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There are a wide range of definitions for Stroke Units and it is understandable that stroke units will look very different between, for instance, a large city hospital and island NHS Boards

The core criteria for defining a stroke unit are well described in the academic literature, including in Langhorne et al (2002). Professor Langhorne is a member of the Scottish Stroke Care Audit (SSCA) Team and has been influential in defining different models of stroke unit care.

NHS Boards are expected to describe their stroke unit models through the SSCA processes and the Scottish Stroke Improvement Programme Team review this information during Board Reviews (now occurring at least twice annually). This ensures that optimal and evidence based services are being delivered and demonstrates that stroke units are viewed as a core component of care.

We are supporting the National Advisory Committee on Stroke to develop a progressive stroke pathway document which will set out the vision for what stroke services across Scotland should deliver across the whole patient pathway, including access to stroke rehabilitation, and access to support for people who have experienced a stroke.

Scottish Government will work closely with the Stroke Improvement Programme Team and stakeholders throughout 2022 to develop an implementation plan to deliver the vision set out in this document.

We will continue to take steps to introduce a high quality and clinically safe thrombectomy service in Scotland. A Scotland wide service is expected to be operational by 2023.

The Scottish Government’s Scottish Zero Emission Bus Challenge Fund (ScotZEB) is awarding £62 million to support bus operators to acquire 276 new zero emission buses and associated infrastructure. Bus operators are free to choose which manufacturer they purchase from and we do not seek to influence this, in order to ensure a level playing field.

Level playing field provisions in trade agreements ensure that competition is open and fair, and that businesses from one trading partner to not gain an unfair advantage and undercut rivals from others. The success of the bus manufacturing industry in Scotland and the UK requires that the industry makes available high-quality products for bus operators at competitive prices and which can compete in the international market.

ADL will manufacture their buses in Falkirk, Wrightbus, Switch and Orion manufacture elsewhere in the UK (with Orion chassis being manufactured in Italy, Poland and Turkey), EVM manufacture in the Republic of Ireland (with the chassis manufactured in Germany) and Yutong manufacture in China. In total, 137 buses will be manufactured in Scotland, 23 in the rest of the UK, and 116 in China.

The following table shows how many buses from which manufacturer ScotZEB is supporting operators to acquire:

Planning of community rehabilitation delivery is the responsibility of individual NHS Boards and Health and Social Care Partnerships.

Our vision is for everyone with rehabilitation needs to be able to access the care and support they need to live well, on their own terms. Exploring ways to improve access to rehabilitation is a key aspect of the work underway to develop a progressive stroke pathway document.

With regard to measuring performance, the provision of appropriate rehabilitation, in both acute and community settings, currently forms part of the Scottish Stroke Improvement Programme (SSIP) criteria-based assessments.

These are currently being reviewed and expanded and will form part of the regular reviews which are undertaken by the Scottish Stroke Improvement Programme team with each Health and Social Care Partnership. We will also consider how these might be integrated into the Scottish Stroke Care Audit if effective.

The self-isolation exemption guidance for health and social care staff is based on the latest clinical and public health evidence and advice, and has been updated on a regular basis as we learn more about new variants, transmission and severity of illness from COVID-19. Clinical advisors within Scottish Government and Public Health Scotland (PHS) provided their expert advice to this guidance. For more information on this advice you can visit the latest PHS guidance for Health Protection Teams.

It is worth noting that as of 28 February this exemption does apply to the general population. Self-isolation guidance states that if you test positive, you should pause routine LFD testing for 28 days after self-isolating. Count the 28 days from the day your symptoms started, or the date of your positive test if had no symptoms. If you are identified as a close contact during this time, you do not need to test or self-isolate as long as you do not have any new symptoms, regardless of vaccination status. If you develop new symptoms, self-isolate and book a PCR test.

The number of confirmed strokes discharged during 2021 showing total length of stay and length of stay in a stroke unit is in the following table.

For some of the figures, the length of stay in the stroke unit are longer compared to stay in the audit. The patient may have completed the stroke part of their journey, but they did not have a discharge plan, so would be discharged from the audit. However, they are still in the stroke unit, for example if they have another condition that is more important than stroke.

As of 28 February, general population self-isolation guidance states that if you test positive, you should pause routine LFD testing for 28 days after self-isolating. Count the 28 days from the day your symptoms started, or the date of your positive test if had no symptoms. If you are identified as a close contact during this time, you do not need to test or self-isolate as long as you do not have any new symptoms, regardless of vaccination status. If you develop new symptoms, self-isolate and book a PCR test.

Throughout the pandemic, the Scottish Government has kept self-isolation policy under review in line with the most up to date scientific evidence and clinical advice. We continue to balance the need to dampen transmission of the virus whilst limiting the impact on the economy and critical public services.

Work on the Global Affairs Framework is continuing and the Framework will be published in due course.

The Scottish Government has committed to invest £10 million over this parliamentary term in our Programme for Government. As part of our commitment to increasing opportunities for disabled people, this funding will increase the number of changing places toilets across the country and support mobile changing places to allow people easier access to outdoor venues and events across Scotland.

Funding will commence in FY 2022-2023 and will be delivered in phases over the course of the parliamentary term. The first phase of work, currently being undertaken, is to develop the plans for the Changing Places Toilets Fund to ensure that the toilets which are built are fit-for-purpose. Further information will be available in due course.

The management of asbestos in buildings is a reserved matter for the UK Government and the Health and Safety Executive (HSE) has UK wide responsibility for enforcement of the legislation and regulations.

My officials asked the HSE for information on current activities to collect data on the number of premises containing asbestos either publicly or privately-owned. There is no requirement on any authority to collect data, and in recent evidence to the UK Parliament Work and Pensions Committee, HSE confirmed that the exact number of business premises in Great Britain containing asbestos is not known. There is however a duty on owners of any premises to know whether their building contains asbestos and to manage it in accordance with the Control of Asbestos Regulations 2012.

HSE is currently carrying out a statutory, five yearly, review of the Control of Asbestos Regulations 2012. Part of the cost benefit analysis for the report which is due to be published in the summer will include estimates about the number of premises containing asbestos. HSE has also given a commitment that future research will address the number of business premises containing asbestos.