Chamber and committees

In Scotland, the Scottish Medicines Consortium (SMC) appraises the clinical and cost-effectiveness of newly-licensed medicines. Following a full submission for zanubrutinib (Brukinsa ® ) as monotherapy for the treatment of adult patients with Waldenström’s macroglobulinaemia (WM) who have received at least one prior therapy, or in first line treatment for patients unsuitable for chemo-immunotherapy, the SMC issued ‘not recommended’ advice for routine use of this medicine in NHS Scotland on 12 September 2022. The advice detailed that a comparable drug is currently available for this indication, and the company did not present a sufficiently robust economic analysis to gain acceptance by the SMC.

However, the SMC has received a fast track resubmission which was reviewed at the SMC’s Committee meeting on 4 October 2022, and its advice will be published on 7 November 2022. In the meantime, you can access a summary of the current status of this resubmission on the SMC’s website here .

There are alternative routes of access available for a medicine that is not recommended by the SMC. A doctor can request access to licensed medicines for a patient on an individual ‘case-by-case’ basis through the Peer Approved Clinical System (PACS) Tier Two process, where a doctor considers there would be a clinical benefit for a patient.

The decision on whether to prescribe a medicine for a patient, and which medicine to prescribe, is entirely one for the clinician in charge of a patient’s care to make, having taken into account the patient’s clinical condition and the safety of the patient.

The A75 and A77 routes were considered as part of the UK Government’s Union Connectivity Review (UCR), with potential funding following on from the recommendations.

In March 2022, Transport Scotland (TS) officials had an initial discussions with their UK counterparts in from the Department for Transport (DfT). The subject of possible UCR related funding opportunities, which was first identified in March 2021, was raised by DfT officials and TS officials followed-up with a number of specific clarification questions. Answers to these were received in May, and a follow-on meeting occurred on 16 June.

A subsequent discussion is scheduled for 31 October which will cover UCR recommendations and associated proposed funding for the A75. Potential development work for the A77 was not identified for funding by the UCR process, so will not be on the agenda for discussion, as, along with all other transport recommendations identified by STPR2, it remains a devolved matter.

As set out in our public consultation we are considering how to address health inequalities and promote equitable access to cancer services. We have outlined ‘reducing inequalities’ as one of our main aims in the consultation. With over 250 responses received we have now commissioned independent analysis of the responses and anticipate the results to be published shortly. The results will inform the cancer strategy.

In addition, we held a series of workshops with patients and key stakeholders in September 2022 to help us gain further insight into the consultation responses and hear directly about peoples’ experiences of cancer and inform the development of the cancer strategy.

The final Union Connectivity Review (UCR) Report was published in November 2021.

In March 2022, Transport Scotland officials had discussions with their UK Government counterparts at the Department for Transport (DfT) at which the findings of the UCR were discussed. Transport Scotland also provided an update on the second Strategic Transport Projects Review (STPR2) which had been published in January 2022, in particular Recommendation 40, which relates to the A75 and A77.

Discussions have continued on the subject of possible related funding opportunities for development work on the A75 and the next scheduled meeting between officials is on 31 October.

Scottish Ministers are committed to developing a Scottish school milk scheme to replace current subsidy arrangements. We are working with stakeholders and local authority partners to develop a fully funded universal school milk scheme for primary and special schools, and a pilot in secondary schools within the current parliamentary term.

Data showing the percentage of pre-registration students who were in the "inactive" training state on a three-year pre-registration midwifery programme over the last five years for which complete figures are available is found in the table below. “Inactive” refers to students who are neither in training nor have completed their programme – many students will return to their studies and go on to complete their programme.

Provisions within Part 1 of the Cost of Living (Tenant Protection) (Scotland) Act 2022, introduce a temporary cap on in-tenancy rent increases. The cap is set at 0% until at least 31 March 2023.

This means that a landlord is able to set the rent for any new tenancy and is allowed to put the rent up between one tenant moving out and the next tenant moving in.

Where a tenant remains the same person, but is required, in line with statutory processes, to be issued with a new tenancy agreement, the rent cap provisions within the Act do not apply.

Information on what the age profile of the NHS midwifery workforce was in (a) Scotland and (b) each NHS board, in (i) 2016 and (ii) the most recent year can be found in the following link: NHSScotland workforce | Turas Data Intelligence

The Employment - demographic tab gives the percentage of the workforce over the age of 55 and the median age, this information can be broken down by board and job role from 2012.

In the letter of direction I issued to delivery partners on 23 June 2022 on implementing the MAT Standards, I asked for timed, specific plans for implementing the standards to be submitted and published. I also requested a lead officer be nominated to take responsibility for driving the necessary changes and reporting on progress for each area across the country.

I can confirm that a lead officer has been nominated by delivery partners for each of their Health and Social Care Partnership areas.

We are now scrutinising the submitted Implementation Plans to ensure they will deliver the standards and, we will be asking each area to publish their plans, which will detail the position of lead officers for each area.

Public Health Scotland (PHS) receives monthly data from most NHS Boards on the number of patients covered by the 18 weeks Referral to Treatment (RTT) standard seen within each specialty, including audiology. Due to the aggregate nature of this data collection, the requested detail on average length of wait and age are not available.

However, Table 1 shows the total number of patients seen and the number that waited over 18 weeks to be seen for audiology services across NHS Scotland, from January 2014 to December 2021 – the latest complete calendar year. This includes all patients reported as seen on the 18-week RTT pathway for audiology. Please note, almost all patients on this pathway are not admitted for treatment and their journey ends after seeing an audiologist in an outpatient setting.

Due to the complexities of 18 week RTT local data collection and reporting, the length of wait cannot be accurately measured by the Board of treatment for all patients. The impact of which for audiology is reflected in the number of unknown waits reported in the following table.

Table 1: Total patients seen and number of patients that waited over 18 weeks, January 2014 – December 2021, NHS Scotland, Audiology.