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All pandemic PPE procurement undertaken by public sector organisations has been conducted in line with the relevant public procurement legislation and policy. In addition, direct awards have taken place using procedures outlined in Regulation 33 within the Public Contract (Scotland) Regulation 2015.

Information on contracts awarded by the Scottish Government for PPE was included in the answers to PQs S6W-02211 and S6W-02212 on 28 September 2021.

Information on contracts let by other national public sector organisations is a matter for those bodies.

The Procurement (Scotland) Regulations require all public bodies to publish an award notice for all regulated procurements no later than thirty days after the award of the contract. These can be found on the Public Contracts Scotland website: www.publiccontractsscotland.gov.uk

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

The COVID pandemic has inevitably affected A&E attendance and the pressure is being felt across the UK. While Scotland continues to have the best performing A&E in the whole of the UK, our NHS staff are facing unprecedented pressures as they work tirelessly and consistently to respond to the pandemic whilst continuing to provide vital treatment and optimal patient care.

Demand on NHS Highland services has been, and continues to be challenged. This is largely due to limited bed capacity due to staffing pressures, and an increase in attendances to A&E by those who are much sicker and require higher levels of care.

We are in daily contact with NHS Highland and continue to support improvement work within the Board and the Health & Social Care Partnerships to minimise delays for patients no matter where they are in the system. We also invested an additional £12 million in the summer to support improvements, NHS Highland has used its allocation to increase capacity in community hospitals.

Additionally, to help alleviate pressures across the whole system we announced a substantial new investment of over £300 million in hospital and community care to support the NHS and social care system over winter. The new funding will support a range of measures to maximise capacity in hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care, helping to improve waiting times for people attending A&E.

The Vaccination Transformation Programme (VTP) is funded via the Primary Care Improvement Fund, which began in 2018 and will have provided £250 million to health boards up to the end of financial year 2022. The extended flu programme and COVID-19 vaccination programme (including boosters) are outside the scope of this fund, however work to deliver these programmes has helped to build Health Board capacity to vaccinate and complete the VTP.

Scottish Government officials are in regular contact with NHS Highland to support the service management team with the delivery of orthopaedic elective procedures within the Health Board.

In response to the pressures on NHS services caused by the pandemic, which we are still firmly in the midst of, the First Minster launched the NHS Recovery Plan, on the 25 August. The Plan sets out the Scottish Governments key headline ambitions and actions to be developed and delivered now and over the next 5 years, including an increase in both inpatient and outpatient capacity across the Country. The plan is backed by more than £1 billion of investment over the next five years.

As part of this, we are investing over £400 million in a network of National Treatment Centres, one of which will be located in NHS Highland. When fully operational, the National Treatment Centres will provide increased capacity for surgeries and procedures across 14 specialties, including hip and knee surgery.

The number of patients who have waited over 12 weeks for Trauma and Orthopaedic surgery in NHS Highland are published by Public Health Scotland (PHS) on a quarterly basis. These details are available on PHS’s website and can be found in table 1.2 through the following link: https://www.publichealthscotland.scot/media/8811/newop_aug21.xlsx

We are working closely across the four nations and international partners on restarting international travel safely. Our discussions are still ongoing with the UK Government and international partners on exemptions for people who cannot receive COVID-19 vaccinations. In the meantime, people intending to travel should check that vaccination status is a requirement of the country they are visiting on the GOV.UK foreign travel advice pages, as PCR testing is also widely accepted.

The number of people for whom vaccination cannot be safely completed with the right support will be very small. Reasons for exemptions would be medical contraindications that might include severe anaphylactic reaction across the range of vaccines and those receiving end of life care. We would encourage people to take a vaccine where they can do so safely and they can contact our national helpline on 0808 196 8565 for support in arranging this.

The Scottish Government is committed to the early detection of cancer. We are in currently in the process of establishing Scotland’s first Early Cancer Diagnostic Centres which will see the creation of a person-centred fast-track pathway for patients with non-specific symptoms (i.e. weight loss, nausea, fatigue) suspicious of cancer. These centres have been in operation since June 2021 and are continually taking patients with plans for equitable access across Scotland over the course of this parliament.

An estimate of the number of patients who have missed an early diagnosis of melanoma can be made by using data from the Public Health Scotland (PHS) Covid Wider Impacts Dashboard ( https://scotland.shinyapps.io/phs-covid-wider-impact/ ). The data indicates there were a total of 1,131 individuals with pathologically confirmed specimens for malignant melanoma of the skin between 1 April 2020 and the week ending 21 st February 2021. This was 398 individuals fewer than in the same period one year before.

Therefore, the data suggests there have been around 400 fewer melanoma diagnoses overall during the time of the COVID-19 pandemic.

GP practices have remained open, accessible and at the forefront of our community services to deal with non-COVID-19 medical care throughout the pandemic. As outlined in the NHS Recovery Plan, a key aim is to work with our GPs to continue to restore face-to-face practice consultations as quickly and safely as possible, while ensuring everyone can continue to make use of eHealth services if that is their preference.

Public Health Scotland have published guidance on social distancing and infection control measure in health settings, changing the 2 metre social distancing rule to 1 metre, enabling more patients in waiting rooms, while continuing to ensure that vulnerable patients and staff are kept safe. In addition, specific guidance to general practices has been published making it clear that there is no longer a need to triage every patient, although they should continue to screen patients for Covid before seeing them face-to-face. We will continue to take advice from public health experts and clinicians when reviewing these measures.

With these recently announced changes I would expect the number of face-to-face appointments to increase.

While high quality data from across the health system is collected, we are working with stakeholders to improve the quality of data we can collect from GP practices to ensure it is robust.

We have continued to meet routinely with GPs and their representatives, and hear regularly from patients, to help build intelligence around appointments and pressures in GP practices throughout the pandemic, and are currently working together with NSS and PHS on a more advanced digital solution for capturing this information moving forward.

Between 1 April 2020 and 31 March 2021, COPFS concluded 59 FAIs, an increase from 57 the previous year. This increase took place notwithstanding an increase of more than 40% deaths reported to COPFS compared to previous years as well as the restrictions on court business for much of that period due to the COVID-19 pandemic.

In relation to those 59 FAIs, 43 related to deaths which had occurred between 2018 and 2020.

In recognition of the fact that some death investigations have taken too long, COPFS has made significant changes to its practices and additional resources have been applied to this important area of work. There has been a particular focus on clearing a backlog of cases and consequently some older FAIs concluded during this period which will have affected the figures quoted.

There are legitimate and unavoidable reasons for prolonged periods of investigation: the overriding necessity of conducting death investigations thoroughly; the need to wait for the outcome of other related investigations; the need to obtain expert advice; and the need to consider and, in some cases, conclude criminal proceedings before holding an FAI.

The Scottish Government has been discussing with businesses and other stakeholders the detailed plans for implementing the previously-announced policy to end overseas trade support and promotion activities focused solely on fossil fuel goods and services by the time of COP26. Under this policy, trade support and promotion will be refocused to support the Scottish Government’s objective of a Just Transition.

In the light of those discussions, and in recognition of the need for SMEs to have sufficient time to adjust, when this policy enters into force on 1 November 2021 it will include an exemption for SMEs until 31 March 2022. This matches the timing of the equivalent policy of the UK government, bearing in mind that in many cases the companies affected work with and receive support from both governments. Detailed guidance on the implementation of the policy, including this and other exemptions, will be published on the Scottish Government website at 2pm Friday 15 October at this link - https://www.gov.scot/isbn/9781802014662 .