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The new Small Business Unit, including the team’s remit, will be scoped out as part of the new Business and Better Regulation Directorate that was formed on the 18th September.

The Scottish Government published a new national Specification for Psychological Therapies (PT) and Interventions on 29 September 2023. This follows a two-year period of development working closely with partners, including the workforce, and other key stakeholders.

We have worked in collaboration with Public Health Scotland (PHS) to revise the waiting reporting guidance for PT and PHS have re-issued the Waiting Times data definitions guidance document which will help to improve accuracy of reporting against the PT waiting times standard. This applies to the delivery of PT as set out in the new Specification. The updated guidance document will be fully operational by 1 April 2024.

Scottish Government officials and Professional Advisors will continue to support NHS Boards to improve reporting of PT waiting times through the established engagement processes. We will work with data analysts and PHS to ensure improved information reporting is carried out consistently across Scotland.

The Scottish Government recognises that evidence is important in supporting policy design, monitoring progress and evaluation of impact. Our refreshed Tobacco Action Plan will be published in Autumn this year and is based on a wide range of evidence. This has included and will continue to include input from Public Health Scotland and Scottish Government Analysts. In addition, evidence requirements will continue to be considered and updated as plans around refreshed tobacco actions progress. Further detail on evidence will be published later this year.

Current PHS analysis on smoking attributable deaths and smoking attributable admissions can be found on the PHS website - Smoking attributable deaths - ScotPHO and Smoking attributable admissions - ScotPHO

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

The Medication Assisted Treatment standards published on 31 May 2021 and are a set of standards aimed at providing a framework to ensure that MAT is sufficiently safe, effective, acceptable, accessible and person-centred to enable people to benefit from treatment for as long as they need it.

The standards are evidence based and were developed through extensive consultation with multiagency partners that deliver care, and, with the individuals, families and communities with experience of problematic drug use.

The Scottish Government has committed to full and sustained implementation of MAT standards 1-10 in community and justice settings by April 2026. To help local areas achieve this, the MAT Implementation Support Team (MIST), based within Public Health Scotland (PHS) is supporting the roll out of the standards ensuring local areas have systems, protocols and procedures in place to be able to continuously improve services based on evidence.

In order to demonstrate implementation of the MAT standards, local areas provide process, numerical and experiential evidence to MIST which helps to inform an annual National Benchmarking Report, published by PHS. Process evidence includes formularies, clinical guidelines, care pathways, standard operating procedures, policies and other supporting documentation.

The National Benchmarking Report for 2022/2023, published in July 2023 reported that the 29 ADP areas assessed against each of the 10 MAT standards, 66% (96/145) of MAT standards 1–5 were fully implemented and 88% (127/145) of MAT standard 6–10 were partially implemented.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

The Partnership Delivery Framework to Reduce the Use of and Harm from Alcohol and Drugs which was approved by COSLA Leaders and Scottish Ministers in 2019, sets out clear arrangements for quality assurance and quality improvement work to be undertaken at a local level.

The Drugs Death Taskforce recommended in their final report, Changing Lives , that; The Scottish Government should develop a National Specification outlining the key parts of the treatment and recovery system that should be available in every local area, ensuring it also delivers on the principles of quality, choice, access and parity of treatment with other health conditions.

We have made a commitment in our Cross Government Plan that we agree that a National Specification for services would help set these requirements out more clearly. This would also provide more accountability, particularly for those with lived and living experience and their families who will be able to see clearly what they can expect to be available in the treatment and recovery system.

We are working with partners to scope out the components of a Specification for further development and consultation. This process will need to involve a range of local and national partners and most important amongst those will be people with experience of using the services and their families.

Rights, Respect and Recovery sets a clear expectation that all people accessing services with a substance use condition should receive holistic, person-centred care. MAT standard 9 builds upon this, stating that ‘all people with co-occurring drug use and mental health difficulties can receive mental health care at the point of MAT delivery.’ The government is taking forward a number of measures to ensure that people with co-occurring mental health and substance use conditions receive this joined-up care.

We have funded Healthcare Improvement Scotland to test new models of care in five health boards – Tayside, Grampian, Lanarkshire, Greater Glasgow & Clyde, and Lothian.

The government also published a rapid review into mental health and substance use services in November 2022. This included a literature review, a survey of practitioners in substance use services, and a set of recommendations.

