Questions and answers

Question reference: S5W-18421

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Tuesday, 28 August 2018
Current Status: Answered by Jeane Freeman on 13 September 2018

To ask the Scottish Government, further to the answer to question S5W-17620 by Jeane Freeman on 23 August 2018, how calls are coded for the purposes of prioritisation.

The Scottish Ambulance Service launched its New Clinical Response Model (NCRM) in November 2016, based on a detailed clinical analysis of around half a million 999 calls. Since then, following triage, 999 calls are coded to one of five categories based on the likelihood of serious outcomes or the requirement for specific interventions:

Purple: where a patient is identified as having a 10% or more chance of cardiac arrest. Purple codes represent approximately 2.5% of total 999 call volume and the actual cardiac arrest rate across this category is 53%.

Red: where a patient is identified as having a likelihood of cardiac arrest between 1% and 9.9%, or having a need for resuscitation interventions such as airway management above 2%. Currently the cardiac arrest rate in this category is approx. 1.5%

Amber: where a patient is likely to need diagnosis and conveyance to definitive care; for example, patients diagnosed with heart attacks who need to go to specialist centres for expert cardiology interventions or patients affected by stroke who need to be taken to specialist stroke units. The cardiac arrest rates for all of these codes are less than 0.5%

Yellow: a patient who has a need for emergency care but has a very low likelihood of requiring life-saving interventions. For example, patients who have tripped or fallen but not sustained any serious injury.

Green: a patient does not fit the above categories and there is potential for an alternative care pathway.

The rationale behind these changes were to maintain fast responses to those patients who needed active resuscitation, principally the purple and red categories, and for all other 999 calls, to match the best clinical response to patient need, even if that may take a little longer because this would enable the patient to more effectively access definitive care either in hospital or in a community setting.

Question reference: S5W-18422

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Tuesday, 28 August 2018
Current Status: Answered by Jeane Freeman on 13 September 2018

To ask the Scottish Government, further to the answer to question S5W-17620 by Jeane Freeman on 23 August 2018, how many calls coded as (a) life-threatening, (b) serious and (c) neither life-threatening or serious were responded to within (i) under 10, (ii) 10 to 29, (iii) 30 to 59, (iv) 60 to 120 and (v) over 120 minutes in each of the last five years.

Until the 23 November 2016, in Scotland 999 calls were triaged into three categories:-

• Categories A, potentially immediately life threatening

• Category B, serious but not life threatening

• Category C, not serious but may require an ambulance

The Scottish Ambulance Service (SAS) launched its New Clinical Response Model (NCRM) in November 2016, based on a detailed clinical analysis of around half a million 999 calls. Since then, following triage, 999 calls are coded to one of five categories based on the likelihood of serious outcomes or the requirement for specific interventions.

For this reason I have not provided the data exactly as requested, but broken down initially in the triaged categories up until the NCRM was introduced, and thereafter into colour-coded categories.

Category A

Year		10 - 30 Minutes	30 - 60 Mins	60 -120 Mins	Over 120 Minutes
2012-13	110265	19171	318	9	4
2013-14	119654	22228	438	15	4
2014-15	118587	23971	504	31	6
2015-16	116883	32347	836	64	3
2016-17	89908	24360	714	63	9

Category B, C or non-immediately life threatening

Year		10 - 30 Minutes	30 - 60 Mins	60 -120 Mins	Over 120 Minutes
2012-13	218197	117262	8981	2468	823
2013-14	207212	119648	8560	2346	640
2014-15	192834	143583	13111	3236	839
2015-16	164542	153254	19604	4539	1236
2016-17	167745	177750	29771	6577	1552

Purple

Year		10 - 30 Minutes	30 - 60 Mins	60 -120 Mins	Over 120 mins
2016-17	4610	990	22	0	0
2017-18	7382	1702	33	2	0
2018 to date	2447	524	14	0	0

Red

Year		10 - 30 Minutes	30 - 60 Mins	60 -120 Mins	Over 120 Minutes
2016-17	84958	23359	689	62	9
2017-18	43058	14923	649	103	19
2018 to date	16424	6022	247	20	0

Amber

Year		10 - 30 Minutes	30 - 60 Mins	60 -120 Mins	Over 120 Minutes
2016-17	24710	26405	1466	65	2
2017-18	47396	58933	4210	399	66
2018 to date	15258	20625	1359	75	0

Yellow

Year		10 - 30 Minutes	30 - 60 Mins	60 -120 Mins	Over 120 Minutes
2016-17	139630	147631	24977	4284	583
2017-18	106565	151440	46236	15170	3829
2018 to date	30554	52715	17170	5322	1030

Green

Year		10 - 30 Minutes	30 - 60 Mins	60 -120 Mins	Over 120 Minutes
2016-17	3147	3677	3321	2228	967
2017-18	2114	2785	2059	1586	883
2018 to date	271	629	568	442	242

It should be noted that the NCRM is helping to save the lives of more critically ill patients – in 2016-17 SAS saved the lives of an additional 62 patients who had suffered an out-of-hospital cardiac arrest.

Response times, whilst important, are just one element which ensures the best outcomes for patients. SAS call handlers now spend more time understanding the needs of each individual patient to ensure patients get the right, not necessarily the fastest, resource. Whilst this has led to a slight increase in wait times for patients whose lives are not immediately at risk, this approach is helping the Service to save the lives of more critically ill patients.

