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We are aware of the serious negative impact this condition can have on people’s lives and therefore it is important that access to treatment and support is timely. We want to ensure that people have informed conversations with their GP in order to support the diagnosis of lipoedema.

We have now finalised the new NHS Inform webpage on Lipoedema . The new resource aims to provide people with consistent, reliable and accessible information empowering them to make informed decisions about their health and includes information on the symptoms, causes, self-management and treatment options.

We will continue to work with organisations such as Talk Lipoedema to find ways to raise awareness of the condition and its symptoms.

In March 2022, the National Institute for Health and Care Excellence’s (NICE) Interventional Procedures Advisory Committee did a rapid review on the available evidence on the safety and efficacy of liposuction as treatment for lipoedema and found it to be inadequate. The recommendation was for the procedure to only be carried out in the context of research.

Previously, NHS Tayside was the only Health Board to provide liposuction as a treatment for lipoedema. Due to the updated guidance, NHS Tayside have stopped liposuction as a treatment option until NICE reviews its guidelines in 2025 after further evidence and research has been undertaken.

There are currently non-surgical treatment options for lipoedema and those with the condition will be treated by healthcare professionals at primary care level and, where appropriate, referred to specialist services in secondary care. Any particular treatment is at the discretion of the lead clinician. It is NHS Boards and healthcare professionals locally who have responsibility for service delivery and patient treatment.

NHS National Procurement in partnership with the Health Boards are responsible for the provision of medicine homecare services and have met with affected providers on a weekly basis over a 12 month period to address services provision and monitor return to good service levels.

When service problems arise, through performance management arrangements linked to service level agreement and contracts, there is work with providers to agree an action plan and then closely monitoring delivery of performance improvements against that plan until service levels return to agreed standards.

The Scottish Government have not undertaken any assessment on the effects of inflation specifically within the medicines homecare service. Like a number of sectors, homecare providers have experienced challenges in recruitment and retention of staff, which has been one of the drivers of the service problems.

Scottish Government is aware of recent difficulties experienced by some homecare providers. NHS National Procurement in partnership with Health Boards have worked closely with the homecare providers to improve service performance. All homecare providers are now demonstrating improved service levels.

Medicines homecare providers must demonstrate that they can meet the standards for registered pharmacies set by the General Pharmaceutical Council (GPhC). The standards are designed to create and maintain the right environment for the safe and effective practice of pharmacy and to improve the quality and safety of services provided to patients and the public. The GPhC inspect registered pharmacies to seek assurances that the standards are being met. Depending on the range of services provided, medicines homecare providers may also be registered with additional regulators such as the Care Inspectorate and the Medicines and Healthcare products Regulatory Agency.

As this is an operational matter for Scottish Water, I have asked Douglas Millican, Chief Executive, to respond. His response is as follows:

Scottish Water completed an exercise with the James Hutton Institute in 2021-22 to understand the current carbon capture on its landholdings and to baseline performance. This has enabled Scottish Water to identify areas where it can improve carbon performance. Scottish Water is planning to survey and restore all circa 4400Ha of poor condition peatland on its land that were identified in the baseline exercise. In addition, it is working with other landowners to identify peatland for restoration where the poor condition peat has an impact on raw water quality. This programme of work has been underway for several years with a focus on water quality, and now has added benefit of carbon reduction.

In parallel, Scottish Water has been reviewing all of its landholdings for their potential for woodland creation. In 2021-22 they created 100ha of new woodland and are developing several schemes to increase this. In developing the plans for each site, Scottish Water engages with its tenant farmers to ensure that the plans integrate with the needs of the tenant. Scottish Water’s largest land holding is the Loch Katrine estate, where over the last two years it has been working in partnership with Forestry and Land Scotland to develop a 10 year land management plan. This was submitted to Scottish Forestry for approval in February 2023. The draft plan proposes the creation of some 4600Ha of new woodland. This landscape scale plan has involved close working with communities and stakeholders such as the Loch Lomond and Trossachs National Park Authority.

There are currently no plans to introduce an interoperable prescribing system for homecare medicine services. Any proposed changes will be considered as part of the wider Digital Prescribing and Dispensing Pathways Programme being taken forward by NHS National Services Scotland.

As referenced in the answer to S6W-15157 on 13 March 2023, in its annual update to its routemap, Scottish Water confirmed that priority locations have been identified for the 1,000 spill monitors, with installation programmed over 2023 and 2024. Over the past year, Scottish Water has invested significant time in developing a prioritisation approach for monitoring locations, based on amenity levels and predicted spill frequencies, and agreed this with SEPA. This has been published on Scottish Water’s website at https://www.scottishwater.co.uk/-/media/ScottishWater/Document-Hub/Key-Publications/Urban-Water-Improvements/EDMmethodology.pdf . Scottish Water has also made considerable effort to review the marketplace to determine the most appropriate monitors to deliver maximum value for customers. A priority list of locations will soon be available on Scottish Water’s website and Scottish Water has committed to providing an annual update on its website to outline progress being made in delivering commitments under its Improving Urban Waters Route Map.

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

Scottish Forestry is the Scottish Government agency responsible for regulating forestry activities and leads on unauthorised felling.

Scottish Forestry does not routinely discuss unauthorised felling with the bodies listed.

Unauthorised tree felling may be discussed with them on a case by case basis if required, for example:

• Police Scotland can be requested by Scottish Forestry to assist with unauthorised felling where suspects refuse to be interviewed under caution or where a wildlife crime is suspected.
• NatureScot is an agency within Scottish Government advising on the natural environment, but plays no part in the delivery of felling regulations. NatureScot maybe be engaged in the process if the site is home to a protected species.

When Scottish Forestry receive a report of suspected unauthorised felling, investigations, including site visits and evidence gathering is then carried out.

When investigations conclude that it is likely that unauthorised felling has occurred, Scottish Ministers have a range of powers available to achieve a positive outcome. The priority is normally to secure the replanting of the site and protection of the woodland. The most appropriate action is often to issue a restocking notice to secure the replanting of the site.

Prosecution is considered in each case where unauthorised felling has taken place. A range of factors, such as the seriousness of the impact and whether there were aggravating circumstances are taken into account when considering whether to pursue a prosecution. The final decision on whether to pursue a case to prosecution lies with the Procurator Fiscal and not with Scottish Ministers. Where replanting has been secured and the woodland has been protected it is often concluded not to be in the public interest to pursue a prosecution.

Prior to April 2019, when the Forest and Land Management Scotland Act 2018 was enacted, prosecutions were required in order to secure a restocking notice. Since April 2019 Scottish Forestry have greater powers and so are able to secure the restocking of a site by issuing Restocking Directions.

Scottish Forestry have issued 36 Restocking Directions for unauthorised felling from April 2019 to the year end 2020-21.

I have asked Teresa Medhurst, Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

On 10 March 2023, there were 7 transgender women located within the female estate in the care of the SPS. Out of those 7; 4 individuals were sentenced, and 3 were held on remand.

The 4 sentenced individuals all had an index offence in the Non-sexual crimes of violence group. The remanded individuals are alleged to have committed index offences in the Non-sexual crimes of violence group and the Crimes against society group.