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There is no funding solely allocated to the Respiratory Care Action Plan (RCAP) in 2025-2026. However, a number of the commitments in the Plan are being addressed by work that is part of other Scottish Government strategies– such as the Cleaner Air for Scotland Strategy, Warmer Homes Strategy, and the refreshed Tobacco Action Plan - or by additional funding we have provided to NHS Boards on a broader basis to make improvements that apply regardless of condition. This means it is difficult to break down funding we provide to various areas and organisations that is spent on delivering commitments listed in the RCAP.

For example, we are investing a record £21.7bn in our NHS in Scotland in 2025-2026, this includes £200m to reduce waiting times, which will deliver additional MRI, CT, ultrasound and endoscopy procedures and supports the delivery of the RCAP commitment to improve and simplify access to appropriate diagnostic tests.

As this is an operational matter for Scottish Water, and the Scottish Government does not hold the information, I have asked them to respond. Their reply is as follows:

Scottish Water measures the performance of its partner organisations through a structured framework that ensures alignment with its standards for safety, health and wellbeing, cost management, efficiency, and service excellence. Executive Director led Strategic Boards, and Senior Manager led Operational Boards are in place to review performance, and set direction for future strategic improvements.

The Scottish Government’s Respiratory Care Action Plan (RCAP) sets out our priorities from 2021 to 2026 for driving improvement in the prevention, diagnosis, care, treatment and support of people living with respiratory conditions. A number of areas included in the RCAP are broad priorities requiring continuous work rather than finite commitments that can be completed.

We have undertaken action against every area of the Plan.

To give just some examples, significant steps have been taken on preventing respiratory disease with the launch of the Cleaner Air for Scotland Strategy, Warmer Homes Strategy and the refreshed Tobacco Action Plan that have their own specific recommendations and targets, and all of which embed respiratory prevention into wider Scottish Government policy.

In 2024, we published the Quality Prescribing Strategy for Respiratory: A Guide for Improvement 2024-2027 that sets out our ambitions for better access to respiratory care. This can be found here --https://www.gov.scot/publications/quality-prescribing-strategy-respiratory-guide-improvement-2024-2027

The Centre for Sustainable Delivery based at the Golden Jubilee National Hospital is developing national patient pathways for respiratory conditions including severe asthma, COPD and sleep apnoea. This work aligns closely with the commitments in the RCAP.

In 2023, the Scottish Government provided Public Health Scotland with funding to undertake a scoping exercise with a view to developing a respiratory audit programme. However, due to current fiscal challenges, it has not yet been possible to progress this work further.

We recognise the importance of having access to meaningful data in relation to respiratory services and we are carefully considering the best way that this can be achieved going forward.

The Scottish Government does not assess geographical variations in people accessing Scottish Medicines Consortium-approved therapies for advanced or complex Parkinson’s Disease. However, the Centre for Sustainable Delivery are having initial conversations about the potential to undertake Parkinson’s Disease pathway work, which we understand would help to explore and articulate pathways for therapies for advanced and complex Parkinson’s Disease.

The Scottish Medicines Consortium (SMC) assesses the clinical and cost- effectiveness of newly licensed medicines on a once for Scotland basis and publishes advice for Health Boards to consider. It is expected that Health Board Area & Drug and Therapeutics Committees (ADTCs) will consider making an SMC-recommended medicine, or an equivalent, available on their local or regional formulary for routine prescribing within 90 days of SMC advice being published.

Health Boards are expected to apply common principles and processes in the introduction of newly licensed medicines to facilitate consistency of approach to local decision-making. The decision to prescribe a medicine, and which medicine to prescribe, is entirely for the clinician in charge of a person’s care, having considered their clinical condition, their safety, and any relevant clinical guidance.

Decision-making on Scotland’s vaccination programme continues to be guided by the independent, expert advice of the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI currently advises flu vaccination for all those aged 65 years and over, along with individuals who have specific underlying health conditions.

Before the COVID-19 pandemic, the JCVI advised routine flu vaccination for those 65 years and over, as well as those with underlying health conditions. Scotland followed this advice.

Our programme was expanded during the pandemic in order to protect the people of Scotland, the NHS and the wider health and social care sector, while it was under severe COVID-related pressure. The programme was expanded to those aged 55 years and over in 2021, and then to those aged 50 years and over in 2022 and 2023.

In winter 2024, as we moved beyond the COVID-19 pandemic, we reverted to the standard JCVI-advised groups and those aged 50-64 years were no longer included. This is in line with JCVI advice, endorsed by Scotland’s Chief Medical Officer.

On 25 April the Scottish Environment Protection Agency (SEPA) started publishing weekly water scarcity reports. These use a range of hydrological and meteorological data to describe water scarcity levels across the country. The latest report can be found on SEPA’s water scarcity webpage and highlights areas in Scotland currently at risk of water scarcity. Scotland’s National Water Scarcity Plan explains what the different levels mean in terms of risk and sets out when regulatory action may be required.

The Scottish Government supports a wide range of research projects which investigate Scotland’s future risk and resilience to water scarcity. Within its Environment, Natural Resources and Agriculture Strategic Research Programme, the Scottish Government is funding a five-year project led by the James Hutton Institute that is developing our understanding of drought vulnerability in Scotland. Part of this project includes working with SEPA to improve drought risk assessment.

The Scottish Government also funds the Centre of Expertise on Water (CREW), which has funded, and continues to fund, projects to improve our understanding of water scarcity in Scotland. For example, in June 2024, CREW completed a study into the “Future Predictions of Water Scarcity in Scotland: Impacts to Distilleries and Agricultural Abstractors” and published a series of infographics highlighting potential future risk areas for different agricultural sectors.

It is our aim to publish final outputs from the evaluation of the early adopter community (EAC) work in the second half of 2026.

As outlined in our previous answer, due to the significant financial challenges facing the Scottish Government as a result of budget choices made at Westminster, Ministers have had to make tough decisions for the current parliamentary session to protect our existing investment in childcare. This includes almost £1 billion a year for local authorities to deliver our current offer of 1140 hours of high quality, funded early learning and childcare. We are working with local authorities to maximise uptake of our existing offer for eligible 2 year olds to ensure that as many children as possible benefit from the offer and investing up to £16 million over 2024-25 and 2025-26 in the six council areas participating in the EAC work.

Private sector investment in energy and infrastructure projects will be critical to realise a just transition at Grangemouth. That is why our final Just Transition Plan will seek to instruct and mobilise wider support from investors and developers, centred around the clear opportunities present at Grangemouth.

The Scottish Government welcomes the publication of Project Willow and its recommendations which set out a transformative future for parts of the Grangemouth cluster, if the public and private sectors work together.

To support this, Scottish Enterprise and the UK Office for Investment have established an “Investor Taskforce” to identify and attract investors with an interest in progressing the Project Willow proposals. I would encourage any interested investor to engage with Scottish Enterprise in the first instance to explore how any opportunity could be progressed.

The Scottish and UK Governments are working jointly, along with trade unions, to fund a tailored skills intervention for workers facing redundancy at the Grangemouth Refinery. This is designed to support the transition of the impacted workforce through the job market into in-demand industries. Forth Valley College (FVC) are the delivery provider.

Given the urgent nature of the work, both governments meet weekly to discuss this intervention. Our priority focus is ensuring that all eligible members of the workforce have access to training aligned to their redundancy. However, it is critical that this intervention retains skilled workers in the Scottish economy and we will continue working with partners to understand how it can support workers to play a central role as future low carbon projects are phased in at Grangemouth.