Question reference: S5W-18306

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Wednesday, 22 August 2018
Current Status: Answered by Jeane Freeman on 11 September 2018

To ask the Scottish Government what its position is on whether it considers that there is robust evidence to support the use of homeopathy in the NHS.

Question reference: S5W-18307

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Wednesday, 22 August 2018
Current Status: Answered by Jeane Freeman on 11 September 2018

To ask the Scottish Government how much was spent in GP prescribing on homeopathy in each of the last five years, also broken down by NHS board.

Figures in the requested format are not held centrally.

NHS Information Services Division publishes monthly figures on dispensed prescription items in their community open data files. These files show number of paid items, paid quantity and gross ingredient cost (GIC) broken down to GP practice level for all prescription items. The open data files are available from November 2015 and are available at the following link -

In addition to the published monthly figures, there is a Dispenser Payments and Prescription Cost Analysis report, published annually, which details the total number of dispensed items and GIC costs for Scotland, with a breakdown of the figures by health board. British National Formulary (BNF) subsection 190203 includes prescribable homeopathic preparations, however, it should be noted that this does not capture bespoke prescribed items prepared for individual patients based on their clinical needs. The most recent annual report is available at -

Question reference: S5W-18310

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Wednesday, 22 August 2018
Current Status: Answered by Jeane Freeman on 11 September 2018

To ask the Scottish Government what its position is on NHS boards using homeopathic treatments.

The Scottish Government position remains unchanged. We recognise that some Complementary and Alternative Medicines (CAM), including homeopathy, may offer relief to some people suffering from a wide variety of conditions. It is for individual NHS Boards to decide which medicines and treatments they make available based on national and local priorities and the needs of their resident populations, in line with national guidance:

The prescribing of any medicines/treatments, including homeopathy, is a clinical decision taken in consultation with patients based on clinicians’ competencies and awareness of the medicines/treatments concerned. This includes evidence based advice and guidance. The Scottish Government expects any treatment to be appropriate, person-centred, safe and effective and that clinical and care professionals review the effectiveness of any treatment with their patients.

Question reference: S5W-18305

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Wednesday, 22 August 2018
Current Status: Answered by Jeane Freeman on 11 September 2018

To ask the Scottish Government, in light of the recommendation by NHS England that GPs and other prescribers should stop providing homeopathic treatments after finding "no clear or robust evidence to support" its use, what its position is on NHS Scotland continuing to fund homeopathic treatments.

The Scottish Government position remains unchanged. We recognise that some Complementary and Alternative Medicines (CAM), including homeopathy, may offer relief to some people suffering from a wide variety of conditions. It is for individual NHS Boards to decide which medicines and treatments they make available based on national and local priorities and the needs of their resident populations, in line with national guidance:

The prescribing of any medicines/treatments, including homeopathy, is a clinical decision taken in consultation with patients based on clinicians’ competencies and awareness of the medicines/treatments concerned. This includes evidence based advice and guidance. The Scottish Government expects any treatment to be appropriate, person-centred, safe and effective and that clinical and care professionals review the effectiveness of any treatment with their patients.

Question reference: S5W-18303

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Wednesday, 22 August 2018
Current Status: Answered by Jeane Freeman on 5 September 2018

To ask the Scottish Government how much each NHS board spent on homeopathy and alternative medicine in each of the last five years.

Question reference: S5W-18247

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Friday, 17 August 2018
Current Status: Answered by Fiona Hyslop on 5 September 2018

To ask the Scottish Government what work is being done by Historic Environment Scotland to reduce the risk of fires in Holyrood Park.

The Historic Environment Scotland Act 2014 created a new public body, Historic Environment Scotland (HES) to carry out the regulatory and other functions which were formerly delivered by or on behalf of Scottish Ministers.

HES acts as the lead public body on matters relating to Scotland’s historic environment and as guardian of Scotland’s historic environment, including responsibility for delivering Scottish Ministers’ functions relating to the properties in their care, of which Holyrood Park is one.

Since your query relates to an operational issue, this is a matter for HES, the answer to which is not held centrally. I have therefore referred your question to the HES Chief Executive who will reply to you directly.

Question reference: S5W-18308

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Wednesday, 22 August 2018
Current Status: Answered by Jeane Freeman on 4 September 2018

To ask the Scottish Government whether there are any NHS training posts that include placements in homeopathy.

None of the GMC approved medical training programmes require placements in homeopathy, and there are currently no training rotations in any medical placements which include homeopathy attachments.

There are no homeopathy nurses or allied health professions (AHP’s). Homeopathy is an entirely different training and not directly related to any AHP or Nursing; it is not a skill which would be registered or annotated on the Health and Care Professions Council/Nursing and Midwifery Council (HCPC/ NWC) register.

Question reference: S5T-01185

Asked by: Daniel Johnson, MSP for Edinburgh Southern, Scottish Labour
Date lodged: Monday, 03 September 2018
Current Status: Taken in the Chamber on 4 September 2018

To ask the Scottish Government whether it will provide an update on the integration of British Transport Police and Police Scotland.

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Chamber and committees