Chamber and committees

Through the development of the Scottish Intercollegiate Guidelines Network (SIGN) guidelines on chronic pain in adults and children and young people , Scotland has been a world-leader in promoting evidence-based approaches for healthcare professionals to improve standards of care and management of chronic pain.

The Programme for Government 2020-21 committed to developing and publishing a new Framework for Chronic Pain Service Delivery. A draft Framework was published for public consultation and the responses are currently being analysed. We will publish our response to the findings, including how these views have been used to shape the final Framework, later this year.

The draft Framework sets out the Scottish Government’s aim to ensure that people have a choice of treatments for chronic pain, where there is evidence they are effective, underpinned by commitments to support patients and healthcare professionals to better understand and agree effective options to manage pain. This is intended to lead to less variation in the quality and availability of services for people with chronic pain.

As part of implementation of the Framework, we will explore opportunities to update the existing guidelines to ensure they reflect the most recent evidence and best practice, including offering new treatments where there is evidence that they are effective.

Ministers have not visited any care homes in their official capacity during the COVID-19 pandemic, but have closely monitored the situation throughout. Both the Cabinet Secretary for Health and Social Care and myself took office in May 2021, partway through the pandemic.

I was previously scheduled to undertake two care home visits, however these had to be postponed for safety reasons due to a COVID outbreak and the emergence of the SARS-CoV-2 variant Omicron. The safety and protection of residents and staff is paramount in such situations. In my role as lead for Social Care policy, I have regularly spoken to a range of stakeholders from the sector including family and sector representatives. I have also spoken to care home staff and managers. I will be rescheduling care home visits in due course.

Of the professional advisers:

• the National Clinical Director, last visited a Glasgow Care Home on 21 st February 2021 and prior to the pandemic made a visit to a care home in October 2019;
• the Chief Social Work Adviser has not visited any care homes in her official capacity during the pandemic. Prior to the pandemic she visited David Walker Gardens care home in Rutherglen on 5 th August 2019;
• the Chief Medical Officer, who was appointed in December 2020, has not visited any care homes in his official capacity during the pandemic.

First-dose vaccine appointments for children aged 5-11 at higher risk from Covid-19, or who are a household contact of someone who is immunosuppressed, began scheduling from late January 2022. Appointments for first doses for all 5-11s are scheduled from 19 March with older children invited first and families invited together wherever possible. NHS Lanarkshire have reported adequate supply having run a number of paediatric clinics to date and continue to offer vaccines to those who are eligible. If the member has received individual queries regarding supply, I would ask them to write to me with details for further investigation.

Dry powder inhalers(DPIs) make up 33% of the total in Scotland in primary care. In the last financial year (2020/2021), there were 4.5 million metered dose and 2.3 million dry powdered packs prescribed and dispensed via primary care and we have not seen a clear trend of those numbers changing and inverting.

Effectiveness of a powdered drug depends on a number of factors, including the inspiratory flow rate generated by the patient. For a significant proportion of patents, making the switch to a DPI will be successful, however, for some a DPI will not be suitable e.g. those with significantly impaired breathing. We would advocate regular medication reviews between the patient and GP at which time consideration should be given to switching to a DPI if deemed suitable for the individual patient’s circumstances

We recognise that hydrofluorocarbons used as propellant in metered dose inhalers prescribed for asthma and chronic obstructive pulmonary disease (COPD) can have a global warming potential of 1430 or 3220 times greater than CO2 depending on the type of gas used. Reducing the environmental impact of these inhalers is a priority.

A draft NHS Scotland Climate Emergency and Sustainability Strategy was published on 10 November 2021 and the consultation closed on 10 March 2022. This sets out the Scottish Government’s intention to publish an updated Scottish Quality Respiratory Prescribing guide which will focus on minimising patient over-use of inhalers through review and improving patient outcomes, using propellant free options where possible.

Other actions within the draft strategy include encouraging manufacturers to make inhalers with lower emissions and to support inhaler return to pharmacy schemes to help patients dispose of their used inhalers in a more environmentally friendly way.

The Scottish Government has been clear that fair work practices sit at the heart of Green Freeports. All applicants are required to set out their strategy for embedding fair work across the Green Freeport area. Any application which does not show a clear commitment to fair work practices will not be supported by the Scottish Government.

The manner in which P&O decisions have been communicated is completely unacceptable. Scottish Ministers expect all businesses to apply fair labour practices and treat their staff with respect. P&O Ferries have fallen well short of that standard.

The Scottish Government will consider all of the information received from people affected by historical adoption practices through our ongoing engagement activity before next steps are decided.

Regulation for the licensing, safety and efficacy of medicines is reserved to the UK Government and is the responsibility of the UK’s independent medicines regulator the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA, an executive agency of the Department of Health and Care (DHSC), is responsible for investigating any current safety concerns regarding licensing of diethylstilbestrol.

The Scottish Government has worked with stakeholders including individual local authorities, COSLA, advice agencies such as Shelter Scotland and Citizens Advice Scotland and representative bodies of landlords including PropertyMark and the Scottish Association of Landlords (SAL) on developing The Tenant Grant Fund in order to assist tenants struggling with rent arrears as a result of the pandemic.

The Scottish Government continues to have discussions with these stakeholders. Officials met with Shelter Scotland and Citizens Advice Scotland on 2 March to discuss how we can work together to further support efforts to publicise the Tenant Grant Fund, particularly to private rented tenants.

In addition, in developing our Money Support Scotland campaign we have worked with stakeholder organisations including Citizens Advice Scotland, Christians Against Poverty and StepChange. This campaign raises awareness of the services available to those with financial worries.

Energy policy and markets remain reserved to Westminster, as do the majority of tax levers. We have called repeatedly on the UK Government to consider all options to help those affected by increased utility bills, including a temporary cut in VAT on energy bills, but to no avail. However, we will continue to push for four-nations discussions to develop an effective response to energy bill increases and press for changes to help those in need, as well as calling for the devolution of the powers to make those changes ourselves if the UK Government refuses to act.

The Scottish Government operates a water and sewerage charges exemption scheme for eligible small charities. The charity must be registered with the Scottish Charity Regulator and have an income below £300,000. Charities should contact their licensed provider in order to apply for the scheme. Additionally, Business Energy Scotland will be delivered by Energy Saving Trust (EST) from 1 April, as part of EST’s extensive advice and support offerings delivered on behalf of the Scottish Government.

Group antenatal classes were able to resume from 31 July 2020. Current guidance for delivery of maternity and neonatal services throughout the Covid-19 pandemic states that antenatal and postnatal group sessions can continue virtually or in person, subject to local risk assessment in NHS Boards.

Coronavirus (COVID-19) delivering maternity and neonatal services through the pandemic: beyond Level Zero - guidance - gov.scot (www.gov.scot)

The Scottish Government does not hold this information centrally. While we provide guidance for NHS Boards on the management of maternity and neonatal services during COVID-19 to aid local service planning, NHS Boards are responsible for undertaking local risk assessments to evaluate whether antenatal sessions can take place virtually or in person.