Chamber and committees

I recognise that stigma associated with liver disease can create very specific challenges, including by isolating people from their communities and act as a significant barrier to seeking help and support. This can increase the harms experienced due to delayed presentation especially given the generalised association between liver disease and alcohol misuse and/or drug abuse.

The Scottish Government is committed to tackling this stigma, including among health care professionals across the healthcare system. We are currently developing a national stigma action plan for drugs and alcohol that will include taking the principles of the stigma charter developed by the Drugs Death Taskforce and putting these into action.

The issue of stigma is also clearly referenced on the NHS Inform website which states that a drug or alcohol problem is a health condition and people should receive help and support, not judgement.

Alcohol and drugs are of course not the exclusive causes of liver disease. On 20 June 2022, Public Health Scotland launched the Challenging Weight Stigma Learning Hub . The learning hub aims to raise awareness of the impact weight stigma can have on people living with overweight and obesity and what health professionals can do to mitigate this. It is interactive and has been developed alongside academics, health professionals and those with lived experience of stigma.

In 2020-21 and 2021-22, over 15,000 deaths were reported to COPFS. This was a 40% increase from 2019/20. Notwithstanding this increase, in 2021-22 95% of deaths where no investigation was required were closed within 6 weeks of receipt of the death report, and 49% of deaths requiring further investigation were concluded within 12 weeks. Only a small proportion of reported deaths result in a Fatal Accident being held.

In relation to deaths which require further investigation, there are a number of factors which may influence when those investigations may be concluded and many are outwith the Crown’s control. These include the need to await the outcome of investigations by other reporting agencies, information from other public bodies and receipt of expert opinion. In addition, in some cases criminal proceedings require to be initiated and concluded before a decision can be taken on the holding of an FAI.

The lodging of a First Notice is the process by which the Crown will intimate that a FAI requires to be held. Thereafter, the Crown has limited control over the timescale for commencing and concluding the Inquiry. Matters such as the scope of the Inquiry and the evidence that requires to be led are ultimately for the presiding Sheriff to determine.

The following information relates to the five FAIs in 2021/22 which took the longest time to conclude:

The Scottish Government does not hold information on the number of people reported missing from NHS hospitals or other healthcare settings, as there is no specific variable within Public Health Scotland’s data to highlight where a patient is reported missing.

Some information is available from Police Scotland on incidents of a person going missing from the NHS (covering those cases that were reported to the police). This is provided in the following table. The data is drawn from the Missing Person’s Database and is available on a consistent basis from April 2019 onwards. The figures relate to a count of incidents (and their associated investigations) rather than a count of people going missing. As such, the same person may appear multiple times within any year if they have been reported missing on more than one occasion during that period.

It should also be noted that the data covers all NHS grounds and not just hospitals.

Missing Person Investigations, “Missing From The NHS”, Police Scotland

This report was funded by The Promise Partnership, of which the Scottish Government is the principal funder. The Scottish Government recognises that it raises important issues about how children and young people are supported to enforce their rights, and welcomes that Clan ChildLaw commissioned this work. Many of the report’s findings align with The Promise, particularly that Scotland must consider the creation of an accredited legal specialism to set standards for legal professionals representing children.

Through legal aid, children and young people can access legal support for a wide range of matters including children’s hearings, criminal proceedings and to resolve civil disputes. The Legal Aid Fund pays for legal advice and representation, but it is not designed to fund wider support needs. The young people’s statements of their ideal legal services, as captured by the report, extend beyond the traditional model of service delivery by law firms, and the scope of the current legal aid system.

As the report has highlighted, “There may be a need for the development of initiatives, partnerships and funding bids focused on specific issues and needs” and officials will continue to engage on how to best to support such work.

The National Concessionary Bus Travel Scheme for Young People currently covers bus travel only. At this time, there are no plans to extend this to rail.

On public transport fares more broadly, the Scottish Government is progressing its Fair Fares Review to develop and assess options to create a fairer, more transparent system of fares across all modes that maintain and increase affordability for those who need it most, taking cognisance of the relative changes to the overall cost of travel.

The 2021 Digital Health and Care strategy aims to make the right information available to all appropriate staff, when and where it is needed, building on the existing use of electronic patient record systems used by all Health Boards and GP practices. Whilst our strategy is for all health records to be held electronically, this will not result in a single, discrete electronic patient record that maintains all of the data from all of the health and care systems in Scotland in a single platform. Rather the focus is on allowing medical records to be stored, linked and shared securely according to the information needed. To achieve this most Health Boards have a Clinical Portal. This system works across organisational, regional and national boundaries to provide a timely transfer of information.

