Chamber and committees

There is a requirement for Health Boards to maintain accurate and up to date information on Peer Approved Clinical System (PACS) Tier Two requests. The Scottish Government does not hold official validated statistical data on the number of PACS applications that Health Boards have received from clinicians for individual medicines. This information would need to be requested from Health Boards directly.

The Access to New Medicines Horizon Scanning Advisory Board (HSAB) identifies disruptive medicines which are predicted to have a significant impact on financial and/or service provision and provides recommendations on what will be required for their use should they be accepted for routine use in the NHS in Scotland.

The HSAB is not currently assessing any medicines for Friedreich’s Ataxia, however new disease modifying treatments identified through horizon scanning, will be considered in line with established HSAB criteria for disruptive medicines.

I refer the member to the answer to question S7W-04063 on 19 October 2026. 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 Scottish Medicines Consortium (SMC) appraisal is undertaken independently of Scottish Ministers. Following a not recommended decision, a pharmaceutical company may resubmit the medicine to the SMC. This may involve offering the NHS a lower price for the medicine and/or providing additional evidence to support its clinical and cost effectiveness. The decision on whether to resubmit omaveloxolone (Skyclarys®) to the SMC, and the timing of that resubmission, is entirely one for Biogen to make.

It is the responsibility of individual Health Boards to consider the implementation of new medicines within their services in order to meet the needs of their local population, including children and young people, in a safe and clinically appropriate way.

At a national level, the Access to New Medicines Horizon Scanning Advisory Board (HSAB) has been established to identify medicines which are predicted to have a significant impact on financial and/or service provision and provide recommendations on what will be required for their use should they be accepted for routine use in the NHS in Scotland.

In addition, officials are developing proposals for a national approach to service readiness for innovative medicines, building on existing horizon-scanning arrangements and supporting timely and equitable implementation of innovative treatments across Scotland.

The Chief Pharmaceutical Officer (CPO) and Scottish Government officials have met with representatives from Biogen to understand if the company has any intention to resubmit omaveloxolone (Skyclarys®) to the Scottish Medicines Consortium (SMC). Biogen has provided assurance that it remains open to further commercial discussions, to support routine access to omaveloxolone (Skyclarys®) in the NHS in Scotland. Notably however, the decision on whether to resubmit to the SMC, and the timing of that resubmission, is entirely one for Biogen to make.

The Scottish Government is committed to ensuring that children, young people and adults across Scotland have access to high-quality, person-centred speech and language therapy services.

Decisions regarding the assessment, treatment and delivery of speech and language therapy services are matters for individual NHS Boards and Health and Social Care Partnerships. Clinical interventions are determined by appropriately qualified speech and language therapists based on individual needs, clinical judgement and evidence-based practice.

Speech and language therapists use evidence-based practice, informed by high-quality research, professional guidance and clinical expertise, to ensure they remain responsive to emerging evidence and advances in practice from Scotland and internationally. The principles of evidence-based practice include integrating research evidence, clinical expertise and the preferences and circumstances of the individual receiving care. Guidance from the Royal College of Speech and Language Therapists supports this approach.

The Scottish Government has no current plans to undertake a national review of speech and language therapy treatment approaches. We continue to work with NHS Boards, Allied Health Profession leaders and the Royal College of Speech and Language Therapists to support effective and evidence-informed services.

We are aware that a range of therapy delivery models are used internationally, including more intensive one-to-one programmes delivered over defined periods of time. The suitability of any intervention depends on the individual's needs, circumstances and clinical goals. Evidence continues to emerge regarding the effectiveness of different approaches, and decisions on their use remain a matter for clinical judgement. Research has demonstrated positive outcomes from intensive speech and language therapy interventions in some clinical groups; however, findings vary according to the condition being treated, the individual concerned and the specific intervention used.

While the findings of the Thirlwall Inquiry relate to services and regulatory arrangements in England, the Scottish Government recognises the importance of the report and will carefully consider its recommendations.

Scotland has established national arrangements for the handling of whistleblowing concerns within NHSScotland through the National Whistleblowing Standards and the Independent National Whistleblowing Officer (INWO). The INWO operates independently of both NHS Boards and the Scottish Government and has powers to review how NHS Boards have handled whistleblowing concerns where an individual remains dissatisfied after local processes have been exhausted.

NHS Boards are responsible for considering and responding to whistleblowing concerns raised within their organisations. Where an individual believes their concern has not been handled appropriately, they may ask the INWO to undertake an independent review of how the concern was managed.

The Scottish Government commitment to ensuring staff are appropriately trained and developed is set out in the Staff Governance Standard that is underpinned by legislation. This aims to ensure that NHS staff work in an environment that is safe, supportive and focused on high standards of patient care.

As employers, NHS boards are responsible for ensuring that staff and board members receive appropriate training, development and support to fulfil their roles. Decisions on the content, delivery and frequency of training are therefore matters for individual NHS boards.

NHS Scotland has established a range of measures to support staff to raise concerns where patient safety may be at risk. This includes the National Whistleblowing Standards, which set out how concerns should be raised, received and responded to, and which apply to all NHS boards. The Standards include expectations around responding to concerns raised by workers and ensuring appropriate action is taken.

In addition, every NHS board has a designated Whistleblowing Champion, whose role is to seek assurance that staff are encouraged and supported to speak up and that whistleblowing arrangements are operating effectively.

NHS staff and those providing services to the NHS can raise concerns through Scotland's whistleblowing framework. Where an individual remains dissatisfied with how a concern has been handled locally, they may ask the Independent National Whistleblowing Officer (INWO) to review the handling of their whistleblowing case.

The Scottish Government recognises the importance of the recommendations made by the Thirlwall Inquiry. We will carefully consider Recommendation 4, alongside the Inquiry's wider findings, and assess whether any further action is required in the context of existing arrangements in NHS Scotland.

The Thirlwall Inquiry examined systems and services that operate in the NHS and wider system in England. I recognise the wide-ranging nature of the lessons learned and recommendations and will take time to fully consider these within the context of devolved Scottish health care and the actions already being delivered here.

The independent Patient Safety Commissioner for Scotland already has statutory powers to carry out investigations into systemic patient safety issues and make recommendations to which organisations will be obliged to respond.

Separately, Healthcare Improvement Scotland provides support to NHS Boards to improve the management of adverse events, including the ways in which they are reviewed and reported. This is part of Healthcare Improvement Scotland’s extensive framework of assurance, inspection, scrutiny and improvement at local and national levels.