Chamber and committees

Safety and security on our railways is reserved to UK Government and as such the British Transport Police (BTP) is responsible for the enforcement of the law on Scotland’s rail network. BTP can only investigate matters that are reported to them and not every incident reported to and recorded by ScotRail as the employer will be reported to BTP.

Therefore, ScotRail advised the following for how many assaults on ScotRail staff were reported since 2017, noting that 2017 is the last year that ScotRail holds data for:-

As committed to within our Heat in Buildings Strategy, work is currently underway to develop a new Heat in Buildings Public Engagement Strategy, to be published in early 2023.

This will build on the broader approach to public engagement on climate change that we published last year, and will aim to:

• Increase understanding of the changes we need to see in how we heat our homes and buildings, and why;
• Raise the profile of energy efficiency and net zero carbon heating options so that people are aware of the benefits and begin to see them as a positive choice; and
• Raise awareness of advice and support services to maximise uptake of the help available.

The strategy will to set out a range of activities for public engagement that will be implemented over the transition to zero emissions heating, including: national marketing campaigns; education initiatives; a social research programme; and public participation in policy and delivery programme design, to ensure the needs of different (domestic and non-domestic) groups are considered. This reflects our commitment to supporting a just and fair transition.

To inform development of the strategy, this autumn we will undertake a Call for Evidence. Alongside publication of the strategy, next year we will launch a national conversation and campaign on heat decarbonisation, working with a range of practitioners, consumer organisations and others across Scotland to increase awareness of the heat transition with different audiences over the coming months. Early focus will be on building readiness for change amongst a wide cross-section of society ahead of the introduction of proposed regulations. We will also launch a national marketing campaign this autumn to promote awareness of our free and impartial advice and support services – Home Energy Scotland and Warmer Homes Scotland.

The Capital Spending Review sets the broad parameters for Scottish Budgets to 2025-26 as best can be done at this time and outlines high-level spending plans to deliver Programme for Government and Bute House commitments. This is against a backdrop of real-term reductions in the capital grant provided by UK Government.

Whilst the CSR sets out high-level multi-year spending parameters, it does not provide the Scottish Government with the authority to spend public funds. Annual budgets will continue to be set through the annual parliamentary budget Bill process and the annual budget will be based on the latest fiscal information.

The UK Government has not provided details on how their plans to reduce the number of civil servants by 91,000 will affect their staff working in Scotland. There are around 24,800 1 Civil Servants who are part of the reserved Public Sector in Scotland.

For Civil Servants who serve the Scottish Government, the responsibility for determining our workforce size resides with Scottish Ministers and the Permanent Secretary.

The Scottish Government is committed to contributing to achieving the broad aim set out in the Resource Spending Review to return the total size of the devolved public sector workforce to around pre-COVID-19 levels by 2026-27. This will be achieved through effective vacancy and recruitment management, working in partnership with the Council of Scottish Government Unions.

The RSR also sets out how the wider decrease in the public sector workforce will not be achieved via a uniform approach due to varying trends in demand for different services and the recovery of services from COVID-19. Whilst we consider the longer term workforce requirements, and the impact of the Resource Spending Review on the Scottish Government's workforce size and cost for the future, we are already taking action and have enhanced recruitment controls in place, ensuring as much money as possible is directed onto the delivery of the policy priorities of the Government and improving the lives of the people of Scotland.

[1] Source: Public Sector Employment In Scotland Statistics For 1st Quarter 2022

We are aware that a number of local authorities in Scotland and elsewhere in the UK are considering setting up warm banks this coming winter, to ensure people who cannot afford to heat their own home have a place they can access to stay warm. This is a relatively new concept, which we will continue to monitor, working together with our local government partners, alongside other measures that we may be able to deploy to provide support to those most affected by the rising cost of energy prices.

Our foremost concern is to support people worried about heating their homes to access the information and support they need to reduce their energy bills, and we have expanded the capacity of our Home Energy Scotland advice service this year to help an extra 12,000 households a year receive free, impartial advice.

