Chamber and committees

Cancer continues to be a top priority for this Government. On 28 June I announced £10 million of funding to support cancer waiting times improvements during 2021-22. This funding will support targeted diagnostic activity, including for breast cancer. We have also provided five mobile MRI scanners and four mobile CT scanners to increase diagnostic capacity across NHS Scotland.

The Scottish Cancer Registry, hosted by Public Health Scotland, collects information on registrations for primary cancers. It does not hold information on secondary cancers.

There is work ongoing to develop systems for the routine collection of secondary cancer data, including secondary breast cancer. However, validation of these systems would require clinical time that is being focussed on seeing patients as we continue to prioritise cancer in the NHS. Any national system for the routine collection of secondary breast cancer would take several years to produce the first tranche of data. The Scottish Government’s National Cancer Plan has committed up to £114.5m until March 2023 which will drive a range of improvements across all cancer services.

There are no plans to undertake a metastatic breast cancer audit. Officials continue to closely monitor all patients referred with an urgent suspicion of cancer in NHS Scotland to ensure they are seen and treated as timely as possible.

We regularly engage with people who are at highest risk from COVID-19 through surveys, in-depth interviews and testing communications. Earlier this year we spoke directly to people at highest risk who have returned to the workplace as restrictions eased, to understand their challenges and what guidance and support may be needed when restrictions ease. Most recently, we launched a survey about the move to level 0 and beyond which asks how people are feeling about those changes. The results will be published late summer.

Three Disabled People’s Organisations (Inclusion Scotland, Disability Equality Scotland and Glasgow Disability Alliance) were consulted on the easing of restrictions.

Throughout the pandemic we have been engaging with both carers and carer organisations to ensure unpaid carers have the advice they need to help protect themselves and their loved ones during the COVID-19 outbreak.

Data on diagnosis of sepsis by age, gender and location can be found at:

https://publichealthscotland.scot/publications/acute-hospital-activity-and-nhs-beds-information-annual/acute-hospital-activity-and-nhs-beds-information-annual-annual-year-ending-31-march-2020/ .

At present the Scottish Government has no plans to publish data on people affected by sepsis, broken down by ethnicity.

Following clinical advice, and in agreement with stakeholders, we will not be running a sepsis awareness campaign while the COVID-19 public awareness campaign continues.

We are aiming to re-start the annual sepsis public awareness campaign in 2022. In the meantime we are in discussion with sepsis charities around how we can support them in other ways to raise awareness of sepsis.

As I noted in my statement to Parliament on 24 June, a single NHS Board first discovered in December 2020 that a small number of women who had subtotal hysterectomies had been wrongly excluded.

In 2016, a review was carried out of all individual records on the Scottish Cervical Call-Recall System (SCCRS) which had both a subtotal hysterectomy entry and also an open exclusion on the record. This was prompted by an IT error that had led to ‘no cervix’ exclusions being automatically added to the system when a subtotal hysterectomy was recorded together with recommended management of ‘no follow up’ or ‘no further recall’. This error was swiftly addressed.

In the course of addressing the issue, a number of other cases were identified, where a subtotal hysterectomy had been recorded on SCCRS and a manual exclusion had subsequently been opened. As soon as this was discovered, a process was initiated to identify all records on SCCRS with subtotal hysterectomies and open exclusions.

Following a rigorous review of affected records, it was established that some exclusions had been opened in error. Anyone affected was re-instated to the screening programme, and provided with a full explanation. Recommendations were made for safeguards to be put in place to prevent further instances of inappropriate manual exclusions.

At that time, it was believed that the records review had captured all affected patients, and there was no evidence to suggest further widespread errors in the recording of subtotal hysterectomies or the general application of exclusions.

It should be noted that, in 2006, in preparation for the migration to SCCRS, a data cleansing exercise was carried out. GP practices were provided with a list of women where there were discrepancies between the exclusion status and screening history and asked to resolve these before the transfer to SCCRS was complete.

This data cleansing exercise was standard good practice prior to the migration to SSCRS and did not uncover significant coding or data issues that gave rise to widespread concerns. Once the inconsistencies were resolved, the migration to SCCRS was carried out. A decision was made to migrate total hysterectomy information and all exclusions but not subtotal hysterectomy information, as individuals with subtotal hysterectomies would continue to be screened.

Although the actions taken in response to the issues detected in 2006 and 2016 were reasonable in light of the available evidence, we will consider whether there were opportunities to detect the wider issues now identified, and, if so, what lessons can be learned to strengthen monitoring and auditing going forward.

I refer the member to the answer to question S6W-01898 on
‎ 23 August 2021. 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.

The timing for restarting the over-70’s self-referral scheme is regularly reviewed. The Breast Screening Programme Board (BSPB) agreed criteria to resume the option for women over 70 to self-refer in line with the programme’s recovery route map. The option for women over 70 to self-refer into the breast screening programme will resume once all screening centres are able to offer those aged 53-70 their breast screening appointments within 39 months of their previous screening. Progress towards this criteria is being closely monitored, and the National Screening Oversight, National Screening Committee and BSPB continue to work with Health boards to increase the number of available appointments within the programme.

Regardless of their age, women should remain symptom aware and report any symptoms to their GP immediately for these to be investigated.

The mesh fund is being administered by NHS National Services Scotland on behalf of the Scottish Government. The following table illustrates, as at 26 July 2021, the number of applications approved, declined and pending: