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In 2019 COPFS began to experience delays in the provision of toxicology reports from the University of Glasgow, the main contractor for this service. This was further compounded during 2020 due to the pandemic.

Once a toxicological report has been finalised, it is then considered by the pathologist(s) who conducted the post mortem, and thereafter a final post mortem report is issued to the appropriate team in COPFS, who require to review it in detail before the next of kin can be informed of the final cause of death.

Working with Glasgow University, COPFS put various measures in place to address both the backlog and the increasing number of new deaths requiring toxicological analysis. The measures included agreeing a new format of abbreviated report for some cases, and an Improvement Plan which set out weekly performance targets and ensured focused progression with both the backlog of cases and newly reported cases.

Successful implementation of the Improvement Plan in particular means that there is now no backlog of toxicology reports and toxicology analysis is being completed in the majority of cases within 8 weeks.

Since the start of the outbreak, Public Health Scotland (PHS) has been working closely with the Scottish Government and health and care colleagues to support the surveillance and monitoring of COVID-19 amongst the population. There is a large amount of data being regularly published regarding COVID-19. For example, the COVID-19 Education Surveillance dashboard is updated daily and published by Public Health Scotland. COVID-19 PCR test results in educational populations and settings are not broken down individually but are included as part of the wider community-wide surveillance in the PHS COVID-19 dashboard .

We are also reassured by PHS analysis on the risks to teachers when compared to similar working age adults. Analysis published in the BMJ shows that neither teachers, nor their household members, were at increased risk of hospital admission with COVID-19 when compared to similar working age adults from March 2020 to July 2021.

Scottish Government officials are currently finalising options for Phase 3 of the Learning Estate Investment Programme and these will be considered by Scottish Ministers.

We expect to make an announcement on the timescales for Phase 3 before the end of this year.

COPFS and the University of Glasgow agreed an Improvement Plan to reduce the toxicology waiting times. This plan defined performance targets and required the University of Glasgow to provide data to COPFS on a weekly basis. The required data was to highlight the laboratory’s progress with outstanding cases and new cases.

The Improvement Plan has been successful; the toxicology waiting times are now reduced and there is no delay in provision of those reports to the pathologists who require them to finalise the post mortem report.

An indication of the effectiveness of the improvement plan is that, in the week of 25 September 2020, there were 1351 open toxicology cases with University of Glasgow and in the week of 26 September 2021 there were 351 open toxicology cases.

We consider that as part of a package of measures in the forthcoming Land Reform Bill, a public interest test could potentially make a significant contribution to our longstanding land reform objectives by stimulating a more productive, diverse and dynamic pattern of land use.

The test will aim to ensure that the public interest is considered on transfers of particularly large scale land holdings, and we will aim to introduce a pre-emption in favour of community buy-out where the public interest test applies, and where it is appropriate to do so. We intend that the public interest test will help address the issues associated with concentrated land ownership.

It will comply with both the European Convention on Human Rights, including the right to private property, and the terms of the current devolution settlement. This reflects the principled position of the SG, and our explicit commitment to respecting, protecting and fulfilling human rights for every member of society. It will also complement existing Community Right to Buy legislation.

We will be undertaking a wide-ranging public consultation on proposals for the Bill in 2022, including the public interest test, and we are committed to engaging with all stakeholders to develop policy and legislative solutions to progress our proposals.

An analysis of the obtained from the two toxicology providers in Scotland – NHS Grampian which provides approximately 10% of the analysis capability and Glasgow University which provides the rest – is set out in the tables below.

It should be noted however that the extent of toxicological analysis required will depend on the individual circumstances of each case and the extent and nature of substances that are found. Factors such as the need to research the effects of unusual drugs or instruct separate analysis for insulin quantification will result in toxicological reports taking longer to be finalised. 

Additionally, in determining the final cause of death, completion of the toxicological report is only one part of a process which involves a number of separate organisations before a final post mortem report can be issued.

Depending on the circumstances surrounding a death, the pathologist(s) may require a number of further investigations to be completed – including further toxicological analysis as well as input from other experts in the fields of neuropathology or histopathology for example – and the findings of all those enquiries must then be carefully considered by COPFS before a cause of death is confirmed.

GU TOXICOLOGY TURNAROUND TIMES

NHS GRAMPIAN TOXICOLOGY TURNAROUND TIMES

We have an ongoing and unwavering commitment to land reform, and to tackling the issues associated with the scale and concentration of land ownership. We will be introducing a new Land Reform Bill by the end of 2023, which will aim to ensure that the public interest is considered on transfers of particularly large scale land holdings. We also aim to introduce a pre-emption in favour of community buy-out where the public interest test applies, and where it is appropriate to do so.

In addition we are committed to doubling the funding available for communities to buy land and land assets through the Scottish Land Fund, to £20 million, by the end of this Parliament.

We will be undertaking a wide-ranging public consultation on proposals for the Bill in 2022, and we are committed to engaging with all stakeholders to develop policy and legislative solutions to progress our proposals.

The EU Water Framework Directive (WFD) sets the legal obligations to monitor and assess a range of chemicals in the water environment.

The Scottish Environment Protection Agency (SEPA) monitors the water environment for a range of contaminants of emerging concern (including 4 antibiotics, 1 antidepressant, and 3 antifungal medicines) at targeted watercourses. Through the WFD watch-list prioritisation mechanism environmental quality standards for a number of pharmaceuticals are currently being developed by the EU. This includes antibiotic clarithromycin, painkiller ibuprofen, anticonvulsants and painkiller carbamazepine, anti-inflammatory diclofenac and estrogen medication EE2 in this study.

SEPA is working with partner organisations on the identification of chemicals of emerging concern in the environment, and is developing new analytical techniques that will allow it to screen environmental samples for a much larger number of chemicals, including a number of pharmaceuticals. This work will allow us to better understand the risks posed by pharmaceuticals in Scotland’s water environment.