Clinical portals are in place across Scotland within acute services and provide access to multiple specialist clinical systems, supporting the better transfer of information between Health Boards and within services. Currently, Clinical Portals cover the West of Scotland Boards, the East of Scotland boards and the North of Scotland Boards are in the process of implementing their Clinical Portal. Further key national developments are also underway that we expect to further improve data sharing. The National Digital Platform has improved our digital health and care infrastructure, supported the development of key digital platforms for the covid-19 response and will now look to focus on linking different sources of data where that offers value. The significant investment in new GP IT system rollout is also underway to provide modern, secure GP IT systems which will support evolving models of care.

The key developments to improve the sharing of information within Health Boards is the GPIT Programme, the National Digital Platform, TRAK Care and Clinical Portal. The total funding provided for these key developments to improve data sharing this financial year is £3.743 million.

We are due to publish a Digital Health and Care Strategy Delivery Plan in the coming weeks that will be available to all Parliamentary Members. Additionally, we will also publish the first ever Data Strategy for Health and Care in early 2023, which will further set out our ambition for ensuring the right data is available to the right professionals at the right time.

The Remote and Rural General Practice Working Group was created in 2018 to support the implementation of the GP Contract in remote and rural areas. It met between 2018 and 2022. In 2020, the Group put forward recommendations to Ministers which are contained within its Shaping the Future Together Report. The Group last met on the 9 th June 2022 and agreed to bring the Group to an end.

The Scottish Government is committed to supporting and developing rural general practice and primary care. In terms of planned developments, The Scottish Government is working to develop a Remote and Rural workforce recruitment strategy by the end of 2024. This will support employers to ensure that the Health and Social Care needs of people who live in remote and rural communities are met. In addition, The Scottish Government’s Programme for Government 2021-22 included a commitment to create a centre of excellence for rural and remote medicine and social care, with scoping work starting in 2021-22. The Scottish Government has been working closely with NHS Education Scotland (NES) over recent months to carry out extensive scoping and consultation with stakeholders. NES has submitted a business case for the Centre. The Scottish Government is evaluating the business case and considering next steps.

We are already taking forward a range of initiatives to support recruitment and retention of workforce in rural General Practice. The Golden Hello scheme offers a one-off bursary of £10,000 to every GP taking up an eligible post in a remote and rural area. Furthermore, ScotGEM is a four-year graduate-entry medical degree which began in 2018, with a focus on rural medicine and healthcare improvement, supporting graduates to choose careers in general practice. The Scottish Government is also supporting an initiative by the four rural boards in the north of Scotland, NHS Shetland, NHS Orkney, NHS Highland and NHS Western Isles who have piloted an innovative recruitment campaign called Rediscover The Joy (RTJ). RTJ aims to recruit experienced GPs to provide support for remote and rural practices.

The number of resident places by funding category (i.e. self-funded/publicly funded) is not available. However, Public Health Scotland have published the estimated number of long stay residents in care homes for older people by funding category and by local authority since 2009.

a) i) This information is not held centrally and is not published by Public Health Scotland.

a) ii) These figures are available in two parts:

The latest Public Health Scotland Care Home Census for adults publication contains figures from 2012 - 2022. The figures can be found in the “Funding and Charges” section of the dashboard.

The Public Health Scotland Care Home Census for adults 2020 publication contains figures from 2009 – 2011. The figures can be found in Table 13C of the accompanying Care Home Census Data Tables.

b) i) This information is not held centrally and is not published by Public Health Scotland.

b) ii) These figures are available in two parts:

The latest Public Health Scotland Care Home Census for adults publication contains figures from 2012 - 2022. The figures can be found in the “Funding and Charges” section of the dashboard.

The Public Health Scotland Care Home Census for adults 2020 publication contains figures from 2009 – 2011. The figures can be found in Table 13C of the accompanying Care Home Census Data Tables.

Responsibility for the management of the police estate sits with the Scottish Police Authority and the Chief Constable.

However, Police Scotland has confirmed that 15 police stations have been closed since 2013 across Ayrshire, Renfrewshire and Inverclyde with the majority of them been moved to a new modern co-located accommodation within the same towns or officers were moved to new police stations nearby.

The Police Scotland Estate Strategy, approved by the SPA in May 2019, provides a framework for planning the future of the police estate to support the long term vision of policing which includes enhanced partnership working, and seeks to respond to the changing needs of communities while maintaining public visibility and confidence.

Making the Future contains two substantive references to the Land Reform Bill.

One (under “Strategic Priorities) welcomed the publication of the consultation on the Bill https://www.gov.scot/publications/land-reform-net-zero-nation-consultation-paper/ published 4 July 2022).

The second was a recommendation: that “An ambitious Land Reform Bill should tackle concentrations in ownership and enshrine transparency, equality and public good into the future of Scotland’s land use.”

The measures put forward in the consultation for inclusion in the Bill aim to achieve these objectives. They will do so within the context of Article A1P1 of the European Convention of Human Rights, and the devolved settlement.

The consultation closed on 30 October 2022. Responses to the consultation, and the views of the Just Transition Commission, will be carefully considered as the proposals set out are developed.