Chamber and committees

The breakdown of the information requested is not held centrally the collation of this information would incur disproportionate costs.

With reference to S6W-12070 on 16 November 2022, we continue to work with IJBs to understand their financial forecasts. Therefore, no COVID-19 reserves have been recouped to date.

Further detail will be communicated later in the financial year at an IJB level and the process and timetable will follow through further communications.

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

With reference to S6W-12408 on 7 December 2022, no COVID-19 reserves have been recouped to date. Work is on-going, with IJBs, to understand their financial forecasts.

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

This budget provides funding for the national Childsmile programme as well as wider measures to tackle oral health inequalities in all age groups. Funds that are allocated are based on need, and final confirmation of spend will be included as part of the Scottish Government provisional outturn.

Funding provided to NHS Boards for Childsmile programme delivery is set out in the following table.

In addition to direct programme allocations, funding is provided to NHS Boards through the annual Outcomes Framework allocation to deliver a range of core services, including for Childsmile. The total value of this allocation for each of the five years is also set out below:

The Covid Recovery Strategy focuses on reducing poverty and inequality and making progress towards three priority outcomes: to enhance the wellbeing of children and young people; to increase the financial security of low income households; and to create good, green jobs and fair work. These outcomes have been agreed with local government and the Scottish Government remains committed to achieving these outcomes together with partners across Scotland.

The financial situation facing the Scottish Government is, by far, the most challenging since devolution; the impacts of the pandemic coupled with Russia’s continued illegal invasion of Ukraine have created a disruptive set of financial and economic challenges that every government must address. The fiscal constraints of devolution mean that the Scottish Government cannot borrow to meet increased costs associated with the current financial situation. This means we have had to make hard choices to prioritise spending which supports those who need it most and find savings. In the context of the ongoing cost crisis, we are prioritising funding to help families, back business and protect the delivery of public services; the recent Programme for Government and Emergency Budget Review provide more detail about the Scottish Government’s approach.

The Emergency Budget Review, published in November 2022, identified savings in excess of £1.1 billion from the 2022-23 budget and confirmed a range of additional support in response to the cost of living crisis, guided by the principles of the Covid Recovery Strategy. This includes: expanding the Scottish Child Payment to eligible 6-15 year olds and increasing its value to £25 per child per week; doubling the Fuel Insecurity Fund to £20 million in 2022-23; and providing local authorities with additional Discretionary Housing Payment funding to mitigate the UK Government’s benefit cap as fully as possible.

The Scottish Government is committed to making progress towards the shared Covid Recovery Strategy outcomes and will continue to prioritise spending which is targeted to support those in most need across Scotland.

COVID-19 and Flu vaccine uptake data is available from the Public Health Scotland dashboard . As of 23 November 2022 there has been a total of 1,625,091 Adult (18+) flu vaccinations and 1,653,929 COVID-19 vaccinations administered under the 2022 Winter Vaccination Programme. The data on the dashboard is updated every Wednesday and includes the latest headline figures by week and JCVI priority group.

The National Audiology Review Group continues its independent review of services having most recently convened on 25 October. It will shortly be meeting with the Review’s Chair for an update on their progress and their developing recommendations.

The review is pursuing four workstreams encompassing the lived experience, governance, quality assurance and education and will fully report in the new year.

Following the publication of the review findings in December 2021, NHS Lothian has had extensive interactions with a range of professionals who work with children and young people to highlight the key findings in the report and this has included Speech and Language Therapists, Health Visitors, General Practice, Ear Nose and Throat clinicians, Community Paediatricians and teaching staff, with further communication to the Director of Education.

This has involved individual meetings with professionals as well as the development of a staff briefing document, which was widely circulated across key networks. As part of this process, those working with children who had any concerns about a child's hearing were encouraged to contact the Audiology department directly or to refer the child through the normal referral route (e.g. Health Visitor, Speech and Language, the GP, etc.).

