Chamber and committees

Any decision on whether or not to introduce screening for Spinal Muscular Atrophy (SMA) in Scotland will be guided by the recommendations of the UK National Screening Committee (UK NSC), an independent expert advisory group which advises Ministers and the NHS in all four nations of the United Kingdom on screening policy. The UK NSC last reviewed SMA in 2018 and did not recommend screening for this condition.

The UK NSC is expected to review SMA screening later this year, taking into consideration the latest evidence since the previous recommendation in 2018. Should the UK NSC recommend screening for this condition, the Scottish Screening Committee, in consultation with medical experts in this field, will advise Scottish Ministers on the most appropriate future course of action for Scotland.

Scottish Government officials have been involved in initial discussions with academics and clinicians about the potential for a Scottish research study of newborn screening for Spinal Muscular Atrophy (SMA), and are awaiting a fully developed proposal. Any decision thereafter to run an SMA pilot will depend on the expert advice of the Scottish Screening Committee as well as the organisations that oversee implementation of any changes to the newborn screening programme.

Funding under the Young Patients Family Fund is available to eligible visitors of all young inpatients. Requirement for in-patient care can vary by condition and type of treatment, and some patients may have multiple conditions or treatments over time. For these reasons we do not collect data on individual conditions.

Whilst there is no legal definition of elder abuse, the World Health Organisation has defined it as ‘a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person' ( Elder abuse (who.int) ). They note this can cover several types of violence, including but not limited to physical, sexual, psychological and financial abuse or neglect.

In general the Scottish Government does not hold information centrally on levels of elder abuse, as the Official Statistics on police recorded crime and criminal proceedings do not include details on whether the victim was an older person, or their relationship to the perpetrator. Police Scotland are in the process of introducing a new system to record crime, which once fully operational may allow for more detailed analysis within Scotland’s recorded crime statistics (including victim age for each type of crime committed). Going forward, statisticians will keep users of crime statistics informed of developments, as the new system rolls out during 2022 and 2023.

Some information on the age of victims and their relationship to perpetrators is available from topic based Official Statistics, including for example police recorded Domestic Abuse and Homicide. In 2020-21, victims of domestic abuse aged 60 and over had a rate of 12 incidents per 10,000 population (compared to 119 incidents for all ages). This has remained broadly stable over the past five years. Between 2016-17 and 2020-21 there were 36 victims of homicide in Scotland aged 60 or over. Of these, over two-thirds (69% or 25 victims) were known to the perpetrator (including partners or ex-partners, relatives and acquaintances). Furthermore the Scottish Crime and Justice Survey (SCJS) can provide estimates of some measures by age, however this only covers adults living in private households and excludes other settings such as care homes. In 2019/20, 6.9% of those aged 60 and over experienced crime in Scotland (including those not reported to the police), compared to 11.9% for all aged 16 plus. The victimisation rate for those aged over 60 has shown no change since 2014/15.

Some data is also available from the Care Inspectorate, which operates a complaints procedure for registered care services. For example in 2019/20 there were 35 upheld complaints about protection of people in care homes for older people. Further information on this process is provided in Care Inspectorate reports Complaints Annual Report 2019-20 final 12012021 (1).pdf (careinspectorate.com) and their published board papers (June 2021) Board_1706202_Final_Published.pdf (careinspectorate.com) .

The Scottish Budget for 2022-23 confirms funding of £4 million to deliver the Young Patients Family Fund.

Salus and Working Health Services Scotland (WHSS) provide return to work and occupational health services for people who have health conditions or injuries that are impacting on their work, including long COVID. These services are adapting to meet the additional needs required of them due to the pandemic. Currently there are no plans to develop an occupational health return-to-work support service for people with long COVID.

NHS inform provides people living with long COVID with clear and accessible guidance on managing their symptoms. It includes specific advice on navigating a return to work and signposts to information developed by the Society of Occupational Medicine and the Advisory, Conciliation and Arbitration Service.

The Scottish Government is aware of a growing number of studies linking autistic people (both diagnosed and undiagnosed) to increased chance of suffering from self-harm and suicidality, including the academic report Autistic traits in adults who have attempted suicide published by Richards, G., Kenny, R., Griffiths, S. et al. Molecular Autism and the academic report Links between self-injury and suicidality in autism published by Moseley et al. Molecular Autism in 2020.

People experiencing suicidality often face a complex set of personal issues and circumstances. As such, services must be person-centred and trauma-informed to ensure they provide compassionate and effective support. It is important services recognise and respond to the mental health challenges autistic people face in their day-to-day lives. In terms of learning resources, NHS Education for Scotland (NES) have developed Knowledge and Skills Frameworks for the Scottish Workforce on Mental Health Improvement, Self-Harm and Suicide Prevention, and Children and Young People’s Mental Health and Wellbeing; these learning frameworks include resources and guidance on providing mental health support for autistic people. In addition, as part of a National Trauma Training Programme funded by the Scottish Government, NES have developed a knowledge and skills framework and training resources to support the Scottish workforce to better understand and respond to trauma.

