Chamber and committees

The Scottish Government takes an evidence-based approach to tackling child poverty by ensuring that plans are underpinned by evidence and that we carefully monitor progress. The evaluation strategy summarises the approach which is split across three key areas:

(1) Careful monitoring of the four child poverty targets(relative poverty, absolute poverty, low income and material deprivation, and persistent poverty).

(2) Examination of the three drivers of poverty via the child poverty measurement framework (income from employment, cost of living, and income from social security and benefits in-kind) and

(3) monitoring impact of key interventions on child poverty.

The hyperlinks to all key documents mentioned above are included in the background note.

Healthcare Improvement Scotland (HIS) is the health body which undertakes assessments and reviews of the quality of care throughout Scotland, however third sector organisations are not captured by their current inspections of NHS services. Health Boards might arrange for treatment to be provided for patients by non-NHS Scotland providers in exceptional circumstances for clinical reasons however the responsibility for consultation, diagnosis and treatment of patients fully remains with the originating Health Board.

Independent Healthcare is regulated by HIS which consists of independent hospitals, private psychiatric hospitals, independent clinics and also voluntary hospices; some of which are commissioned to provide NHS services.

We have established a £10 million long COVID Support Fund, which aims to support NHS Boards to increase the capacity of existing services providing support to people with long COVID, develop these into more clearly defined pathways and to provide a more co-ordinated experience for those accessing support.

We have also commissioned NHS National Services Scotland to establish a National Strategic Network for long COVID. This brings together representatives from NHS Boards across Scotland to provide a forum for the exchange of learning and best practice in delivering supporting and services for people with long COVID.

In May 2023 we published an analysis of survey responses from NHS Scotland Boards on their arrangements for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) care. This is accessible at https://www.gov.scot/publications/myalgic-encephalomyelitis-chronic-fatigue-syndrome-cfs-services-scotland-findings-analysis-surveys-issued-nhs-boards-autumn-2022/ . The report highlights examples noted by NHS Boards of where practice developments relating to ME/CFS and long COVID respectively may have mutually supportive benefits for patient care, and the management of other long term conditions which share common symptoms.

The resource for Mental Health and Wellbeing in Primary Care Services was published in June 2022. The resource was developed to support staff working as part of a multi disciplinary team within GP settings. The resource provides a directory of additional sources of help, which patients can access, to complement the support, assessment and treatment they receive from the team. It brings together a range of national resources and tools that support and improve mental health and wellbeing. Section 7 of the resource contains links to sources of support specifically for Perinatal and Parent Support. The resource was promoted via the Mental Health in Primary Care National Oversight Group, Mental Health in Primary Care Leads and NHS Board Mental Health Leads.

The Scottish Government recognises the document is not exhaustive and there will be a number of local resources and tools that staff will also want to use. The resource can be found at the following link the link for the resource Resources for Mental Health and Wellbeing in Primary Care Services (www.gov.scot) .

In addition to this wider work, there is also a resource dedicated to promoting third sector perinatal and infant mental health services. This resource is available to provide information to families and professionals, including in primary care, to raise awareness of over 110 local third sector services. In the last year the resource page has received 2,693 views. Inspiring Scotland have been promoting the tool on X and in their recent newsletter which reaches NHS staff as well as wider partners. The resource can be found here: Perinatal and Infant Mental Health Third Sector Service Directory - Inspiring Scotland .

The Scottish Government have regular and consistent engagement with representatives of the care sector.

Recent engagement has explored resilience, viability, surge pressures, fair work, Healthcare Framework for Adults Living in Care Homes, workforce challenges and support, including NCS design and Workforce Charter.

The Scottish Government has worked with NHS Education for Scotland (NES) to develop ‘Perinatal mental health curricular framework : a framework for maternal and infant mental health’. This framework sets out the different levels of knowledge and skills required by members of the Scottish workforce who have contact with mothers and their babies, to enable them to support mothers, babies and their families to have positive well-being and good mental health during the perinatal period.

The Scottish Government has also worked with NES to advance training on Perinatal and Infant Mental Health. Training in evidence-based approaches and interventions is delivered to staff across sectors and across practice types including informed, skilled, enhanced and specialist, as appropriate to their role.

This includes education and training within Perinatal and Infant Mental Health through e-learning modules which are available on TURAS, covering seven topic areas of essential knowledge. We have also worked with NES to create a specialist Perinatal and Infant Mental Health Learning Programme which allows NES to track the progress of staff in Specialist Perinatal and Infant Mental Health Services including Mother and Baby Units, Community Perinatal Mental Health Teams and Maternity and Neonatal Psychological Interventions.

During 2024-25, NES will continue to promote training at all levels across the sectors that support the development of positive relationships and attachment in the early years. This will be achieved through increasing workforce capacity to deliver evidence-based parent-child relationships focused interventions and approaches from the antenatal period, through infancy and across childhood.

The Perinatal and Infant Mental Health Managed Clinical Network Scotland (PIMHNS) has developed a workstream ‘Parents as Patients’ to develop guidance around joined-up working (i) between perinatal/infant mental health services and other mental health services (e.g. general adult mental health, unscheduled care, liaison mental health), and (ii) between perinatal/infant mental health services and other relevant medical care services (particularly primary care and acute hospital care). The important role of the third sector will feature in both. Initial meetings of two Short Life Working Groups (SLWG) have taken place to progress these workstreams, along with amending the existing care pathways which were published in 2021 ( https://www.nn.nhs.scot/pmhn/wp-content/uploads/sites/11/2021/06/Care-Pathways-full.pdf ) .

Both SLWGs will focus on the themes of:

• Interfaces – to cover both care between specialist and general or universal services. This would also include principles of joint working and good practice.
• Education and training – to address knowledge of parent infant relationships and infant mental health needs as well as child protection issues and risks in relation to childbearing.

The final guidance and updated care pathways are due to be published in the final quarter of the financial year.

The Scottish Government recognises that social prescribing can be an effective method of improving an individual’s physical, mental and social health. It plays an important role in helping us achieve our commitment to prevention, holistic care and Realistic Medicine. Our Primary Care Community Link Worker programme has been in place since 2014 and a 2017 commitment to create 250 Community Link Worker posts in general practice has been achieved.

Due to the wide range of activity which is described as social prescribing, there are many Scottish Government policies and resources which play a role in supporting its delivery. For example, we recognise the important role played by local organisations in supporting the health and wellbeing of their communities and we are working with the community and voluntary sector to look at how we can enhance the capacity of the sector to help those organisations address the challenges they face. The ongoing development by the ALLIANCE of the ALISS online database helps to provide information on community resources and our Green Health Partnership programme led by NatureScot helps to promote the connection between health and the natural environment.

We recognise that there may be a need for more national guidance to support Community Link Workers. We are currently considering how to take that forward in relation to the Community Link Worker programme in Primary Care. While this work will focus on Link Workers in Primary Care, we hope that there will be wider learning that may be able to be shared with the wider social prescribing community.

The Scottish Government does not hold this information centrally as it is a matter for NHS Boards.

Any decision to introduce changes to a national screening programme in Scotland is guided by the recommendations of the UK National Screening Committee (UK NSC), an independent expert advisory group which advises all four UK nations on screening policy. The UK National Screening Committee is expected to make a recommendation on the use of cervical self-sampling in the screening programme later this year.

The Scottish Government recognises the potential of cervical self-sampling to improve uptake of cervical screening. In Scotland, a working group has been established to consider potential models to understand any changes that would be required to the screening programme to support an initial roll-out. This work will be influenced by the on-going work of the UK NSC and emerging global research.