Within our limited budget, we have allocated almost £3 billion in this financial year to help families and households face the increased cost of living. This includes support for energy bills, childcare, health and travel, as well as social security payments not available anywhere else in the UK. We will continue to monitor the best ways we, along with our local government partners, can provide support.

In further response to the cost of living crisis and our winter preparedness, the Scottish Government has already committed £10 million towards our Fuel Insecurity Fund across 2022/23, which provides direct support to people who are at risk of self-rationing their energy use, or self-disconnecting entirely. From winter 2022-23, we will also introduce our Low Income Winter Heating Assistance, which will guarantee a £50 annual payment to around 400,000 low-income households each winter.

The Scottish Government is mindful of the use of mesh in non-transvaginal settings. In February 2018, the then-Chief Medical Officer wrote to NHS Scotland Medical Directors about public interest in the use of mesh implants, including in hernia repair. Medical Directors were asked to ensure that clinicians offer patients all appropriate options for surgery, as well as the option of no surgery. In addition, the importance of shared decision making, informed consent and listening and acting upon patients’ concerns was noted.

Furthermore, the Scottish Government has commissioned the Scottish Health Technologies Group (SHTG) to produce two reports on the use of mesh in hernia repair; the first published in January 2020 and the second in December 2021 . These reports, based on current published evidence, support the continued use of mesh in a variety of abdominal wall and groin hernia subject to all the tenets of Realistic Medicine – ensuring shared decision making and informed consent with knowledge of the benefits, risks alternative measures and the possibility of doing nothing. The findings of the reports have been discussed with professional bodies, including the Royal Colleges and the British Hernia Society.

The Chief Medical Officer (CMO) wrote to the Board Chief Executives and Medical Directors in December 2021 to draw their attention to the SHTG report. In the letter, the CMO asked Health Boards to consider the availability of non-mesh surgery, how best to address skill gaps, if they exist, and the development of broader clinical networks for management of complex cases. The actions resulting from this will be discussed at a meeting of the Scottish Association of Medical Directors in August.

There is also work ongoing with regard to establishing a Medical Device Information System (MDIS) which will provide important surveillance and outcome information.

Schools already have the flexibility to teach about relationships and domestic abuse. The Scottish Government is committed to ensuring all children and young people receive high quality relationships, sexual health and parenthood (RSHP) education, an integral part of the health and wellbeing area of the Scottish curriculum which has been in place since 2010. The curriculum is not mandatory, it is for teachers to decide which resources they use to deliver relevant and engaging learning. However, we are clear about the need for children and young people to gain knowledge appropriate to their age and stage of education. The aim of RSHP education is help children and young people build positive, safe and healthy relationships as they grow older and content should be delivered in a non-judgemental manner, within a framework of sound values and an awareness of the law, including that on sexual behaviour.

In addition, we are taking forward a wide range of actions in schools such as Mentors in Violence Prevention, aimed at reducing and preventing sexual harassment and violence in schools. Mentors in Violence Prevention Scotland have developed a wakelet on domestic abuse to help teachers and school staff provide appropriate support, resources and signposting to pupils. We continue to implement ‘Equally Safe’, Scotland’s strategy to prevent and eradicate all forms of violence against women and girls and Equally Safe at School provides a suite of whole school materials. We are also committed to publishing a national framework for schools on addressing gender based violence. This work is being delivered by the Gender Based Violence in Schools Working Group who will also review existing resources and develop new resources where needed.

In accordance with the Bute House Agreement, the Gender Based Violence in Schools Working Group and the Harmful Sexual Behaviour Delivery Group met in September 2021 to consider existing work on addressing gender based violence in education settings and identify any gaps in the current approach. The minutes of this meeting can be found here . The Scottish Government have committed to commissioning an independent review following the completion of the work of both groups, which will consider the impact of the work, establish positive practice, and any further areas for improvement.

