Chamber and committees

The National Elective Coordination Unit (NECU) does not directly remove patients from NHS health board waiting lists. As part of the agreed pathway to support national waiting list validation, and to ensure a patient’s appointment requirements are accurately recorded, NECU’s digitally supported waiting list validation methodology collates the information provided by patients, before returning it to the NHS Board of residence for update within patient administration systems.

To ensure any removals from waiting lists are appropriate, the NECU system records patient responses and their reason for removal. NECU follow-up directly with all patients who have not responded or have not left a comment explaining why they wish to be removed. Similarly, for patients who are unsure of the nature of their appointment, NECU follow-up with the patient directly. Where there is a clinical query from the patient, this is highlighted and the clinical team within the NHS Board of residence are asked to follow-up with the patient. To action a removal, Health Boards review both the patient response and the comment to ensure the reason for removal is appropriate.

Throughout the waiting list validation activity, patients remain on their respective waiting list until the NHS Board agrees it is appropriate to remove the patient.

NECU’s validation process is digitally supported, however, it is not a digital only process. Although all patients are contacted by text message and invited to access a patient portal to record their response, patients who may be unable to access the digital platform are followed-up by the NECU patient coordination team by telephone. If the patient is unable to be reached by both text message and telephone, a recommendation is returned to the NHS Board of residence to send a letter to the patient asking them to contact their Health Board directly. No amendment to the patient’s waiting list entry is actioned until confirmation is received from the patient.

NECU will publish its first annual update in October 2023.

Waiting List Validation is not new. Local Health Boards routinely validate patients on waiting lists to ensure patient requirements are correctly recorded. The establishment of a national approach is based on existing principles. By adopting these principles, a patient would not be removed from a waiting list without contact either by text or phone call, and if required, a clinical consultation.

After a consultation, it may be agreed no treatment is required at the time of referral. However, if the clinical team believe that a further referral for the same condition is likely in the future, or if it is felt that treatment will be required but the patient is not quite ready for this, or if the patient wishes to defer a decision on treatment, the patient will have the ability to make an appointment for the same condition at a future time.

Scotland’s Health Board’s operate their own escalation policy for the management of whole system capacity that includes well established processes with locally agreed trigger points. We believe Health Boards are best placed to judge what reasonable measures should be taken to maintain a safe service and ensuring patient safety.

The Winter Plan for 2023-24 seeks to provide a whole system approach to mitigate pressures that will be experienced over the course of winter. We know that this winter will present a sustained period of pressure for Health and Social Care services and we are committed to supporting local systems to ensure that appropriate levels of care are delivered at the right time.

It also reflects and recognises the complex landscape of Health and Social Care and articulates the actions that are being taken now to create capacity within the system and support resilience over the course of winter 2023-24.

The Scottish Government will continue to work with health boards and partners to support preparations for this coming winter.

The annual local government settlement will continue to be distributed in full using the needs based formula, which is discussed and agreed each year with COSLA on behalf of all their local authority members. The Scottish Government is always open to any suggestions on how to make the formula fairer, however any such requests must, in the first instance, come from COSLA.

The Scottish Government has noted with interest the recommendations made in the publication by Camurus - A primary care solution to Scotland’s drug deaths crisis and is working with local partners to address the challenges highlighted.

We are working with local Health Boards and Integration Authorities to ensure as many primary care providers as possible are actively implementing the MAT standards, including MAT standard 7 which seeks to ensure that people who choose to will be able to receive medication or support through primary care providers. We will ensure that Health Boards appropriately disperse the annual £10 million ring-fenced under the Enhanced Service contract to support the provision of drug services in primary care settings.

Healthcare Improvement Scotland has established a learning system for sharing best practice between local services which will include existing models for implementing MAT standard 7. Public Health Scotland will publish further information on potential best practice models which local areas may wish to consider.

The Scottish Government is supporting Health Boards and local practices to adopt multidisciplinary shared care arrangements wherever appropriate and we remain committed to tackling stigma across all drug services

Our recently published Cash-First Plan recognises the role of the community food sector, including pantries, in helping people to access cash and wider support in a crisis to reduce the need for emergency food parcels.

That is why we are providing The Scottish Pantry Network with £16,000 in 2023-24 to support the development and evaluation of cash-first models to tackle food insecurity within the context of pantry-type organisations. This funding will support them to work with their membership of around 20 pantry initiatives to increase access to cash-first support alongside access to dignified food services, and to develop learning and resources that can be shared with pantries beyond their network.

Pantries and the wider community food sector can also contribute to Scotland being a Good Food Nation by promoting healthier diets, increasing access to local and sustainably sourced foods and supporting our climate ambitions.

The Scottish Government has no current plans to provide financial support for homes to use Hydrotreated Vegetable Oil for heat. However, we already offer a comprehensive support package for domestic heat and energy efficiency measures through our Home Energy Scotland service.

