Keeping the Promise requires a collective approach across all of our services, including care, health, education and justice. The Scottish Government requires to lead from the front, working with partners across local government and third sector, to bring the transformational change required. The actions and commitments we will take are set out in our Promise Implementation Plan published in March 2022.

The Promise Oversight Board includes members with lived and professional experience and is responsible for holding Scotland to account on whether the Promise is being kept.

The Promise Scotland has been established to support organisations across Scotland to Keep The Promise. The Promise Scotland published its set up year report in July 2022. This includes a helpful timeline of work undertaken from the point The Promise Scotland was established.

The Scottish Government has published a child friendly version of the Promise Implementation Plan, developed with the support of Who Cares? Scotland and other stakeholders which is available on the Scottish Government website .

The importance of farming and crofting to our rural and island areas is fully appreciated by the Scottish Government.

We have committed over £580m investment for ports and vessels which will support and improve Scotland’s ferry services over the next five years, as part of our wider Infrastructure Investment Plan. We continue to work constructively with partners and key stakeholders to progress a sustainable and efficient fleet replacement programme; noting the recent purchase of the MV Loch Frisa, as well as the chartering of vessels such as the MV Arrow.

The vast majority of cancelled sailings, particularly at the start of 2022, related to weather impacts. In January and February alone, 92.75% of cancellations were due to either weather or Covid-19. Weather accounted for 16.3% of all cancellations in February alone, which is unprecedented.

It is a decision wholly for a ship’s master as to whether or not a vessel should sail and it would not be appropriate for me to question that professional judgement – which is made on safety grounds. Farmers, like the Masters who sail CalMac’s ships, make these judgments every day and it is important those with expertise are given the respect to do so.

I am aware that the NFU have raised an issue in relation to agricultural vehicles and CalMac’s systems. I am more than happy to meet with the NFU Union to discuss their concerns and to ensure systems are improved to support agricultural traffic when using the CalMac fleet.

Through Reset and Rebuild - sexual health and blood borne virus services: recovery plan, published in August 2021, the Scottish Government provided an additional £0.5m of funding to assist sexual health and blood borne virus services to begin recovery from the covid-19 pandemic.

Amongst the numerous projects funded through the Recovery Plan was the SHARE project launched by HIV Scotland, further details of which can be found here:

https://www.hiv.scot/stories/share-study-launch .

In addition, the Scottish Government has supported the Conundrum project, which was designed to understand factors shaping young people’s experiences of contraception, and provided insight into how young people’s access to condoms and contraception was disrupted during the early months of the COVID-19 pandemic. Details of the project can be found here: University of Glasgow - Schools - School of Health & Wellbeing - News - CONUNDRUM project .

Understanding the impact of the pandemic will require on-going support, and it is expected that the next iteration of the Sexual Health and Blood Borne Viruses Framework, which will be published this year, will continue this work.

The NHS in Scotland has a strong track record of delivering innovative sexual health and blood borne virus services.

For example, in 2017, Scotland was one of the first countries in the world to introduce an HIV Pre-Exposure Prophylaxis service - offering free preventative medication to those deemed at highest risk of acquiring HIV.

To ensure we build on this progress, in December 2022, the Scottish Government committed to support a pilot for an online service providing access to PrEP. Work on this is now being taken forward.

The Scottish Government has also committed to improving testing for sexual health and blood borne viruses, to ensure more people can receive the treatment they need. We have funded a home-testing HIV pilot project run by HIV Scotland to help evaluate the viability of this approach and its scope to increase parity of access in remote and rural areas. We have also provided over £0.5m for the development of a “once for Scotland” approach to STI home testing. This was rolled out in NHS Lothian in December, and work is underway to explore further roll-out. This service allows people to request a test online and perform home self-sampling, while providing clinicians with comprehensive, real-time data.

We recognise that the development of new models of service and treatment is an ongoing, iterative process. The Scottish Government will continue to support this, including through development of the next Sexual Health and Blood Borne Viruses Framework.

This information is not held centrally by the Scottish Government. However, information regarding PrEP uptake is published by Public Health Scotland and can be found here: https://publichealthscotland.scot/publications/hiv-in-scotland/hiv-in-scotland-update-to-31-december-2021/ .

There are a number of ways that good practice, clinical updates and learning on women’s health are shared across primary care. Examples of this include:

• Regular women’s health update days for primary care held at both board and national level.
• Regular training and updates for a range of women’s services, including perinatal care, smear taking, long acting contraception insertion and removal, and the menopause.
• Working with pharmacy colleagues on ensuring up-to-date and relevant prescribing information is available.
• Primary care engagement through local interface groups in developing local pathways and protocols for women’s health.
• Dissemination of updated guidelines on women’s health from areas such as SIGN, NICE and Royal Colleges through local distribution networks, signposting to new, relevant publications such as the Women’s Health Plan.
• Supporting shared learning around good practice through initiatives such as funding for first 5 GPs to attend local, problem-based small learning groups.

Additionally, locally and nationally driven learning through innovative practice is shared via primary and secondary care networks. Examples of this include:

• Increasing cervical screening uptake through using enhanced engagement techniques targeting opportunistic and vulnerable groups.
• Learning from recent trials of group education and group consultations on menopause at general practice level.
• The National Menopause Specialist Network, where examples of innovative practice across primary and secondary care are regularly shared.

Sharing good practice will be an ongoing piece of work throughout the lifetime of the Women’s Health Plan.

Yes, the Scottish Government has taken significant steps to promote the use of video, through NHS Near Me, and telephone consultations where appropriate to support access to services for women.

Key actions have included:

• Targeted social media campaigns via the NHS Near Me Twitter account throughout 2022, including a targeted campaign in March for International Women’s day and Endometriosis month to establish stronger partnership engagement.
• Direct engagement with women and health services; the initial focus has been on Endometriosis with the view to expand this further.
• Partnerships with third sector organisations such as Endometriosis UK, Endo Warriors, Endo Bonds, Endoborders, ALLiance, Lets Get on With Scotland and Sports Scotland.

The rollout of the Women’s Health Plan also sets out commitments to ensure that all women enjoy the best possible health throughout their lives. The Near Me programme aims to ensure that healthcare services are responsive and adaptive to the individual needs of women, with practitioners adequately trained to be able to help women, particularly those who have been affected by trauma or adversity and where choice of appointment is offered routinely.

In addition, use of remote consultations continues to be explored within Family Nurse Partnerships and community maternity services.

Work to widen eligibility for PrEP in Scotland is well underway. This has been progressed by a dedicated PrEP Short Life Working Group, comprising clinical and third sector representatives, which is developing guidance for new eligibility criteria. The goal is to ensure that anyone who is at risk of acquiring HIV is eligible to receive PrEP.

Widening eligibility will also require ensuring appropriate capacity to provide PrEP. In December 2022, the Scottish Government committed to support a pilot for an online service providing access to PrEP. Work on this is now being taken forward. If successful, in the long term, an online service could improve access, including for those living in remote or rural areas.

The most recent surveillance data has been published by Public Health Scotland, and this includes treatment levels since 2007-08. The report can be found here: https://hps.scot.nhs.uk/web-resources-container/surveillance-of-hepatitis-c-testing-diagnosis-and-treatment-in-scotland-2019-update/ .

We have commissioned the Health and Social Care Alliance to take forward a programme of work on ‘lived experience’ to inform women’s health policy and ensure women are meaningfully involved in decision making and priority setting going forward.