Seòmar agus comataidhean

As set out by me in the statement to Parliament on 13 November on winter preparedness and national planning, winter resilience planning is best undertaken by those delivering the services themselves. The Scottish Government supports this via the nationally agreed priorities and principles set out in the document “National Planning Priorities and Principles for Surge and Winter Preparedness in Health and Social Care” which was published on 13 November 2025.

The Scottish Government expects all NHS Boards and healthcare professionals to follow relevant clinical guidelines when assessing children and to refer them for testing where clinically necessary.

Decisions on testing are a matter for clinicians, guided by national clinical standards, and it would not be appropriate for the Scottish Government to mandate this. In May 2023, the National Institute for Health and Care Excellence updated its diabetes guideline (NG18), which recommends that any child displaying symptoms such as excessive urination, thirst or tiredness should be referred immediately to paediatric diabetes services for diagnosis and care. This process includes appropriate testing to confirm diagnosis.

The Scottish Government expects all NHS Boards and healthcare professionals to follow relevant clinical guidelines when assessing children and to refer them for testing where clinically necessary.

We encourage parents and carers to contact their GP urgently if their child is displaying symptoms.

We remain committed to improving early diagnosis and awareness among healthcare professionals and will continue to monitor emerging evidence to inform future policy decisions.

The Scottish Government is taking steps to improve early detection of type 1 diabetes in children through research, awareness initiatives, and clinical guidance.

Scotland contributed to the UK’s largest screening trial for children with type 1 diabetes, the ELSA study, which screened 20,000 children aged 3 to 13 for early markers of the condition. The findings will help inform future policy decisions.

Our Diabetes Improvement Plan sets out priorities for early diagnosis and prevention and is overseen by the Scottish Diabetes Group, which brings together clinical leaders and stakeholders to drive improvements in care.

A key commitment within the Plan is raising awareness of type 1 diabetes in primary care to ensure clinicians can recognise early signs and symptoms and act quickly.

The Scottish Diabetes Group works closely with the Diabetes Managed Clinical Network-Managers and Leads group to ensure frontline perspectives inform policy and practice. National clinical guidelines are regularly discussed at Scottish Diabetes Group meetings to reinforce best practice.

At its next meeting in March, the Scottish Diabetes Group will consider a suggestion brought forward by the Scottish Government, to promote awareness of the 4Ts (Toilet, Thirsty, Tired, Thinner) which are key symptoms of type 1 diabetes in children. We remain committed to improving early diagnosis and will continue to monitor emerging evidence to inform future policy decisions on diabetes care for children and young people.

The Scottish Government has not engaged directly with families or clinicians calling for the introduction of routine point-of-care testing for diabetes symptoms. However, we regularly engage with Diabetes Scotland and other third-sector organisations, and clinicians, through forums such as the Scottish Diabetes Group, which provide opportunities for clinical leaders and patient representatives to inform policy development.

We also engage with people with lived experience of diabetes through events such as World Diabetes Day and other awareness activities, ensuring their perspectives help shape our approach to improving care and early diagnosis.

Through these channels, we ensure that views from healthcare professionals, organisations supporting families and those directly affected by diabetes are considered in shaping policy.

The Scottish Government does not hold centrally data on how many cases of diabetic ketoacidosis (DKA) in children have resulted specifically from delayed diagnosis in each of the last five years.

While information on diabetes diagnoses and hospital admissions for DKA is recorded nationally, through SCI-Diabetes, these datasets do not capture whether an episode of DKA was attributable to delayed diagnosis. Assessment of the clinical circumstances leading to DKA sits with local NHS Boards and care teams.

Reducing the number of children presenting in diabetic ketoacidosis remains a priority. Evidence shows that improved awareness, timely referral, and better glucose control can reduce the likelihood and severity of DKA.

Closed Loop Systems support more stable blood glucose control and provide early alerts that can help prevent deterioration and emergency admissions. Local experience in Scotland demonstrates sustained improvements in glycaemic control among children using these systems, reducing future risk of acute complications.

The Scottish Diabetes Survey 2024 highlights continued improvement in monitoring and technology uptake among children and young people, reinforcing the importance of prevention and early intervention across the pathway rather than retrospective attribution of individual cases.

Alongside technological advances, the Scottish Government continues to support early detection and prompt referral through national clinical guidance, professional education and the Diabetes Improvement Plan, overseen by the Scottish Diabetes Group. This approach is intended to reduce avoidable harm, including diabetic ketoacidosis, in children and young people with type 1 diabetes.

