Chamber and committees

The Scottish Government is committed to ensuring that women across Scotland have timely access to reproductive health services. Work continues on the actions set out in the Women’s Health Plan 2021 and the Sexual Health and Blood Borne Virus (SHBBV) Action Plan 2023-26 to ensure that anyone accessing contraception, or deciding to terminate their pregnancy, is provided with fully accessible and person-centred pathways, with information provided to allow for informed decisions to be made about their own sexual and reproductive health.

As part of the SHBBV Action Plan, the Scottish Government has committed to visiting all 14 Health Boards. During these visits the Scottish Government will be recognising the challenges that Boards are facing and the good practice being delivered. This time will also be used to explore areas for collaboration between Boards, both nationally and regionally, especially within rural areas. Officials’ visit to NHS Grampian is scheduled for May 2025.

The evaluation of early medical abortion at home (EMAH) in Scotland was published in March 2023, demonstrating high levels of effectiveness of EMAH, but noting some variations in service delivery across the country. The Scottish Government has taken various actions forward with the Scottish Abortion Care Providers network following this to improve and increase consistency of EMAH services for women across Scotland, and particularly in rural areas, including by providing improved patient information.

An updated medical abortion approval was signed in December 2024, allowing women to take abortion medication in residential or temporary accommodation if clinically appropriate, particularly benefitting patients who may live significant distances from hospitals or clinics.

The Scottish Government is working with Health Boards and Public Health Scotland to monitor access to services, including analysis of annual statistics. As part of the commitment to ensure services are accessible to all, officials regularly discuss barriers to these reproductive health services with Health Boards, including NHS Grampian, to inform possible improvements to services for patients in rural locations.

Early intervention, including diagnosis, for visual impairments largely takes place in community optometry practices following patient presentation to the service.

Scottish Government is currently taking forward work to respond to the findings of the Independent Review of Audiology. In addressing the Review’s recommendations, audiology has been designated a clinical priority area, with improvement work being progressed through the National Planning and Delivery Board arrangements, led by the Chief Operating Officer – NHS Scotland.

Our 2018 Diet and Healthy Weight Delivery Plan set out ambitious and wide-ranging action to deliver our vision for a Scotland where everyone eats well and has a healthy weight. We are taking forward a range of action across five key outcomes: giving children the best start in life; creating a healthier food environment; better access to weight management services; leadership and reducing health inequalities.

We continue to support convenience stores to increase the accessibility of fruit and vegetables in more deprived areas and support businesses to reformulate their products to make them healthier.

We have maintained funding to community food networks, enabling them to increase access to affordable, healthier food to their communities and to promote the health benefits of nutrition and physical activity.

The Scottish Government is committed to supporting the health and wellbeing of our children and young people. All food and drink served in schools must comply with the Nutritional Requirements for Food and Drink in Schools (Scotland) Regulations 2020 which are designed to provide children and young people with an appropriate amount of energy and nutrients to support their health growth and development.

In addition, food and health education is a key part of Curriculum for Excellence helping to ensure that our children and young people are provided with the skills and knowledge they need to make positive food choices that benefit their health now and in the future. To further support this holistic approach, more children than ever before are being offered balanced and nutritious free school meals as a result of our free school meal expansion programme.

The Scottish Government recognises the importance of ensuring that women in rural areas are able to access cervical and breast screening services.

The breast screening programme operates from six centres across Scotland and is supported by 21 mobile units to allow screening to be delivered more locally to minimise travel and distance as barriers for attendance. The latest statistics released by Public Health Scotland (PHS) show that for the breast screening programme, the NHS Health Boards which include the highest level of rural areas saw above-average uptake in Scotland, and also met Healthcare Improvement Scotland’s acceptable uptake standard of 70% for the three-year period 2020-23.

The Scottish Government supports women to access the cervical screening programme by funding GPs to deliver it in their communities. As with breast screening, the latest PHS statistics for cervical screening also show a higher than average uptake in NHS Health Boards that have the highest level of rural areas.

To strengthen the delivery of comprehensive, sustainable and accessible services, the Scottish Government is developing a Route Map for Primary Care to further enhance sustainability of Primary Care, aligned to wider reform of Health and Social Care. This encompasses evaluation of both how the Primary Care system operates currently, including across rural areas, and how it will operate in the context of wider reforms. Under a shared vision for Health and Social Care, the Route Map will set the strategic direction for Primary Care as a whole.

In addition to this, the Scottish Government has annually made £1m available through our Inequalities Fund. Boards are allocated funding for use in developing local initiatives taking into consideration specific barriers for individuals. For example, NHS Highland’s partnered with the North’s Scottish Breast Screening Service to deliver telephone reminders targeted at individuals invited to take part in screening for the first time. During the initiative's second year, uptake among individuals living in 'Remote Small Towns', 'Accessible Rural Areas' & 'Remote Rural Areas' (all categories within the Scottish Urban Rural Classification), was statistically significantly higher among those who were contacted relative to those who were not contacted.

