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Financial planning for the significant challenges our public finances continue to face took place in advance of the Deputy First Minister and Cabinet Secretary for Finance's update on the 2023-24 in-year budget changes on 21 November.

The difficult decisions which have had to be made have allowed us to help balance the Scottish Government's budget while still progressing implementation of our mental health and wellbeing strategy from a revised direct budget of £260.3 million.

The in-year budget changes impacted on a number of planned new programmes which could not proceed as anticipated. Planned increased funding to existing programmes were also not able to be progressed.

Despite the savings made, we have continued to focus on delivery of our mental health and wellbeing strategy and recently published delivery plan, which includes commitments around mental health services and specific programmes of work around learning disability and autism, and cross-cutting trauma work.

Sheriff Jack Brown is subject to ongoing Fitness for Judicial Office Tribunal proceedings. Under Section 23(6) of the Court Reform (Scotland) Act 2014, Scottish Ministers are obliged to pay such expenses as they consider are reasonably required to be incurred to enable a tribunal to carry out its functions. The Scottish Government will publish costs of the tribunal at the conclusion of the proceedings.

This information is not held centrally.

3,297 square kilometres of Scotland’s inshore waters are permanently closed to both scallop dredging and bottom trawling, with no permanent prohibitions for creeling in place.

Scottish inshore waters are defined from the mean high water spring up to the extent of the territorial sea (12 Nautical Mile limit)

The Scottish Government remains committed to improving mental health service provision in primary care settings. The newly published Mental Health and Wellbeing Delivery Plan sets out our ambition to drive a shift in the balance of care across mental health to ensure a focus on prevention and early intervention in the community, including a focus on providing high quality mental health care in General Practice, by:

• Working collaboratively to improve access to support, assessment and treatment in primary care mental health and wellbeing services. This will include the development of multi-disciplinary teams in general practice, and maximising the role of community mental health teams, digital provision and NHS 24 to make access simpler and quicker, aligning care and quality with the Getting it Right For Everyone (GIRFE) principles. We will produce an initial report on progress, which will include equality impacts, by November 2024;
• Publish guidance on measuring and evaluating outcomes from mental health and wellbeing services in primary care by the end of 2023. This includes data indicators for protected characteristics and deprivation; and
• Continue to include primary care and community mental health as priorities within the Mental Health Outcomes Framework.

We will work with partners, including primary care stakeholders, to progress this ambition.

Additionally, as at 12 July 2022, 958.9 whole time equivalent (WTE) mental health roles have been filled using Action 15 funding, including 356.1 WTE posts in GP practices. Having met and exceeded the Action 15 commitment, the Scottish Government has continued to fund the roles that were recruited to.

By March 2023 186 WTE mental health workers had been recruited under the Primary Care Improvement Fund (PCIF). The PCIF also funds Community Link Workers (CLWs) as part of primary care multi-disciplinary teams (MDTs) and, at March 2023, more than 308 WTE CLWs were in post supporting GP practices. We are investing almost £190 million (£170m plus Agenda for Change Uplifts) in the Primary Care Improvement Fund in 2023-24, for the ongoing development of primary care multi-disciplinary teams and we have committed to the PCIF being £170m plus Agenda for Change uplifts in future years.

NHSScotland is following the guidance from the Institution of Structural Engineers (IStructE) who do not recommend that all sites with Reinforced Autoclaved Aerated Concrete (RAAC) should be vacated simply because RAAC is present. They do however recommend that if RAAC planks are present, their structural condition will need to be determined by a Chartered or Incorporated Structural Engineer to determine the risks and whether any remedial work is required. This is the approach that NHSScotland is taking. Where RAAC has been found in the NHSScotland Estate there has been no immediate disruption or concern although additional monitoring and management of is required in all cases. NHS Boards will consider their buildings with RAAC on an ongoing risk based approach to the management of those assets.

Ending homelessness continues to be a key priority for the Scottish Government. Our ambition can only be achieved through a shared public responsibility when government and partners all play their part.

With that in mind, I met with the Scottish Veterans Commissioner on 30 November and have agreed a number of actions to raise the profile of veterans’ housing and homelessness issues with relevant stakeholders such as local authorities and social landlords.

I have also discussed with the Minister for Veterans how we can work together to provide support to veterans and their families and I have invited him to join the Ministerial Oversight Group on Homelessness, which brings together ministers from a range of portfolios across the Scottish Government to identify the actions required to prevent and end homelessness, including for veterans.

The Scottish Government measures progress against the commitment to increase GP numbers using headcount data as this provides an accurate number of GPs registered on the Performers List in Scotland at the time the data is collected. Currently whole-time equivalent data is calculated as an estimate, based on returns from General Practices through the General Practice Workforce Survey.

The latest publication can be found here: General practice workforce survey 2022 - General practice workforce survey - Publications - Public Health Scotland

The Scottish Government uses both headcount and whole-time equivalent data to inform workforce planning to increase GP capacity.

The Scottish Medicines Consortium (SMC) has accepted a cannabidiol (Epidyolex ® ) for three severe treatment-resistant epilepsies:

• as adjunctive therapy of seizures associated with Dravet syndrome (DS) in conjunction with clobazam, for patients 2 years of age and older
• as adjunctive therapy of seizures associated with Lennox-Gastaut syndrome (LGS) in conjunction with clobazam, for patients 2 years of age and older
• as adjunctive therapy of seizures associated with tuberous sclerosis complex (TSC) for patients 2 years of age and older

The biggest barrier to the prescribing of other Cannabis Based Products for Medicinal Use (CBPMs) on the NHS is that most products remain unlicensed with a limited, or non-existent, peer-reviewed clinical evidence base for their use.

The National Institute for Health Research (NIHR) is currently leading on the design of CBPM clinical trials into epilepsy. The Chief Pharmaceutical Officer continues to engage on the progress of these trials, which will be critical in building the evidence for CBPMs.

In the year 1 November 2022 to 31 October 2023, there were 3,501 referrals to DBI support in Lanarkshire, including 856 for people living in Lanarkshire and referred via NHS24 and the Scottish Ambulance Service national contact points.

More broadly across Scotland, DBI has now supported over 52,000 people who have been referred for help since the original pilot programme was launched in 2017. Referral numbers across the programme are currently at over 1,800 per month.

DBI Level 2 support is provided by commissioned and trained third sector staff who contact the person within 24-hours of referral. They then provide compassionate, problem solving support, wellness and distress management planning, supported connections and signposting for a period of up to 14 days.