Chamber and committees

I recognise that stigma associated with liver disease can create very specific challenges, including by isolating people from their communities and act as a significant barrier to seeking help and support. This can increase the harms experienced due to delayed presentation especially given the generalised association between liver disease and alcohol misuse and/or drug abuse.

The Scottish Government is committed to tackling this stigma, including among health care professionals across the healthcare system. We are currently developing a national stigma action plan for drugs and alcohol that will include taking the principles of the stigma charter developed by the Drugs Death Taskforce and putting these into action.

The issue of stigma is also clearly referenced on the NHS Inform website which states that a drug or alcohol problem is a health condition and people should receive help and support, not judgement.

Alcohol and drugs are of course not the exclusive causes of liver disease. On 20 June 2022, Public Health Scotland launched the Challenging Weight Stigma Learning Hub . The learning hub aims to raise awareness of the impact weight stigma can have on people living with overweight and obesity and what health professionals can do to mitigate this. It is interactive and has been developed alongside academics, health professionals and those with lived experience of stigma.

Transient elastography, commonly measured with a FibroScan, is currently used in several NHS Boards throughout Scotland to assess liver disease in hospital settings.

However its use in community settings is less well established. Local trials of its use in the community to assess those at high risk of liver disease have been initiated.

As we strive to deliver evidence-based policy, we await a more full evaluation of the data before considering the next steps. Experience so far has shown it to be feasible to introduce this technology in primary care and community settings and this could improve early detection of liver disease. Early detection of those with unrecognised advanced liver disease provides greater opportunity to prevent liver-related illness and deaths.

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.

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.

The Social Work Strategic Forum commissioned a research project in 2016 into the public perception of social services in Scotland. Overall, the research findings suggested a good level of support for social services in Scotland and a reasonable level of literacy among respondents about what social services do. The findings also suggested that the public has a much more positive view of social services than social service workers and institutions perceive. Overall, people in Scotland are positive about social services’ impact on society and believe these services perform an important public role.

The Scottish Social Services Awards have been held annually since 2017 (except in 2020 due to COVID-19) and provide an opportunity to recognise the social work and social care workforce, raise the profile of the sector, demonstrate that it is valued and highlight the commitment and innovative approaches of those who work within it.

Under current arrangements, the Scottish Government sets the overall strategic framework for social work delivery. The majority of social workers are employed by councils with terms and conditions set by individual employers, resulting in local variations in pay and grading. There is no single national body which has oversight and leads social workers’ professional development, education, improvement, data and workforce planning.

The recently published National Care Service (Scotland) Bill will establish a new National Social Work Agency, which will support and invest in the social work profession by providing national leadership, and overseeing and supporting social work in a range of areas, including: workforce planning, improvement and social work terms and conditions. In establishing the National Social Work Agency, the Scottish Government will work with frontline social workers, their representative bodies and the wider social work and social care sector to raise the profile of the sector and promote understanding of the role of social workers.

Audiology Waiting Times have not been published since 27 May 2014, following an agreement between the Scottish Government and Public Health Scotland that this was no longer required. Audiology services are currently measured as part of the 18 Weeks Referral to Treatment (RTT) standard. For more information on this standard, and to view the latest publication, please see the 18 Weeks RTT page . Please note that this publication does not go down to specialty level and shows the performance of NHSScotland and the Health Boards for all specialties only. This information can also be found at ISD Audiology Waiting Times website .

In January 2022 the Cabinet Secretary of Health and Social Care announced an Independent Review of Audiology would be established to examine hearing services provided to both children and adults in Health Boards across Scotland, to ensure public confidence in the quality and effectiveness of current service provision. The group will provide recommendations for a national plan for improvement of the service and its specific remit will be published by the Chair via its Terms of Reference in due course.

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, the following table 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 Referral to Treatment (RTT) pathway for audiology.

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

There is no place for racism and we recognise that structural and institutional barriers continue to exist in the NHS.

The NHS ethnic minority forum is working with the Scottish Government to drive change. Work is underway to develop anti-racist resources and targeted interventions to support minority ethnic staff and help them progress in their careers.

A refreshed Fair Work action plan will be published later this year, including a focus on minority ethnic employment. A new ethnicity pay gap strategy will also set out our approach for employers in addressing racial inequality in workplaces.