Chamber and committees

Information on the number of Clinical Nurse Specialists by specialist cancer fields is not held centrally.

However, we recognise the scale of the challenge facing Health Boards across Scotland. We are working closely with partners to accelerate domestic and international recruitment to Scotland. New investment of £300m has helped services deal with system pressures over winter and the NHS Recovery Plan, backed by over £1bn, has introduced a range of direct workforce investments and new measures to support Boards’ capacity for both domestic and international recruitment.

Overall NHS staff and nursing staff levels are currently at a record high, following ten consecutive years of NHS Scotland workforce growth. We are investing £11m over the next five years in new national and international recruitment campaigns and have established a national Centre for Workforce Supply to provide labour market intelligence. We are also recruiting at least 200 registered nurses from overseas, with funding of £4.5m available to Health Boards to take this forward.

Our latest DCE lung cancer campaign entitled - ‘Settling In’ – was launched in May 2021 with the aim of increasing awareness of the early signs of lung cancer and encouraging people with possible symptoms to contact their GP practice. Almost two-thirds (64%) of those who saw the campaign did something as a result, including looking out for symptoms and deciding to go to their GP practice with possible signs. As committed to in our NHS Recovery Plan, a new early cancer diagnosis vision for Scotland is also being developed to direct early diagnosis efforts over the coming years, including that of lung.

I refer the member to the answer to question S6W-07488 on 25 April 2022. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

Long waiting times for treatment are unacceptable and we remain committed to meet the standard that 90% of patients begin treatment within 18 weeks of referral. This is why we have allocated £40 million to NHS Boards to improve CAMHS in the last financial year. £4.25m of that allocation was directly focussed on offering treatment to those already on CAMHS waiting lists, with a view to clearing all backlogs by March 2023. Whilst Boards continue to respond creatively to treat significant numbers of children and young people, their priority is to ensure that emergency and urgent cases are seen, and this has regrettably meant longer waits for some.

Waiting lists are managed locally by individual Health Boards. However, the Scottish Government has issued key principles for Health Boards to shape their policies for managing waiting lists. These set out our expectation that patients on the waiting list, and where appropriate their families, are kept informed of their situation; that those waiting the longest should be contacted first; and that support and personalised, meaningful signposting should also be provided to the patient and their families, with informed consent, to access other services within the children and young people's service network, in cases where families' needs are best met elsewhere.

Additionally, to enhance the support that is available, in the last financial year we provided local authorities with an additional £15 million to fund over 230 new and enhanced community-based mental health supports and services for children and young people. This financial year, we will issue a further £15 million to councils to fund the continuation of these supports.

This funding gives local authorities the flexibility to implement supports on the basis of local priorities and to make services available to children and young people who are awaiting CAMHS treatment or for whom CAMHS is not suitable. Councils have advised us that the community-based supports have started receiving referrals from CAMHS.

The services include mental health support for LGBTQI+ children and young people in Glasgow; family mediation and counselling services in Dundee; online self-directed support and counselling in Aberdeenshire and Bereavement and Loss support in the Scottish Borders. Establishing these services is a significant step forward in supporting the mental health of our children and young people, making sure they receive the help they need when they need it.

This data is not centrally available; aggregated data for Child and Adolescent Mental Health Service (CAMHS) Waiting Times is sent to Public Health Scotland (PHS) from each NHS Board. It does not contain explicit information on the type of assessment or treatment children and young people are waiting for. It reports on the number of referrals for young people to CAMHS; numbers waiting to start treatment and total waiting; not accepted for treatment from referral and Did Not Attend status numbers for 1st contact appointments; and the time between referral and first treatment.

The CAMHS statistics capture children and young people who meet the CAMHS criteria. Children and young people who are waiting for a neurodevelopmental assessment but do not meet the CAMHS criteria are not reported in these statistics.

PHS are developing a patient-level dataset to provide detail for these aggregate CAMHS statistics. This Child, Adolescent and Psychological Therapies National Dataset (CAPTND) will contain reason for referral to CAMHS, which will include assessments for neurodevelopmental support needs where this is included in the care plan.

The Scottish Government is committed to working with Boards to implement the National Neurodevelopmental Specification: Principles and Standards of Care for Children and Young People, published in September 2021, which specifies service standards that all children’s services should follow, to ensure access to support is effective and consistent across Scotland.

