Chamber and committees

Through the development of the Scottish Intercollegiate Guidelines Network (SIGN) guidelines on chronic pain in adults and children and young people , Scotland has been a world-leader in promoting evidence-based approaches for healthcare professionals to improve standards of care and management of chronic pain.

The Programme for Government 2020-21 committed to developing and publishing a new Framework for Chronic Pain Service Delivery. A draft Framework was published for public consultation and the responses are currently being analysed. We will publish our response to the findings, including how these views have been used to shape the final Framework, later this year.

The draft Framework sets out the Scottish Government’s aim to ensure that people have a choice of treatments for chronic pain, where there is evidence they are effective, underpinned by commitments to support patients and healthcare professionals to better understand and agree effective options to manage pain. This is intended to lead to less variation in the quality and availability of services for people with chronic pain.

As part of implementation of the Framework, we will explore opportunities to update the existing guidelines to ensure they reflect the most recent evidence and best practice, including offering new treatments where there is evidence that they are effective.

Recovery certificates contained within the NHS Scotland Covid Status App adhere to the standard set by the European Commission, through the EU Digital Covid Certificate scheme which Scotland is a member of. This recognised standard does not allow for unsupervised self-reported LFD tests to be used to create a recovery certificate.

The monitoring of new and potentially dangerous variants is absolutely critical as we move into a new phase of the pandemic. For this reason, the Scottish Government is working with Public Health Scotland (PHS) to develop a comprehensive Respiratory Surveillance Plan and implement programmes to detect respiratory pathogens at a population level. In addition, a Variants and Mutations Plan is being developed that sets out an approach to manage new variants detected through surveillance programmes. PHS intends to publish these plans in Spring 2022.

Surveillance is a critical part of our approach to monitoring and managing the spread and prevalence of Covid-19 and other respiratory viruses. It helps us to determine the right public health strategies and timing to manage transmission in the community. The Surveillance Plan will set out existing and new and emerging surveillance programme that will be used to support early identification of future variants, including community surveillance in primary and secondary care, whole genome sequencing and wastewater surveillance.

In addition, Public Health Scotland will continue to participate in the Global Influenza Surveillance and Response System (GISRS), GISAID and the UKHSA Variant Technical Group. These surveillance and horizon scanning activities have been used during the COVID-19 pandemic to rapidly share intelligence internationally and provide early warnings of new variants and track their spread globally.

We aim to ensure the arrangements in place covering spending decisions on flood risk management are transparent.

In 2016, agreement was reached between Scottish Ministers and COSLA on a new strategic funding plan for flood protection schemes. The agreement guarantees that until 2026 the level of flooding capital grant in the local government settlement is set at a minimum of £42 million per annum. A further £150 million for flood risk management was confirmed in 2020. Support to local authorities in a given year is included in the Scottish Budget that is considered and approved by the Scottish Parliament. The annual allocations are set out in the relevant Local Government Finance Circulars.

The Flood Risk Management (Scotland) Act 2009 provides the framework for effective management of flood risk. In January 2022, SEPA published 14 regional Flood Risk Management Plans (FRMP) for the period 2022-2028. Approved by Scottish Ministers, they have been prepared in collaboration with all 32 local authorities, Scottish Water and other organisations with a responsibility or interest in managing flooding. They have also been shaped in consultation with the public.

These plans complement the separate local flood risk management plans that will be published later this year. The local plans will explain in more detail how the actions set out in the 14 FRMPs will be delivered. They are published by the local authority who is nominated as the lead local authority for the Local Plan District.

These arrangements give local authorities the certainty they need to deliver the broad range of actions set out in the regional and local plans, recognising local needs and priorities.

The Civil Contingencies Act 2004 places 7 duties on local authorities including duties to assess the risk of an emergency occurring, and to plan for such emergencies, and maintain those plans accordingly. Further guidance and best practice for categorised responders, including local authorities, on planning and preparing for emergencies is set out in our Preparing Scotland guidance.

The Scottish Government monitors the size of the challenge ahead by consideration of climate projections, flood mapping, modelling and analysis carried out by a number of key, expert partners such as the Met Office, SEPA and Scottish Water.

We recognise that our urban areas in particular face mounting challenges with surface water drainage and related flooding. This is why we must ensure that communities and places are water resilient and set-up for the climate challenges ahead. This will require a concerted effort across all sectors to ensure that new development is appropriately sited and designed and that existing buildings can transition to managing rainwater through blue green infrastructure instead of sewers reducing the pressure on our drainage systems.