We recognise the impact of technology in helping children and young people manage their type 1 diabetes. This is why we have invested over £50 million in diabetes technology since 2016, prioritising access for children and young people.

The funding we are providing ensures that every child or young person in Scotland with Type 1 diabetes who wants to use a hybrid closed loop system can access one. As of September 2025, 77% of under-18s with Type 1 diabetes have access, and every child or young person should have received at least a referral. This paediatric focus helps prevent complications early and get the most out of this life changing technology.

The Scottish Government Executive Committee, settled on implementing 40% in-person working over a working month, for staff in core directorates. This target was settled on following an internal review of evidence from a number of sources. The aim is to spend 40% of contracted hours working in-person with colleagues and/or stakeholders or other settings from 27 October 2025. The 40% target is averaged over a four-week period and is a target not a mandate.

The Scottish Government has no current plans to publish a national audit of diagnostic pathways for paediatric diabetes.

Diagnosis of diabetes in children is a clinical responsibility and is carried out in line with national clinical guidance. Current NICE guidance recommends that any child displaying symptoms of type 1 diabetes is referred immediately to paediatric diabetes services for assessment and diagnosis.

Scotland has a system-level approach to quality improvement in diabetes care. Rather than relying on standing national audits, this approach is based on a single national clinical information system in the form of SCI-Diabetes, annual national reporting through the Scottish Diabetes Survey, and improvement led through Managed Clinical Networks with national oversight provided by the Scottish Diabetes Group. This model embeds data collection within routine clinical care and supports continuous improvement and local accountability.

Quality improvement activity, including review of diagnostic practice and local pathway effectiveness, is best led by NHS Boards and clinicians who are responsible for service delivery and can take account of local population need and service challenges.

The Scottish Government continues to work with the Scottish Diabetes Group and Managed Clinical Networks to support early diagnosis, consistent application of clinical guidance, and reduction of avoidable harm, through education, data-driven improvement and national oversight.

The Scottish Government recognises the importance of ensuring that parents and carers receive clear and consistent information about symptoms that may indicate type 1 diabetes in children.

Responsibility for providing advice and discussing symptoms lies with clinicians, who are expected to follow established clinical guidance and ensure families receive accurate information tailored to individual circumstances. We encourage parents and carers to urgently contact their GP if their child is displaying symptoms of diabetes, as they are best placed to provide specific advice and support.

To support this, we fund and promote a range of trusted resources:

• NHS Inform, Scotland’s national health information service, provides accurate and up-to-date information on identifying, treating and managing diabetes. The diabetes pages were reviewed by clinicians in 2025 and updated where appropriate.
• My Diabetes My Way, Scotland’s interactive self-management platform, offers NHS-accredited eLearning resources and personalised tools to help families understand diabetes care.
• DigiBete, a digital tool designed for children and young people which provides age-appropriate educational videos, milestone-based learning modules, and practical tools in multiple languages.

We also work closely with Diabetes Scotland and other third-sector partners to promote awareness and peer support, ensuring families have access to practical advice alongside clinical guidance.

Through the Scottish Diabetes Group and its subgroups, we continue to deliver the commitments set out in the Diabetes Improvement Plan, including improving knowledge and confidence in primary care teams to ensure consistent messaging across Scotland.

The Scottish Government fully supports driver education as an alternative to prosecution where appropriate, understanding how these courses can positively influence behaviour and align with our long-term goal of reducing the number of people killed or seriously injured on Scotland’s roads. It’s important to note that we are not only looking to bring in speed awareness courses but a full suite of courses aimed at lower-level offences where the aim is behaviour change rather than punishment.

We have undertaken an in-depth review of all of the leading studies in this area. For example a three year evaluation, previously published by DfT, found that course participation reduced the likelihood of reoffending within six months by up to 23%. It further highlighted that the course was more effective in reducing speed reoffending than the penalty points and fines typically associated with fixed penalty notices for eligible drivers. This positive impact appeared to persist for up to three years following participation. Although a direct link to a reduction in road traffic collisions was not established, it was determined that the speed awareness courses contributed to reduced reoffending rates, and it is reasonable to anticipate that course participation encourages safer driving behaviours, indirectly lowering future collision risks.

Additionally, in 2023, the Transport Research Laboratory conducted an evaluation of the majority of National Driver Offending Retraining Scheme (NDORS) courses, which found that overall the courses are having a positive impact on the various behaviours they target.