Chamber and committees

Article 26 of the UN Convention on the Rights of Persons with Disabilities ( Article 26 – Habilitation and rehabilitation | United Nations Enable ) sets out several obligations relating to habilitation and rehabilitation.

These obligations have the stated aim of enabling “persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life”, through timely access to “multidisciplinary assessment of individual needs and strengths” to “support participation and inclusion in the community and all aspects of society.”

The Scottish Government are committed to ensuring that people who have had a stroke receive the best possible care as quickly as possible. We know that early assessment of rehabilitation need following an acute stroke, and the delivery of rehabilitation by a multi-disciplinary team, are important elements of improving outcomes and these are priorities within the Scottish Stroke Improvement Plan (2014).

Through the Scottish Stroke Improvement Programme (SSIP), NHS boards are required to demonstrate their provision of access to acute therapy assessment, access to inpatient stroke therapy, access to community stroke therapy and the availability, by days per week, of community therapy input.

Article 26 also requires the provision of appropriate training for professionals working within habilitation and rehabilitation, as well as the “availability, knowledge and use of assistive devices and technologies, designed for persons with disabilities”.

Through SSIP reviews, NHS boards are also required to demonstrate that health and social care staff in hospital and community settings are trained to a level appropriate for their involvement in stroke care. Where appropriate, highly-trained specialist staff involved in the rehabilitation process are best placed to advise on the provision of assistive devices and technology that may be of benefit to people affected by stroke.

The most recent Scottish Stroke Improvement Programme annual national report ( Scottish stroke improvement programme 2021 national report - Scottish stroke improvement programme - Publications - Public Health Scotland ), which includes data from the Scottish Stroke Care Audit (SSCA), was published on 29 June 2021.

This annual report reflected the impact of the COVID-19 pandemic on the provision of stroke services, as well as the incredible work that NHS Scotland staff in stroke services continued to deliver in unprecedented circumstances.

This report shows us the high level of care provided for stroke patients throughout the Covid-19 pandemic. It is positive that, despite the pandemic, performance improved in a number of key areas.

We remain focused on ensuring that people who have had a stroke receive the best possible care as quickly as possible to enable them to live longer, healthier and independent lives.

The Scottish Stroke Improvement Programme Lead, who conducts the annual review process, meets with NHS boards on behalf of Scottish Government. This engagement allows us to understand the provision of stroke services, including training and staff capacity across NHS boards, and where challenges or opportunities for sharing good practice exist.

Scottish Government representatives also sit on the National Advisory Committee for Stroke (NACS), where specialists from NHS boards across Scotland provide expert advice and recommendations relating to Scottish Government policy for the provision of stroke care. NACS has recently developed the Progressive Stroke Pathway ( Strokes: progressive stroke pathway - gov.scot (www.gov.scot) ), which was published on 22 March 2022. This document sets out an ambitious vision of what a progressive stroke service in Scotland should look like.

The rehabilitation sub-group of NACS, which is made up of specialists across a range of disciplines from various NHS boards in Scotland, played an important role in helping to shape the Progressive Stroke Pathway recommendations relating to stroke rehabilitation services. On the back of this input, the Progressive Stroke Pathway makes a number of recommendations relating to the provision of stroke care, and the contributions of appropriate training and staff capacity in helping deliver this.

We will continue to engage regularly with these specialists from across Scottish NHS boards as we move into the implementation phase, considering the recommendations made in the Progressive Stroke Pathway.

The Scottish Stroke Improvement Programme Lead, who conducts the annual review process, meets with NHS boards on behalf of Scottish Government. This engagement allows us to understand the provision of stroke services, including training and staff capacity across NHS boards, and where challenges or opportunities for sharing good practice exist.

Scottish Government representatives also sit on the National Advisory Committee for Stroke (NACS), where specialists from NHS boards across Scotland provide expert advice and recommendations relating to Scottish Government policy for the provision of stroke care. NACS has recently developed the Progressive Stroke Pathway ( Strokes: progressive stroke pathway - gov.scot (www.gov.scot) ), which was published on 22 March 2022. This document sets out an ambitious vision of what a progressive stroke service in Scotland should look like.

The rehabilitation sub-group of NACS, which is made up of specialists across a range of disciplines from various NHS boards in Scotland, played an important role in helping to shape the Progressive Stroke Pathway recommendations relating to stroke rehabilitation services. On the back of this input, the Progressive Stroke Pathway makes a number of recommendations relating to the provision of stroke care, and the contributions of appropriate training and staff capacity in helping deliver this.

We will continue to engage regularly with these specialists from across Scottish NHS boards as we move into the implementation phase, considering the recommendations made in the Progressive Stroke Pathway.

The Scottish Government does not hold information containing a detailed breakdown of stroke rehabilitation services provided in individual health boards.

Within NHS GG&C, acute stroke thrombolysis is already available on a 24/7 basis. This is currently based at the Queen Elizabeth University Hospital (QEUH), with patients transferred for thrombolysis where appropriate. Work is ongoing to establish a telemedicine thrombolysis model to provide 24/7 thrombolysis at other sites.

The Scottish Government recognises that thrombectomy procedures can significantly improve outcomes and quality of life for some people who have suffered an ischaemic stroke by avoiding or reducing the level of disability. We are committed to introducing a high quality and clinically safe thrombectomy service in Scotland and are making important progress against this commitment. In NHS Greater Glasgow and Clyde, the thrombectomy service is currently in the test of change phase, and has provided thrombectomies to 13 patients since October 2021.

Since its launch in October 2020, the value of the Self-Isolation Support Grant has been aligned to the value of the Real Living Wage (RLW) during the period that a worker might be required to self-isolate.

The Grant was initially available to workers in receipt of Universal Credit, but was expanded to workers who earn less than the RLW on 16 February 2021.

The Scottish Government is committed to supporting and empowering women and girls to reach their full potential through our sustainable and inclusive economic growth ambitions.

In our recently published Best Start, Bright Futures: Tackling Child Poverty Delivery Plan 2022-26, we committed to building on existing work to remove barriers to employment, taking a strategic and intersectional approach to tackling employment inequalities. We know that the voice of lived experience is vital in developing and implementing policy to tackle poverty, and will continue to work with partners in the delivery of this plan.

To incorporate understanding of women’s experiences, we will be working in partnership with our key stakeholders and partners, as well as key advocacy groups who work directly with parents in the priority families groups outlined within the Tackling Child Poverty Delivery Plan. We have committed to establishing a Parental Lived Experience Panel in Summer 2022, to help inform our activity around employability. This will build on the on the success of our existing Lived Experience Panel, which has been invaluable in co-designing No One Left Behind, and aligns with our wider commitments to embedding the Scottish Approach to Service Design in employability. Work is also underway to develop a lifetime skills offer to support individuals and businesses to develop the skills needed now and in the future, and as these proposals are developed, we will link with key expert groups to inform the process.

The latest forecasts produced by the Scottish Fiscal Commission forecast that £15 million will be spent on Self-Isolation Support Grants in 2022-23. The Commission will be publishing new forecasts on 31 May 2022 following engagement with Scottish Government. We will continue to collect and publish monthly Management Information on applications, awards, and expenditure.