Chamber and committees

The Scottish Government remains committed to ensuring that everyone who needs it can access seamless, timely and high-quality palliative care.

We have appointed a National Clinical Lead for Palliative and End of Life Care to drive this, supported by a Clinical and Practice Advisory Group and a wide-reaching Strategy Steering Group.

The Steering Group is currently reviewing the information and evidence we have and need to develop the strategy, including mapping services and support across Scotland.

This is a matter for each territorial NHS Board. The information requested is not held centrally.

Care and support for people with long COVID is being provided across the full range of services delivered by our NHS. This includes assessment in a setting close to home by local primary care teams, and referral to community-based rehabilitation services or secondary care settings for further investigation of specific complications where clinically appropriate.

This is a matter for NHS Greater Glasgow and Clyde. The information requested is not held centrally.

The vast majority of mothers in extreme preterm labour will be transferred before giving birth, and the normal destination for Lanarkshire mothers will be Queen Elizabeth University Hospital in Glasgow.

In the small number of cases where it is not possible to transfer mothers before they give birth, as has been established practice for many years, our specialist neonatal transfer service (ScotSTAR) will transfer those babies in specialist ambulances equipped to care for neonates.

We recognise that all parents want to ensure their baby gets the safest care possible, and would expect that we organise care to ensure that this happens. The Best Start aims to keep mums and babies together as much as possible. If there is a high risk of the baby needing intensive care after birth then antenatal care will be planned with the input of a specialist maternity team, and with the expectation that the woman will be admitted to a maternity unit in a hospital with a NICU on site when it is time to give birth.

If a woman is in suspected extreme pre-term labour, she will be transferred by ambulance to a maternity unit in a hospital with a NICU on site, to deliver the baby there. If there is not sufficient time to transfer the woman before birth, the baby will be born in her nearest hospital and given immediate short-term intensive care on site to stabilise the baby, before being transferred to a NICU by the specialist neonatal transport service ScotSTAR when it is safe to do so.

The same level of care will also be provided to the mother who, once stable enough, will also be transferred to the maternity unit within the same hospital as her baby.

Where cot capacity has been reached then clinical judgement with parental involvement will determine the best receiving unit.

Neonatal cot capacity is managed on a network basis through a daily call attended by all Neonatal Units. The data provided is then collated and is used to identify any sustained or acute pressure on intensive care cots.

The availability of beds is not solely down to the availability of neonatal cots, but also maternal beds and the availability of specialists to support both mother and baby. This ensures that for any woman or baby who requires immediate delivery, suitable arrangements are made. The perinatal teams across Scotland, including ScotSTAR who coordinate such transfers work hard to negotiate and create space when required.

The recommendations for the new neonatal model of care are underpinned by strong evidence that population outcomes for the most premature and sickest babies are improved by delivery and care in units looking after a critical mass of these babies, with experienced staff, and with full support services.

The Best Start recommended that Scotland should move from the current model of eight Neonatal Intensive Care Units (NICU) to a model of three units supported by the continuation of current NICUs redesignated as Local Neonatal Units (LNU’s).

As part of the next phase of the work Scottish Government have commissioned Consulting firm RSM-UK to undertake detailed modelling work to fully map the capacity requirements across the system to inform capacity building and implementation of the new model.

The Scottish Ambulance Service will be included as part of the modelling work. We expect that mothers in threatened extreme early labour, or those whose babies will need surgery, will be identified pre-birth and will birth in the maternity unit alongside the NICU. The Perinatal Network has been leading some work, and recently published guidance on transfer in these cases.

The Scottish Government does not hold this information.

Scottish Government does not hold this information.

Neonatal cot capacity is managed on a network basis through a daily call attended by all Neonatal Units. The data provided is then collated and is used to identify any sustained or acute pressure on intensive care cots. The availability of beds is not solely down to the availability of neonatal cots, but also maternal beds and the availability of specialists to support both mother and baby. This ensures that for any woman or baby who requires immediate delivery, suitable arrangements are made.

The Young Patients Family Fund (YPFF) helps to offset the cost of any accommodation required by eligible visitors.

The YPFF terms and conditions direct claimants to access NHS Board visitor accommodation in the first instance. Where this is not available, private accommodation (e.g. hotel) can be booked and the fund’s terms and conditions direct the NHS Board to book on behalf of the claimant where this is possible.

This process helps to ensure that most claimants avoid having to pay large accommodation bills upfront. My officials have not been alerted to an issue with this process, however, I have asked them to write to YPFF administration teams in NHS Boards to remind them of the importance of taking action to reduce unnecessary temporary financial pressures on families.