Chamber and committees

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.

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.

It is for each Board to decide how to deliver healthcare services in line with the needs of their local populations. However, following the suspension of treatment targets in 2020, and after advice from the Scottish Health Protection Network Hepatitis C Elimination Group, national treatment targets were reinstated in 2021 at a level of at least 2000 new treatment initiations for 2021-22 rising to 3000 in 22-23.

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/ .

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.

I refer the member to the answer to question S6W-13514 on‎ 16 January 2023 for an update on the development of a menopause and menstrual health workplace policy for NHS Scotland. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

Once developed for the NHS this policy can be used/adapted for other sectors, such as social care.

The HIV Transmission Elimination Proposal, led by Professor Rak Nandwani (the then co-chair of the Scottish Health Protection Network Strategic Leads) was published on 1 December 2022 and can be found at: https://www.gov.scot/publications/ending-hiv-transmission-scotland-2030/

Evidence from the evaluation of minimum unit pricing (MUP) has shown that consumers have responded to the introduction of MUP in a variety of ways including reduced purchasing of products whose price has increased, switching to smaller pack sizes, to more premium products and to lower strength products.

Public Health Scotland (PHS) are undertaking a comprehensive evaluation of MUP, which includes assessing the impact of MUP on health, crime, public safety and public nuisance in Scotland, and the impact on the alcohol industry. A final evaluation report will be published in 2023.

All published studies are available on the PHS website: https://www.publichealthscotland.scot/

Work is currently underway in the Scottish Public Health Workforce Development Group to assess needs and agree priority actions in relation to the public health workforce. Three additional Public Health training places for trainee doctors have been created in recent years following recommendations made by the Scottish Shape of Training Transition Group. While this may seem like a modest increase, it is relative to the specialty’s training establishment i.e. there were 35 established training places prior to the creation of those three extra posts. This will continue to be reviewed as part of public health workforce planning.