Chamber and committees

Scottish Government is supportive of NHSScotland sharing learning, and also learning from experience and practice of NHS England in relation to operational delivery of government policy, including neonatal policy.

The Scottish Government commissioned independent modelling report was published on 29 May, and, following consideration of that report, we have asked the Regional Chief Executives to progress with the development of implementation plans.

We have asked that implementation plans are developed with the input of multidisciplinary clinical teams and describe service requirements for the new model and how they will be achieved.

Neonatal clinical outcomes data is gathered from neonatal units in Scotland and routinely published by Public Health Scotland on their Scottish Pregnancy, Births and Neonatal Data Dashboard. The National Neonatal Audit Programme run by the Royal College of Paediatrics and Child Health also provides a further level of detailed comparable neonatal clinical outcomes data for units in England, Scotland and Wales on their Data Dashboard, and in their annual reports.

The Review of Maternity and Neonatal Services was led by a review group consisting of representatives from the key professional groups involved in managing and delivering maternity and neonatal services, representatives of the Scottish Government, staff side organisations, Royal Colleges, third sector representatives and academics working in maternal and infant health research.

The full membership of the Review group can be found in Appendix E of The Best Start: A Five Year Forward Plan for Maternity and Neonatal Care in Scotland, and membership of Sub Groups and their remit in Appendix F.

No consulting firm has been hired or paid to oversee the implementation of the Best Start programme for maternity and neonatal care. The Best Start Implementation Programme Board (IPB), Chaired by Jane Grant, Chief Executive of NHS Greater Glasgow and Clyde was established in June 2017 to guide the implementation of The Best Start: A Five-Year Plan for Maternity and Neonatal Care in Scotland.

Members of the IPB are drawn from NHSScotland, third sector organisations, Partnership and Royal Colleges. Members are not paid; however, third sector representative have been reimbursed for travel expenses.

Special Advisers in the Scottish Government are paid using the following Pay Bands and Pay Ranges which are effective from 1 April 2024:

The terms of Special Adviser contracts of employment are reserved to the UK Government. Those contracts include a requirement that severance payments are made to special advisers where their employment is terminated in the circumstances where a First Minister demits office, or on the dissolution of Parliament prior to a Scottish Parliamentary election. The value of severance payment due is dependent on an individual’s length of service and range from the equivalent of 3 months’ pay up to a maximum of 6 months’ pay.However, payment of severance is subject to agreement that should an individual be reappointed as a special adviser, they will repay any severance pay less the amount of salary they would have been paid had they been employed during the period between the termination of the previous contract and re-appointment on a fresh contract. Therefore the amount of severance to be repaid upon reappointment varies depending on the length of time between termination of employment and later reappointment. The following table sets out for each of the last 5 years to July 2024, the net cost of severance payments once the approximate level of repayments received are taken into account for those who were reappointed:

The Scottish Government recognises the importance of ensuring equitable access to living kidney donation. All nine Renal Units in Scotland are currently supporting living kidney donation, with sixteen living donor co-ordinators in post across the Renal Units. In 2016, the Scottish Government supported the creation of the Living Donation Scotland Board, whose role, working with referring Renal Units and Transplant Centres, is to make it easier to access living donor kidney transplantation. The Scottish Government also supports the Renal Units in their work by hosting an annual event for staff to share good practice and learning.

In addition, the Scottish Government is taking a number of steps to make accessing kidney donation easier as set out in the Scottish Donation and Transplantation Plan: 2021-2026 . The plan makes clear that whilst it will not be feasible for everyone, the aim is to encourage all those who need a kidney transplant to consider and explore options for a living donor transplant as their first transplant.

To ensure that every recipient who would benefit from a kidney transplant receives standard information about living donation during transplant assessment, the Scottish Government provides living donor information packs and a range of resources through the Organ Donation Scotland website, including written information, video and clear pathway contact information access for recipients and donors. Annual living donation multi-media campaigns have also proven successful in increasing awareness for donors.

Finally, following a pilot project, the Renal Education and Choices at Home (REACH Transplant) programme was implemented in 2022. REACH Transplant is funded by the Scottish Government and has involved the appointment of both a REACH transplant programme lead and ten REACH Transplant nurses across Scotland, based in each Renal Unit. The REACH Transplant nurses work with local nephrologists to identify those at an early stage who may need a kidney transplant in the future. A visit is organised with the recipient and their support network in a place of their choice to provide information on living kidney donation and to support the recipient to discuss living donation. The aim of this tailored support and timely referral for living donor transplantation is to increase the likelihood of pre-emptive transplantation by overcoming barriers and ensuring equity of treatment choice.

Transplant patients can experience a variety of emotions following their transplant and as a result the Scottish Government recognises the importance of psychological and emotional support. In order to better understand patients’ experiences, the Scottish Government carried out a patient survey on organ transplant aftercare and support between September and December 2023, receiving 569 responses from patients in Scotland, including 192 from those who had received a kidney transplant. The survey asked about patients’ experience of psychological and emotional support both before and after transplant; about the sources of such support; about patients’ preference for where to receive this support; and about whether they had any further comments about what would have improved their experience.

The Scottish Government is currently analysing the responses to the survey with the intention of publishing the analysis by the end of the year. Working with the Scottish Donation and Transplant Group, which brings together key stakeholders, and NHS National Services Division as commissioners, the Scottish Government will consider whether further actions might need to be taken in this area and how best to ensure patients get what they need.

Current targets for nursing and midwifery controlled funded places have been set for 3 years. Prior to that, targets for controlled places were set annually. The multi-year targets were set in 2022 after extensive engagement with key stakeholders. Those stakeholders included NHS Boards, NHS Board Planners, NHS Education for Scotland (NES), Council of Deans Health Scotland, Scottish Executive Nurse Directors, RCN, RCM, Unite, Unison and internal Scottish Government policy teams.

A multi-year intake was agreed to provide stability across partners including higher education institutions.

Both quantitative and qualitative data were considered when arriving at the controlled intake targets for each student group. A modelling exercise was carried out by NES to support decision-making and this information was made available to all stakeholders ahead of the engagement process. Stakeholders were also invited to share their own data in advance as well as being invited to discuss their insights on vacancies, establishment figures and clinical placement capacity.

The Scottish Government does not provide universities with planning assumptions for neonatal nurse places as these are decided within NHS Boards in order to match the resource requirements in the Board and training needs of their staff.