Chamber and committees

About 1 million people in Scotland live with hearing loss and an estimated 70% are over 70 years old. Unaddressed hearing loss can cause distress due to cognitive decline and reduced social interaction, communication and education. Hearing loss is often accompanied by tinnitus, vertigo and balance problems and can be a contributing factor in dementia. Deaf people and people with hearing loss are less likely to be employed and have a lower household income than people with normal hearing. Hearing loss may also be a contributing factor to early retirement and could cost the UK economy £38.6 billion by 2031 (NHSE, 2017).

It is the responsibility of NHS National Services Scotland to assess the need for an environmental impact assessment.

The NP805/19 Healthcare Waste Services framework, implemented in 2019, requires NHSScotland clinical waste suppliers to follow SEPA regulations and permit requirements for healthcare waste handling and disposal and thereby meeting environmental impact standards. Additionally, environmental and sustainability impacts of the procurement of products and services to NHSScotland are an essential element of awards.

For the 2019 clinical waste award, as part of the specification, suppliers were asked to demonstrate how to minimise environmental impact by reducing waste, improving material recovery, and exploring new disposal methods.

The national contract, which is the responsibility of NHS National Services Scotland, requires suppliers to treat high temperature incineration (HTI) waste, but it did not require a specific solution to create the capability in Scotland. HTI waste constitutes around 15% of NHSScotland clinical waste, and at this time, there remains no investment plan for creating HTI clinical waste treatment capacity in Scotland, as that would involve diverting capital investment away from frontline health and social care services.

We are working with various delivery partners to implement the commitments in the Respiratory Care Action Plan (RCAP), which runs into 2026.

We established the Scottish Respiratory Advisory Committee to provide expert support to the implementation of the RCAP. The Committee identified three initial areas of focus: child to adult transition, pulmonary rehab and respiratory data.

The Committee’s Child to Adult Transitions subgroup has produced a set of recommendations to ensure children with asthma and other respiratory conditions have the best possible care and treatment as they move into adult service.

To improve the data available on respiratory conditions and ensure people with respiratory conditions are receiving the right care and support, we are working towards establishing a national audit programme for respiratory conditions. We aim to progress this with Public Health Scotland in 2025/2026.

In 2024, we published the Quality Prescribing Strategy for Respiratory: A Guide for Improvement 2024-2027 that sets out our ambitions for better access to respiratory care. This can be found here – https://www.gov.scot/publications/quality-prescribing-strategy-respiratory-guide-improvement-2024-2027/

The Centre for Sustainable Delivery based at the Golden Jubilee National Hospital is developing national patient pathways for respiratory conditions including severe asthma, COPD and sleep apnoea. This work aligns closely with the commitments in the RCAP.

The RCAP also recognises the importance of commitments under the Scottish Government’s Cleaner Air for Scotland and Warmer Homes Strategies and the refreshed Tobacco Action Plan in preventing respiratory disease.

We remain committed to a tobacco-free Scotland by 2034 and welcome the re-introduction of the UK-wide Tobacco and Vapes Bill to UK Parliament, which will help us to achieve our ambitious target.

We are supporting the introduction of Low Emission Zones to improve air quality and protect public health.

We are also committed to supporting those living in fuel poverty or at risk of fuel poverty through installing insulation and heating measures into individual properties, known as the Warmer Homes Scotland scheme. Since the launch of the first Warmer Homes Scotland scheme in 2015, the scheme has invested around £289 million and helped over 39,000 households across Scotland to live in warmer, healthier homes which are more affordable to heat through both phases of the scheme.

The Scottish Government does not hold this information centrally.

A significant aspect of our pulmonary rehabilitation improvement work was to support the specialist respiratory workforce. This work is now being taken forward by a small group within the Respiratory Speciality Delivery Group. We also continue to work with many types of clinical advisors on delivering improvements to respiratory care and much of this is related to workforce.

The Scottish Government remains committed to delivering the National Workforce Strategy (Health and social care: national workforce strategy - gov.scot) and achieving the overall vision for “A sustainable, skilled workforce with attractive career choices and fair work where all are respected and valued for the work they do”. Whilst no formal update has yet been published, significant progress has been made in a number of areas and we remain committed to providing a fuller update to the strategy at an appropriate time. Whilst the Strategy does not set out operational workforce planning requirements, it states how we are directing policy to support the achievement of our workforce.

The Respiratory Care Action Plan contains broad commitments from a wide range of areas including increasing uptake of vaccines, ensuring people live in warm homes and improvement of air quality. We have made progress across a number of areas under these commitments, such as the Four Nations approach to tobacco.

Along with obesity, smoking represents a chief threat to Scotland's public health and we remain committed to a tobacco-free Scotland by 2034 and welcome the re-introduction of the UK-wide Tobacco and Vapes Bill to UK Parliament, which will help us to achieve our ambitious target.

The Bill will gradually increase the age of sale for tobacco products and provide powers to legislate on vape flavours, displays, packaging, as well introduce an advertising ban for vapes and nicotine products.

I refer the member to the answer to question S6W-34909 on 4 March 2025. We recognise the importance of having access to meaningful data in relation to respiratory services, in 2023 we provided Public Health Scotland with £60,000 to undertake a scoping exercise with a view to developing a respiratory audit programme. Now that the budget for 2025-26 has been passed by Parliament, we aim to progress this in the current financial year.

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

Audiology is considered as a clinical priority area and the Scottish Government remains committed to its vision for an integrated and community-based hearing service in Scotland.

Whilst our response to the Independent Review of Audiology in Scotland is implemented, we will continue to work with the NHS, Third Sector and private providers to identify and cost an appropriate model of community care for any future service reform and ensure that the voices of those with lived experience inform this work.

Scottish Government officials and the Centre for Sustainable Delivery national planned care team meet monthly with Chief Operating Officer and / or Acute Directors from all Health Boards to review performance and delivery across all Planned Care specialities, including ENT.

216 people were discharged to an interim care home bed placement through the 2023 interim care beds funding. The scheme was open between 10 January and 31 March 2023. The average cost per placement was £1108.22. This varied by placement in practice dependant on length of stay.