Chamber and committees

The local road network is the responsibility of local authorities and they will allocate resources on the basis of local priorities. The vast majority of funding to local authorities from the Scottish Government is provided via a block grant and we do not stipulate how local authorities should utilise their individual allocations. It is therefore the responsibility of each local authority to manage their own budget and to allocate the financial resources available to them on the basis of local needs and priorities, having first fulfilled their statutory obligations and the jointly agreed set of national and local priorities.

In the most challenging budget settlement since devolution, we are providing over £13.2 billion in the Local Government Settlement 2023-24.

The local authority may also wish to contact the Coal Authority to establish if there is any recourse to them regarding the historical mine works.

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 Sexual Health Digital Group has not yet been established, in recognition of the pressures facing the NHS as it recovers from the pandemic, and to avoid further demands on the time of the clinicians and NHS professionals who would be required to join.

However, to maintain momentum, the Scottish Government has continued to support digital solutions, including online testing and ePrEP. Additionally, much of the anticipated work that the Group would have taken forward will be addressed through other forums, such as the forthcoming update to the Sexual Health and Blood Borne Virus Framework or through the refreshed Digital Health and Care Strategy. However, the establishment of the Group will remain under review and be stood up, should the need arise and resources permit.

Establishing a Women’s Health Lead in every board is a medium term action in the Women’s Health Plan due for delivery by September 2024 . NHS Boards have begun the process of identifying their Women’s Health Lead.

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/ .

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.

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.

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.

The Scottish Government is committed to ensuring women can access appropriate contraception when and where they need it. Since November 2021, community pharmacies have been able to supply the progestogen-only pill for a 3-month period, if clinically appropriate to do so, and in line with a national Patient Group Direction (PGD). The national roll-out followed a successful pilot in pharmacies across Lothian and Tayside.

This availability of bridging contraception from community pharmacies enables women to access contraception without the need for a prescription and receive healthcare advice and treatment from their community pharmacist. Thereafter, individuals wishing to continue with a regular supply or access an alternative method of contraception, may contact their GP practice to request a repeat prescription or request an appointment to discuss their options.

Contraception can be obtained for free from:

• most GP surgeries

• community contraception clinics

• some genitourinary medicine (GUM) clinics

• sexual health clinics

• some young people's services.

However, there are two brands of the progestogen-only available to purchase over the counter (OTC) in pharmacies, increasing choice for women in the ways in which they can access contraception.