Finally, the government has recently commissioned Healthcare Improvement Scotland to produce an exemplar protocol which will set out how mental health and substance use services should work together. This will build on existing best practice and support local areas to implement the recommendations from the rapid review and the criteria of the MAT standards.

The area of forest that has been felled in Scotland is not monitored on an annual basis. Scottish Forestry is the Scottish Government agency responsible for the regulation tree felling and monitors the area approved for felling each year. After approval for felling is issued, the landowner has flexibility to decide on the timing of felling.

Felling approvals are issued in a number of ways, including as standalone Felling Permissions, where felling is approved for a two year period, and Long-term Forest Plans, where felling is approved for a ten year period. Local Authorities may also approve felling as part of planning permission, but these figures are not collated. As approvals can be valid for over several years, the area of forest felled in a particular year is not available.

For the last seven years, including private sector approvals and forests managed by Forestry and Land Scotland, the areas approved for felling are as follows. Of this area, 96-98% is for conifer forest:

The Programme for Government 2023-24 set out major new commitments on childcare including how we will test, for the first time, what an all-age childcare system will look like for Scotland in six councils.

We will work closely with those communities, our partners, and providers to consider how the early learning and school age childcare workforce can support these systems, and what they will need to do so. This will include consideration of regulatory issues, qualifications and professional development, which will take time to do fully and is why we will now set out our plans in 2024.

In the meantime, we will continue to work with the Framework Steering Group and other partners to support delivery of the actions being developed as part of the original plan. We have, for example, already developed a range of new learning resources, implemented a Protecting Vulnerable Groups (PVG) fee waiver and are starting work on a new national portal for professional learning.

The National Elective Coordination Unit (NECU) does not directly remove patients from NHS health board waiting lists. As part of the agreed pathway to support national waiting list validation, and to ensure a patient’s appointment requirements are accurately recorded, NECU’s digitally supported waiting list validation methodology collates the information provided by patients, before returning it to the NHS Board of residence for update within patient administration systems.

To ensure any removals from waiting lists are appropriate, the NECU system records patient responses and their reason for removal. NECU follow-up directly with all patients who have not responded or have not left a comment explaining why they wish to be removed. Similarly, for patients who are unsure of the nature of their appointment, NECU follow-up with the patient directly. Where there is a clinical query from the patient, this is highlighted and the clinical team within the NHS Board of residence are asked to follow-up with the patient. To action a removal, Health Boards review both the patient response and the comment to ensure the reason for removal is appropriate.

Throughout the waiting list validation activity, patients remain on their respective waiting list until the NHS Board agrees it is appropriate to remove the patient.

NECU’s validation process is digitally supported, however, it is not a digital only process. Although all patients are contacted by text message and invited to access a patient portal to record their response, patients who may be unable to access the digital platform are followed-up by the NECU patient coordination team by telephone. If the patient is unable to be reached by both text message and telephone, a recommendation is returned to the NHS Board of residence to send a letter to the patient asking them to contact their Health Board directly. No amendment to the patient’s waiting list entry is actioned until confirmation is received from the patient.

NECU will publish its first annual update in October 2023.

Waiting List Validation is not new. Local Health Boards routinely validate patients on waiting lists to ensure patient requirements are correctly recorded. The establishment of a national approach is based on existing principles. By adopting these principles, a patient would not be removed from a waiting list without contact either by text or phone call, and if required, a clinical consultation.

After a consultation, it may be agreed no treatment is required at the time of referral. However, if the clinical team believe that a further referral for the same condition is likely in the future, or if it is felt that treatment will be required but the patient is not quite ready for this, or if the patient wishes to defer a decision on treatment, the patient will have the ability to make an appointment for the same condition at a future time.

We committed in our Integrated Health and Social Care Workforce Plan (December 2019) to create 225 more Advanced Musculo-Skeletal Practitioners in Primary Care.

This is to support the embedding of multi-disciplinary teams in primary care settings and enable people to be seen by a specialist physiotherapist at the very earliest opportunity.

A total of 37 students were recruited in 2021-22, and a further 52 were recruited in 2022-23. It is anticipated that 50 students will be recruited in each of the next 2 academic years, meaning we are on track for meeting this commitment by 2025-26.

The first cohort of students will graduate in September 2023 and a number will be located in NHS Ayrshire and Arran.