The Scottish Government set up the National Suicide Prevention Leadership Group (NSPLG) to oversee the delivery of the Suicide Prevention Action Plan ‘Every Life Matters’, published in 2018. The Plan continues to deliver a wide range of actions, including: campaigns to reduce stigma and promote suicide awareness (with a focus on reaching groups with a higher risk of suicide), improving suicide prevention skills of the workforce; ensuring effective, compassionate support to anyone in crisis, and supporting local suicide prevention planning.

In developing the new suicide prevention strategy and action plan, which will publish in September, the Scottish Government and COSLA are focussed on how to further develop effective approaches to reach and support groups at heightened risk of suicide, including autistic people. This will include drawing on research, lived experience insight, and examples of good practice.

The Scottish Government published our Learning/Intellectual Disabilities and Autism Towards Transformation Plan in March 2021. The plan looks at the actions needed to shape supports, services and attitudes to ensure that the human rights of autistic people and people with learning/intellectual disabilities are respected and protected and that they are empowered to live their lives, the same as everyone else. Vital to the successful implementation of the plan are actions to improve diagnostic and post-diagnostic services, to improve waiting times and to provide the support newly diagnosed autistic people require.

We are also carrying out new leadership and engagement work where lived experience is at the heart of the whole process. This process looks to empower autistic people and people with learning disabilities to be the leaders in transforming Scotland, starting by looking at what is needed to improve mental health for autistic people and people with learning disabilities.

The main Mental Health professional groups that the Scottish Government holds data for are Psychiatrists, Mental Health Nurses and Psychologists, including other psychological clinical staff and therapists. The Scottish Government also holds workforce figures for CAMHS, which are multidisciplinary teams that include, in addition to the professions mentioned above, AHPs, counsellors and social workers.

Under this government (since 2007), the number of:

a. Psychiatric Consultants across all specialities in NHSScotland has increased by 21.6% to 548.8 WTE posts;

b. The Mental Health Nursing workforce in NHSScotland has increased by 34.7% to 9,763.2 WTE posts;

c. Staff providing Psychology Services in NHSScotland has increased by 95% to the current all-time high of 1,359.3 WTE posts; and

d. Staff within CAMHS is up by 83.4% to the current all-time high of 1099.5 WTE posts.

NHS Scotland’s Mental Health Nursing, Psychology and CAMHS staffing numbers were at a record high on 31 December 2021.

Vacancy rates at 31 December 2021 were: 16.6% (107.5 WTE) for Consultant Psychiatrists, 12.4% (1,377.3 WTE) for Mental Health Nurses, 12.3% (191 WTE) for Psychology staff and 14.7% (190 WTE) for staff within CAMHS reflecting demand for staff as services continue to grow.

The Scottish Government also collects and publishes figures for mental health workers recruited under Action 15 of the Mental Health Strategy 2017-27, representing our commitment to recruit an additional 800 mental health workers between 2018-19 and 2021-22, to key settings such as A&E departments, GP practices, police station custody suites and prisons. As at 1 January 2022, 756.9 WTE mental health posts have recruited under Action 15.

The latest Action 15 recruitment figures as at 1 January 2022 can be accessed at Mental health workers: quarterly performance reports - gov.scot (www.gov.scot)

Despite this workforce expansion, demand for Mental Health Services remains high. The Scottish Government has committed to develop a long-term Mental Health Workforce Plan in the first half of this Parliament, and to ensure that by 2026, 10% of frontline NHS budget is invested in mental health, with 1% directed specifically to children and young people.

I refer the member to the answer to question S6W-08108 on 3 May 2022. 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

This data is not centrally available; whilst Public Health Scotland publish the total number of patients waiting for specialist mental health services, detail of the individual types of assessment or diagnosis is not held. The publications for both CAMHS and Psychological Therapies waiting times for the quarter ending December 2021 can be found at Publications - Public Health Scotland .

The Scottish Government is committed to implementing the National Neurodevelopmental Specification: Principles and Standards of Care for Children and Young People, published in September 2021, which specifies service standards that all children’s services should follow, to ensure access to support is effective and consistent across Scotland. Scottish Government have also commissioned Directors of eHealth, working with others including Public Health Scotland, to work to improve digital infrastructure, applications and data to report on all standards within the National Neurodevelopmental Specification.

The Scottish Government have also established the National Autism Implementation Team , in partnership with Queen Margaret University, to support Health and Social Care Partnerships to consider best practice and support improvement through the redesign of autism diagnostic services.

The National Implementation Team is supporting NHS Boards to examine diagnostic pathways for autism and establish regional experts to assist with improving tiered autism specialisms across health boards.