Both adult and paediatric patients with Cystic Fibrosis (CF) can access a range of appropriate services via their local NHS Boards, Integrated Joint Board and specialist centres.

The National Services Division (NSD) of NHS National Services Scotland commission a number of highly specialist services for young people and adults with CF are delivered via multi-disciplinary teams, including clinical psychologists at 3 specialist centres around the country – in Aberdeen, Glasgow and Edinburgh. There are also outreach services in Dundee and Inverness. Paediatric CF services are delivered locally by NHS Boards like through the South-East Scotland Paediatric Cystic Fibrosis Service.

Due to the variable management required, much of the treatment required by CF patients is specialist and tailored to the needs of the individual patient. The Scottish Government therefore expects NHS Boards to treat CF patients according to individual need, this includes ensuring clinical psychologist and social work input when required.

The Scottish Government is committed to working to improve outcomes for people with rare conditions, including Cystic Fibrosis. We are developing an Scottish Action Plan for Rare Disease based on the four priorities of the UK Rare Disease Framework: faster diagnoses, increased awareness, better care co-ordination, and access to specialist treatments and care.

The requested information on retirement numbers is not centrally held. NHS Education for Scotland publishes annual data on joiners/leavers, but this information is not available by reason for leaving or destination.

Information on joiners/leavers by staff group for each financial year can be found (turnover tab) here: https://turasdata.nes.nhs.scot/data-and-reports/official-workforce-statistics/all-official-statistics-publications/01-march-2022-workforce/dashboards/nhsscotland-workforce/?pageid=6429

Health Boards are responsible for conducting pre-retirement interviews and no data is held on this centrally. The Scottish Government would expect Boards to ensure that managers engage with staff at all points within their career as a matter of good practice, including prior to retirement to discuss staff experience and career journeys.

The Scottish Government's 'Supporting the work-life balance' PIN Policy contains provisions for supporting staff approaching retirement, including the opportunity to attend a pre-retirement course where they will have access to a wide range of information to support their retirement planning: https://www.gov.scot/binaries/content/documents/govscot/publications/corporate-report/2015/07/supporting-worklife-balance-partnership-information-network-policies/documents/supporting-work-life-balance-pin-policy-july-2015/supporting-work-life-balance-pin-policy-july-2015/govscot%3Adocument/00481986.pdf

Following receipt of the Royal College of Nursing's recent 'Nursing Workforce in Scotland' report, I was fortunate to attend a roundtable event on 30 March, hosted by the RCN, to hear directly from nurses on their priorities and concerns. These discussions will inform work with Health Boards to explore what more can be done to ensure even greater workforce flexibility.

The Scottish Government continues to invest in the registered nurse role across community, social care and primary care settings. We have introduced in partnership with NHS Education for Scotland a funded scheme to enable former nurses and midwives to complete a Nursing and Midwifery Council (NMC) approved Return to Practice (RtP) programme and to re-enter the professional register across all fields of practice.

We have also invested over £45m since 2021 to train and introduce into the workforce an additional 375 nurses within the district nursing service. This investment supports the shift in balance of care into community settings by delivering more care in homes and reducing rates of admission to the acute hospital service.

The Scottish Government launched a national marketing campaign in November 2021 to attract more people with the right skills and values to the social care sector including nurses for social care settings. This campaign concluded in February 2022. In addition, the Scottish Government is working with the Department for Work and Pensions to host a series of sector-specific job fairs across Scotland during April and May to support recruitment efforts to all role types, including nurses, within the sector.

We have been working with NHS Boards to increase the use of international recruitment to alleviate pressures and fill key roles by supporting a number of measures. We have already provided £1m across NHS Scotland to build capacity within recruitment teams and a further £1m to fund International Recruitment Lead Posts. We are also recruiting at least 200 registered nurses from overseas with funding of £4.5m available to Health Boards to take forward this recruitment.

The COVID-19 Advisory Sub-Group on Education and Children’s Issues noted in its recently published evidence summary , that the evidence continues to indicate that teachers do not have an increased risk of severe disease. Guidance for all schools has been updated to reflect public health guidance on symptoms of a respiratory infection, including COVID-19 and we are asking ask people to continue to take sensible, basic steps in order to protect themselves and others in the same way as we do within shops and on public transport.

In relation to those who are clinically vulnerable, the Scottish Government announced on 27 April that we will formally end the Highest Risk List on 31 May 2022. The success of the vaccination programme, and availability of new medicines to treat Covid-19, mean the majority of people on the list are at no greater risk from Covid-19 than the rest of the population in Scotland.

