Chamber and committees

Both adult and paediatric patients with Cystic Fibrosis (CF) can access a range of appropriate services via their local NHS Boards, Integrated Joint Board and specialist centres.

The National Services Division (NSD) of NHS National Services Scotland commission a number of highly specialist services for young people and adults with CF are delivered via multi-disciplinary teams, including clinical psychologists at 3 specialist centres around the country – in Aberdeen, Glasgow and Edinburgh. There are also outreach services in Dundee and Inverness. Paediatric CF services are delivered locally by NHS Boards like through the South-East Scotland Paediatric Cystic Fibrosis Service.

Due to the variable management required, much of the treatment required by CF patients is specialist and tailored to the needs of the individual patient. The Scottish Government therefore expects NHS Boards to treat CF patients according to individual need, this includes ensuring clinical psychologist and social work input when required.

The Scottish Government is committed to working to improve outcomes for people with rare conditions, including Cystic Fibrosis. We are developing an Scottish Action Plan for Rare Disease based on the four priorities of the UK Rare Disease Framework: faster diagnoses, increased awareness, better care co-ordination, and access to specialist treatments and care.

Once again, I want to thank our health and care staff for their magnificent work to date. The last few months have been enormously difficult and our health and care services are continuing to deal with a challenging combination of issues.

We are now seeing a steady reduction in new Covid cases. However, I am aware that the system remains under significant pressure. We must continue with a measured and consistent approach to the recovery and renewal of the vital service that we all rely upon. This will require balancing the capacity of the NHS and the wellbeing of our workforce to respond to increasing demands of emergency and urgent care, whilst reducing the backlog of planned care.

As we move through the next phase of the Strategic Framework, we will continue to support our NHS Boards to deliver against commitments in the NHS Recovery Plan and associated Delivery Plans to enable our NHS to plan and prepare the future delivery of health and social care services to our communities. We are confident that we have continued to build on lessons learned and that NHS Boards will be able to respond appropriately to any further challenges which lie ahead.

With that in mind, I have decided that the NHS will no longer remain on an emergency footing after 30 April 2022.

There are temporary terms and conditions provisions that were enacted to support the NHS through this time, including to support those who came back to work on a temporary basis to aid with pandemic response. We will now take the opportunity to review these, and will work through the established structures to set a timetable to return to normal arrangements. In the meantime, these temporary measures remain in operation.

In May 2021 we implemented the most generous pay rise anywhere in the UK (and the largest since devolution) for NHS Agenda for Change Staff.

For the year 2021-22, a starting salary for new Nurses in Scotland was £26,104 compared to £25,655 for Nurses in England and Wales – a difference of £449 per year.

Per person, frontline health spending in Scotland is £111 (3.6%) higher than in England and £146 (4.8%) higher than in Wales.

Proportionately, that’s over £600 million more spending on frontline health services in Scotland compared to England, and almost £800 million more compared to Wales; this would be equivalent to over 14,000 and 18,000 nurses, respectively

The Scottish Government, in November 2021, issued a joint protocol for the examination of dogs suspected of livestock worrying and seized by Police Scotland under the 2021 Act. That offers guidance to veterinarians who may be asked to examine such dogs.

The Scottish Government considers that education is the key to ending livestock worrying incidents and the associated unnecessary suffering for all involved. While not solely focussed on livestock worrying, the Scottish Government undertook an awareness raising digital campaign, in partnership with the Scottish Society for the Prevention of Cruelty to Animals in March 2021 to promote responsible dog ownership. The campaign was re-run in September and December 2021, to further emphasise the importance of training pet dogs correctly; and reminding dog owners of their legal responsibilities to keep dogs under proper control in order to prevent and reduce the risks of incidents occurring.

The Scottish Government supported the introduction of the Dogs (Protection of Livestock) (Amendment) (Scotland) Bill, which gained Royal Assent on 5 May 2021, and accords with advice in the Scottish Outdoor Access Code on responsible behaviour for people walking dogs. These messages are promoted widely on social media by NatureScot as part of on-going communication campaigns promoting responsible behaviour in various outdoor settings.

