Decisions about patient care should be taken by the clinicians and the patient involved following meaningful discussion and the sharing of all necessary information, including benefits, risks and alternative treatments.

In a circumstance where two NHS boards are involved in a patients care, it would be expected that healthcare professionals from both health boards communicate with each other to discuss and agree a coordinated treatment plan. If a resolution cannot be reached by the clinical teams involved, then concerns can be escalated to the Health Board Management through the appropriate channels.

Patients can consider submitting a formal complaint to the Health Board(s) involved. It is through feedback of this nature that health services can identify any issues and take steps to make improvements. The Patient Advice & Support Service (PASS) is a free, independent and confidential service that supports NHS patients. PASS can offer help and advice with complaints, advocacy support, and help navigating the healthcare system.

Patients can also use their right to request a second opinion from another clinician. This may be appropriate in cases where Health Boards cannot agree on a recommended course of action. If a patient would like a second opinion their clinician or GP will be able to provide advice and make arrangements.

The Scottish Government does not hold information on numbers of patients travelling and the means of travel. However we are aware of an increase in travel on the sound of Harris Ferry following changes to the Benbecula Stornoway air service in April 2024.

As you may be aware, at the meeting to consider Access to Health Services in the Western Isles on 21 August, it was agreed to establish a working group, led by HITRANS, to consider ways to improve the patient experience.

At the first meeting of this group, NHS Western Isles and CalMac confirmed that they are working together to minimise issues for patients using ferry travel through a block booking of 2 cars per day for NHS Wester Isles patients. It was noted that monitoring of capacity and demand is ongoing by NHS Western Isles and CalMac will consider an increase in pre booked spaces if required.

The Medicines Homecare Review is an independent review commissioned by the Chief Pharmaceutical Officer (CPO). The CPO is currently considering the recommendations in order to determine the next steps and will publish the review thereafter.

Preparing for Sustainable Farming (PSF) has received a total of 1964 claims to date for soil analysis with a development payment associated with the first claim, with the following number of claims per scheme year: 607 (2022); 1201 (2023); 156 (2024, to date). As part of the claim submission process, high level data was captured to assess if there has been any barriers to acting on the analysis recommendations, whether or not more or less fertiliser was applied than expected, if variable rate application has been used, and whether lime was required based on the analysis. It is worth noting that from the UK-wide British survey of fertiliser practice, only 37% of the farms included in the survey undertook a standard soil analysis (which measures levels of P, K, Mg and soil pH). Data gathered and lessons learnt have been incorporated into the new Whole Farm plan requirements.

The latest release by Public Health Scotland (PHS), providing information on Hospital Standardised Mortality Ratios (HSMRs), for the period April 2019 to March 2024 is available via the PHS website. (Hospital Standardised Mortality Ratios - April 2023 to March 2024 - Hospital Standardised Mortality Ratios - Publications - Public Health Scotland).

These statistics are updated on a quarterly basis and reflect the HSMR for the latest 12-month reporting period, whilst crude mortality data is presented by quarter and month to show trends. For the period April 2023 to March 2024, the Royal Infirmary of Edinburgh (RIE) is within two standard deviations of the Scotland-wide average for their HSMR, and no hospital in Scotland had a significantly higher standardised mortality ratio than the national average.

NHS Lothian’s January 2024 HSMR report explored the reasons behind the higher ratio of the standardised mortality measure at RIE and specifically to understand if there is any evidence of avoidable mortality.

The report identified 4 cases where a different plan and/or delivery of care may have resulted in a different outcome for patients, but the use of ‘may’ identifies this classification as hypothetical in nature, it is impossible to know if a different care plan would have resulted in a different outcome. Furthermore, the report specifically advised the Healthcare Governance Committee that there is no clear current evidence of avoidable mortality in any of the cases considered.

School meal debt is a matter for local authorities in the first instance, and the Scottish Government expects them to use the powers available to them to support families struggling with school meal debt. Authorities approach to the management of meal debt should align to the guidance produced by COSLA on this issue.

The Scottish Government made a fund available to support councils to help remove the impact of school meal debt in the 2024-25 Budget and will confirm allocations to councils in due course.

Following the announcement by Petroineos to continue supplying fuel via an import terminal at Grangemouth and reflecting the reserved nature of the security of fuel supplies, the Scottish Government has been engaging collaboratively with the UK Government’s Department for Energy Security and Net Zero (DESNZ) to assess the efficacy of the business’ import terminal plans.

We will continue to seek assurance from both the UK Government and Petroineos that appropriate controls and actions are in place to ensure adequate fuel flows to continue from Grangemouth long into the future.

I can confirm that the new overbridge at Westerton Lane has been designed to include passive provision for any potential future double tracking of the East Kilbride line.

I refer the member to the answer to question S6W-30277 on 11 October 2024. 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.

I refer the member to the answer to question S6W-30277 on 11 October 2024.. 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.