Chamber and committees

As set out in my response to S6W-00871 on 5 July 2021 we’ve taken a number of steps to provide advice and support to people with chronic pain during the pandemic, including highlighting relevant information on the matter of injections to assist them in discussions with their clinician and Health Board.

In June 2020, joint guidance was issued by the Faculty of Pain Medicine (FPM) and the British Pain Society (BPS) in relation to pain interventions which stated: ‘decision[s] to resume injections should be based on a balance of risks and benefits for individual patients’ . This statement reflected the factors the FMP/BPS said should be considered when resuming pain interventions, including the local prevalence of COVID-19, reducing the risk to patients (specifically in relation to steroid injections) and prioritising lower risk aspects of pain services first. It also emphasised the importance of patient consent in relation to additional risks of attending hospital and receiving an injection during the pandemic.

Following this, the advice issued by the FPM in July 2020 again set out that there was insufficient evidence to assess the potential associated risks should a patient come into contact with COVID-19. It goes on to on to clearly state: ‘Our previous recommendations - “FPM & BPS Joint Guidance on Pain Interventions during the COVID-19 Recovery Phase” published on the 8th of June 2020 in conjunction with the British Pain Society […] still stand ’. The update also stated, when making treatment decisions, the: ‘risk benefit ratio [should] also [be] measured in the context of the local prevalence of the COVID-19 virus at that point in time.’ Our replies to correspondence about this matter therefore continued to include a link to the June 2020 guidance and in response to feedback from a member of the public in April 2021, we now direct people to the overarching FPM webpage containing both advice documents.

Neither Scottish Government officials or Ministers make or influence treatment or prescribing decisions as these are entirely for clinicians in charge of a patient’s care to make. When taking these decisions we expect clinicians to discuss risks and options fully with their patients taking into account relevant guidance, the impact of pain on people’s quality of life and any safety considerations.

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 following table shows the number of cases submitted for annual invasive cervical cancer audits in the years from 2014 until 2018, which are the years where full data is available. For the year 2019 five health boards have provided data and 129 cases were reported; in 2020, one health board submitted 16 cases. The audit schedule for the 2019 period was affected by the impact of the Covid-19 pandemic on services as staff were redeployed to Covid duties. A catch-up schedule has been put in place to audit 2019 cases at the same time as 2020 cases and these will be reviewed this year. It is important to note that the cases are assembled annually and reviewed by a multidisciplinary team within each Health Board.

The information requested relating to (a) Aspergillus, (b) Pneumocystis jirovecii, (c) Staphylococcus epidermidis and (d) COVID-19 cases by hospital site is not centrally held by the Scottish Government. This information is held locally for local learning and quality improvement and can be sourced by contacting [email protected].

The Scottish Government does not hold this information centrally. Information on the number of NHS dental consultations can be found on Public Health Scotland at: https://publichealthscotland.scot/publications/dental-statistics-fees-and-treatments/dental-statistics-fees-and-treatments-statistics-as-at-march-2020/ .

Invasive cervical cancer audits have been carried out annually by Health Boards for at least the last 20 years, although a new national methodology to standardise the information collected was introduced in 2014. These audits review the screening histories of people who develop invasive cervical cancer.

Validated information on referrals to NHS dentals hospitals is not held centrally.

However the member may find it useful to know that information relating to outpatient activity including total number of attendances by NHS Board and location of treatment can be found in the Acute Hospital Activity publication using the link below.

https://publichealthscotland.scot/media/4991/table-1-outpatient-activity-consultant-led.xlsx.

The Scottish Government does not hold this information centrally. Information on how many NHS dental consultations were emergencies is held with the individual dentist. However, the overall number of NHS dental consultations can be found on Public Health Scotland at: https://publichealthscotland.scot/publications/dental-statistics-fees-and-treatments/dental-statistics-fees-and-treatments-statistics-as-at-march-2020/ .

We have provided additional funding to NHS Boards where required to support prioritised care for individuals affected by the incident within the cervical screening programme.

Four Boards have requested funding to provide additional clinics as follows:

• Lanarkshire - £28,000
• Lothian - £8,098
• GGC - £5,000
• Fife: £2,700

No other Boards have requested funding, but we will keep the situation under review and will provide further funding if needed. Additionally, Jo’s Cervical Cancer Trust, who are helping support the response with their Helpline, have also received funding from the Scottish Government.

The UK Government has proposed creating a separate Warm Home Discount scheme for Scotland that does not take account of current levels of need or the definition of fuel poverty as decided by the Scottish Parliament. We have urged the UK Government to reconsider their proposals on this basis and review their use of levy funding more generally. These proposals will increase charges on everyone's energy bills but this does not reflect every household's ability to pay.

Given that UK Ministers believe that a reformed scheme is needed in England and Wales, Scottish Ministers have proposed a simpler, fairer and more flexible fuel poverty scheme for Scotland. As set out in our draft Heat in Buildings Strategy, we believe that combining the current Energy Company Obligation and Warm Home Discount schemes would provide the flexibility needed to target the different needs of Scottish communities and reflect the will of the Parliament.

The Scotland Act (2016) does not provide powers for Scottish Ministers to simply change these levy funded schemes. In all circumstances the approval of the Secretary of State would be required for any changes to be implemented. Scottish Ministers cannot meaningfully consult about the design of a proposed Scottish scheme or engage with the Parliament on this basis.

From April 2010 until September 2020, there have been 808 revisional mesh procedures to either remove or oversew transvaginal mesh, inserted for stress urinary incontinence, pelvic organ prolapse or another unknown reason.