Chamber and committees

The Scottish Government’s 2019 Welfare Reform Report estimated the effect of major UK Government welfare reforms that have been introduced since 2015. These reforms include the benefit freeze, Universal Credit work allowance changes, changes to the first child premium and the two child limit. Taken together they could reduce benefit spending in Scotland by £500 million per year once Universal Credit is fully rolled out.

These reforms apply to social security benefits over which the Scottish Government has no control, as they remain reserved to the UK Government. Therefore, the Scottish Government does not receive any additional financial resources as a result of the reduced spending caused by UK Government reforms.

Nonetheless, our Tackling Child Poverty Progress Report showed that in 2018-19 the Scottish Government continued to dedicate over £1.4 billion per year to supporting low-income households. This includes £100 million we invest each year to mitigate the worst impacts of UK Government welfare reforms.

I refer the member to the answer to question S5W-24637 on 2 September 2019 which provides a summary answer for 29 PQs that was lodged regarding the Royal Hospital for Children and Young People.

Payments for the new hospital commenced following confirmation from the Independent Tester that the Certificate of Practical Completion could be issued. As part of that process, both NHS Lothian and IHSL agreed a Settlement Agreement which intended to confirm all known areas of dispute and costed what both parties thought needed to be done in order to complete the hospital. This agreement was approved by the Scottish Government prior to it being signed by both parties, however at that point, the problem with the air change rate in the Critical Unit which delayed the opening of the hospital was not known, therefore the Settlement Agreement did not address this issue.

The Independent Tester is a joint appointment, agreed between NHS Lothian and IHSL, and is an arrangement which is included in the standard NPD contract documentation which was developed by the Scottish Futures Trust.

NHS Lothian have published on their website the costs of the project

(https://org.nhslothian.scot/CapitalDevelopments/CurrentProjects/
ProudHistoriesNewChapters/Pages/default.aspx )

The RHCYP DCN contract is published on the Scottish Future Trust Website and can be accessed at https://contracts.scottishfuturestrust.org.uk/category/npd .

All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: http://www.parliament.scot/parliamentarybusiness/28877.aspx

Government officials met with the British Red Cross on 16 October to discuss the report, and how the Scottish Government can support the implementation of the recommendations from the report.

We continue to encourage taking a 'Home First' approach where an initial risk assessment is carried out prior to discharge, and immediately followed up by a supported assessment process at home, or in a step-down care facility. This provides the person with the opportunity to recover at home, with tailored support, often provided through the voluntary sector. Support will change as the individual regains strength, confidence and mobility, and can lead to a significant reduction in the need for longer-term care, or may eliminate that need altogether. Through our work with COSLA we are actively encouraging all local authorities to adopt this effective, person centred approach.

Under the terms of the Social Work (Scotland) Act 1968 it is the responsibility of local social work services to arrange for the assessment of an individual's practical, social, psychological, physical and financial needs, and to provide any support the individual is eligible to receive.

In terms of hospital discharge, research has shown that a hospital ward is not the best place to carry out a comprehensive assessment, and that this is actually best done in the comfort of the person's own home, or in a homely setting.

A number of Integration Authorities, such as Inverclyde, East Ayrshire, and Dundee are taking a Home First approach to discharge planning, where an initial risk assessment is carried out prior to discharge, and immediately followed up by a supported assessment process at home, or in a step-down care facility. This provides the person with the opportunity to recover at home, with tailored support, often provided through the voluntary sector. Support will change as the individual regains strength, confidence and mobility, and can lead to a significant reduction in the need for longer-term care, or may eliminate that need altogether. Through our work with COSLA we are actively encouraging all local authorities to adopt this effective, person centred approach.

The information requested is not held centrally and the member should make this request of NHS Lothian as the employing Board.

The Scottish Government is committed to ensuring that our children and young people are provided with balanced and nutritious food and drink at school. We expect all local authorities to have robust procedures in place to ensure that pupils' medical and dietary needs are taken into account when planning and providing food and drink in schools. This applies to all pupils, including those who are entitled to a free school meal.

Food and drink provided as part of a medically prescribed diet are exempt from the school food and drink regulations. We expect local authorities to work with parents/carers of a child or young person with food allergy or intolerance to agree a way forward which ensures the pupil is provided with a balanced and nutritious meal which complies with the regulations in so far as they are compatible with medical advice.

The report ‘Bias and Biology’ raises important questions around the inequalities faced by women with heart disease and the Scottish Government welcomes the report and notes the recommendations.

We are committed to ensuring that everyone, regardless of gender, has access to the best care and rehabilitation opportunities. That is why our Programme for Government commits to establishing a Women’s Health Plan to tackle women’s health inequalities. One action in the plan is to reduce inequalities in health outcomes for women, including work on cardiac disease.

We continue to implement our Heart Disease Improvement Plan, which sets out the priories and actions to deliver improved prevention, diagnosis treatment and care for people living with and affected by heart disease in Scotland.

The Scottish Intercollegiate Guidelines Network (SIGN), which sits within Healthcare Improvement Scotland (HIS), aims to improve the quality of healthcare for patients in Scotland by reducing variation in practice and outcome, through the development and dissemination of national clinical guidelines containing recommendations for effective practice based on current evidence. Guideline topics are selected on the basis of burden of disease, the existence of variation in practice, and the potential to improve outcomes.

HIS is committed to equality and diversity and assesses all of its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual orientation. SIGN guidelines are produced using a standard methodology that has been equality impact assessed to ensure that these equality aims are addressed in every guideline. Guideline development groups are therefore required by law, as well as good practice, to consider whether any recommendations they make will have a differential impact on any of these groups.

When setting the clinical questions to be addressed, consideration is given to issues of equity, ensuring that any subgroup of the patient population that has particular needs in relation to the topic under review has those needs specifically addressed. This should take account not just of the needs of that population, but any evidence of differences in effectiveness of interventions between equality groups. It may be necessary to analyse the evidence for specific subgroups of the population to see if and how it differs from the main results. If there are substantial differences it will be necessary to make separate recommendations for these subgroups taking these differences into account.

The Scottish Government is committed to ensuring that everyone, regardless of gender, has access to the best care and treatment. Our Programme for Government committed to establishing a women’s health plan to reduce inequalities in health outcomes that affect women. That includes reducing inequalities relating to cardiac disease. We will work closely with the third sector, including the British Heart Foundation, as we develop that plan.

We also continue to implement our heart disease improvement plan, which sets out the priorities and actions that we will take to deliver improved prevention, treatment and care for all patients.

I refer the Member to the answer to question S5W-25695 on 25 October 2019. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: http://www.parliament.scot/parliamentarybusiness/28877.aspx

There are no current plans to develop a national database that that identifies support for people experiencing poor mental health.

However, as set out in our Programme for Government commitments, we will:

• undertake to develop 24/7 crisis support for children and young people and their families and introduce a text service so children and young people can text as well as phone to access help.
• put into place a new community wellbeing service to support the mental health needs of children and young people, using an open access model that also allows self-referral.

To help facilitate this comprehensive package of measures we continue to explore the digital solutions that children, young people and their families would find useful.

We will investigate the possibility of extending these services in the future to people of all ages across Scotland