Chamber and committees

A rigorous approach is taken to ensure accurate census paper questionnaire data.

Paper questionnaires are scanned and the answers are captured digitally using character recognition software. During scanning, the system looks to automatically allocate a numeric code to each answer, which allows the data to be easily analysed. Trained Quality Control operators perform daily checks on a sample of cases to ensure the quality of data captured from scanned questionnaires meets expectations.

It is not always possible to automatically allocate valid codes during scanning as some answers provided are not always on lists the system matches to. To ensure complete information is recorded, National Records of Scotland (NRS) set up a manual coding service where trained coding operatives visually inspect census questionnaires and make a decision on the most accurate code to assign.

Further manual inspections of the paper forms are made by NRS staff to check allocated categories and codes.

Under the Edinburgh Process strand of the Nature Restoration Fund, Local Authorities have been allocated a share of £5 Million for 2022-23, using a formula based on the area of urban greenspace and local nature reserves, as set out in the following table:

In March 2021, we published our Respiratory Care Action Plan for Scotland, setting out our commitments to drive improvement in the prevention, diagnosis, care, treatment and support of people living with respiratory conditions such as bronchiectasis.

We recognise the importance of data in understanding respiratory care in Scotland. Our Plan contains a key commitment to build a core respiratory data set, which will enable the Scottish Government, NHS Boards and clinicians to identify improvements needed in delivery of respiratory care and also monitor how the implementation of our Plan is delivering better outcomes for people in Scotland.

At its first meeting in October, the Scottish Respiratory Advisory Committee (SRAC) identified data as one of the 3 key priorities for year 1 of implementation.

We have since established a sub-group consisting of clinical experts representing health boards across Scotland, Public Health Scotland and third sector representation to progress and deliver this commitment. The sub-group have held their first meeting and are in the process of commencing a scoping exercise on the data currently available across Scotland, before determining what data should be collected in the future in order to improve respiratory care.

In 2020, the latest year for which data are available, there were 912 chronic liver disease deaths in Scotland. Of these, 759 were alcohol-related liver disease deaths. Data are not available for obesity related liver disease deaths.

Liver diseases are generally avoidable or treatable if diagnosed at an early stage and stigma often prevents people from accessing treatment; 75% of people are currently being diagnosed at a stage when it is too late for lifestyle changes or intervention.

We take a whole population approach to reducing alcohol consumption and the risk of alcohol-related harms across the population and that’s why we’ve taken a range of actions to reduce the availability, attractiveness and affordability of alcohol.

We are also taking action to reduce the impact of poor diet on people’s health which is also a significant and growing contributor to liver disease. We are taking wide-ranging action to support healthier choices, as set out in our 2018 Diet and Healthy Weight Delivery Plan , and have set a challenging aim to halve childhood obesity by 2030 and significantly reduce diet related health inequalities.

We are currently in the process of evaluating minimum unit pricing (MUP) as a whole over its first five years of operation. Public Health Scotland will be producing a final report on MUP in 2023, which will inform our evaluation report which will be laid in Parliament and published in 2023.

Work on reviewing the level of MUP has started as part of our overall evaluation, as the impact of MUP is connected to the unit price. We are evaluating the impact of MUP at the current price of 50 pence per unit and will assess what level MUP should be set at going forward, if MUP is to continue. It is important that we have a robust evidence base to support any decision on a change in the level of MUP.

Against that background, I am announcing that the conclusion of the review of the level of MUP will be completed in late 2023. If our overall evaluation supports a continuation of MUP, we will lay Orders in Parliament in late 2023 to continue MUP beyond the initial six year period and if the evidence supports a change in price, to set a new unit price. If Parliament approves those Orders, it is intended that any new price would take effect from 1 May 2024 i.e. immediately after the initial six year period which would have otherwise have expired on 30 April 2024.

We know people living in poverty have poorer health outcomes and this is why we are committed to addressing the underlying causes of health inequalities and increasing healthy life expectancy. There is a stark social gradient to alcohol harms and outcomes linked to poor diet with those in the most deprived areas being the most affected

Population-wide measures to transform the food environment are more likely to be effective in reducing health inequalities than measures aimed only at encouraging individuals to change their behaviours. That is why we will introduce a Bill in this Parliament that includes powers to restrict promotions of foods high in fat, sugar or salt and introduced Minimum Unit Pricing for alcohol. The Scottish Government’s Alcohol Framework 2018 sets out our priorities for preventing alcohol-related harm, including our world-leading minimum unit pricing policy.

A recent study by Scottish Health Action on Alcohol Problems has highlighted the effectiveness of alcohol nurses in Deep End practices in Glasgow, in supporting people with alcohol problems who have complex needs. The Scottish Government will carefully consider the findings of the report which highlight the need for more research into the effectiveness of these services.

The existing National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of cirrhosis recommends that very heavy daily drinkers (men drinking up to 50 units per week or women 35 units per week) should be screened for cirrhosis using one of the newer non-invasive diagnostic technologies.

NICE suggests FibroScan and in 2020 published a Medtech innovation briefing around its use in primary care settings, but blood tests for fibrosis markers are also accurate and should be available to any clinician.

The Scottish Government currently has no plans to increase the use of FibroScan and enhanced liver fibrosis (ELF) tests in primary care in order to improve the early diagnosis of liver disease.

However, the Office for Health Improvement and Disparities is developing UK Clinical Alcohol Treatment Guidance, which is expected to include the issue of liver disease. These are expected to be published for consultation later this year. Once finalised, the Scottish Government will consider recommendations regarding early diagnosis of liver disease.

The disease control response to the avian influenza outbreak is being coordinated across the four administrations, with the Animal and Plant Health Agency leading on surveillance, triage and testing in the UK. Wild bird findings (suspected of HPAI) in Scotland, England and Wales are reported to Defra’s national hotline. This information is then given to relevant teams to triage the collection of samples for testing, where required. This is an evolving situation with the species identified for collection and testing under constant review and adjusted according to surveillance needs.

As of 24 June 2022, 490 wild birds from multiple locations across Scotland, consisting of 24 species, have tested positive for highly pathogenic avian influenza (HPAI) H5N1. More information, including the findings of HPAI in wild birds are available at: https://www.gov.scot/publications/avian-influenza-outbreaks/#wildbirds

Avian influenza is spread mainly through live birds, and current veterinary advice is that wild bird carcases should be left in situ, unless landowners consider it necessary to remove them. The Scottish Government has published advice for local authorities, landowners, wildlife rescue centres and members of the public regarding reporting, collection and safe disposal of dead wild birds. We will keep our guidance under continuous review as the situation develops.

Avian influenza is a highly infectious disease, and while there is little that can be done to limit the spread within seabird colonies, action can be taken to reduce the risk of onward transmission from infected colonies to uninfected colonies and other locations, and to minimise additional stress on potentially infected birds. To that end, NatureScot has suspended all ringing activities within seabird colonies for the remainder of the breeding season to mitigate these risks. Surveys of some seabird colonies are also ongoing to monitor bird numbers, and any mortality events.

Moving forward, we are in contact with the other UK administrations and statutory nature conservation bodies with regard to the response plan for future disease outbreaks. Although the immediate response is to the spread of the disease, there is a need to look ahead at how we can quantify the impacts and what else can be done to improve resilience within the colonies.