The Scottish Partnership Against Rural Crime (SPARC) has also been supporting the Dogs (Protection of Livestock) (Amendment) (Scotland) Act 2021. In January 2022 they launched a national Livestock Attack and Worrying campaign with the slogan ‘Your Dog – Your Responsibility’ designed to educate and raise awareness about the new legislation amongst dog owners, whether new or experienced. This attracted significant media attention from TV, radio, written and social media forms with the campaign lasting 5 months until end of May 2022.

Numerous local Partnerships Against Rural Crime have supported the national campaign and kept focus on the new legislation by holding local launches. SPARC is promoting a second national launch to highlight the issue once more in the Autumn and will further promote the legislation at the agricultural events and shows it attend this year.

We have considered carefully whether people need to continue to be on the Highest Risk List. A significant body of evidence has been reviewed by clinical advisers related to the impact of vaccination for the approximately 176,000 people who have, for the most part, been on Scotland’s Highest Risk List since the start of the pandemic when we initially asked people to shield.

Based on the strong evidence that the risk of hospitalisation or death from Covid has significantly reduced for the majority of people on the Highest Risk List as a result of vaccination, alongside effective new treatments now being made available to people who will benefit most, we have decided to stand down the Highest Risk List from 31 May 2022. The Chief Medical Officer (CMO) will write to everyone on the Highest Risk List to advise them of this, along with a summary of the evidence that informed this decision and information about further, ongoing guidance and support.

The CMO wrote to everyone on the Highest Risk List on 4 March and indicated that we were undertaking a review of the Highest Risk List in light of the evidence that has emerged over the past two years. This intention was also set out in the update to the Strategic Framework in February.

Since July 2021, the CMO has advised people on the Highest Risk List to follow the same guidance and take the same precautionary measures as the rest of the population, unless advised otherwise by their GP or clinician who will understand their health condition and individual circumstances best.

The CMO also said in his letter that we will share the evidence that we have used to make those decisions and we are publishing a summary of the clinical evidence today. You can read the full publication at the following link https://www.gov.scot/isbn/9781802017311 which will go live at 10:00. We are aware that a core of immuno-suppressed people are unable to mount a full immune response due to their condition and/or treatment. We will publish separate advice for this group. We are working with Public Health Scotland and have put an identification process in place to be able to rapidly generate an accurate and current list of individuals for vaccine prioritisation and covid treatments, and to provide additional advice in the event of any escalated threat level to those who may need it.

We are also aware from our own and Public Health Scotland research with people on the Highest Risk List of ongoing wider negative impacts, particularly in terms of mental health, and issues of isolation, for some people on the Highest Risk List. We know that some people will continue to be more cautious or anxious about what this change means for them, or need more time to reconnect with people, or to restart the things they were doing before the pandemic. To help support these people, we have funded the British Red Cross to extend their Connecting with You Service to support people to rebuild their confidence and lives. We are also engaging with partners across all sectors to find ways to support people who may need more help to adapt, and will continue to provide guidance on protecting ourselves and others, including promoting the Distance Aware Scheme.

This is a positive step as there is no longer a need for the vast majority of people who have been on the Highest Risk List to consider themselves at any significantly higher risk. Our hope is that this will enable them to adapt to living with COVID and enjoy a better quality of life.

The Scottish Government has consistently and unequivocally indicated to the UK Government the significant impact Brexit would have across our whole economy, including health and social care. Leaving the EU, and in particular the loss of freedom of movement, has undoubtedly added to the challenge of attracting and recruiting new staff to work in remote and rural communities.

Further to engagement between the Minister for Future Borders and Immigration, my predecessor and other devolved administrations about the impact of EU exit on the recruitment and retention of health and social care workers, the UK Government has amended the shortage worker visa scheme including social care workers through the Scottish Government remains of the view that this does not adequately address the barriers that exist.

We continue to invest in recruitment and retention of health care staff, including GPs in remote and rural locations and this include record levels of investment in international recruitment, direct support to international recruits, the Golden Hello scheme and the development of a National Centre for Remote and Rural Health and Social Care.