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Decisions about patient care should be taken by the clinicians and the patient involved following meaningful discussion and the sharing of all necessary information, including benefits, risks and alternative treatments.

In a circumstance where two NHS boards are involved in a patients care, it would be expected that healthcare professionals from both health boards communicate with each other to discuss and agree a coordinated treatment plan. If a resolution cannot be reached by the clinical teams involved, then concerns can be escalated to the Health Board Management through the appropriate channels.

Patients can consider submitting a formal complaint to the Health Board(s) involved. It is through feedback of this nature that health services can identify any issues and take steps to make improvements. The Patient Advice & Support Service (PASS) is a free, independent and confidential service that supports NHS patients. PASS can offer help and advice with complaints, advocacy support, and help navigating the healthcare system.

Patients can also use their right to request a second opinion from another clinician. This may be appropriate in cases where Health Boards cannot agree on a recommended course of action. If a patient would like a second opinion their clinician or GP will be able to provide advice and make arrangements.

The Scottish Government is committed to ensuring that everyone receives the benefits to which they are entitled. In 2024-25 we have invested over £12 million in free income maximisation, welfare and debt advice services – including £4.6 million for Citizens Advice Scotland’s Money Talk Team service, which last year supported over 9,000 older people, securing financial gains of over £7 million.

The creation of a Safer Drug Consumption Facility in Glasgow is progressing well - construction work is nearing completion to convert the existing facilities and make them fit for purpose and necessary staff recruitment and training is well underway. A provisional opening date of 21 has been announced by Glasgow Council.

We are committed to help deliver drug checking facilities across Scotland. The three pilot areas (Dundee, Aberdeen and Glasgow) have now submitted their licence applications to the Home Office and we are providing support as they are being progressed. We expect the application for the National Testing Laboratory, which will provide additional analysis of drug samples, to be submitted shortly. Edinburgh have also recently joined the national project group and they are at the early stages of considering the establishment of a similar facility.

Over £38 million has been made available through two rounds of the Residential Rehabilitation Rapid Capacity Programme (RRRCP) to increase residential rehab capacity across Scotland. This fund supports eight capacity projects – of which four are new projects and four are expansions to existing services. This will provide 140 more bed by 2025-26.

36 of these beds are already operational and additional projects will be completed over the coming year to add a further 34 beds across Ayrshire, Aberdeenshire and Highlands and Islands. Collectively, these not only substantially increase the number of bed spaces available but also importantly widen access to specific groups and addresses geographic barriers to accessing rehab.

Work is continuing through a range of projects and initiatives to expand access to naloxone and the latest estimated reach of the National Naloxone Programme was 74.7% (percentage of people at risk of opioid overdose who have been supplied with THN) at the end of 2023-24 Quarter 3. We continue to support Police Scotland in their carriage of naloxone by all front-line police officers, where it has been administered to over 450 individuals. Our click-and-deliver service continues to distribute large numbers of kits (894 in quarter 3 of 23-24, last data available) while the work we have supported through the Scottish Ambulance Service also meant 211 kits were distributed by them in the same period.

Recent activity to further expand access to naloxone has included making it available in first aid kits (crash packs) within Scottish prisons while also expanding the work being done by the Scottish Drugs Forum to distribute naloxone to people on liberation from prison through peers. We also continue to engage with UK Government colleagues around the forthcoming legislative change to naloxone prescribing regulations which will make accessing kits easier across the UK.

Additional harm reduction measures being implemented can be found on the Scottish Government’s website: https://www.gov.scot/policies/alcohol-and-drugs/national-mission/

The Chancellor has set out plans to end universal Winter Fuel Payments in England and Wales by restricting it to those receiving Pension Credit and other means tested benefits from this year onwards. This decision was taken without any consultation or discussion with Scottish Government Ministers, which is deeply disappointing given both governments committed to resetting the relationship between them.

The UK Government’s approach reduces the Block-Grant Adjustment associated with devolution of the UK’s Winter Fuel Payment by an estimated £140 million to £160 million in 2024-25 – nearly 90% of the cost of the Scottish Government’s new replacement benefit, Pension Age Winter Heating Payment.

Following careful consideration of the options available for Scotland it is with deep regret that I confirm that the Scottish Government must replicate the decision made by the UK Government and restrict eligibility for Pension Age Winter Heating Payment to older people on relevant eligible benefits. This has been a very difficult decision and not one we want to, or expected to, be making. However, despite all efforts to review our financial position it is a necessary decision when faced with such a deep cut to the budget and in the most challenging financial circumstances since devolution.

The timing of the UK Government announcement has meant it is not practical to make changes in good time for the launch of Pension Age Winter Heating Payment. Delivery will therefore be deferred until winter 2025. However, I can offer reassurance that the Scottish Government is in discussion with the Department of Work and Pensions, which has committed to make payments this winter to eligible pensioners in Scotland on terms equivalent to Winter Fuel Payments in England and Wales.

We are also keen to understand the UK Government’s wider plans to protect energy customers in greatest need, such as a social energy tariff, and will work closely to ensure that they take every possible step to drive up the take-up of Pension Credit and other benefits which pensioners are entitled to.

All new parents are entitled to infant feeding support regardless of how they feed their babies. Appropriate assessments will be carried out by qualified staff where there are feeding issues that could impact growth and development.

Information on feeding issues including tongue tie, and where to seek help, is available on national on-line platforms such as Parent Club Tongue-tie | Parent Club and through local resources.

Following the recent MHRA review into topical steroid withdrawal, regulatory action means topical steroids will soon be labelled with their potencies. This will aid correct selection and simplify the advice for patients. The Scottish Government will cascade the MHRA updated safety alert, new labelling and revised patient safety leaflet to prescribers through clinical networks.

The Scottish Government encourages individuals to review their treatment plans with their healthcare professionals at least annually, and we are working with Health Improvement Scotland to develop searches for clinicians to identify patients using steroids.

We are already working on a four nations approach with MHRA as a hub.

The report makes a number of useful contributions, which Scottish Forestry is considering. A number of the recommendations made are already in place, including changes to sustainability standards increasing the required proportion of tree species diversity, tougher measures to protect soils during tree planting, and supporting an increase in woodlands by rivers across Scotland.

Public forestry grants are vital and a well-established means used across the UK to stimulate woodland creation, supporting Scottish sector worth over £1bn annually and 25,000 jobs. The Scottish Government is clear that Scotland needs to plant a mixture of both productive as well as native species if we are to tackle climate change, nature loss and a growing demand for timber.