Chamber and committees

The Scottish Government is taking a range of actions to strengthen value-based standards in health and social care procurement, with a particular emphasis on whole-life costs across integration authorities, local authorities and NHS Scotland.

Central to this work is the NHS Scotland Value Based Health and Care Action Plan, which sets out the national approach to embedding value-based principles, including the use of realistic medicine to ensure treatments and services deliver the best outcomes relative to cost. The plan outlines the strategic aims, governance structures and improvement processes required to support the transition to value-based care as part of Scotland’s 2030 vision.

In parallel, the Delivering Value Based Health Care: A Vision for Scotland document highlights the contribution procurement can make in achieving these aims. It includes a case study on National Procurement’s role in the Care Home Continence Improvement Project, demonstrating how whole-life cost analysis and value-based decision-making can improve outcomes while delivering better long-term value.

To underpin this, the NHS Scotland Procurement Strategy requires all regulated procurements to consider total cost of ownership - covering acquisition, use, maintenance and end-of-life disposal - while aligning with national priorities such as net-zero, circular economy principles, ethical sourcing and community benefit requirements. The strategy promotes collaborative frameworks, digital tools for transparency, and strengthened governance to support consistent, value-driven procurement practice across the system.

Through these policies, guidance frameworks and practical programmes, the Scottish Government is ensuring that procurement decisions across health and social care increasingly focus on whole-life value, improved outcomes and long-term sustainability.

The Scottish Government does not regard it as appropriate to engage in public comment in respect of live court proceedings.

Every area of government which is or may be affected by the Supreme Court judgment is reviewing policies, guidance and legislation. This action is co-ordinated by the Working Group on the Supreme Court Judgment, convened by the Permanent Secretary, to ensure a cross-government approach and understanding is taken to this complex area of work.

I have asked Teresa Medhurst, Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

The SPS Policy for the Management of Transgender People in Custody protects the rights and welfare of transgender people living in Scotland’s prisons in a way which promotes the safety of all people in custody.

When placing a transgender person within our estate, we adopt an individualised approach to ensure the safety of everyone in our care by assessing and managing identified known risk.

There is a total of 21 transgender people in custody representing 0.3% of the total prison population. As a public body we must uphold our statutory obligation to ensure everyone in our care has their personal information protected. Given these small numbers, we are unable to provide any further disaggregation of this data due to potential risk of identification of individuals.

SPS also aim to publish prison numbers and relevant data on a quarterly basis, the last of which can be found here.

The First Minister was approached by members of For Women Scotland while attending an International Women’s Day event on Saturday 8 March 2025. In conversation, it was proposed by a representative of For Women Scotland that a meeting take place with the First Minister after the UK Supreme Court had reached a decision in For Women Scotland Ltd v The Scottish Ministers. The Supreme Court published its judgment on 16 April and I, as the Cabinet Secretary with portfolio responsibility for equality, and the Minister for Equalities, met For Women Scotland on 22 May 2025.

No meeting has taken place between the First Minister and For Women Scotland since then, and we would not consider a meeting to be appropriate due to the live legal proceedings between For Women Scotland and the Scottish Ministers.

The Scottish Government has been taking forward the detailed work that is necessary as a consequence of the ruling. Since the judgment, we have:

• Engaged with Health Boards on the requirement to implement the Supreme Court judgment in line with their own legal advice. On 30 September, the Director of Health Workforce wrote to Health Boards to reinforce the importance of complying with the law, and the Supreme Court judgment implemented. Application of the law following the Supreme Court ruling remains a matter for Boards, in accordance with their own legal advice.
• Published revised Supporting Transgender Pupils in Schools Guidance, while recognising that the EHRC are also reviewing Technical Guidance for schools;
• Advanced joint work with Police Scotland, with a public consultation on the Stop and Search Code of Practice scheduled before the end of this year.
• There have been no changes to prisons guidance.

We have also:

• Updated our guidance for the Gender Representation on Public Boards (Scotland) Act 2018.
• Amended the public appointments recruitment process for public bodies subject to the Act, now collating and using biological sex at birth data to apply the Act.
• Moved to an interim Trans and Non-Binary Inclusion Policy, removing a line regarding facilities use, while we develop new policy and guidance in consultation with trade unions.
• Conducted an initial review of facilities across the SG estate with a more detailed review now underway to ensure our provision meets the needs of staff and legal requirements.

The Scottish Government does not regard it as appropriate to engage in public comment in respect of live court proceedings.

The Scottish Government is committed to delivering a more equitable and accessible approach to the provision of equipment and adaptations. Our revised guidance on the Provision of Equipment and Adaptations is statutory guidance issued under Section 53 of the Public Bodies (Joint Working) (Scotland) Act 2014. This means that responsibility for delivering it and assessing its impact rests with Integration Authorities.

This includes capturing data which evidences the value that effective and efficient community equipment and adaptation provision makes to the delivery of key service goals. However, to support national implementation of this guidance, the Scottish Government works closely with our national Equipment and Adaptations Network to support good practice and aid a more consistent approach to implementation.

The Scottish Government is aware of how critical equipment is to allow individuals to participate fully in daily life and to support the person being cared for to live safely within their home environment. Anyone requiring equipment should experience a seamless journey through the pathway of care, which ensures they receive the right intervention at the right time.

That is why the Scottish Government engaged robustly with Health and Social Care Partnerships (HSCP) to establish the impact of the collapse of NRS Healthcare Limited. This engagement concluded that there was little to no immediate impact on services providing community equipment. Where required, HSCPs have taken appropriate steps to mitigate any immediate disruption to services. This includes; purchasing stock in bulk, purchasing from other suppliers, and utilising off-contract purchases. HSCPs have also confirmed that they have been taking the necessary steps to mitigate any disruption to the supply chain in the medium to longer term.

The National Equipment and Adaptions Network is available for HSCPs to collectively discuss local impact and mitigating actions. The Scottish Government will continue to monitor this matter.