Chamber and committees

The Scottish Government welcomes the publication, on 10 April, of the final report and recommendations of the NHS England-commissioned Independent Review of Gender Identity Services for Children and Young People, chaired by Dr Hiliary Cass (‘the Cass Review’).

The findings of the review, and the associated systematic review papers, are being closely considered by both the Scottish Government and Health Boards in Scotland in the context of how such healthcare is best delivered here.

On 18 April, in a joint statement, NHS Greater Glasgow and Clyde and NHS Lothian confirmed that both Boards have paused any new prescription of puberty-supressing hormones and cross-sex hormones for young people as a treatment option for gender dysphoria.

The small number of patients directly impacted by this change, and their families, were notified in advance of this statement. It is right that they were the first to hear about it, sensitively and from the services caring for them, before a public statement was made.

The term “puberty-suppressing hormones” is non-specific, and could be applied to a range of medicines used for a variety of conditions.

In the context of the provision of gender identity healthcare to children and young people, I refer the member to question S6O-03286 on 28 March 2024. which is available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/official-report/search-what-was-said-in-parliament .

The Scottish Government does not routinely hold or collate this information. This information should be requested from the relevant Health Boards.

The Scottish Government has commissioned NHS National Services Scotland to work with a wide range of clinical and other stakeholders to consider how best to meet the needs of the population in terms of young people’s gender healthcare services for NHS Scotland. This work is ongoing, and aims to define the scope of a specialist service in Scotland.

The Scottish Government anticipates that an outline service specification based on this work will be presented to NHS Strategic Planning Board for Scotland for consideration later this year.

Scottish Government has confirmed funding for the Workforce Specialist Service (WSS) for 2024-25 and the current contract will be extended for a further 12 months. WSS provides confidential mental health assessment and treatment for regulated health, social care and social work professionals in Scotland.

The Digital Prescribing and Dispensing Pathways (DPDP) programme, is scheduled to replace the current paper prescription in Scotland with a digital approach by the end of this parliamentary term.

The business case which sets out the proposal for the next phase, and associated funding, for the programme are currently under consideration.

We do not know the numbers of children affected because the information has not been collected historically.

In response to the Independent Medicines and Medical Devices Safety Review (IMMDSR), the Scottish Government commissioned Public Health Scotland (PHS) to establish a medicines in pregnancy surveillance asset. This resource will support monitoring and reporting to progress improvements in the safe use of valproate and other teratogenic medicines in Scotland. Its first output is due to be published by PHS in April 2024 and will include prescribing data and trends for valproate and other anti-seizure medicines.

The Scottish Fire and Rescue Service (SFRS) naloxone programme was launched in February 2022, backed with investment of £89,000 from Scottish Government. The programme aims to establish a network of fire officers who will carry naloxone and be trained to administer it in the event of an emergency.

Since then, all SFRS staff have been invited to complete online training to learn more about drug deaths in Scotland and how naloxone can help someone in the event of an opioid overdose. To date, 3,379 out of all 7,619 staff have voluntarily completed the training.

There is additional training for Flexi Duty Officers (FDOs) who have volunteered to carry naloxone and there are now 31 trained FDO volunteers within SFRS who are able to do this. It is expected that over the next 6 weeks a further 130 FDO volunteers will be trained and equipped to carry and administer naloxone.

The carrying and administering Naloxone is considered by the Fire Brigades Union (FBU) to be a form of emergency medical response which currently sits out-with the role map of firefighters. SFRS has a desire to broaden the role of firefighters which would incorporate emergency medical response but this is dependent on reaching agreement with the FBU.

SFRS and Scottish Government are determined to fully implement this programme and will continue to work closely with all parties, including representative bodies, to overcome any barriers to its full implementation.

The Scottish Government will await the view and any decisions by the UK Government in relation to redress for anyone who was affected by exposure to valproate.

As set out in our letter to MSPs, this is because the recommendations on redress the UK Government is considering may involve a new agency and schemes that would be funded via a levy on manufacturers of medicines and medical devices and the Scottish Government has only limited powers under the devolution arrangements to impose levies.

We will of course update the Parliament about any important developments.

Section 8.1 of the ‘COVID-19 rapid guideline: managing the long-term effects of COVID-19’ developed jointly by the National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP) recommends to “provide access to multidisciplinary services, if available, [. . .] for assessing physical and mental health symptoms and carrying out further tests and investigations. Services should be led by a doctor with relevant skills and experience and appropriate specialist support, taking into account the variety of presenting symptoms.”

The rationale section of the guideline relating to this recommendation notes that “1 model would not fit all areas” and “in areas where multidisciplinary services are not available, services may be provided through integrated and coordinated primary care, community, rehabilitation and mental health services.”

Patient related experience and patient outcome measures will be recorded through NHS Boards’ use of the C-19 YRS digital screening tool. The provision of heath data through this tool will assist in understanding the provision and effectiveness of long COVID services. Where possible, the data will be disaggregated by age, gender, ethnicity, and deprivation quintile. This will support understanding of any inequitable variation in service provision, experience and outcomes which may need to be addressed through service changes.

The Strategic Network has contracted the University of Leeds to support the initial evaluation of long COVID services in Scotland, using data from the C19-YRS tool. The outputs of the evaluation are expected following the end of the financial year.