Chamber and committees

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.

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/ .

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.

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.

During 2020, national treatment targets were suspended in recognition of the necessary response to the covid-19 pandemic, before being reinstated in 2021.

We know that the covid-19 pandemic had a major impact across our health services, including the detection and treatment of Hepatitis C. In considering the re-instatement of Hepatitis C treatment targets, both the impact of COVID and associated steps to manage it were considered by the SHPN Hepatitis C Elimination Group, which comprises clinical expertise from Scottish Health Boards.

A recent PHS report shows that the number of new diagnoses made in 2020 and 2021 were the lowest recorded in the last decade. Encouragingly, however, it also shows that major progress has been made despite the pandemic. For example, there is evidence to indicate that Scotland has already achieved one of the WHO targets set for 2030; 80% of those ever diagnosed having received treatment.

The full PHS report can be found here: Surveillance of hepatitis C in Scotland (publichealthscotland.scot).

The Scottish Government remains committed to eliminating Hepatitis C as a major public health concern by 2024.

We must recognise the impact the covid-19 pandemic has had on services, as well as the monitoring and evaluation of HCV data.

However, despite that impact, PHS recently published a report (“Surveillance of hepatitis C in Scotland”) which shows that major progress has been made on a number of key targets including a large drop in cases in people who inject drugs, with some parts of Scotland seeing as much as a 70% reduction. This is hugely encouraging. As we continue to recover from the pandemic, we must build on that progress and continue to work with key stakeholders to remove this public health threat.

A number of high-calibre candidates have been interviewed for this important role and the appointments process is in the final stages. Ministers will provide an update to Parliament shortly.

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.

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.

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/ .