Chamber and committees

The Scottish Government is committed to tackling health inequalities and providing access to the highest quality of care for all. We work across the clinical research system to ensure sponsors of clinical studies understand their ethical and legal responsibilities, including increasing equitable access to clinical trials. We recognise the benefits of innovative approaches to the future of clinical trials, including the opportunities presented by increased use of data and digital technologies, and learning from the response to the COVID-19 pandemic.

Information on how many midwives there have been in the NHS in (a) Scotland and (b) each NHS board area, in each year since 2016, broken down by (i) headcount and (ii) full-time equivalent terms can be found in the following link: NHSScotland workforce | Turas Data Intelligence

Neither the Scottish Government nor Public Health Scotland (PHS) currently gather data on paediatric audiology waiting times. You may wish to contact NHS Highland directly to request this information.

Along with the other large household surveys that rely on face-to-face interviews, the Scottish Crime and Justice Survey (SCJS) was suspended in March 2020 to restrict social contact during the COVID-19 pandemic. As such, no SCJS interviews were conducted during 2020-21 and no report will be published for that year. In recognition of the evidence gap opened up by the suspension, the Scottish Government introduced the Scottish Victimisation Telephone Survey as a discrete and additional collection to the SCJS. This asked people about their experiences and perceptions of crime, safety and policing during the COVID-19 pandemic, with findings available at: Coronavirus (COVID-19): Scottish Victimisation Telephone Survey 2020 - gov.scot (www.gov.scot).

Fieldwork for the SCJS resumed in late 2021, with a full year’s worth of interviews due to be complete by December and findings published in mid-2023.

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.

COPFS aims to conduct its investigation and advise the next of kin of the outcome within 12 weeks of the initial report of the death in at least 80% of cases.

Reporting years 2020-21 and 2021-22 saw increases in deaths reported to COPFS of 44% and 40% respectively, reflecting a combination of factors including, but not restricted to, excess deaths attributable directly to COVID-19, local GPs having less contact with patients in the community and being unable to certify deaths, and changes in the process of dealing with and reporting deaths in the community.

The number of cases requiring further investigation, because no cause of death was immediately apparent, has therefore increased, with 7085 post-mortem examinations instructed in 2021-22, an increase of 742 on the previous year. The following table shows the numbers and percentage of deaths requiring further investigation for the last two reporting years and the first two quarters of the current year.

Progress against the published performance target is monitored regularly and has improved significantly this reporting year.

The Scottish Government’s Chief Scientist Office operates open competitive funding schemes for applied health research projects and fellowships across the wide range of NHS and health challenges in Scotland.

These schemes continue to operate and are open to consideration of applications addressing priorities for research conditions that effect menstrual health. Applications to these schemes are assessed through independent expert peer-review with funding recommendations made by independent expert committees.

A number of research projects on menstrual health including fibroids and endometriosis, have been funded through these schemes in the past.

In partnership with Wellbeing of Women, this year we are jointly funding a £250,000 research call which aims to develop improvements into treatment and management options for endometriosis. The funding will be awarded in December 2022, fulfilling our medium term commitment in the Women’s Health Plan to commission research into endometriosis.

The Women’s Health Plan also includes a long term action to establish a Women’s Health Research Fund with the aim of closing gaps in scientific and medical knowledge in women’s health for both sex specific and non sex-specific conditions.

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.

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.

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.