Chamber and committees

The Scottish Government provides funding annually to Health Boards for smoking cessation and prevention services. The funding is provided as part of a wider Outcomes Framework allocation, whereby budget is provided to Health Boards to cover a range of outcomes. It is up to Health Boards to decide how much of this funding to allocate to each outcome. The published Scottish Budget for 2023-2024 includes £74.1 million for the Outcomes Framework.

The Scottish Government do not currently have plans to add a section on chronic UTIs to NHS inform at this time. The NHS 24 Clinical Change Governance Group (CCGG) routinely assess new and updated clinical guidelines to ensure the clinical content on NHS inform is underpinned as far as possible with current clinical evidence. The group will continue to consider what improvements are required regarding information on UTIs based on any new evidence or changes to clinical guidelines or pathways that arise.

NHS inform does advise that if acute symptoms do not improve, get worse, or come back after initial treatment, the patient should return to their GP for further advice. Thereafter the GP should follow relevant clinical guidelines that outline how to treat and manage chronic UTIs for individual patients.

A consultation on the Bill’s proposals ran from 29 August 2022 to 5 December 22, where a wide range of views were received. On 22 June 2023, the Scottish Government published the Agriculture Bill - Analysis of Consultation Responses which details the findings of this extended engagement.

As is convention, following consultation on proposed legislation, Ministers are considering the views received to inform a new Agriculture Bill which will be introduced in 2023. In turn, Parliament will consider the proposals and provide further comment on draft proposals, accordingly.

NHS Education for Scotland (NES) are responsible for managing all training provided to doctors in Scotland. NES ensure that all doctors receive high quality training in line with curricula that is set by the relevant Medical Royal College so that they are able to demonstrate that they have met all GMC curricular requirements, in order to practise independently as a GP in the UK.

The General Practice Specialty Training (GPST) programme lasts for 3 years with trainees typically spending 18 months in General Practice and 18 months in secondary care i.e. hospital settings.

All GP practices receive funding for protected time consisting of one session a month (usually within practice time) to allow GPs to maintain and develop their training and skills, and those of their practice teams.

Training currently provided to GPs on the diagnosis and treatment of UTIs include:

1. Educational activities during the first year of training under most GP Speciality Trainees (GPSTs), such as: tutorials, case based discussions, post consultation prescribing checks and referral reviews that are undertaken by their GP educational supervisors.

2. Management of UTI’s (uncomplicated lower UTI’s in females) in primary care also occurs through the Scottish Pharmacy First initiative. https://www.nss.nhs.scot/publications/pharmacy-first-scotland-urinary-tract-infection-uti/ .

3. The RCGP ‘Being a General Practitioner’ Curriculum Guide ( https://www.rcgp.org.uk/mrcgp-exams/gp-curriculum/clinical-topic-guides#kidney ) section on Kidney and Urology includes: Urinary tract infections in children and in adults including lower urinary tract infection, pyelonephritis and persistent/recurrent infection There are questions based on this clinical topic guide within the Applied Knowledge Test (AKT) and Simulated Consultation Assessment (SCA- OSCE style exam) which form essential components of the MRCGP exam.

4. SIGN 160: “Management of suspected bacterial lower urinary tract infection in adult women. A national clinical guideline. September 2020” is a readily available resource for all GPs in Scotland.

5. All GP practices receive an annual prescribing report which focusses on antibiotic prescribing and review of current guidelines on management of UTI’s in primary care. Each Health board has its own guidance - see below:

https://www.clinicalguidelines.scot.nhs.uk/nhsggc-guidelines/nhsggc-guidelines/emergency-medicine/diagnosis-treatment-and-management-of-uti-in-children-rhc-glasgow/

https://handbook.ggcmedicines.org.uk/guidelines/infections/urinary-tract-infections-utis/

6. Evaluation of the impact of Scottish Reduction in Antimicrobial Prescribing (ScRAP) programme on GP Practice management of patients with suspected UTI – is an example of initiatives regularly offered to GP practices to review their antibiotic prescribing. GPs through annual appraisal have to demonstrate annual QI initiatives and many include antibiotic prescribing in UTI’s and compliance with local and national guidelines.

7. Common reference sources used by GPs (GP notebook, NICE CKS guidelines, BNF, BMJ best practice) all have comprehensive sections on management of UTI in adults and children.

The Scottish Intercollegiate Guidelines Network (SIGN) is part of Healthcare Improvement Scotland (HIS) who operate independently of the Scottish Government, Health Boards and Integration Authorities with responsibility for updating SIGN guidelines.

Guidelines on management of suspected UTIs were developed by (SIGN) in September 2020 and the Scottish Government expects all NHS healthcare workers in Scotland to follow best practice when providing care for people with UTIs.

These support clinicians to provide advice to patients and carers on appropriate treatment, risks and lifestyle and behaviour issues which can support management and prevention of UTIs. The guideline also includes the diagnosis and management of recurrent UTIs in these groups.

SIGN guidance is bespoke to Scotland. In NHSScotland, where there is no SIGN guideline on a particular topic, healthcare professionals would be expected to look for another high quality, evidence-based guideline e.g from the National Institute for Health and Care Excellence (NICE).

The Scottish Government does not hold this information centrally. The funding and commissioning of specialist and general palliative and end of life care services, including workforce planning and allocating resources for staffing, is a matter for Integration Joint Boards. A wide range of specialist and generalist staff in hospitals, care homes, primary care, social care, hospices and the third sector, will be involved in providing palliative care to people and their families.

An underlying principle of the new National Strategy for Palliative and End of Life Care for Scotland being developed will be equitable and timely access to palliative care as needed, by each person of any age, living with any illness, in all places.

The Strategy Steering Group has established a number of working groups to address priorities, including a Workforce, Education, Training and Resources Working Group, to support the workforce and ensure care is delivered by a multi-disciplinary and multi-agency workforce that is trained, skilled, valued and supported.

The Scottish Government’s universal Baby Box programme, the only one in the UK, opened for registration on 15 June 2017. Nationwide delivery of Baby Boxes began on 15 August 2017 for all babies born and resident in Scotland.

Where a parent has registered for a Baby Box these are dispatched by our Baby Box Managing Agent APS Group (Scotland) approximately 6 weeks prior to due date. If APS receive a late request, the Baby Box is prioritised by their system and dispatched as urgent, this would usually be the next working day. Where APS are made aware of a hidden pregnancy, premature birth or a parent has not registered, these requests are also treated as urgent and usually dispatched the next working day.

APS do not keep a record of any late issued boxes, which can happen for a number of reasons, but once confirmation of a birth and request for a box is received, a Baby Box will be dispatched the following day.

I refer the member to the question S6W-20677 on 13 September 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

I have asked Teresa Medhurst, Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

On 7 August 2023 the prison population was 7859. A breakdown is provided below in relation to the accommodation the individuals were located in:

• 4800 people were accommodated alone in a cell intended to accommodate one person;
• 165 people were accommodated alone in a cell that is designed to be double occupancy;
• 1098 people were accommodated in a cell, or dormitory, intended for more than one person; and
• 1796 people were accommodated with another person in a cell intended for one person.