As we deliver our Heat in Buildings programme our delivery programmes and support mechanisms will support the phase out of fossil fuel heating systems towards zero emissions heating systems in existing buildings, in tandem with achieving a good standard of energy efficiency across all buildings, in line with our strategic priorities.

In line with the recommendation of the Committee on Climate Change, we agree that bioenergy – such as biomass, bio-heating oil and bio-propane - should only be used in those applications where its carbon reduction impact is maximised, where alternative options are not available, and where it comes from sustainable sources. We recognise that, for a small number of homes, bioenergy might offer the only feasible way to reduce emissions from heating to displacing fossil fuels, especially where electric heating or heat pumps are unsuitable. We will therefore consider how such homes may be dealt with under any future regulatory system.

The Scottish Government has a Memorandum of Understanding with the Danish Government to promote collaboration on zero emissions heat, heat networks and energy efficiency, plus onshore and offshore wind energy and hydrogen economy.

In September 2023, I led a trade delegation of Scottish companies to Denmark to promote the Scottish renewables sector, exchange best practice, and develop key stakeholder relationships.

During meetings with the Danish Energy Agency and the Danish Parliament’s Climate, Energy and Supply Committee the onus on developers to provide meaningful community support, engagement, and benefit was discussed. In meetings with industry, this was further raised, with me impressing the importance of developers needing to develop proposals that deliver lasting tangible benefit to local communities when proposing new projects.

I was interested to hear about the work taking place in Denmark on cooperative and community ownership. Scottish Government officials are working with Danish Government officials to share lessons and better understand the Danish model, to inform Scottish Government thinking.

The Scottish Government is providing almost £3 billion in this financial year to help families and households face the increased cost of living. We continue to do everything we can within our limited powers to support those worst affected by the Cost Crisis.

This includes tripling the Fuel Insecurity Fund to £30 million this year, which supports anyone who is at risk of self-disconnection or self-rationing their energy use, regardless of which home they live in or fuel type they use. The Fuel Insecurity Fund continues to be a vital lifeline for many struggling households.

The Scottish Government is also taking action to support longer term ambitions for heat, energy efficiency and fuel poverty measures, including £119m targeted at fuel poor households. This will continue to be delivered through a package of support via long-standing programmes that have already supported over 150,000 households in or at risk of fuel poverty.

With subsidised support under the Energy Price Guarantee ending in July, the UK Government now has the means and opportunity to provide targeted support for those that need it the most. As the UK government holds the necessary levers, the Scottish Government has consistently called for the provision of meaningful, targeted support to those who need it most – which is why we support the call for the introduction of a social tariff to help the most vulnerable in our society.

The Scottish Government remains committed to delivering Anne’s Law within the National Care Service (Scotland) Bill (NCS) to further support the rights of people living in adult care homes to connect with their loved ones.

At Stage 1 of the NCS Bill, evidence was heard from seven committees and many individuals and representatives on a wide range of topics. The extension to Stage 1 has allowed the Scottish Parliament and the Scottish Government the necessary time to consider all of the evidence to best inform the development of the NCS Bill including Anne’s Law. During this time we have continued to work with care home providers, relatives and other stakeholders to develop the detail of Anne’s Law and prepare for its implementation.

Meantime, the Scottish Government has already utilised existing powers to adopt the core foundations of Anne’s Law through the development of two new Heath and Social Care Standards introduced in April 2022.

The new Standards establish that people living in care homes can expect to see someone who is important to them, even during an infectious outbreak and be able to name a person or persons who can directly participate in meeting their care needs. The Care Inspectorate now refer to these Standards when registering, inspecting and supporting care homes.

Furthermore, Public Health Scotland’s COVID guidance supports visiting during an infectious outbreak situation. Three named visitors can visit a resident, one per day, in the event of an outbreak, and essential visiting for end-of-life care and distress should always be supported, regardless of the circumstances.

Taken together, these measures have resulted in over 99% of care homes in Scotland reporting that they are supporting indoor visiting (in week ending 17 July 2023, COVID-19 in Adult Care Homes in Scotland , Public Health Scotland). The Scottish Government will continue to work with all parties to ensure that people living in care homes are supported to connect with their loved ones.

The present state of the pandemic has been transformed by science, moving away from population level restrictions to strong programmes of vaccination and therapeutics.

As part of our enhanced surveillance systems, we continue to monitor, assess and be ready to respond to COVID-19 and other health threats. Any response including change to guidance on use of face coverings or face masks will be driven by the data and evidence gathered as well as expert advice as illustrated in the answer to question S6W-18103 on 31 May 2023 from Foysol Choudhury, MSP for Lothian, Scottish Labour.

A risk-based approach to face coverings and face masks is in place across all settings with respect for those who may be unable to or wish to wear a face covering.

There are currently no general Covid-19 restrictions in place but the advice remains the same – please take up the offer of vaccination when invited, and try to stay at home and avoid contact with other people if you have symptoms of a respiratory infection. If you have symptoms but do need to go out, wear a well-fitting face covering if possible.

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