Chamber and committees

There were significant capacity constraints across the medicines homecare market in 2022. A key challenge has been recruitment of staff in a challenging labour market, with some providers more adversely affected than others. The situation is improving but continues to be closely monitored.

Certain homecare providers have highlighted issues with nursing capacity in recent months. Where this has been raised as an issue, there has been close working with providers to ensure that available staffing resource is used in a way that helps minimise disruption to service performance.

Homecare providers have not reported any recent issues with staffing within their pharmacy departments.

Several homecare providers have experienced staffing shortages within customer services departments, and this has been a major contributing factor to the capacity constraints experienced.

There have been a small number of instances where there have been delays to the delivery of medicines to patients, which has the potential to impact on patient safety. Medicines homecare providers and Health boards have processes in place to support managing and learning from any patient safety incidents that arise during service delivery.

As pharmacies, medicines homecare providers must demonstrate that they can meet the standards for registered pharmacies set by the General Pharmaceutical Council (GPhC). The standards are designed to create and maintain the right environment for the safe and effective practice of pharmacy and to improve the quality and safety of services provided to patients and the public. The GPhC inspect registered pharmacies to seek assurances that the standards are being met. Depending on the range of services provided, medicines homecare providers may also be registered with additional regulators such as the Care Inspectorate and the Medicines and Healthcare products Regulatory Agency.

To ensure compliance with regulatory standards, providers must have governance arrangements in place to safeguard the health, safety and wellbeing of patients and the public. This will include effective systems for risk management and the management of complaints and incident including root cause analysis of issues arising and implementing corrective and preventative actions.

Health Boards have contractual arrangements in place with Homecare Providers via either Service Level Agreements or Framework Agreements. These agreements detail responsibilities for service provision and define service requirements including governance and reporting.

Before arrangements are made to set-up a new service, Health Boards undertake risk assessments to assess the risks associated with supplying a particular medicine through a home delivery service. In addition, before a patient is on-boarded on to a service, checks are undertaken to help ensure that homecare is suitable for an individual patient.

The current plan is to fully dual the A96 route between Inverness and Aberdeen; however, we are conducting a transparent, evidence-based review of the programme which is underway and the first part of the review, a report on the Public Consultation and the Initial Appraisal: The Case for Change was published on 22 December 2022. This is sensible good governance for major investment of this kind.

Transport Scotland is now pushing forward with the next phase of further detailed work to inform the remaining stages of the Review. These include a robust appraisal of the remaining options alongside a Climate Compatibility Assessment, with outcomes expected to be announced in the first half of 2023 for final public consultation, before a final decision can be reached.

In relation to the A96 Dualling Inverness to Nairn (including Nairn Bypass) scheme, we continue to progress the preparation stages of the scheme with a view to completing the statutory process. This includes the significant work required to prepare for publication of made Orders, including the Compulsory Purchase Order, in the coming weeks. Subject to no legal challenge being received, the Scottish Ministers will then have the relevant powers to acquire the land necessary to construct the scheme.

Delivery can only commence if approved under the relevant statutory procedures and thereafter a timetable for progress can be set in line with available budgets.

Moray Council attended a series of A96 Corridor Review stakeholder sessions and provided feedback to the public consultation survey undertaken as part of the review during 2022. We will continue to engage with stakeholders including Moray Council as we progress the review.

The transparent, evidence-based review of the A96 corridor has included a public consultation which received an unprecedented level of engagement, with approximately 4,600 responses, generating more than 11,000 suggestions and potential opportunities for the route.

Given the sheer volume of responses received and the high level of options generated, it has rightly taken Transport Scotland more time than originally anticipated to examine and appraise all these options. However, we have now reported on the Public Consultation and the Initial Appraisal, which were published on 22 December 2022.

Transport Scotland is now pushing forward with the next phase of further detailed work to inform the remaining stages of the Review. These include a robust appraisal of the retained options alongside a Climate Compatibility Assessment, with outcomes expected to be announced in the first half of 2023 for final public consultation, before a final decision on the route can be reached.

National Procurement (NP), part of NHS National Services Scotland (NSS), with representation from Health Boards, have regular performance management meetings with homecare providers to review key performance metrics and to agree and track progress against recovery plans.

Where a particular provider is experiencing service disruption, Health Boards will seek to register patients, where feasible, with alternative providers to help reduce demand on the affected provider. A challenge over the past year has been that multiple providers have experienced staffing issues which has created market-wide capacity constraints.

The Scottish Government are currently working with a steering group comprised of key stakeholders from across the sector to develop an updated Sexual Health and Blood Borne Virus (SHBBV) Framework. It is anticipated that the Framework will be published in Spring this year.

The Scottish Government recognises the challenges and distress caused by the stigma experienced by those at risk of or living with Hepatitis C and other blood borne viruses.

Evidence shows that Hepatitis C is most commonly diagnosed in those who inject drugs and we know that stigma can increase the harms experienced by people affected by substance use. People with experience of problem substance use and the harms associated with it, deserve parity of treatment as with any other long-term life-affecting health condition. That is why, later this month, we will publish an action plan to tackle the stigma faced by those with experience of problem substance use.

The Scottish Government is also working with HIV experts and third sector organisations on an HIV awareness campaign that will launch later this year. The development of the campaign is ongoing but in broad terms, it will seek to educate and address common misconceptions and misinformation about the realities of living with HIV, as well as reducing the stigma surrounding HIV.

Since 2018, We have also funded third sector organisations, through the Sexual Health and Blood Borne Virus (SHBBV) Framework, for a variety of work regarding addressing stigma, such as training for professionals who work with those who inject drugs.

A new SHBBV Strategy is currently being developed with clinical, academic and third sector representatives, and is due to be published in Spring.

The reform of NHS dental services survey was responded to by over 500 dentists, the survey built on the Oral Health Improvement Plan which was developed through wide ranging public consultation in 2017. The reform of NHS dental services is presently focused on delivering payment system reform and sustaining NHS dental access for the general public.