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Ensuring high quality palliative and end of life care for people towards the end of life is an important priority for the Scottish Government.

Since 2016, it has been the responsibility of Integration Authorities to commission and plan palliative and end of life care services and supports to meet the needs of their local population. The assessment of palliative and end of life care services is also their responsibility.

For this reason, the Scottish Government does not collect this data centrally.

However, Integration Authorities report on their progress using a range of indicators within their Annual Performance Reports, which provides some data on palliative and end of life care services. Information on the Core Suite of Integration Indicators can be found at https://publichealthscotland.scot/media/8411/2021-07-13-coresuiteindicators-background-and-glossary.pdf. It is, however, important to note that due to the pandemic, full data is not currently available for all indicators at present.

Public Health Scotland also publish official statistics on the percentage of time spent at home or in a community setting in the last six months of life. ( Percentage of end of life spent at home or in a community setting - Financial years ending 31 March 2011 to 2020 - Percentage of end of life spent at home or in a community setting - Publications - Public Health Scotland ).

The information about the number of individuals requesting hospital-based palliative care is not collected centrally.

The following table shows the number of people recorded as receiving inpatient palliative care in 2019-20. However, this information may not reflect the totality of hospital-based palliative care as it only contains the patients recorded under the care of a palliative medicine consultant, in a Palliative care unit or diagnosed with a Palliative care condition.

Scottish Government officials are currently working to identify the most appropriate and effective way to appoint a National Clinical Lead for Palliative and End of Life Care. This work is ongoing and further information regarding this appointment will be made available in due course.

Using the latest available forecasts published by the Scottish Fiscal Commission in January 2021 1 , it is estimated that 163,000 children are eligible for Scottish Child Payment in 2021-22.

Social Security Scotland publish official statistics on the number of applications they have received, processed and the number of children who have benefited from Scottish Child Payment. The latest statistics published in May 2021 2 cover the period from 9 November 2020 to 31 March 2021. The next publication, covering up to 30 June 2021, will be released on 31 August 2021.

1 Scottish Fiscal Commission (January 2021) Scotland’sEconomic and Fiscal Forecasts. Available at https://www.fiscalcommission.scot/publications/scotlands-economic-and-fiscal-forecasts-january-2021/ .

2 Social Security Scotland (May 2021) Scottish Child Payment: high level statistics to 31 March 2021. Available at https://www.gov.scot/publications/scottish-child-payment-high-level-statistics-on-applications-to-31-march-2021/ .

Social Security Scotland has been proactively promoting Scottish Child Payment by writing to those eligible on Universal Credit and HMRC tax credit databases to invite them to apply. Social Security Scotland also continue to work closely with public sector services and third sector organisations to reach out to families. This includes information in the baby box, NHS midwife and health visitor packs, nurseries and schools, food banks and other family support and welfare advice groups.

To drive take up of Scottish Child Payment further, as well as Best Start Grant and Best Start Foods, we launched a Five Family Payments campaign in March 2021, which will continue throughout this financial year, and targets parents through TV, radio, online adverts and social media.

Our focus for the current Programme for Government stroke commitments is to continue our work to deliver a national thrombectomy service for stroke and define a progressive stroke pathway. We are making progress against both of these commitments, with a report on progressive stroke services due by the end of December 2021, and a Scotland wide thrombectomy service operational by 2023.

The progressive stroke pathway report, will set the intention for improving care for people with stroke and following completion of the report, we will consider the appropriate next steps to planning its implementation.

The Scottish Government does not hold this information centrally. We are however developing a meaningful equality and diversity objective for Chairs of NHS Boards that directly support the work of staff equality networks, ensuring they have a voice and influence to drive change, with clear and defined lines of accountability. While this is in development we are actively encouraging Health Boards to develop staff led equality networks across a range of protected characteristics, which includes disability.

We are also working with service-led disability organisations to support graduates with disabilities enter the NHS workforce and the development of a user-focussed workplace adjustment policy.

Around 10-15% of patients presenting with acute stroke in the NHS Greater Glasgow and Clyde (NHS GG&C) Health Board area are candidates for reperfusion with thrombolysis. The other 85-90% of admissions require specialist local care. Within NHS GGC, acute stroke thrombolysis is already available on a 24/7 basis. This is currently based at the Queen Elizabeth University Hospital (QEUH) with a thrombolysis on-call rota covering the entire NHS GG&C area.

Patients presenting to the Glasgow Royal Infirmary (GRI) out of hours and at weekends with acute stroke, are assessed immediately on arrival and have appropriate imaging performed. If it is thought that the individual patient would potentially benefit from thrombolysis, then they will be transferred to QEUH. Patients presenting at GRI during weekday hours, who are thought to potentially benefit from thrombolysis, would have thrombolysis performed at GRI.

Patients presenting to other NHS GG&C sites with acute stroke, and who are thought to potentially benefit from thrombolysis, are either assessed, have appropriate imaging performed, and transferred to QEUH where appropriate, or are taken directly to QEUH by the Scottish Ambulance Service (SAS), where stroke thrombolysis can take place.

Reperfusion in acute stroke circumstances is time-critical, as the benefit of thrombolysis diminishes with any delay to treatment. Therefore, work is ongoing within the NHS GG&C Stroke Improvement Group to develop a consultant telemedicine thrombolysis model with local stroke specialist nurse support for patients presenting with acute stroke.

NHS GG&C can provide further information on the Acute Stroke Service.

The Scottish Child Payment team are working closely with the DWP Scottish Devolution Programme to refine the scope of the delivery, including the data sharing requirements, to ensure the safe and secure roll out of the Scottish Child Payment to eligible families with children under 16 years of age by the end of 2022.

We recognise that local carer support services have been under additional pressure during the pandemic.

Local authorities and integration authorities are responsible for carer support under the Carers Act and commission third sector organisations to provide much of that support on their behalf. The 2021-22 budget contains an additional £28.5 million in the local government settlement for Carers Act implementation. Added to similar (baselined) increases in previous years since the Act came into force in April 2018, this brings the total additional investment for 2021-22 to £68 million per year.

The previous Cabinet Secretary for Health and Sport wrote to local authorities in March 2021 to highlight the importance of using this additional funding to expand carer support: www.gov.scot/publications/carers-act-finance-2021-2022-letter .

The Scottish Government also funds the Time to Live scheme, administered by Shared Care Scotland, to enable local carer organisations to provide small grants for carers to spend on short breaks or something that gives them a break from caring. In response to the pandemic, we have put an additional £910,000 into the scheme in 2020-21 and a further £250,000 in 2021-22.