Chamber and committees

The impact of addressing the COVID-19 pandemic has meant that many health and social care services, including some cardiology services, had to be suspended or reduced in scope and scale. In some instances, novel modes of delivery were adopted to maintain important services (for example, some local services implemented drive up clinics for pacemaker checks).

Evidence based caution has been, and continues to be, at the forefront of our decision making around the provision of services throughout the pandemic. To support this, the Cabinet Secretary for Health and Sport published a national Clinical Prioritisation Framework for Supporting Elective Care across NHS Scotland on 16 November 2020, updated on 8 December 2021. The expectation is that NHS Boards will follow the principles of this Framework to ensure that the patients with the greatest need are treated quickest.

Furthermore, addressing the backlog of care while continuing to meet the ongoing urgent health and care needs of the country is a priority. We published an NHS Recovery Plan in August 2021 which sets out our plans for health and social care over the next 5 years and is backed by over £1 billion of funding,

Regular pacemaker checks typically take place in outpatient clinics and so it is relevant to note that the Recovery plan includes a focus on increasing outpatient activity through supporting sustainable improvements and new models of care.

We are also taking specific action to minimise preventable heart disease and ensure that everyone with suspected heart disease in Scotland has timely and equitable access to diagnosis, treatment and care, through the implementation of our Heart Disease Action Plan (2021).

In March 2018, the European Medicines Agency (EMA) issued new measures to limit exposure to sodium valproate in utero, including the adoption of a Pregnancy Prevention Programme.

Following this, new and strengthened information materials for healthcare professionals and patients have been issued, including an updated Summary of Product Characteristics and Patient Information Leaflet, new education materials for professionals, as well as updated packaging stamped with a new pictogram. Furthermore, updated guidance on the use of sodium valproate has been issued by both the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).

Prescribers in Scotland are expected to follow current drug safety information and the new measures in relation to sodium valproate to ensure women being prescribed this medicine are fully apprised of the risks and are able to make informed decisions.

The information requested is not held centrally. Public Health Scotland publishes a quarterly report on Diagnostic Waiting Times which covers eight key diagnostic tests. These diagnostic tests are used for a range of conditions, including cancer.

Anyone who reports a positive LFD test through the UK Government website is directed to complete a contact tracing form at a website hosted by Test and Protect. To complete this form, the individual must input their surname, date of birth, and input a unique code given to them when contacted by Test and Protect after testing positive. Without these three unique identifying factors, an individual cannot access the contact tracing form, ensuring the form is correctly matched to the specific individual.

If any information on their Covid-19 Status is wrong, individuals should phone the Covid-19 Status Helpline on 0808 196 8565.

The Scottish Government has had several discussions with lead breast clinicians. The most recent was on 18th March at a meeting with the group leading on quality performance indicators for breast cancer. The group has indicated an interest in improving data on breast cancer recurrence and metastatic disease.

The Scottish Government met with the charity Breast Cancer Now on 3rd November 2021 and requested updated evidence of need for improved data. This was received on 26th January 2022 followed by email exchanges over the recent months.

A 2017 review of the use of sodium valproate in pregnancy by the European Medicines Agency (EMA) found that babies exposed to sodium valproate are at higher risk of malformations or developmental problems. Following this review, the EMA agreed new measures to avoid the use of sodium valproate in women and girls of child bearing potential. This included the adoption of a Pregnancy Prevention Programme.

On 7 January 2022, the Medicines and Healthcare products Regulatory Agency (MHRA) published the results of the Commission on Human Medicines (CHM) review of the safety of anti-epileptics in pregnancy. The CHM recommended that the MHRA should review whether the available data raises any new safety concerns or changes current understanding about the safety of other epilepsy medicines during pregnancy. The Scottish Government is continuing to work closely with the MHRA on issues around medicines safety, including those relating to sodium valproate.

Furthermore, the Scottish Government is funding the roll-out of a pilot Scottish Epilepsy Register in three NHS Health Boards (NHS Greater Glasgow and Clyde, NHS Tayside and NHS Lanarkshire). This will help identify patients taking sodium valproate, as well as any other anti-epileptic medicines, some of which may also have the potential to cause harm. Alongside the data we already collect on prescribing, this has the potential to form the basis of a Scotland-wide epilepsy registry and, with further adaptation, could collect outcome data. This can help support better shared decision making to reduce the risk of harm and improve delivery of and access to care and support.

The ongoing costs of the COVID Status App are publicly available via Public Contracts Scotland . The costs of developing and maintaining the App are broken down between Netcompany and Jumio who provide the core App and Identity Verification systems respectively.

The most recent update from Public Contracts Scotland as of 4 March 2022 places the total value of development of the core App from Netcompany at £2,400,000.00 and the Identity Verification systems from Jumio at £4,373,360.00.

The ongoing and future costs of the COVID Status App will be published as and when these figures are available.

The Scottish Government currently publishes a range of intersectional equality data, for example Scottish Household Survey data can produce a variety of intersectional breakdowns where sample sizes allow. However, there remain many costs and challenges to collecting, analysing, and reporting this. Despite improvements in recent years, there remain gaps in Scotland’s equality evidence base.

The Scottish Government launched the Equality Data Improvement Programme (EDIP) in April 2021 to address these gaps. The EDIP is aligned with the Scottish Government’s wider Mainstreaming Equality and Human Rights Strategy which is currently under development and aims to make intersectional equality data more wide-ranging and robust, enabling policy makers to develop sound, inclusive policy.

Work is underway to produce equality data improvement plans for each Analytical Service Division (ASD) across the Scottish Government. These plans will be shaped by equality stakeholders and will form the basis of the next iteration of Scotland’s Equality Evidence Strategy. Better data will in turn help identify intersectional discrimination.

To share learning and good practice, the Scottish Government led an evidence review which focused on how to apply the concept of intersectionality to public sector analysis and policymaking. This review showcased examples of how organisations have collected data on intersectional discrimination and was published in March 2022.

The Scottish Government formally adopted the International Holocaust Remembrance Alliance’s (IHRA) definition of antisemitism in June 2017. The Scottish Government and its agencies have been expected to adhere to the definition since June 2017.

While it is not legally binding, the Scottish Government would encourage publicly funded bodies to similarly adopt the IHRA definition of antisemitism, noting however that it is up to these bodies to make this decision for themselves.

Adopting the IHRA definition demonstrates a determination to tackle antisemitism and sends a strong message that it is entirely unacceptable in Scotland.

In order to raise awareness of the early signs and symptoms of cancer, including ovarian cancer, a symptom-checker tool is included on our public facing website, getcheckedearly.org. An ovarian cancer survivor’s story and a link to the ovarian cancer page on Detect Cancer Early’s (DCE) website will be shared on our wee c social media pages, as part of Ovarian Cancer Awareness Month.

The NHS Recovery Plan – published August 2021 – commits an additional £20m for the DCE Programme, to provide greater public awareness of possible signs and symptoms of cancer and supporting the development of optimal cancer pathways to improve earlier diagnosis rates. Research is currently being undertaken to better understand the possible barriers and levers to early diagnosis that any new DCE campaigns should focus on.