Chamber and committees

The NHS England Long-Term Workforce Plan, published under the previous UK Government in June 2023, committed to an expansion of Physician Associate (PA) training places with a view to establishing a workforce of 10,000 PAs by 2036-37. No such target for expansion has been set by Scottish Ministers who are clear that any growth of the profession must be gradual and evidence-based. While high profile examples of harm involving physician associates did not take place in Scotland and there is no empirical comparative data between countries on adverse events involving PAs, the Scottish Government’s approach to this role is being informed by a national Programme Board tasked with considering issues including Scope of Practice and supervision. Statutory regulation of the professions by the General Medical Council is due to commence in 13 December, introducing consistent UK-wide standards for education, training and practice with individual professional accountability and meaningful consequences when these are not met.

The Scottish Government does not collect information on how many children and young people have been placed in informal kinship care arrangements in each year since 1999, broken down by local authority. We do, however, hold figures for the number of children who are looked after in kinship care and these are included in the Children’s Social Work Statistics for Scotland.

In support of the Scottish Government’s broader aims to protect Scotland’s place in Europe following Brexit and mitigate any associated economic, social and reputational damage, an international marketing campaign was delivered by Brand Scotland in France, Germany, Ireland and Spain in 2019.

This ‘Scotland is Open’ campaign aimed to promote Scotland as a welcoming and open country to boost positive perceptions of Scotland as a place to live, work, study, visit and do business with in order to build and maintain strong relationships with the EU and member states.

The campaign included video on demand, paid social, OOH digital display and print advertising ran initially from 29 March until 11 April in 2019. The second burst ran from 31 January until 4 February in 2020 and added Belgium alongside France, Germany, Ireland and Spain.

As with all marketing campaigns delivered by the Scottish Government, a series of SMART objectives were set to evaluate the performance of the campaign and its impact on perceptions of Scotland, before it began.

Pre and post campaign research was undertaken by research agency BVA BDRC in France, Germany and Spain with four audience groups: potential relocators, students, holiday makers and senior business leaders who would consider doing business.

In just two weeks the campaign activity reached over 80 million people, generating 27% awareness in key markets (France, Germany and Spain) against a target of 10%. The video was viewed over 52 million times, with 25 million of these through to completion, and 8.8 million engagements.

The SMART objectives for the campaign were:

• To achieve 10% awareness of the campaign among live / work / study / visit / business target audiences in France / Germany / Spain by mid-April 2019 Among campaign recognisers in France / Germany / Spain achieve 30% agreement that Scotland is an (i) open and (ii) welcoming nation by mid-April 2019
• Among campaign recognisers, achieve 30% agreement that Scotland continues to extend a warm welcome even in uncertain times by mid-April 2019
• Among campaign recognisers, achieve 20% agreement that the Scotland of today is (i) inclusive (ii) innovative by mid-April 2019
• Among campaign recognisers, achieve a 10% consideration level of Scotland as a place to (i) live (ii) work (iii) study (iv) do business (v) visit by mid-April 2019
• Among campaign recognisers, achieve 3% claimed action as a result of seeing the campaign by mid-April 2019

The campaign significantly exceeded these targets, achieving the following results:

• 34% campaign awareness amongst live/work audiences, 49% awareness amongst study audiences, 30% awareness amongst visit audiences and 33% amongst business audience
• 70% agreement that Scotland is an open and welcoming nation 76% agreement that Scotland continues to extend a warm welcome even in uncertain times
• Among campaign recognisers, 56% considered Scotland to be innovative and 60% considered Scotland to be inclusive
• Among campaign recognisers, positive consideration of Scotland as a place to live and work achieved 39%, as an overseas study destination 44%, as a place to do business 40% and a place to visit 43%.
• 82% of all campaign recognisers claimed to have taken action as a result of the campaign

The UK Government Apprenticeship Levy is a reserved tax on employers which was implemented by the UK Government. Scotland receives a proportionate share of tax revenues via the block grant as per the Fiscal Framework agreement with UK Treasury.

On 14 November 2016, the UK Government announced the Scottish Government’s settlement from the UK Apprenticeship Levy based on a population share of projected revenue for the first three years only.

Since 2020-21 the Scottish Government has not received a direct allocation of apprenticeship levy revenue. Scotland receives a share of funding calculated through the Barnett Formula as part of the block grant and has no direct control or responsibility for the operation of the apprenticeship levy, this means the Scottish Government has no direct control over levy funds or their distribution.

Prior to 2020-21, the notional funding for the levy was spent on a range of apprenticeships, workforce development and pre-employment support, meaning businesses had access to a range of both direct and indirect support. We do not hold information on the number of businesses who accessed funding from the Apprenticeship Levy.

The Scottish Government wants patients to get the help they need, when they need it, and we understand how important a timely ADHD diagnosis is for individuals.

While local Health and Social Care Partnerships (HSCPs) have responsibility for putting in place services to meet local needs, including the needs of adults with ADHD, we fund the National Autism Implementation Team (NAIT) to support HSCPs to consider best practice and improve services in the redesigning of neurodevelopmental diagnostic services.

