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The final spend for 2023-24 will not be known until year end. The latest budget position for 2023-24 is set out in the Autumn Budget Revision 2023 to 2024: supporting document .

Our guidance to stay well and help others in winter can be found here Respiratory infections including Coronavirus (COVID-19): staying well and protecting others - gov.scot (www.gov.scot) . We have no current plans to mandate the wearing of face coverings.

It is due to the success of vaccines in protecting people, driving down cases and the availability of treatments that the guidance on wearing masks was withdrawn.

The Scottish Government follows JCVI for clinical recommendations for vaccination and their current assessment of the evidence does not support the inclusion of long COVID as an eligible at risk health criteria. We intend to continue to be guided by the expert independent advice of the JCVI on this issue.

We continue to monitor studies on COVID-19 vaccination and their relationship to long COVID. There have been a selection of international studies that suggest that receiving COVID-19 vaccination, before infection, can reduce the risk of receiving a diagnosis of long COVID. It is therefore important that we continue to work to improve uptake of our COVID-19 vaccination programmes to potentially prevent more instances of long COVID, but also to continue to protect those at higher risk from severe illness, hospitalisation and death and to protect our NHS.

The Cancer Action Plan 2023-2026 sets out our ambitious programme of work to ensure access to cancer prehabilitation.

The Scottish Government is working with experts across health and social care to ensure timely access to all services providing the multi-modal, tiered and personalised interventions that make up prehabilitation. This includes developing the frameworks to screen, assess and signpost people affected by cancer to the relevant services as soon as possible. A national website has been created in partnership with those with lived experience to provide universal and accessible information and advice. A new primary care cancer education platform for NHS Scotland that will feature prehabilitation advice will also go live early 2024 to enable effective decision-making and support earlier diagnosis efforts.

Prehabilitation is a key part of the Optimal Cancer Diagnostic Pathways and Clinical Management Pathways (CMPs) that have been developed for Lung Cancer and the CMP for Adult Brain Cancers, also in development. The Scottish Government has also provided £350,000 to develop and implement universal prehabilitation workshops for the Maggie’s Centres. Further funding has been allocated to support each board area to adopt the nationally provided tools to reinforce care pathways, directly benefiting those affected by cancer, including less survivable cancers.

Cancer prehabilitation is a complex, multi-modal intervention and personalised to suit individual need. It is not achieved through accessing a single service, nor is it likely to be delivered in a single setting. As such, no single mechanism or metric has been identified for measuring equity of access across Scotland, the UK or internationally. Instead proxy measured are used, such as numbers referred to a specific service/intervention and uptake and/or adherence.

The Centre for Sustainable Delivery is leading improvement work that will define core outcome measures for cancer prehabilitation in Scotland, and where possible this will include activity data.

The Centre for Sustainable Delivery is leading improvement and pathway redesign work via their Macmillan National Improvement Advisor for Cancer Prehabilitation. This will see core outcome measures agreed for use across Scotland, and introduce processes for data collection and reporting.

Some targeted and specialised prehabilitation has been developed within NHS settings and further services are being developed with funding from the Macmillan and Scottish Government’s Transforming Cancer Care programme to ensure people can access the right care in the right place at the right time.

Up to £1 million was allocated in 2023 for prehabilitation to NHS boards via the Transforming Cancer Care programme. This has been distributed via the Regional Cancer Networks through regionally agreed prioritisation processes.

£80,000 was allocated to Maggie’s in 2023 to embed their pilot of universal prehabilitation at all eight Maggie’s Centres in Scotland, building on our previous investment to develop this programme of £270,000 in 2021.

Cancer remains a national priority for the NHS and Scottish Government which is why we published a ten year strategy in June 2023, focused on improving cancer survival and providing equitable access to treatment. The strategy and plan take a comprehensive approach to improving patient pathways in cancer from prevention and diagnosis through to treatment and post-treatment care.

The evidence base for prehabilitation specifically for each of the less survivable cancers is currently limited. Work is underway to improve this, particularly with respect to upper gastrointestinal and lung cancers. Learnings from the prehabilitation currently being delivered under the Transforming Cancer Care Programme in association with our findings from the Single Point of Contact and Improving the Cancer Journey initiatives will provide opportunities to target areas of deprivation with early interventions. As such, efforts are being made to exploit these opportunities and progress screening, assessment and timely prehabilitation interventions across Scotland.

The evidence for prehabilitation across several areas of oncological care has grown and demonstrates that a multi-modal tired intervention can lead to better functional outcomes and improve other important outcomes associated with cancer treatment including quality of life.

Focus groups with people affected by cancer, evaluations of prehabilitation activities, and evidence collated by others working with people with lived experience of cancer, also tells us that prehabilitation is welcomed by the Scottish population and provides an opportunity for them to engage in their care.

I refer the member to the answer to question S6W-24444 on 22 January 2024. 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 .

a) A list of external consulting firms engaged to provide consultancy for research, co-design, engagement, and external support, and the cost of these contracts to date is provided in the following table.

These figures are as of 15 January and are provisional and subject to adjustment prior to and at year-end. Further costs may be incurred before the year-end.