As part of the Scottish Government’s 2021-22 Mental Health Recovery and Renewal Fund, we allocated an additional £40 million to NHS Boards to improve Child and Adolescent Mental Health Services (CAMHS) and to clear waiting list backlogs by March 2023. We are also continuing to work directly with Health Boards with the poorest performance to ensure the 18 week waiting time standard is met.

As set out in the Mental Health Transition and Recovery Plan, we are taking a whole systems approach to improving children and young people’s mental health. Alongside investing in acute CAMHS, we are ensuring community services and school counselling are also available in a responsive and timely manner. We are developing responses to young people experiencing crisis and distress, as well as investing in approaches that promote prevention, early intervention and reducing stigma.

To support this approach, an additional £15 million was provided to local authorities in 2021-22, with the same amount being provided again in 2022-23, to deliver locally based mental health and wellbeing support for 5-24 year olds in their communities, providing alternative treatment options focussed on prevention and early intervention. We have also ensured access to counselling support services in all secondary schools.

This package of commitments is designed to ensure the right help is available, in the right place, at the right time. This additional investment will contribute towards delivering our commitment to ensure that, by the end of this Parliament, at least 10% of frontline NHS spend goes towards mental health, with 1% going towards CAMHS.

The National Workforce Strategy for Health and Social Care was published on 11 March. It is designed around the strategic objectives which support recovery, growth and transformation of health and social care services. Through the plan we have committed to modelling a sustainable cancer workforce. This work will be taken forward by a subgroup of the National Cancer Recovery Group.

Alongside the work on the National Workforce Strategy, a short life working has been established to review immediate pressures on oncology services and identify measures needed to ensure we have a sustainable and resilient oncology service across Scotland. This group is chaired by our Senior Medical Officer and is reporting directly to the Cabinet Secretary for Health and Social Care.

Anyone who is not able to use the app, including children, can obtain a paper vaccination certificate from the NHS Inform website or our COVID Status Helpline on 0808 196 8565 . We are currently developing a way to issue paper certificates for proof of recovery, which is evidence of a positive PCR test; and an age-appropriate way to provide digital access to Covid Status for children. In the meantime people who cannot use the app can show proof of their recovery status using the email or text messages that notifies them of a positive PCR test.

In response to the COVID-19 pandemic, the Scottish Government Chief Scientist Office (CSO) launched a call for Rapid Research in COVID-19 on 25 March 2020 and a second call specifically addressing longer-term effects of COVID-19 infection on 5 October 2020. Following independent expert review, 65 projects were funded in total, 56 through the Rapid Research programme and 9 through the long COVID call.

None of the projects specifically address microemboli and long COVID. Many of the projects are still active and include research on vascular aspects of COVID-19.

The full list of funded projects is available from the CSO website

https://www.cso.scot.nhs.uk/covid-19-research/

The CSO's Translational Clinical Studies Committee and the Health Improvement, Protection and Services Research Committees each meet twice per year to consider funding applications. Details of the application process are published on the CSO website.

Grant Funding – Chief Scientist Office (scot.nhs.uk)

Applications looking at links between microemboli and long COVID may be submitted to the CSO funding committees. In common with all other applications, these would go through the CSO's standard independent peer review process.

The Scottish Government is committed to ensuring that people living with kidney diseases are able to access the best possible support and benefit from healthcare services that are safe, effective and put people at the centre of their care. We expect NHS Boards to adhere to current guidelines on the diagnosis and treatment options from authorative sources such as the National Institute for Health and Care Excellence (NICE) and the UK Kidney Association (UKKA).

In Scotland we are at the forefront of using service and performance data to improve care and diagnosis of kidney disease. This includes the work of the Scottish Renal Registry which reports on patients receiving renal replacement therapy and promoting excellence in renal care in Scotland through best practice audits.

The National Cancer Quality Steering Group (NCQSG) has responsibility for the development and oversight of tumour specific national quality performance indicators (QPIs) to measure the quality of care for patients, this includes a set specifically for renal cancers.

We have also invested in research which is intended to inform new approaches for earlier diagnosis of kidney disease through the Scottish Chief Scientist Office: Kidney function and cancer risk: An analysis using creatinine and cystatin C in a cohort study (nih.gov) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413238/ .