Chamber and committees

The Scottish Government intends to publish the Implementation Plan for the Framework for Pain Management Service Delivery in summer 2022. As advised in a letter to the Convenors of the Cross Party Group on Chronic Pain on 15 June, Ministers intend to meet with patient representatives of the Group once it has been published.

Extensive engagement of people with lived experience was carried out at all stages to develop the Framework. This includes through representation on the National Advisory Committee for Chronic Pain and a national survey of people with chronic pain and their carers. We have also sought input from other stakeholder groups during the development of the Framework including NHS staff, service planners and third-sector partners. This has included work to bring together the diverse clinical disciplines involved in pain management in order to inform and support activities to improve chronic pain services.

The draft Framework also underwent public consultation with a high level of responses from people with chronic pain and other stakeholders. We are grateful for the views and ideas shared through the consultation which have been used to inform the Aims and Actions we will set out in the forthcoming Implementation Plan. Officials will provide a draft of the Plan to Ministers within the coming weeks and publication is anticipated shortly after this.

I refer the member to the answer to question S6W-09303 on 5 July 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 .

There are a number of measures in place to ensure that ancient and veteran trees are protected, including as protected areas for nature, which engage statutory mechanisms to protect sites of ecological interest, such as ancient woodlands.

Protection for woodland is also in place via felling regulations under the Forestry and Land Management (Scotland) Act 2018. It is only in exceptional circumstances that a felling permission would be granted for an ancient woodland, such as public safety or improving woodland condition. Where felling permission is not applicable, the Control of Woodland Removal Policy only permits removal of existing woodland where it would achieve significant and clearly defined additional public benefits.

Scottish Planning Policy 2014 (SPP) seeks to protect and enhance ancient semi natural woodland as an important and irreplaceable resource, together with individual trees. SPP states that Tree Preservation Orders (TPO) can be used to protect individual trees and groups of trees considered important for amenity or their cultural or historic interest. Draft NPF4 is currently considering how to strengthen protection.

We recognise the important role ancient and veteran trees play in our ecosystems, which is why we have committed to support work to restore and expand Scotland’s precious Rainforest habitat.

The Scottish Ancient Woodland Inventory records the location of ancient and other long established semi-natural woodlands, and local authorities record TPO’s for protection purposes. We know this Inventory has an important role to play in ensuring we can identify where protection is needed, which is why we have committed to establish a new National Register of Ancient Woodlands, building on the existing inventory.

The Scottish Government intends to publish the summary report on the responses to the public consultation alongside the Implementation Plan for the Framework for Pain Management Service Delivery later this summer.

In 2020, the latest year for which data are available, there were 912 chronic liver disease deaths in Scotland. Of these, 759 were alcohol-related liver disease deaths. Data are not available for obesity related liver disease deaths.

Liver diseases are generally avoidable or treatable if diagnosed at an early stage and stigma often prevents people from accessing treatment; 75% of people are currently being diagnosed at a stage when it is too late for lifestyle changes or intervention.

We take a whole population approach to reducing alcohol consumption and the risk of alcohol-related harms across the population and that’s why we’ve taken a range of actions to reduce the availability, attractiveness and affordability of alcohol.

We are also taking action to reduce the impact of poor diet on people’s health which is also a significant and growing contributor to liver disease. We are taking wide-ranging action to support healthier choices, as set out in our 2018 Diet and Healthy Weight Delivery Plan , and have set a challenging aim to halve childhood obesity by 2030 and significantly reduce diet related health inequalities.

The intelligent Liver Function Testing pathway (iLFT) used in Dundee, Tayside has been identified as best practice of early detection of liver disease.

It uses an automated, algorithm-based system to further investigate abnormal liver function test results on initial blood samples from primary care.

The Scottish Government has identified the iLFT pathway as eligible for adoption across NHS Scotland as part of its Modern Outpatient Programme.

The Tayside iLFT group is collaborating with other NHS Scotland Boards to assist with the implementation of iLFT within their laboratories and primary care services.

The existing National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of cirrhosis recommends that very heavy daily drinkers (men drinking up to 50 units per week or women 35 units per week) should be screened for cirrhosis using one of the newer non-invasive diagnostic technologies.

NICE suggests FibroScan and in 2020 published a Medtech innovation briefing around its use in primary care settings, but blood tests for fibrosis markers are also accurate and should be available to any clinician.

The Scottish Government currently has no plans to increase the use of FibroScan and enhanced liver fibrosis (ELF) tests in primary care in order to improve the early diagnosis of liver disease.

However, the Office for Health Improvement and Disparities is developing UK Clinical Alcohol Treatment Guidance, which is expected to include the issue of liver disease. These are expected to be published for consultation later this year. Once finalised, the Scottish Government will consider recommendations regarding early diagnosis of liver disease.

The Scottish Government is committed to tackling stigma.

In December 2021 a national campaign was launched to tackle the stigma people with problematic alcohol and drug use face. This campaign sought to communicate that drug or alcohol problems are health conditions; people should receive help and support, not judgement.

We are working with Scottish Health Action on Alcohol Problems to develop an action plan in relation to alcohol and stigma. This will include advice from those with lived experience, third sector organisations and academics.

We are supporting the development of the forthcoming UK-wide clinical guidelines for alcohol treatment, led by the Office for Health Improvement and Disparities. The guidance will look to introduce new approaches to treatment, including non-stigmatising service delivery.

On 20 June 2022, Public Health Scotland launched the Challenging Weight Stigma Learning Hub. The learning hub aims to raise awareness of the impact weight stigma can have on people living with overweight and obesity and what health professionals can do to mitigate this. It is interactive and has been developed alongside academics, health professionals and those with lived experience of stigma.

The Scottish Government is committed to ensuring the sustainability of the NHS and in March 2022 we published, in partnership with CoSLA, the National Workforce Strategy for Health and Social Care . The Strategy outlines our shared vision: a sustainable, skilled workforce with attractive career choices where all are respected and valued for the work they do. To ensure all Health Boards have sufficient capacity, planning guidance has been issued to support the production of new Three Year Workforce Plans, supported by local systems’ workforce data.

Staffing across NHS Scotland is at record levels, having increased by 23.5% under this Government. There are also record high numbers of nursing and midwifery staff, up by 14.8% since September 2006, and numbers of student nurses entering Scottish Government funded degree programmes will increase by 9% in 2022-2023, the 10 th successive increase in recommended student numbers.

We are investing £11 million over the next five years in new national and international recruitment campaigns and have established a national Centre for Workforce Supply to support the development and implementation of resource strategies and services across the system. We are also carrying out work to promote service innovation and redesign, such as utilisation of Associate Physicians, Advanced Nurse Practitioners and Health Care Support Workers; all of which will support maintaining appropriate staffing levels.

The Scottish Government does not hold information on how many crimes were reported in connection with the use of e-scooters.

Police Scotland collect data on road traffic accidents that were a) reported to the police and b) involved someone being injured or killed. Figures for 2021 are provisional and final figures will be published in October 2022. Figures for 2022 are still being collected and verified and are therefore not currently available.

The following table shows the number and severity of casualties in 2021 who were injured in road accidents that involved an e-scooter and the location of the accident.