We have committed to the development of a new National Pharmaceutical Agency (NPhA), to improve links between the life sciences industry and the NHS, and ultimately improve patient care.

Initial scoping work has taken place, with further scoping work required to inform any planning for the future establishment of a NPhA. This work has been paused due to resource constraints.

The Scottish Government does not hold this data.

Over the counter medicines for common illnesses can be provided through the NHS Pharmacy First Scotland service, may be prescribed, or may be purchased from community pharmacies, other retailers and online.

Public Health Scotland (PHS) publishes reports on prescribing and dispensing of NHS prescriptions dispensed in the community. These reports include prescribed items as well as those that have been provided via Pharmacy First. The most recent Pharmacy First publication can be found online at NHS Pharmacy First Scotland 8 October 2024 - NHS Pharmacy First Scotland - Publications - Public Health Scotland.

Additionally, the most recent open data on Prescriptions in the Community contains dispenser level data which can be filtered for the relevant rural/urban locations and medicines if required. It can be found online at Monthly prescribing activity data - Data for October 2024 - Monthly prescribing activity data - Publications - Public Health Scotland Data about medicines that have been purchased by individuals is not collected by the Scottish Government or PHS.

In terms of general availability of medicines, shortages can occur at a local, regional, national, or global level. When supply issues relating to individual medicines or devices arise, that information is shared by NHS Scotland with the relevant networks within the service to help prescribers and dispensers meet patients’ on-going medical needs. The NHS Scotland Prescribing Advisers’ Network provides support to prescribers on the use of alternative products.

The pricing and supply of medicines, including the management of medicine shortages, is a reserved matter for the UK Government, and Scottish Government policy officials continue to engage with them to find lasting solutions to minimise the impact of medicine shortages.

The Scottish Government is committed to ensuring that everyone who needs it can access well-coordinated, timely and high-quality palliative care, care around dying and bereavement support regardless of geographical location.

As part of the development of the Scottish Government’s draft strategy, ‘Palliative Care Matters for All’, the Strategy Steering Group and a number of expert working groups carried out surveys to map palliative care delivery across Scotland, including in rural and island communities. This report can be accessed at www.gov.scot/publications/palliative-care-strategy-palliative-care-matters/

This work has been helpful in providing a clearer picture of the delivery and accessibility of palliative care services and support across Scotland and has helped to inform the actions set out in the draft strategy. The final palliative care strategy is due to published later this year.

It is for Integration Joint Boards (IJBs) to govern, plan and resource adult palliative care in their areas, using the delegated budgets under their control, to meet the needs of their local populations.

The Scottish Government continue to support all community pharmacy contractors, including rural pharmacies in Scotland by delivering the largest ever increase to funding for two years in a row. This settlement will deliver a total of £422 million in guaranteed funding for community pharmacies across Scotland in this financial year.

In addition, there is a Guaranteed Minimum Target Income for essential small pharmacies, most of which are rural, and a pharmaceutical needs weighting payment which acknowledges both demographics and deprivation associated with a patient’s postcode. This helps support rural pharmacies by ensuring they are not disadvantaged because of their location. In our strategy for pharmaceutical care in Scotland ‘Achieving Excellence in Pharmaceutical Care’ (2017) we committed to enhancing access to pharmaceutical care in rural communities, which included use of Attend Anywhere for pharmacist clinics, and use of Near Me to support access to and the delivery of pharmaceutical care in rural communities.

There is no community audiology service in Scotland currently, however consideration of audiology workforce capacity – within existing NHS hospital services – is integral to the work being taken forward to respond to the Independent Review of Audiology.

In addressing the Review’s recommendations, audiology has been flagged as a clinical priority area, with improvement work being progressed through the National Planning and Delivery Board arrangements, led by the Chief Operating Officer – NHS Scotland.

The Scottish Government is acutely aware of the challenges facing the agricultural industry in Scotland and we have been working closely with third sector partners to provide a range of mental health supports for farmers and agriculture workers.

We have provided £615,000 of funding since 2020 for the Royal Scottish Agricultural Benevolent Institution (RSABI) to provide a range of emotional and practical supports specifically focussed on agricultural workers across Scotland. This includes a helpline, online chat service, counselling, mental health first aid training, suicide prevention and financial support.

We have also provided Samaritans Scotland with over £500,000 of funding since 2021 to establish a new service in West Highlands and Skye to reach and support lone and isolated workers, many of whom are in agriculture. In addition, we have supported bereavement service pilots in NHS Ayrshire and Arran and NHS Highland to help anyone affected by suicide death, including agricultural workers.

To inform our wider support in this area, we also fund the National Rural Mental Health Forum, led by Change Mental Health. The Forum brings together over 300 organisations across all sectors to promote mental health and wellbeing and share good practice and innovation in rural and island communities.