Chamber and committees

We want people who need continence support to receive the care that is right for them and their medical circumstances, including those with palliative care needs.

Patient assessment and the subsequent prescription of continence products are typically the responsibility of local continence teams given their specialist knowledge. GPs would not be expected to play a role in the prescription of continence products after a patient has been referred to, and assessed by, the Board’s continence team. Given this, we would expect any changes to a patient’s prescription to be agreed by the continence team to ensure that the new product is appropriate for the patient and will fully meet their needs.

It is also important to reflect that community Practitioner Nurse Prescribers (who are mainly district nurses, specialist community public health nurses (formerly health visitors), and school nurses) with prescribing qualifications known as v100 or v150 qualifications, can prescribe any appliance or reagent in the relevant Drug Tariff from the Nurse Prescribers Formulary (NPF) for Community Practitioners, including incontinence appliances to help ensure that patients are supported appropriately and their dignity is respected. As such we currently have no plans to review prescribing powers.

It is for Health Boards and their planning partners to design, resource and provide services that meet the needs of local people in line with national policies, frameworks and best practice. This includes ensuring that patients have access to the continence products that they require when they need them.

We are committed to improving the mental health support provided to people across Scotland, not only through the NHS and statutory services, but through our investments in community and grassroots organisations. We are seeing progress, with record numbers of staff providing more varied mental health support and services to a larger number of people than ever before. We have also seen the national performance against the 18-week CAMHS standard met for the last year, with 91.5% of children and young people starting treatment within 18 weeks of referral.

However, I recognise there is more to do to further bring down waiting times. That is why the budget for 2026-27, if agreed by Parliament, will see spending on Mental Health exceed £1.5 billion. This includes investment to improve neurodevelopmental assessments and care for children and young people.

The Palliative Care Matters for All Strategy, which was published on 10 September 2025, provides a strategic framework to help improve the delivery of palliative care support to communities across Scotland.

The Strategy is underpinned by an initial 3-year delivery plan (2025-28) which is focused on developing tools that will support frontline delivery across Scotland and the sharing of best practice.

However, it is for Integration Joint Boards to govern, plan and resource adult palliative care, including equipment provision, in their areas using the delegated budgets under their control.

Products listed in the current National Procurement framework meet the ISO11948-1 Rothwell Absorption Capacity for Incontinence Pads.

Products to acute settings are fulfilled via the NSS National Distribution Service as a delivered price. This is 5% higher than products supplied directly by the supplier to community and care home settings. However, the supplier charges and invoices Health Boards for delivery.

Products fulfilled via the National Distribution Service do not differentiate between patient groups as the delivery is to wards, departments and other end points. National Procurement conducts a quarterly meeting with the framework provider, Ontex Healthcare and any local KPIs are managed by individual health boards.

If a patient or carer has concerns about NHS supplied home care products, these can be addressed at a local level through the NHS complaints handling procedure. The Patient Rights (Scotland) Act 2011 provides a specific right for people to make complaints, raise concerns, make comments and give feedback about NHS care and services and places a duty on NHS Boards to thoroughly investigate and respond to any complaints made.

Anyone can make a complaint and do so in writing, in person, by telephone, by email or online, or by having someone complain on their behalf. The NHS complaints handling procedure has a sharp focus on early resolution and speaking to a member of NHS staff can often be the best way to resolve a complaint quickly.

NHS Boards are expected to provide helpful advice and information tailored to everyone’s circumstances at the point of discharge. As such, our Palliative Care Strategy does not contain an action specifically related to providing physical information packs, or their contents.

NHS National Services Scotland provides national logistics services to all Health Boards. Currently the KPIs record the availability of product, as well as the on-time delivery of product. It does not differentiate between patient groups as the delivery is to wards, departments and other endpoints.

National Procurement’s delivery statistics show that they are achieving over 99% of deliveries made on time and in full. Products in the community and care homes are purchased directly from suppliers, and managed, by Health Boards.

The Scottish Government is aware how crucial equipment is in supporting a patient to be cared for and to live safely within their home environment and is committed to delivering a more equitable and accessible approach to the provision of equipment. All individuals, regardless of diagnosis or where they are being treated, should experience a seamless journey through the pathway of care, which ensures they receive the right intervention at the right time. Our national guidance, Supporting documents - Equipment and adaptations: guidance on provision - gov.scot published in 2023, emphasises the importance of this however, once an individual is assessed as requiring support, including any equipment, then it is the responsibility of the Health and Social Care Partnerships to deliver it at the earliest opportunity. Similarly discharge planning is a joint exercise between the Health Board and should begin as soon as a patient is admitted.

Products are supplied via the NHS National Services National Procurement Framework NP57123. The framework provides a range of products for the bladder and bowel and is not a limiting factor to local health board formularies/availability.

Clinical leads can review when assessing patients’ needs and are able to prescribe the appropriate product based on clinical need, and subject to local health board governance.

Health Boards have published their own guidance material on bladder and bowel health, which provides detail on how these arrangements can be managed.

There were 10,524 bed days attributed to delay reason 25E (Awaiting completion of care arrangements in order to live in their own home – awaiting procurement/delivery of equipment/adaptations fitted) during the past 12 months (Dec 2024 – Nov 2025). There were 705,865 delayed discharge bed days during this time. This represents 1.5% of the total occupied bed days associated with a delayed discharge.

Please note, a discharge may be delayed for multiple reasons, and the reason for delay reflects only:

• the principal reason for delay recorded at the discharge date for delay episodes with a discharge date, or
• the principal reason for delay recorded as at the date the monthly data extract is taken, for delay episodes without a discharge date.