Chamber and committees

There is no freeze on Modern Apprenticeships (MAs) this year. We are on track to meet contracted demand for MAs across the childcare related frameworks.

The Scottish Government has not set a prescriptive list of “reasonable costs” for welcome arrangements.

Local Authorities are best placed to determine how best to provide support to the Ukrainian people in their areas arriving under the Scottish Super Sponsor Scheme and the Scottish Government is committed to reimbursing them as delivery partners for any reasonable costs incurred in providing that appropriate support.

While the Scottish Government provides the policies, frameworks and resources for high quality healthcare, we fully expect NHS Board's to utilise funding, facilities and staff while taking account of national and local priorities to meet local health needs.

We expect NHS Boards to plan their facilities and workforce to deliver these services, ensuring the provision of safe, effective and high quality patient care, delivered by the right professional at the right time.

Spend on agency is around 2% of the total NHS expenditure. The majority of temporary staffing in NHS Scotland comes from staff banks; these are NHS staff, working on NHS terms and conditions.

The pandemic has had an impact on bank, agency and locum spend. The rising spend is not unanticipated.

Although bank and agency staff play a crucial role, it is important that we continue our long term investments to attract and retain permanent staff.

The Cabinet Secretary for the Constitution, External Affairs and Culture and I meet regularly with Creative Scotland to discuss our shared priorities, including funding for cultural organisations during the cost of living crisis which was discussed at the most recent meetings in June and October.

The Scottish Government is in regular dialogue with the sector, and will continue to work with it to identify barriers to immediate and long-term recovery, and to do everything within our powers and resources to help those most affected by current economic challenges.

The Cabinet Secretary for the Constitution, External Affairs and Culture and I hosted a virtual roundtable with public bodies and representative groups on 10 November. The Scottish Government will be hosting further roundtable discussions with the sector this winter.

The Scottish Government supports our healthcare support workers (HCSWs) to train to become registered nurses while remaining in the workforce in their local NHS Board area. The Open University offer this pathway and Scottish Government provides £10,000 backfill funding to NHS Boards per student for each of the three years of study. For the 2022-23 academic year, the Scottish Government has increased the target number of Open University places by 12% to 123 places.

The Scottish Government also provides support to enable HCSWs to undertake a HNC Healthcare Practice programme by providing £8,000 in backfill funding to NHS Boards per student per year. Completion of the HNC programme can lead students to progress to nursing or allied health pre-registration degree programmes, on which there may also be the opportunity for advance entry to year 2.

On behalf of the Scottish Government, and as part of their review of career pathways, NHS Education for Scotland have produced a Development and Education Framework for Bands 2-4 nursing, midwifery and allied health professional HCSWs. The framework is available at the following link: https://www.nes.scot.nhs.uk/our-work/health-and-care-support-worker-development-programme/

This ongoing work has focused on a national framework as a ‘Once for Scotland’ approach which outlines the knowledge, skills and behaviours required to enable HCSWs to deliver safe, effective and person centred care. The framework also provides information on how to progress into a registered practitioner role, including as a nurse.

I refer the member to the answer to question S6W-11247. On 27 October 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 .

To provide patients with some reassurance around the possible length of their wait, the Scottish Government have launched a new online platform, which is available at https://www.nhsinform.scot/waiting-times . Developed in conjunction with NHS 24 and PHS, the platform provides patients with information on planned care waiting times by giving an indication of how long patients typically waited over the last quarter. This includes information on the number of patients admitted for treatment as well as the typical wait experienced by people during this time period.

We recognise the impact that long waiting times can have on a patient’s mental health, so the platform also includes information for patients to keep as fit and healthy as possible while waiting for treatment. In addition, the Healthy living | NHS inform page provides advice and tools which includes information on mental wellbeing.

In an effort to reduce the waiting time for patients awaiting cataract surgery, Health Boards across NHSScotland are undertaking additional cataract surgical sessions and independent sector contractors are providing additional support, within NHS facilities, to increase the number of cataract procedures delivered. This will reduce the overall number of patients waiting for surgery as well as their length of wait.

In tandem with this – and in line with guidance from the Royal College of Ophthalmologists - Scottish Government clinically led peer reviews are taking place across all Health Boards. Supporting teams to adopt more efficient ways of working in order to increase the number of patients that can be treated within each cataract only surgical session forms part of these reviews.

Sequential bilateral cataract surgery is also undertaken by some surgeons, particularly in remote and rural areas and where patients’ ability to work has been affected. This prevents duplication of effort across the patient’s journey, as well as reducing the carbon footprint.

The Scottish Government has also commissioned the Centre for Sustainable Delivery (CfSD) to support an increase in theatre productivity, including the development of a national Blueprint which will outline how Health Boards can increase efficiency across the cataract surgical journey. This will be disseminated to all Health Boards in the coming weeks.

We are aware of the distress to families affected by tissue and organ retention at post mortem. We are further aware that while the majority of families have been reunited with their loved ones’ remains, there are a few cases in which this has not been possible.

The Crown Office and Procurator Fiscal Service (COPFS) and NHS boards have responsibility for facilitating the reunion of families with their loved ones’ remains. In cases where COPFS has been made aware of historic retained organs, it has worked with Police Scotland to identify and contact families and facilitate their wishes. However, where the Scottish Government is made aware of such situations we will liaise with the COPFS or NHS boards to try to reunite those affected by organ retention with their loved ones’ remains.

It is now rare for an organ to be retained to establish cause of death. In any case where retention of an organ is considered a realistic possibility, the Procurator Fiscal will ensure that the nearest relative is made aware at the earliest opportunity, preferably by someone already known to them (such as a Victim Information and Advice officer or police Family Liaison Officer).

The Procurator Fiscal will also ensure that the options for how that organ is dealt with following analysis are explained to the family and that, where they wish to discuss and express a view, their request is followed if possible. In certain circumstances, the organ may be retained for research or education but only where the pathologist believes there would be value in doing so and only with the clear authorisation of the nearest relative and the consent of the Procurator Fiscal.

COPFS works with families affected by retention of organs and follows their well-established procedures following a procurator fiscal arranged post-mortem. The retention of tissues and organs following post mortem examination must also follow guidelines produced by the Royal College of Pathologists.

In addition, COPFS maintains a record of all retained organs and carries a monthly reconciliation with pathology providers to ensure that all organs that have been retained are known about and that affected families have been made aware.

At the time when issues were raised in relation to organ retention, a package of work was completed. This included the work completed by the Independent Review Group on the Retention of Organs at Post Mortem Examination, which was established in September 2000 by the then Scottish Executive. The final report was published in November 2001.

And the Audit Scotland validation exercise, which was instructed by the then Auditor General for Scotland to undertake an exercise to validate the information provided to the Review Group by NHS trusts (now known as NHS boards).

Standards for the management of hospital post-mortem examinations were developed and subsequently updated in 2016 by Healthcare Improvement Scotland. The standards apply to NHS boards and staff involved in hospital post-mortem examinations, including the process for authorisation. This includes, but is not limited to, pathologists, anatomical pathology technologists, mortuary technicians, medical and nursing staff, staff involved in transportation of the deceased, and staff involved with bereavement care and support.

As well as this package of work, the Scottish Government created and implemented the Human Tissue (Scotland) Act 2006 which updated the legislation around post-mortem examinations. This ensured that for hospital post-mortem examinations authorisation was required for a post-mortem to take place.