Information has been widely disseminated through professional staff groups working directly with children and their families, with clear mechanisms for children to be referred to the Audiology department where there are concerns about their hearing. A telephone helpline was established on 9 December 2021 and this continues to be in operation to make it easy for families to make direct contact with NHS Lothian about any audiology concerns. NHS Lothian also works closely with the National Deaf Children Society to support families.

As of July 2022, 202 families have been directly contacted by NHS Lothian and offered a retest. This work is based on the timeline associated with the Scottish Public Services Ombudsman (SPSO) investigation and the sample size of the British Academy of Audiology (BAA) review, which covers the period 2009-2018. The number of children that have now had that retest is 47, with a further 31 with an appointment date. The number of children who were retested were found after retesting to have a (new) hearing impairment is 10. Families that have not responded to the initial letter have been sent a follow up letter highlighting the importance to make contact with the service.

The Ombudsman asked for an external audit across 2009-2018 and NHS Lothian commissioned BAA to design and conduct the audit. Nearly 23000 children had been seen in this timeframe. They proposed and audited children in 7 cohorts, which were stratified for those children who were higher risk.

Cohort 1 - Any complaints made to NHS Lothian or anonymous complaints to BAA

Cohort 2 - Any child on permanent childhood hearing impairment (PCHI) register at NHS Lothian

Cohort 3 - Any child who had been seen by the paediatric audiology service at NHS Lothian and discharged but went on the be later diagnosed with permanent hearing loss

Cohort 4 - Any child seen for ABR testing at birth and following result discharged from the service

Cohort 5 - Any child seen three or more times by the service

Cohort 6 - Any child seen for behavioural testing once by the service with no further appointments

Cohort 7 - Any child seen twice by the service then discharged with no further appointments

Of the 1,007 that were able to be reviewed (for various reasons including failed to attend, 113 children could not be reviewed) there were 120 where there were no concerns reported; 542 were reported as having minor concerns; 190 moderate concerns, and 155 with reported significant concerns. BAA defined significant concerns as those where there may have been an impact on the child’s clinical outcome. In all other audited cases, (852 cases) no impact on clinical outcome was considered likely by BAA.

The method and cohorts for the review were set by BAA, not NHS Lothian, and were designed to look particularly at cases where the child had been discharged but then was referred back in or subsequently identified with a hearing loss. At NHS Lothian's request, BAA then undertook to look at more cases from younger children or more recent years, and all children entered onto the register of permanent childhood hearing impairment.

Of the 155 cases, all have been considered by NHS Lothian and action taken. The cases have been prioritised to manage the most urgent within two main groups, those with the possibility of their current active clinical care needing to be changed (92 cases) and those where there was a clinical governance failing (63) but where the treatment was believed to be correct now. The allocation of cases into these categories were shared and agreed with the BAA and the appropriate follow up action has been undertaken by the Health Board.

• Of the 92 cases – 44 were in categories of glue ear, tinnitus and hyperacusis or without follow up and these have been clinically reviewed rather than subject to automatic recall for clinical appointments.
• Of the remaining 48 cases, 36 have attended for review
• 16 children with hearing loss have been identified through the review process

For those 63 children in whom the management by the BAA team was now felt to be correct but in whom a serious concern in the pathway to that management was identified, contact has been made with families and meetings have been offered.

With regards to any review being made public, the first set of reports from the BAA were published and are publicly available on the NHS Lothian website and also the British Academy of Audiology (BAA) website. The further review by the BAA on ABR testing over the last 5 years is not yet complete. The information is currently being reviewed to ensure that the content is accurate and that information provided to patients and families is correct. Once this work is complete, it is expected that a summary report will be discussed at NHS public Lothian’s Board meeting, the papers and minutes of which are published on NHS Lothian’s website. With regards to press releases, the Scottish Government does not hold that information, it would need to be obtained directly from NHS Lothian.

I refer the member to the answer to question S6W-12273 on 5 December 2022. 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 .