Chamber and committees

Fair Start Scotland is an entirely voluntary service where people are not driven to take part by the fear of benefit sanctions. Participants retain the right to leave at any time as they can face a range of challenges and barriers, due to changes in their circumstances, health or for personal reasons. We know from previous research on the transitional employment services (Work First and Work Able Scotland) that participants often leave as a result of a temporary deterioration in their physical or mental health.

As part of our continuous improvement activities over the coming year, we will continue to explore ways to reduce the volume of participants leaving the service early, including improvements to specialist support for those who need it and the introduction of a “right to re-referral” for participants who left early or completed their support without moving into work. Our next FSS evaluation report, due to be published in Autumn 2021 will also include an in depth focus on early leavers and we will ensure that any learning from the results is promptly put into practice throughout the contract extension period.

In line with the values of dignity and respect inherent to Fair Start Scotland, participants continue to be positive about their experience of the service. Of those surveyed for the Year 2 evaluation report:

- 91% of people who have used the service feel they were treated with dignity and respect;

- 80% of people felt the service took account of their individual needs and circumstances; and

- 81% of people felt the service offered support to improve their general quality of life and wellbeing.

The figure of 27% quoted only represents the first quarter of Year 3, from April to June 2020.

In the most recent quarter (July – September 2020) there was a large increase in the proportion of unknown equalities monitoring data gathered by FSS Service Providers, therefore it is not possible to report on the change in the proportion of disabled people during this time.

We recognise the impacts of the COVID-19 pandemic on Fair Start Scotland where people with health concerns or disabilities have become less inclined to engage with services during this time. This has also had an impact on collection of the equalities monitoring data.

While there has been a drop in the overall percentage of people with disabilities joining the service, the proportion (27%) remains broadly in line with the Scottish unemployed population as a whole, 30% of whom report having a disability. ( Source: ONS, Annual Population Survey, Jan-Dec 2019).

As part of our continuous improvement activities with FSS Service Providers over the coming year, we aim to extend the reach of the service to disabled people, ethnic minorities and other groups as suggested by our evaluation feedback and performance data.

The Scottish Government remains committed to at least halving the disability employment gap in Scotland by 2038, and statistics show that there has been a steady growth in employment rates for disable people in between 2014 and 2019 from 41.5% to 49% (Source: ONS, Annual Population Survey, Jan-Dec data).

As part of continuous improvement activities over the coming year, the Scottish Government and Service Providers will continue to promote Fair Start Scotland, reviewing their marketing strategies to adapt to local labour market needs and potential changes in demand as a result of the COVID-19 pandemic.

In response to the COVID-19 pandemic, Service Providers have enhanced digital promotion of the service through an increased social media presence, which has had some success in increasing the volume of referrals from third party organisations during the lockdown period.

We are working with Service Providers to generate local action plans to identify new ways to extend awareness of and reach to some of the more under-represented groups on the service.

We will also continue to work with Service Providers and partners, including the Department for Work and Pensions to promote and improve the service to ensure that those who are eligible would benefit from Fair Start Scotland support, are able to do so.

General practice has continued to provide services to patients throughout the pandemic, albeit with unavoidable restrictions to accommodate necessary infection prevention and control.

Patients with complex needs continue to receive the support of GP practices which are working hard to prioritise those at high clinical risk both through remote consultations and, where appropriate, face to face appointments including where patients have difficulties with remote access.

Where MSPs have specific concerns on behalf of their constituents on the availability of services from an independent contractor to the NHS, the relevant NHS Board should be able to assist in the first instance.

The Scottish Government met the British Pregnancy Advisory Service once in 2016 and once in 2019, but is not aware of other scheduled meetings between the Scottish Government and BPAS over the past five years. Officials occasionally correspond by telephone or email with BPAS staff. However there is no record of the number of these communications over the last five years.

The Scottish Government is consulting on the future arrangements for early medical abortion at home to allow abortion providers and other health professionals, the general public and in particular women who have experience of abortion services the opportunity to comment and submit evidence. Scottish Government officials have asked NHS Boards to make women receiving abortion treatment aware of the consultation where appropriate so that they can respond to it if they wish.

NHS staff always ensure they speak to a patient on their own, at least for part of the appointment, and this still applies in the case of appointments by telephone or video call. This aims to make sure every patient has the space to raise any concerns freely if they are feeling coerced in any way (either to have an abortion or not to have an abortion).

NHS Boards offer counselling services for women both pre- and post-abortion. Preliminary data from NHS Lothian indicates no change in calls to their dedicated abortion service helpline.”

Fewer than ten significant complications or mental health concerns, which would or might have been avoided if the woman had had an in person appointment, have been reported where women had no in person appointment. Similarly, fewer than ten complications have been reported where women took only the second pill (misoprostol) at home, although the Scottish Government does not have information on all complications which may have occurred for this group. Given the very small numbers involved, the Scottish Government is not able to disclose further details, such as gestation, due to the risk of identifying individuals.

The Scottish Government does not hold any information on complications following abortions where women took both pills at a clinic or hospital.

NHS Boards have not indicated to the Scottish Government that women have raised any concerns about this. NHS Boards can provide women with advice on options for sensitive disposal of fetal remains if requested.