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We recognise that the Covid-19 pandemic has had a significant impact on our NHS including diabetes services. We took the opportunity to reflect on these challenges as we determined the priorities for our Diabetes Improvement Plan refresh, which was published in February 2021.

On 25 August 2021 we launched our NHS Recovery Plan which is backed by more than £1bn of investment over the next five years. The plan takes forward our aim of increasing NHS capacity by at least 10% as quickly as possible in order to address the backlog of care and meet the ongoing healthcare needs for people across the country.

The Scottish Government considers a range of data to support policy development. Current data on how Scotland compares to the rest of the UK is considered in the weekly state of the epidemic paper, available on the Scottish Government website. This report ( Coronavirus (COVID-19): state of the epidemic - gov.scot (www.gov.scot) ) brings together the different sources of evidence and data about the COVID epidemic to summarise the current situation, and incorporates data from the UK COVID Dashboard on cases, hospital occupancy and deaths across the four nations. The Scottish Government also refers to the latest data for the four nations from the ONS Covid-19 Infection Survey, which includes estimates of positivity, estimates of the number of people testing positive for antibodies to COVID and long COVID, and has done since the first results were published for Scotland in October 2020.

The evidence and data which informs the Scottish Government is drawn from academic institutions based across the UK which inform SAGE (including via its sub-groups), the UK Health Security Agency and scientific literature from across the world. SAGE includes experts from within government and leading specialists from the fields of healthcare and academia. During the response to the COVID-19 pandemic the SAGE sub groups include:

• New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG)
• Scientific Pandemic Influenza Group on Modelling (SPI-M)
• Independent Scientific Pandemic insights Group on Behaviours (SPI-B)
• COVID-19 Genomics UK (COG-UK)
• Health Data Research UK (HDR UK)

The Heart Disease Action Plan 2021, sets out a strategic vision to address the impact of heart disease across Scotland. This means that the plan does not provide detailed information on specific conditions but instead identifies four priority areas. These are 1) tackling risk factors, 2) ensuring timely and equitable access to diagnosis, treatment and care, 3) addressing key issues within the cardiac workforce, and 4) ensuring effective use of data to support improvement.

The actions within these priority areas should impact across a number of cardiac conditions and therefore improve services for everyone with heart disease, including for people living with heart valve disease.

The Scottish Stroke Care Standards can be found here: ( https://www.strokeaudit.scot.nhs.uk/index.html ). The current standard relating to brain imaging already sets out that 90% of patients should receive this within 12 hours of arrival at first hospital, unless there is a documented contraindication.

The Scottish Stroke Care Standards are regularly reviewed in line with current evidence and updated guidelines. We monitor the implementation of these standards through the Scottish Stroke Care Audit to ensure that stroke patients in Scotland are receiving high quality care.

Further to the answer to question S6W-04701 I can confirm that the case review was undertaken by a small number of NHS Lothian clinicians who are all suitably qualified and experienced in their relevant fields. As none of the clinicians who undertook the review had previously looked after Mr Slorance there was no conflict of interest in undertaking the review.

The Scottish Cardiac Audit Programme, within Public Health Scotland, have been actively seeking data submissions from all sites across Scotland that previously contributed to the UK National Cardiac Audit Programme, managed by the National Institute for Cardiovascular Outcomes Research (NICOR). This includes sites which carry out TAVI procedures.

Where it is clinically appropriate to do so, patients of all ages will be examined with a stethoscope to listen for breathing and heart sounds. They may also have ECG electrical recordings of their heart rate, blood tests and have access to other investigations such as Echocardiograms, rhythm monitors and blood pressure recordings, should these be required.

The Heart Disease Action Plan recognises the need to ensure timely and equitable access to diagnostics, including echocardiography.

As set out within the plan, we are working to address key workforce issues relating to cardiac physiology. Cardiac Physiologists are healthcare professionals who are vital to the delivery of many aspects of cardiac care, including the provision of echocardiography.

Furthermore, we have also recently provided funding for the delivery of a pilot project to improve access to echocardiography. The learning from this will support us in understanding how best to further support improvement across Scotland.

Service levels and the rolling stock used have been designed to match changing demand during the pandemic period, while at the same time considering efficiency of resourcing and overall affordability, for which Abellio ScotRail is responsible. Decisions on service levels are then considered at Scotland’s Railway Task Force which has met throughout the pandemic.

We expect ScotRail, from 1 April 2022, to continue to operate service levels and train capacity adjusted to reflect and encourage growing levels of demand as wider Covid restrictions are eased.

Those who experience difficulties carrying out a LFD test can ask someone they trust to assist them with the swabbing and testing process. Walk-in asymptomatic test sites (ATS) can also advise people how to use a LFD test. After self-swabbing, the person hands their used swab to a site operative for it to be analysed.

People identified as contacts of a case who are unable or do not have the support to carry out LFD testing can call the National Contact Tracing Centre on 0800 030 8012, for advice.

Additionally, for people with access to a smart phone, an expansion to the existing 119 Be My Eyes service was launched on 27 January to assist asymptomatic visually impaired people and anyone else who needs support, to conduct a rapid lateral flow self-test independently.

Instructions for use for LFD self-tests used in the National Testing Programme are also available in large print and easy read and can be accessed here: Acon Flowflex , Innova and Orient Gene .

Regular testing for people without symptoms is voluntary and for some people it may not be appropriate for testing to take place at all. Those who work most closely with the individual will be best placed to decide whether testing will be appropriate, taking into consideration the needs of the individual.