Chamber and committees

The Scottish Government has plans to raise awareness about community optometry services, but is unable to take this forward at the present time due to financial constraints. In addition, the NHS Inform and Eyes. NHS.Scot websites have content relevant to the provision of NHS funded eye examinations in Scotland.

Please find below, the Full Time Equivalent (FTE) number of social media managers currently employed within the Communications division and the associated cost.

The Scottish Government is pleased to note that The latest published statistics show that there are higher uptake rates for breast, bowel and cervical screening within health boards which have a higher proportion of rural or island populations. Nonetheless, we recognise the particular challenges people living in those communities may face in accessing preventative health services, and we are working hard to overcome these.

Initiatives supporting access to preventative health services in rural and island areas include:

• a dedicated financial support scheme to cover travel costs for eligible patients and their authorised escorts, which focuses on those on low incomes or living in the highlands and islands. In addition, Health Boards also have the discretion to reimburse patient travel expenses where it is viewed to be an extension of treatment costs and deemed to be clinically necessary. This allows flexibility within the schemes for Boards to provide support to those who need it but would not otherwise qualify.
• Funding for Scottish Ambulance Service mobile vaccination units. These are available to every Health Board across all vaccination programmes and can be used to reach those in rural areas.
• 21 mobile screening units deployed in the breast screening programme across Scotland to minimise travel for all patients.
• Targeted outreach through Detect Cancer Early roadshows, which visited communities right across Scotland, including those in rural areas, in March 2024 to reinforce key preventative messages.

In addition, the National Equity in Screening Strategy, which was published in June 2023, is designed to address inequalities and ensure equitable access for all eligible screening participants. The Scottish Government is also looking to improve our understanding of the experience of people with cancer living in rural and island communities. Examples include an independent evaluation of their access to cancer care services, and a research programme on rural healthcare funded by the Chief Scientist Office.

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.

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.

The Scottish Government is committed to supporting and enabling people to be more physically active. Mean sedentary time at work is monitored through data gathered from the annual Scottish Health Survey. The Scottish Government work closely with Public Health Scotland, The Physical Activity for Health Research Centre (PAHRC), and other experts to understand the latest research on the negative health impacts of sedentary behaviour.

The Scottish Government recognise that people in rural areas can experience particular challenges in relation to their mental health and wellbeing.

Decisions around the provision of mental health services is a local responsibility, planned by Integrated Joint Boards and delivered through a mixture of NHS, local authority and third sector organisations. Mental Health services will vary depending the local population needs and will be guided by clinical decision making.

While we expect service decisions to be taken locally, we have invested £66 million in our Communities Mental Health and Wellbeing Fund for adults since 2021. The Fund has a strong focus on prevention and early intervention and prioritises a range of ‘at risk’ groups including those people disadvantaged by geographical location (particularly remote and rural areas) with over 900 awards being made to community projects supporting people disadvantaged by geographical location (including rural areas) since its inception.

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.

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.

Initial diagnosis of visual impairments largely takes place in community optometry practices following patient presentation to the service. We are not aware of access concerns to the service at this time.

There is currently no community provision for audiology in Scotland. Diagnosis is performed within secondary care settings and typically on referral from wider health networks and services. Consideration of audiology capacity – within existing NHS hospital services – is being taken forward in response 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.