The Energy Sector which includes resilience of the electricity network is reserved and the responsibility of the UK Government.

The Scottish Government works closely with the UK Government, electricity network operators and owners to ensure Scotland’s energy networks are resilient to a variety of risks, including flooding and other climate change related factors.

In 2020, we published the ‘Keeping Scotland Running’ Guidance Suite, which seeks to support the delivery of Scotland’s Critical Infrastructure Resilience (CIR) Strategy. This Guidance Suite comprises seven separate guidance documents designed to equip and enable CIR stakeholders to work together to build resilience across the critical infrastructure sectors in Scotland. Two of these guides specifically look at Building Resilience to Natural Hazards and Building Resilience to Climate Change (Adaption).

The National Planning Framework 3 (NPF3) and Scottish Planning Policy (SPP) also contain planning policies on managing flood risk and drainage. This includes specific policies which deal with the development management and development planning aspects of managing flood risk.

Our approach to building resilience to the impacts of climate change more widely is set out in the statutory Scottish Climate Change Adaptation Programme 2019-2024. One of the high level outcomes the Programme is structured around is that “Our society’s supporting systems are resilient to climate change”.

The Communications Sector, which includes resilience of the telecoms network, is reserved and the responsibility of the UK Government.

There are no specific obligations on telecoms operators to disclose assets that are at risk of flooding or a single point of failure to the Scottish Government.

However there is a broad requirement for telecoms operators to mitigate and minimise, in accordance with good industry practice, the number of single points of failure within the Network.

The Scottish Government works closely with the UK Government, telecoms operators and owners to ensure Scotland’s telecoms networks are resilient to a variety of risks, including flooding and other climate change related factors.

In 2020, we published the ‘Keeping Scotland Running’ Guidance Suite, which seeks to support the delivery of Scotland’s Critical Infrastructure Resilience (CIR) Strategy. This Guidance Suite comprises seven separate guidance documents designed to equip and enable CIR stakeholders to work together to build resilience across the critical infrastructure sectors in Scotland. Two of these guides specifically look at Building Resilience to Natural Hazards and Building Resilience to Climate Change (Adaption).

Our approach to building resilience to the impacts of climate change more widely is set out in the statutory Scottish Climate Change Adaptation Programme 2019-2024. One of the high level outcomes the Programme is structured around is that “Our society’s supporting systems are resilient to climate change”.

Dry powder inhalers(DPIs) make up 33% of the total in Scotland in primary care. In the last financial year (2020/2021), there were 4.5 million metered dose and 2.3 million dry powdered packs prescribed and dispensed via primary care and we have not seen a clear trend of those numbers changing and inverting.

Effectiveness of a powdered drug depends on a number of factors, including the inspiratory flow rate generated by the patient. For a significant proportion of patents, making the switch to a DPI will be successful, however, for some a DPI will not be suitable e.g. those with significantly impaired breathing. We would advocate regular medication reviews between the patient and GP at which time consideration should be given to switching to a DPI if deemed suitable for the individual patient’s circumstances

We recognise that hydrofluorocarbons used as propellant in metered dose inhalers prescribed for asthma and chronic obstructive pulmonary disease (COPD) can have a global warming potential of 1430 or 3220 times greater than CO2 depending on the type of gas used. Reducing the environmental impact of these inhalers is a priority.

A draft NHS Scotland Climate Emergency and Sustainability Strategy was published on 10 November 2021 and the consultation closed on 10 March 2022. This sets out the Scottish Government’s intention to publish an updated Scottish Quality Respiratory Prescribing guide which will focus on minimising patient over-use of inhalers through review and improving patient outcomes, using propellant free options where possible.

Other actions within the draft strategy include encouraging manufacturers to make inhalers with lower emissions and to support inhaler return to pharmacy schemes to help patients dispose of their used inhalers in a more environmentally friendly way.

The work on the payment panel research was paused due to other Covid-related work. The development of a specification for the gathering of vital data and evidence has resumed and we would hope to share this specification with the Law Society of Scotland and the Scottish Solicitors Bar Association after summer. The co-operation of the profession in building this evidence base will be crucial to this work which will underpin an evidence-based approach to setting payments for legal aid services in the future. The Independent Review of Criminal Legal Aid was able to gather vital data with the support of the Law Society of England and Wales which helped inform the recommendations made. We would hope to gather similar data on the position of Scottish solicitors who deliver legal aid as part of the payment panel research.