Chamber and committees

The Scottish Government has been very clear from day one that the pace and rollout of our national vaccine programme is key to tackling the pandemic and we are determined to reach as much of the population, and in order of vulnerability based on clinical advice, as fast as the vaccine supply allows us. The health of every person living in Scotland is important which is why the Scottish Government is making proactive policy decisions to make this programme as inclusive and accessible as possible, given the current constrains of supply and social distancing.

The Scottish Government and Public Health Scotland are actively engaging with third sector and faith organisations to reach a wide range of people across the community.

In addition, the Scottish Government has undertaken a wide range of campaigns in print, online and across media, and in various locations, to try to reach everyone in Scotland and inform them of the vaccination campaign.

A full update of the work to ensure an inclusive vaccination programme will be included in a future update to all MSPs.

By undertaking these steps we are trying to encourage a high uptake of the vaccine and ensure vulnerable people attend their appointment.

If an individual thinks they have been missed from the appointment list, they can call the vaccination helpline on 0800 030 8013, or use this link on NHS inform: at NHS inform: Missing appointments | The coronavirus (COVID-19) vaccine (nhsinform.scot)

The Scottish Stroke Care Standards are regularly reviewed in line with current evidence and updated guidelines. We monitor the implementation of these standards through the Scottish Stroke Care Audit to ensure that stroke patients in Scotland are receiving high quality care. Relevant guidelines relating to stroke care are also being taken into account in the development of a definition of a Progressive Scottish Stroke Unit.

As with all published guidelines, the strength of the evidence considered as part of the RCP guidelines is detailed in that document. There should be no difference in the robustness of the evidence relating to Scotland, though some discussion of commissioning of services, and of the particular structure of health systems may be based on NHS England structures and therefore may not be entirely relevant to a devolved health system.

It is important to note that clinical guidelines are recommendations to aid healthcare and other professionals in caring for people with specific conditions and are based on the best available evidence. NHS Board areas are encouraged to make best use of all relevant available guidelines.

I refer the member to the answer to question S5W-35029 on 25 February 2021. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx

The Stroke and Heart Disease Improvement Plans (2014) recognises the importance of specialist rehabilitation and the need for the delivery of services to support people living with stroke and heart disease and their families.

We expect NHS Boards to appropriately plan and deliver high quality, safe effective and person centred services including stroke rehabilitation services and to regularly review these to maintain the high levels of quality and safety that people in Scotland expect and deserve.

We continue to work in partnership with NHS boards, the voluntary sector and a range of providers across health and social care to help ensure people who have experienced a stroke receive access to the care and support they need to help them return to independent living.

The National Advisory Committee on Stroke (NACS) has established a Rehabilitation sub-group to focus on improving the delivery of stroke rehabilitation, both in hospital and the community and advise on how rehabilitation can best be delivered as part of a progressive stroke service.

The Programme for Government (PfG) 2019-20 commits the Scottish Government to ensuring that improvements are made to stroke pathways and services, including work to scope out and define what a progressive stroke unit looks like.

Work has been on-going during 2020 to progress this commitment, including several Scotland wide virtual meetings between the CMO Advisor and deputy CMO Advisor, and stroke physicians to gather views on the components of a progressive stroke service. The next meeting of the National Advisory Committee for Stroke, in March 2021, will consider the first draft a definition of a progressive Scottish stroke unit.

This description will refer to the best available evidence based on existing national and international guidelines. Comparisons with current practice and other western countries will reflect the best available evidence.

Once the definition of the progressive Scottish Stroke Unit has been defined, we will be able to compare it with current practice and also with international examples.

We place a great deal of importance on ensuring that stroke patients receive the care that they need in order to achieve their recovery potential. To ensure that this is the case, we fund the Scottish Stroke Care Audit (SSCA) as part of the Stroke Improvement Programme to regularly monitor the quality of care provided by the hospitals in all Health Boards by measuring performance against the Scottish Stroke Care Standards. These standards are regularly reviewed in line with current evidence, including UK wide guidelines such as NICE.

Health Boards and stroke services are supported by the Stroke Improvement Programme to improve performance against the Scottish Stroke Standards, and as a result, continuously improve their delivery of stroke care.

The Scottish Government expects NHS Boards to provide the best possible care for those who have experienced a stroke, including the provision of thrombolysis where considered clinically appropriate.

The Scottish Government continues to support the Scottish Stroke Improvement Programme as key to informing and driving improvement across stroke care, including thrombolysis. The SSCA enables us to see where local areas are achieving the Scottish Stroke Care Standards, including the standard for thrombolysis and where further improvements are required. Health Boards are expected to identify aspects of their stroke services which do not meet the Scottish Standards and to work with their stroke Managed Clinical Networks to improve their standards of care locally.

Further information can be found at: https://www.strokeaudit.scot.nhs.uk/index.html

The Scottish Stroke Care Audit (SSCA) has not set specific targets for the rate of people treated with thrombolysis. There is a need to balance the benefits of any treatment with its risks and a target rate may not reflect that nuance.

Initial assessments of the recently published results of the Scottish Health Survey 2019 have been undertaken.

These assessments note that, although the downward trend in smoking prevalence appears to continue, these particular results are likely to underestimate the true prevalence of smoking which during the previous survey stood at 17% of Scottish adults. This is due to the response rates in deprived areas being lower than usual, even when weighted, as a result of survey restrictions during the pandemic.

Further assessment and future studies will help determine the full impact of COVID-19 on smoking behaviour.

Quitting smoking is the best thing anyone can do to improve their health.

Quitting smoking is the best thing anyone can do to improve their health.

Although NHS free smoking cessation services were initially restricted as staff were redeployed in the early days of the pandemic, they were back on stream within a few weeks – operating between 9am and 5pm each day. Support, advice and prescriptions were available from pharmacies and GP practices throughout.

Both the Strategic Framework Business Fund and the £5 million Travel Agent Fund are tied to having a business premises, which reflects the higher overall costs facing premises-based businesses including rent and utilities.

While self-employed, homeworking travel agents are not eligible for these support schemes, they may be eligible for other forms of support, including the UK Government Self Employed Income Support Scheme (SEISS). In order to help those who are not able to access SEISS, the Scottish Government have recently relaunched the Newly Self-Employed Hardship Scheme, which makes grants of up to £4,000 available to qualifying self-employed people.

We have also recently increased our Local Authority Discretionary Fund from‎ £30 million to £120 million. Through this fund, councils can target additional support wherever they consider it most effective in the context of their local economy and business community. As such they have the option to provide direct support for self-employed or home working travel agents in their area if they consider it necessary.

Information on available support can be found on the Find Business Support website.