NAIT provides HSCPs with resources to help them support these adults, and works with them to ensure that Adult Neurodevelopmental Pathways, which provide diagnostic services and support tailored to the needs of each neurodivergent individual, are implemented.

We also provide funding to NHS Education for Scotland (NES) to deliver training resources to meet the needs of staff working in ADHD services across health and social care. These include webinars on Assessing ADHD and Understanding ADHD in Girls and Women, which are available to all NHS and Social Care staff via an online knowledge hub.

Our intention is that these steps will help streamline diagnostic and support processes, thereby reducing existing backlogs.

Work is ongoing to improve the availability of data regarding the number and distribution of Physician Associates (PAs) across NHS Scotland. It is expected that these improvements will allow for the more effective analysis of workforce trends for this profession from the beginning of the 2025-26 financial year.

Individual decisions about the employment and deployment of PAs are a matter for Health Boards, many of whom will have considerable experience of utilising this role to good effect. The profession is a valued, long-standing part of the NHS Scotland workforce and it is important that discussions about the role are taken forward in a respectful and supportive manner.

The Scottish Government and our partners remain dedicated to bringing innovative and structural change to this complex issue and remain fully committed to reducing drug deaths and harms.

On 31 October, Audit Scotland published a report on alcohol and drug services which acknowledges that we have improved national leadership and made significant progress in tackling Scotland’s longstanding issues with drugs and alcohol. Notably, through significant investment and innovative action in our National Mission, including sustaining a record £112 million for Alcohol and Drug Partnerships (ADPs) this year, as well as innovative initiatives such as piloting a Safer Drug Consumption Facility in Glasgow, which will open early in the new year.

Through the National Mission to date we have:

• Supported over 300 grassroots community organisations through the £65 million Corra National Drug Mission Funds
• Driven improvement in services with 90% of Alcohol and Drug Partnerships assessed as having implemented Medication Assisted Treatment standards 1-5, and 91% of standards 6-10 assessed as partially implemented as of July 2024
• Helped widen access to lifesaving naloxone with 77% of people at risk of overdose estimated to have access to a Take Home Naloxone kit as of June 2024
• Seen a 21% increase in residential rehabilitation beds since 2021 (513 beds as of September 2024) due to our £38 million residential rehabilitation capacity investment.
• Made £1.5 million available for investment in Planet Youth - a whole community approach for substance use prevention
• Provided £480,000 per year since 2023 to support additional trainee placements on Scottish Drugs Forum's 'National Traineeship' which supports people with lived and living experience to undertake an SVQ and access a paid work placement.

Alongside these important practical steps to making improvements to front line services our whole system approach is driving change across mental health, stigma, workforce and children and families, and the Charter of Rights which was published on 11 December, will support people affected by substance use to know and understand their rights in accessing support services.

The five-year National Mission is now in the final stages of delivery, and we have begun to work with partners to ensure long-term strategies are managed smoothly through to the next parliament. The ongoing independent evaluation of the National Mission being undertaken by Public Health Scotland (PHS) will help to ensure these strategies are underpinned by robust evidence.

In my response to question S6W-30360 on 9 October 2024 I said “funding has enabled a concentrated effort to eradicate the last remaining isolated population of grey squirrels in the North East of Scotland.”

I should clarify that the last remaining, isolated population of grey squirrels in the North East of Scotland is found in the City of Aberdeen.

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

Some positive progress has been made in implementing the recommendations of the Adult Neurodevelopmental Pathways report, which aims to provide local single pathways for adult autism and ADHD, including diagnosis and support.

4 Health Boards are undertaking strategic planning to aid implementation. Separately, 2 Boards with established adult autism pathways are working to incorporate ADHD diagnosis and support into those pathways.

However, the Scottish Government recognises that we have more to do to ensure that progress on implementation is maintained.

We are aware that there are differing approaches between NHS Boards in establishing local single pathways for adult autism and ADHD, including approaches that are less neuro-affirming with higher diagnostic thresholds.

We will continue to work with NAIT to encourage these Boards to take approaches aligned to the adult neurodevelopmental pathways report and look to fully implement the recommendations of the report.

The Scottish Government remains focused on increasing the number of places at medical schools to meet the future demands of NHS Scotland while also ensuring there are sufficient educational and training places of appropriate quality in NHS Scotland for our undergraduates and trainee doctors. In line with this between Academic year (AY) 2015-16 and AY 2024-25 the Scottish Government has increased the annual intake of medical places in Scottish universities from 848 to 1,417, representing an increase of 67%. These increases include funding Scotland’s first Graduate Entry Medical programme (ScotGEM), introducing the innovative HCP MED course and GP track courses. The Scottish Government also remain committed to promoting Widening Access (WA) to medicine raising the total number of available places from 60 places in available in AY 2020-2021 to 115 in AY 2024-25.