It is essential that care home staff and residents are comfortable in their environment and this includes mitigating against the effects of heat. Care providers including care homes are therefore expected to take steps to ensure that the environment is suitable for both staff and residents. This is outlined in the Health and Social Care Standards which set out what people should expect when using a Health or Social Care service in Scotland. Standard 5.21 requires care homes to “provide plenty of natural light and fresh air and that lighting, ventilation and heating can be properly adjusted”. The Care Inspectorate regularly assess a care home against their application of the Standards.

In view of the recent high temperatures, the Care Inspectorate issued advice to all care providers of adult services about steps that should be taken to maintain safe temperatures and mitigate the effects of heat. This included ensuring people are kept cool, well hydrated and drinking plenty of fluids and using cold compresses to keep people cool. The information provided also included a link to the recent UK Governments’ Department for Health and Social Care and Health Security updated heatwave advice for Health and Social Care staff. It includes advice both on caring for people most at risk during a heatwave, and on organising others who provide care. This advice is available here: www.gov.uk/government/publications/heatwave-plan-for-england/supporting-vulnerable-people-before-and-during-a-heatwave-for-health-and-social-care-professionals

Public Health Scotland’s COVID-19 - information and guidance for social, community and residential care settings, provides detailed advice on the importance of good ventilation in indoor spaces to reduce the risk of COVID-19 spreading. The guidance also sets out steps to safely maintain adequate room temperatures for the comfort of staff and residents. This includes maximising fresh air during hot weather, wherever possible through natural ventilation - opening windows, vents and doors (excluding fire doors). Where buildings have mechanical ventilation systems, these can maximise the amount of fresh air being introduced and minimise the recirculation of air in rooms and throughout buildings. This advice is available here: settings/covid-19-information-and-guidance-for-social-community-and-residential-care-settings-version-22/"> www.publichealthscotland.scot/publications/covid-19-information-and-guidance-for-social-community-and-residential-care-settings/covid-19-information-and-guidance-for-social-community-and-residential-care-settings-version-22/

The Health and Safety Executive ventilation in the workplace guidance also provides practical steps on improving ventilation. This advice is available here: www.hse.gov.uk/ventilation/overview.htm . The UK Health Security Agency recommends keeping room temperature to at least 18ºC as temperatures below this can affect health, especially in those who are 65 years or older, or have a long-term health condition and they published information ahead of the recent heatwave here: ukhsa.blog.gov.uk/2022/07/14/staying-safe-in-extreme-heat/

The Care Inspectorate has produced guidance for service providers around design, planning and construction considerations for new or converted care homes for adults. This guidance includes information on ventilation of adult care homes and is available here: Care Homes for Adults – The Design Guide.pdf (careinspectorate.com) .

The Autism and Learning Disability Team engages regularly with HSCP leads across Scotland on their strategic approaches and why it is so important for them to increase capacity for autism diagnostic services and to redesign services which are sustainable. We do this on an individual basis and also through the networks of Social Work Scotland.

HSCPs are aware of the actions identified in the current “Towards Transformation” plan for autism and learning disabilities. This includes action on post diagnostic support for adults and the piloting in 4 HSCP areas of a single adult neurodevelopmental pathway. We continue working with the National Autism Implementation Team (NAIT) who help build capacity and expertise, acting as a bridge between national strategy and its implementation at local level by providing a hub of professional autism support and information. The Scottish Government provide funding to a number of charities to provide post diagnostic support locally, linking with HSCP service leads.

HSCP leads are linked into our leadership and engagement framework in partnership with people with lived experience focusing on the topic of mental health. In addition, we will be working with HSCPs as we scope out the work towards a Bill to introduce a commissioner for Autism, learning disabilities and people with neurodivergence.

It is not possible to provide the percentage of individuals admitted to NHS Scotland who are assessed for venous thromboembolism (VTE) as this data is not routinely recorded.

The General/Acute and Inpatient Day case Dataset (SMR01) contains records where pulmonary embolism and phlebitis and thrombophlebitis of the lower extremities are listed as the primary diagnosis.

These conditions are usually recorded in an inpatient setting, on the SMR01. The structure of the International Classification of Disease and Related Health Problems 10 revision (ICD10) does not allow for easy identification of Venous Thromboembolism.