees Scheme, the Clinical Leadership Fellowship Scheme, and Launchpad for Leadership. This ensures that all doctors in training in Scotland have a grounding and introduction to leadership and management concepts before they move into their career posts, giving them an understanding of the importance of clinical staff involvement in management within the NHS.

Neither the Scottish Government nor its agencies have a contract with the Scottish Provincial Press to deliver marketing or other publications.

The Scottish Ambulance Service continually works to improve ambulance response times in all parts of the country. In acknowledgement of the time critical nature of cardiac arrest response and the clearly defined elements of the ‘chain of survival’, the service is working with a range of partner agencies, community responder groups and projects to optimise the chain of survival in all parts of the country. Some of these pathways are currently under development such as the Sandpiper Wildcat project, which will create a network of trained cardiac responders across the north east of Scotland. In rural Grampian there are emerging pilot projects between the Scottish Ambulance Service and the Scottish Fire and Rescue Service. In other remote and rural areas the service works closely with BASICS responders and our network of Community First Responders in Scotland.

The Institute for Social Marketing, School of Health Sciences, University of Stirling has been commissioned to undertake a survey to provide baseline information on the number of people trained. In addition, we are working with the British Heart Foundation and other third sector organisations to explore options for measuring the number of people who undergo CPR training.

The Scottish Government published Out-of-Hospital Cardiac Arrest: A Strategy for Scotland in March 2015. We continue to work with a wide range of stakeholders to deliver the aims of the strategy and improve outcomes for people experiencing out of hospital cardiac arrest.

In the context of a complex, multi-organisational system, it is difficult to calculate the net additional costs of improving out of hospital cardiac arrest (OHCA) given that it is not clear at this stage what proportion of the proposed improvements might be absorbed through different and more effective use of existing resources. Or what efficiencies might be achieved through better co-ordination amongst stakeholders.

Since announcing in October 2014 that an OHCA strategy would be produced, the government has committed over £300,000 to support delivery. Statutory organisations, including the Scottish Ambulance Service and the Scottish Fire and Rescue Service, and third sector organisations, including Chest Heart and Stroke Scotland and the British Heart Foundation have also invested significant resources.

There are already established emergency care pathways in place for patients who experience out of hospital cardiac arrest (OHCA). These pathways involve support from Ambulance Control Centres to help initiate bystander CPR, rapid response by the Scottish Ambulance Service and a range of emergency co-responders, for example Community First Responders and BASICS responders, resuscitation and rapid transfer to the nearest Emergency Department.

The government currently has no such plans.

The government acknowledges and welcomes the work of third sector groups, business, public sector organisations and others in providing CPR training.

As part of the implementation of the Out-of-Hospital Cardiac Arrest Strategy, the government is working with stakeholder organisations to develop ideas and initiatives to increase CPR training. In addition, a report is in preparation on how public attitudes and behaviour can be influenced in order to increase rates of bystander CPR. This report will inform our approach to increasing CPR training rates.