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 NHS Greater Glasgow and Clyde. The information requested is not held centrally.

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

We are currently developing a new National Strategy for Palliative and End of Life Care for Scotland. As part of this work, we are reviewing the information and evidence we have, and need, to develop the strategy. This includes gathering data on current and projected needs for palliative care at a population level, mapping governance, services and support across Scotland, and building on our understanding of people’s experiences of palliative and end of life care.

The outputs of this work will give us a clearer picture of the delivery and accessibility of palliative care across Scotland, and will inform a new strategy that reflects what really matters to people experiencing serious illness, dying and bereavement.

As the Deputy First Minister set out in her Budget Statement on 19 December 2023, the financial position across Scottish Government is extremely challenging and work is ongoing to identify measures to address the continued challenges in 2024-25 and beyond.

Integration Joint Boards are responsible for the governance, planning, and resourcing of adult palliative care services, including hospices, using the integrated budget under their control. We will therefore continue to work with Integration Joint Boards and independent hospices to explore solutions and options for longer term sustainable planning and commissioning for the independent hospice sector.

Under the new model of care, mothers in suspected extreme pre-term labour will be transferred to give birth in hospitals that have neonatal intensive care units. Those maternity units will have expanded capacity to receive those women.

It is recognised that it will not always be possible to transfer mothers before they give birth. In those cases, as has been established practice for many years, our specialist neonatal transfer service (ScotSTAR) will transfer those babies by air or by road in specialist ambulances equipped to care for neonates, accompanied by neonatal staff.

The Scottish Perinatal network has developed and published guidance for all Boards across Scotland to support identification and transfer of mothers in suspected extreme preterm labour. Experiences of testing the new model of neonatal intensive care showed that the vast majority of mothers in suspected pre-term labour were identified and transferred before giving birth.

Women from NHS Lanarkshire would normally be transferred to the Queen Elizabeth University hospital in Glasgow. Should that unit be at capacity, it may it be necessary to transfer those women to Edinburgh, or to Aberdeen, and parents will be involved in those discussions.

Journey times from Wishaw to Aberdeen will vary depending on the time of day and urgency of the transfer.

I refer the member to the answer to S6W-23794 on 29 December 2023. 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 .

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.

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.

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.

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.

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.