Chamber and committees

The majority of the funding which the Scottish Government provides to local government is by the means of a block grant. It is the responsibility of individual local authority to allocate the total financial resources available to it on the basis of local needs and priorities, this includes the Scottish Strategy for Autism funding of £1.12m in the financial year 2012-13, having first fulfilled its statutory obligations and the jointly agreed set of national and local priorities.

The Scottish Government intended the award of £35,000 to each local authority to support the development of local autism strategies and associated action plans. The approach to distributing funds was agreed through COSLA and given that it is the responsibility of individual local authorities to allocate resources based on local needs and priorities no analysis has been carried out of the effectiveness of how each council used this.

The Scottish Government have funded a National Co-ordination Team based in Strathclyde University to support the Scottish Autism Strategy and its implementation at a local level. We appreciate that localities are at different stages in developing autism services to meet local need.

Each drug related death is a tragedy for the individual, their family and the wider community. Unfortunately, there is a general trend of increasing drug related deaths across the UK and many parts of Europe. This is predominantly being driven by an older cohort of long term, vulnerable drug users who are experiencing multiple health problems.

We remain fully committed to tackling the damaging impact of drugs in Scotland. In response to the changing drug landscape and the rise of drug-related deaths, I recently committed to refreshing our drug strategy. This offers an opportunity to reinvigorate our approach, to respond to emerging challenges and to be more innovative in our response to the wider health and social problems individuals face.

Despite the rise of drug related deaths, the general level of drug use in Scotland is falling, drug taking levels among young people remains low and we’ve achieved significant reductions in treatment times for those needing help with drug problems.

We are clear that any death related to substance use is a tragedy and we will continue to do all we can to prevent others from experiencing similar heartbreak.

Evidence supports the view that methadone remains a central component of the treatment for opiate dependency and is just one part of a package of care, treatment and recovery that can be offered to individuals to help them recover from drug addiction. Decisions on the type of treatment to prescribe are for clinicians to make, in discussion with their clients. That view was endorsed in a 2013 report to Scottish Government by an independent expert group on opioid replacement therapies, and is also in line with current UK guidelines.

It is also worth noting that there were only 4 deaths in 2016 where methadone was the only substance present. This highlights the issue of polydrug use which we know is a characteristic of some of Scotland’s problem drug users. We continue to work with our partners to address and better understand these issues.

The Scottish Government is committed to ensuring that no-one is inappropriately delayed in hospital and we continue to drive improvements through local Integration Authorities.

However, the long delays highlighted by the BBC are not awaiting mainstream care and accommodation, but are extremely complex cases with very specialist needs that require specialist facilities or specific, often new-built accommodation that takes a considerable time to design, commission and arrange. Furthermore, the vast majority of these patients are not delayed within acute settings, as reported by the BBC.

Officials are currently working with a collaboration of housing and care providers to test community living solutions for people with complex needs. Following a commitment in the Keys to Life Implementation Framework, a two year project is also underway to consider models of support for people with learning disabilities with complex needs who are currently living in out-of-area placements, or delayed in hospital.

In Scotland the number of people with a diagnosis of dementia - including Alzheimer’s disease - and the number of people dying of dementia has risen as our population ages, and the rates of diagnosis have improved partly due to a greater awareness of getting a timely diagnosis. The Scottish Government commissioned a report last year which assessed, for the first time, estimated and projected annual diagnosed incidence for dementia rising to 20,000 by 2020. Scotland is not alone in experiencing a considerable rise in dementia-related deaths in recent years. In addition, part of the increase is attributable to the introduction by The National Records of Scotland (NRS) of new software to code deaths and adoption of a more recent World Health Organisation (WHO) update to the International Classification of Diseases (ICD). This has resulted in some deaths previously assigned to respiratory causes being allocated to dementia. This development brings Scotland into line with Official National Statistics (ONS), therefore making our mortality figures more comparable with those for England and Wales and further afield.

The Scottish Government published a third three year National Dementia Strategy in June, including an enhanced focus on palliative and end of life care. The strategy builds on our progress over the last ten years in transforming services and improving outcomes for people with dementia, their families and carers. It sets out
21 commitments and provides a framework for further action to ensure the realisation of our shared vision for people with dementia and their carers.

School nurses are valued members of the nursing workforce and the Scottish Government remains committed to their vital contribution to improving the health and wellbeing of children, young people and families.

NHS Dumfries & Galloway and NHS Tayside advised that those staff who left the school nursing service during the pilot phase did so through retirals and transfers to new positions in another area.

The pioneering school nursing pilots showed that a targeted school nursing role added value to the service through maximising their contribution and effectiveness, and by providing additional support to young people. This includes reviewing initial referrals and redirecting children to other agencies such as Child and Adolescent Mental Health Services (CAMHS) if evidence of mental health concerns are identified. In addition, school nurses will work alongside mental health colleagues in CAMHS, Psychology, Education Psychology and other children's services if required.

The existing School Nurse Specialist Practitioner Education Programme is in the process of being revised by NHS Education for Scotland to ensure that future nurses in schools have the enhanced skills to deliver care to school aged children with complex needs. Funding is being provided to support the development of Continuing Professional Development (CPD) for existing nurses working in schools, in areas such as mental health, should NHS Boards and Integrated Joint Boards (IJBs) require to upskill their workforce in light of the refocused role.

The full summary of progress made by the Mental Health Strategy 2012-15 has now been published on the Scottish Government website at the following link:

http://www.gov.scot/Topics/Health/Services/Mental-Health/Strategy/MHSSummary

Action 15 in the Mental Health Strategy 2017-27 commits the Scottish Government to increase the workforce to give access to dedicated mental health professionals to all A&Es, all GP practices, every police station custody suite, and to our prisons. To deliver this commitment there will be an additional annual investment reaching £35 million in 2021-22 for 800 additional mental health workers in those key settings.