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The decision about which treatment to prescribe is a clinical decision made by the prescriber in discussion with the patient, taking into account the individual’s condition and medical history.

Guidance is available to assist prescribers and Scottish Government is in the process of reviewing its “Quality Prescribing for Chronic Pain – A Guide for Improvement” which will include information on addressing the issue of over-treatment with a focus on self-management and non-pharmaceutical treatment of long-term conditions, highlighting the issue of high strength opioid medicines misuse and encouraging clinicians to discuss concerns openly with patients.

Over the period covered by the University of Aberdeen study, steroid injections (a commonly used therapeutic option for Osteoarthritis awaiting surgery) were reduced on advice from Royal College of Rheumatology due to the risk of activation of latent Covid 19 and risk of immunosuppression and susceptibility to the virus, this could have led to an increase in opioid pain medication prescriptions to compensate. Analysis from Public Health Scotland (PHS) shows a marked reduction in the number of corticosteroid injections between March 2020 and April 2021 before returning to previous levels. Analysis from PHS, however, does not indicate an overall increase in opioid pain medication prescriptions over the same period.

The Scottish Government recognises that the lack of a national platform for group therapy has been challenging for services, that is why we have been working with the software developers, Attend Anywhere, to develop their platform Near Me as suitable solution to undertake patient facing group video consultations. Developers are currently testing the Alpha version of the Near Me group platform and it is anticipated that a Beta version (testing by clinicians) of the system will be available for testing with patients in November with full release shortly thereafter.

Meantime, we have issued guidance for NHS Scotland on the use of video consultation for group therapy using existing platforms, available from the Technology Enabled Care Scotland webpage. Use of Video Consulting in Group Settings for Mental Health Guidance | TEC Scotland

Consultant Psychiatrists across NHS Boards

The latest quarterly NHS Workforce stats (published 7 September) provide a data snapshot of the number of consultant psychiatrists across Mental Health and Learning Disabilities (MHLD) services within NHS Scotland and in each of the NHS Boards.

As at 30 June 2021, there are 547.8* whole-time equivalent (WTE) Consultant Psychiatrists across all specialities in NHS Scotland. This is a 23.2% increase since September 2006. The number of WTE consultant psychiatrists across all specialities in each NHS Board as at 30 June 2021 are:

The Mental Health in Schools Working Group have sought to establish a comprehensive approach to supporting children and young people’s mental health and wellbeing through schools. The publication of the whole-school approach framework provides guidance on setting mental health and wellbeing at the heart of the ethos and culture of schools.

This approach is also reflected within the new professional learning resource, which has been specifically developed for use by school staff, as part of a strategic approach to enhancing understanding of supporting children and young people’s mental health and wellbeing in schools. The new professional learning resource is available online and can be used by any member of school staff.

We committed in our 2018-19 Programme for Government to invest up to £5 million over a three year period to support 2,000 women who have had a career break to return to the workplace. This commitment and the scale of ambition built on the learning from our 2017 pilot Women Returners Programme.

An initial Programme commenced in late 2020 which offered immediate support to women during the pandemic. Within the three month period of delivery it attracted twelve projects offering support to over 450 women. This included projects such as HRC Recruitment which provided employability workshops combined with menopause support and mental health fitness coaching to women over 50 years old.

The programme for government published in September 2021 committed to continuing the programme. SDS are delivering the programme this year on behalf of Scottish Government backed with up to £2 million. Bids from prospective providers are currently being assessed. Women will be given support to enable them to apply for jobs or take part in activity such as further training that suits their own personal needs, timescales and circumstances for returning to work.

Following closure of the Lowit Unit at the Royal Aberdeen Children’s Hospital in 2014, a programme of CAMHS redesign started in 2015. This included all services for children and young people with mental health issues being redesigned to support children aged 0-18 years.

During this redesign, the majority of staff were co-located in a new purpose redesigned CAMHS building funded by the Scottish Government. The remainder of staff are now based in Moray as part of a Hub and Spoke model of care. This includes Unscheduled Care and Tier 4 staff to support children, young people and their families. All Tier 4 patients are cared for by a Multi-Disciplinary Team, using a Care Programme Approach. The CAMHS service in NHS Grampian is now also part of a North of Scotland regional Tier 4 network with Tayside and Highland and in-patient beds can be accessed within the Young People's Unit, if required.

It is for individual Health Boards to ensure that they provide mental health services in line with the needs of their local population.

NHS Grampian is currently meeting the CAMHS Waiting Times target of patients starting treatment within 18 weeks, with compliance at 90.8% in the last quarter. Waiting times performance since the whole service redesign in NHS Grampian was completed shows the positive impact this has had on access and care.

I welcome the efforts of Plus Perth, Dundee Healthy Minds Network, Angus Voice and the Tayside Independent Inquiry Stakeholder Participation Group in producing this survey and report. I recognise the value that it has provided to David Strang in informing his progress report on Tayside's mental health services which was published in July. I met with representatives of the Stakeholder Participation Group to hear more about their experiences and recommendations for Tayside Mental Health Services in September and have made clear to Tayside partners that the voices of lived and living experience on mental health services in Tayside is critical going forward.

The Scottish Government is working to establish independent scrutiny of Tayside’s Mental Health Services, an action that is strongly supported by the survey report.

I have asked Teresa Medhurst, Interim Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

Whilst this is primarily an operational matter for the SPS, the SPS and Scottish Government have been in communication regarding the reported tampering of mobile phones used by individuals in custody and security measures in place. A solution was identified with the provider in relation to the concern of illicit SIM cards being used in prison issued mobile phones and it is currently being implemented across the prison estate. This solution enables the SPS to blacklist handsets on various network providers rendering the handsets unusable with a non-prison issued SIM. The security measures in place will continue to be monitored by the SPS.

I have asked Teresa Medhurst, Interim Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

The following table provides the number of SPS issued mobile phone handsets that have been confiscated at HMP & YOI Grampian, each month, since implementation in July 2020:

Home owners are responsible for the costs of on-going work needed to protect and preserve their own property, which includes the costs for the fire alarms to meet the new standard. We have provided £0.5 million additional funding for Care and Repair Scotland to provide help installing alarms for older and disabled homeowners on low incomes. We have also provided £1 million to the Scottish Fire and Rescue Service to provide alarms for owners who are considered most vulnerable to the risk of fire. Local authorities also have broad discretionary powers to provide advice and support to owners.

The Scottish Government has undertaken a comprehensive awareness raising campaign across a range of channels including TV, Radio and digital to ensure people are aware of the new legislation and encourage compliance. This includes material to support third sector stakeholders and messaging on the importance of using reputable tradespeople, including signposting to local government Trading Standards.

The Strategic Framework within Scotland’s Scams Prevention, Awareness and Enforcement Strategy, published in 19 March 2021, focusses on prevention, disruption, awareness, education and enforcement. This is intended to help all consumers with practical steps they can take to recognise common scam tactics and avoid the risk posed by this criminal activity.

Further advice can be obtained from https://consumeradvice.scot/ , which is a free consumer helpline funded by the Scottish Government.