Chamber and committees

The Programme for Government (PfG) 2019-20 commits the Scottish Government to ensuring that improvements are made to stroke pathways and services, including prevention, treatment and care.

The Scottish Government are committed to ensuring that people who have had a stroke receive the best possible care as quickly as possible to enable them to live longer, healthier independent lives.

We are continuing to implement our Stroke Improvement Plan which sets out our priorities and actions to deliver improved prevention, treatment and care.

We expect NHS Boards to appropriately plan and deliver high quality, safe effective services and to regularly review services to maintain high level of quality and safety that people in Scotland expect and deserve. We continue to support the Scottish Stroke Improvement Programme as key to informing and driving improvement across stroke care.

The Scottish Government has provided funding to Chest Heart and Stroke Scotland to refresh the Stroke Training and Awareness Resources (STARS) on line training modules. These include modules on stroke rehabilitation. A new module to provide training to deliver hyperacute stroke care was launched on 17 July. These can be found at: https://www.chsselearning.org.uk/

The section of the minutes of the December 2019 National Advisory Committee for Stroke (NACS) which refers to budget constraints was in the context of a discussion of the development of new guidelines jointly with the Royal College of Physicians of London to update their National Clinical Guideline for Stroke (2016).

As part of the Programme for Government stroke commitments to improve current stroke services, the Chair of the NACS and the Stroke Association met with Healthcare Improvement Scotland (HIS) on 10 March 2020 to discuss guidelines. HIS have provisionally agreed to carry out a review of evidence supporting the description of a progressive stroke service in Scotland.

The Scottish Government is committed to improving services in perinatal and infant mental health across Scotland. The 2019-20 Programme for Government contained a specific focus on the mental health of women, babies and their families accompanied by an investment of £50m over 4 years. The Perinatal and Infant Mental Health Programme Board has been established to provide oversight of this investment and to roll out service provision across statutory and third sector services.

Perinatal Mental Health services across Scotland continued throughout the Covid-19 pandemic and were prioritised for access to Near Me, a secure online platform for providing services. To help support parents, we invested £240,000 in providing access to the Solihull Online programme which is aimed at improving parent-child relationships, managing problematic behaviour and promoting positive mental health. This includes a postnatal course on ‘Understanding Your Baby’ as well as a course for the antenatal period. Information regarding mental health and emotional wellbeing was provided through Parent Club throughout the pandemic. Additionally the Inspiring Scotland Perinatal and Infant Mental Health service directory provides signposting for third sector services across Scotland.

The two Mother Baby Units in Scotland (Leverndale and St Johns) are regionally managed but provide support to all mothers across Scotland. Access to these units is based on need and clinical judgement, rather than geography. The Scottish Government expects that where admission to an inpatient unit is required, that women and infants will be admitted appropriately, in line with clinical judgement and the wishes of the patient.

In 2019-20 and 2020-21 we have invested £750,000 across both Mother Baby Units to improve the experience of care for women in need of intensive support. This funding aims to improve services in line with the recommendations based on the Delivering Effective Services report by the Perinatal Mental Health Managed Clinical Network.

We have also invested £30,000 in the new Mother Baby Unit Family Fund which will provide a contribution to the expenses incurred by partners when travelling to visit a mother and baby receiving care. Making it easier for whole family care to be provided.

We are also in the process of providing funding to every health board in Scotland to increase their specialist Community Perinatal Mental Health services. This builds upon initial investment of £80,000 in the North of Scotland in 2019/20 to support the initial development of community services. We are working with Grampian, Highland, Orkney and Shetland and are providing further funding to create services which support the needs of women across these areas.

In addition, funding has also been offered to support Maternity/Neonatal Psychological Interventions services and to develop Infant Mental Health services. We expect these services to be in place by the end of this year.

The Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020, as amended, give legal effect to the COVID-19 restrictions set out in the Route Map.

The Health Protection (Coronavirus) (Restrictions) (Scotland) Amendment (No. 6) Regulations 2020, which allowed outdoor hospitality businesses to re-open on 6 July 2020, introduced a definition of "indoors" into the Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020. The Health Protection (Coronavirus) (Restrictions) (Scotland) Amendment (No. 8) Regulations 2020 then allowed indoor hospitality businesses to re-open on 15 July.

This definition of indoors, which continues to be used for the purpose of the restriction on public gatherings in regulation 6(1), sets out that a place is indoors if it is considered to be wholly or substantially enclosed for the purposes of section 4(2) of the Smoking, Health and Social Care (Scotland) Act 2005 under the Prohibition of Smoking in Certain Premises (Scotland) Regulations 2006.

In the light of the latest scientific and public health advice, including the World Health Organisation (WHO) guidelines, the Scottish Government has, after discussion with the Education Recovery Group, updated the advice on the use of face coverings in secondary schools and on school transport. Unless specific exemptions apply, face coverings should now be worn in secondary schools by adults and pupils in corridors and confined communal areas where physical distancing is difficult to maintain. Face coverings should also be worn by all children aged 5 and over on dedicated school transport, in line with the guidance for public transport. The advice from the Advisory Sub-Group on Education and Children's Issues, and updated guidance on school reopening were published on 25 August to reflect the latest position.

I refer the member to the answer to question S5W-31010 on 27 August 2020. 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 .

I refer the member to the answer to question S5W-31010 on 27 August 2020. 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 .

Over the past 10 years, the number of people in Scotland dying from stroke has decreased by 35%. This is significant progress but we want to strive for even better outcomes, which is why we continue to implement the Stroke Improvement Plan (2014) and our Programme for Government 2019-20 commits to developing a programme to improve stroke pathways and services, including prevention, treatment and care. The Scottish Government reports annually on how stroke care has performed against the Scottish Stroke Improvement Plan, through the Scottish Stroke Improvement Programme Report. This Report is scheduled for publication shortly.

There are various sets of clinical guidelines that clinicians can consider for the management, treatment and care of stroke patients. These should be taken into account when services are being developed although there is no expectation that clinicians in NHS Board areas would base their management on any one set of guidelines. As such, implementation of guidelines is the responsibility of NHS Boards and their operating divisions, reinforced and supported by their clinical governance arrangements.

The Scottish Intercollegiate Guidelines Network (SIGN) guidelines relevant to stroke are being archived at 10 years in line with SIGN policy. The National Advisory Committee for Stroke is currently working with SIGN to scope out work to review the latest evidence relating to care across the whole stroke patient care pathway. This will include a review of national and international guidelines which have used the most robust methodology. This evidence will inform the Programme for Government stroke commitments including how to describe what a progressive stroke service looks like.

In addition, healthcare professionals working in Scottish stroke services work closely with colleagues across the nations comprising the UK, and also internationally in organisations including the European Stroke and World Stroke organisations to improve care across Scotland for those who have experienced a stroke.