The Chief Medical Officer has for some time advised people on the Highest Risk List to follow the same advice as the rest of the population unless advised otherwise by their GP or clinician. This applies equally to household members of people on the list and includes going into schools and early learning and childcare settings. He has also advised people whose immune system is suppressed to take extra care and follow the advice of their GP or clinician as they would have done before the pandemic.

At this stage in the pandemic it is no longer considered necessary or proportionate to continue to ask school staff and secondary pupils to test regularly. This is in line with advice from Public Health Scotland, senior clinicians and the Advisory Sub-group on Education and Children’s Issues. That advice makes clear that the population currently has much stronger protection against COVID-19 than at any other point in the pandemic, due to the vaccination programme (levels of vaccination are very high amongst school staff) and the development of natural immunity to the infection. In contrast to the position when the testing programme was first introduced, severe health outcomes for all age groups are far less likely to arise due to this protection, availability of and access to antiviral treatments, and increased scientific and public understanding about how to manage risk.

The Scottish Government is working with partners, including the Children and Young People’s Commissioner, on new human rights-based non-statutory guidance to minimise the use of restraint in schools.

The physical intervention working group began work on the new guidance in January 2020. Progress was affected by group members’ focus on the Covid-19 response. However, work resumed in June 2020 and positive progress has been made since then. The working group last met on 23 November 2021. Following that meeting, working group members reached agreement by correspondence that the draft guidance can be put to public consultation. The Scottish Government is currently preparing this consultation.

Details of the membership and notes of the meetings of the physical intervention working group are available on the Scottish Government’s website: Physical Intervention Working Group - gov.scot (www.gov.scot) .

Information on the number of MS specialist nurses were in post in each of the last five years is not centrally held.

Clinical Nurse Specialist (CNS) data by NHS Board from 2009 to the most recent data published in September 2018, can be found at:

https://turasdata.nes.nhs.scot/media/4ndpx4za/clinical_nurse_specialists_s2018.xlsx

Given data quality concerns all historical data, whilst published, should be treated with caution.

A national review into the CNS role and definition is currently underway, NES will work with NHS Boards to cleanse their CNS data once this is complete.

The Scottish Ambulance Service does not produce statistics based on free-text searches, as this data would require a significant amount of resource for analysis and clinical input.

The Board is ensuring the pyramid of support for patients with MS by working in partnership with NHS Greater Glasgow and Clyde’s Neurology Service who provide a specialist neurology service through a Service Level Agreement. The NHS Western Isles Neurology Team has weekly discussions with their NHS Greater Glasgow and Clyde colleagues to discuss the Team’s caseload.

NHS Western Isles is also working to meet Commitment 9 in the Neurological care and support: framework for action 2020-2025, namely testing innovative ways of delivering health and social care, including new roles and new arrangements for co-ordinating care and support for people with neurological conditions such as MS.

The Board also aims to recruit to an Advanced Clinical Nurse Specialist – Neurology role who will work with the current Parkinson’s specialist nurse to support people with neurological conditions including MS that require specialist support, ensuring equity of care.

The NHS Recovery Plan highlights our ambitious plans to expand and grow the workforce, in particular to assist with the additional procedures we intend on undertaking through our NTC's.

Significantly, we are recruiting more staff throughout the NHS so our ambitious recovery can be fully realised, with this plan outlining our commitment to:

Recruit 1,500 new clinical and non-clinical staff for National Treatment Centres by 2026 .

We use a range of measures to monitor the wellbeing of the workforce taking into account the diverse nature of the workforce operating in a range of roles and geographies, the broad spectrum of wellbeing needs at both a professional and personal level and different reporting arrangements across sectors.

We continue to actively listen to colleagues across Health and Social care to understand where the current pressures are, and what actions can be taken to mitigate their impact on staff.

It is critical staff wellbeing is looked after and they are able to take the rest breaks and leave to which they are entitled, as well as being given time to access national and local wellbeing resources at work. That is why we made £12 million available in 2021-22 to support the mental health and wellbeing of the workforce.

Our National Workforce Strategy, published on 11 March 2022, highlights that the wellbeing of our health and social care workforce, wherever they work, remains an essential priority.

Throughout the pandemic, the Scottish Government have emphasised to Boards, Health and Social Care Partners and Local Authorities the on-going need to promote both the physical and the psychological wellbeing of everyone working in health and social care.