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The anticipated cut by the UK Government to the Scottish Government's capital budget of up to £1.3billion in real terms over the coming years has consequences. In December 2023, given the extremely challenging capital funding position, NHS Boards were instructed to pause any project development spend and instead direct capital budgets towards maintenance of the existing estate and essential equipment and digital replacement. Boards were notified that the Scottish Government does not anticipate starting construction of any new project over the next two years at least. Obviously should the UK Government change course on capital investment we have an opportunity to look at this again alongside the capital review ongoing across the Scottish Government.

There is therefore no change to the position on NHS Capital Projects as a result of the ongoing review of the Infrastructure Investment Plan.

We are committed to delivering on the priority in the Women's Health Plan (WHP) to improve access for women to appropriate support, speedy diagnosis and best treatment for endometriosis.

We know that, for many women, diagnosis time for endometriosis is not acceptable. It is vital that we improve care and support throughout the whole diagnosis process.

To do this a number of actions have been taken including:

• The development of the Endometriosis Care Pathway for Scotland which aims to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms.
• A NHS Education for Scotland (NES) training package and framework focused on menstrual health for general practice and others working in Primary Care.
• A NHS NES ‘Masterclass’ on endometriosis for healthcare professionals.
• Improving the information available for women and girls on endometriosis and menstrual health through our work with NHS Inform, Young Scotland, the ALLIANCE and Endometriosis UK.

We are working closely with our stakeholders across Scotland to understand the effectiveness of these workstreams and their impact upon reducing diagnostic times for endometriosis.

The Scottish Government has been engaging with Health Boards regarding their current position in relation to job offers and supply. Health Boards remain committed to maximising opportunities for new qualified nurses to find employment.

Mothers and Babies Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK), reports give us valuable insight into national and local rates of stillbirth and neonatal mortality. We expect all NHS Boards to carefully consider MBRRACE-UK reports, including their local reports, and undertake local reviews of services rated ‘red’ for stillbirth or neonatal death, and ensure that when deaths occur, any improvements are identified and acted on.

We will be writing to NHS Boards shortly to ensure that they have taken account of the MBRRACE-UK reports and to seek assurances in particular from Boards with higher-than-average rates that work is underway, or complete, to understand and learn from the possible factors which may have contributed to the reported increase.

The Scottish Government commissioned Healthcare Improvement Scotland to undertake a review to determine underlying causes of an increase in neonatal mortality in Scotland in 2021-22 and make recommendations for improvements in care.

The report, published in February 2024, found no evidence of systemic failures of maternity or neonatal care, unusual factors, or a cluster of any one factor that would account for the significant increase in neonatal deaths in 2021-22.

Following the publication, we are working with Healthcare Improvement Scotland and other partners on the recommendations of the review.

The Scottish Government remains wholly committed to supporting the development and deployment of CCUS, including the Acorn Project and the Scottish Cluster, including with up to £80 million in support. When we, the project and the Scottish Cluster, are provided with more details by the UK Government on the next stage of the process, timelines and funding, it will then be possible to assess when and how best to support the project with Scottish Government funding.

The additional £30 million for planned care, initially announced in April, will support health boards across the country deliver around 12,000 inpatient procedures, over 40,000 extra diagnostic procedures and around 12,000 new outpatient appointments.

Funding will target reductions to pandemic backlogs, including orthopaedics, ophthalmology, diagnostics for cancer referrals and patients waiting the longest time.

The funding will be allocated to health boards for the activity set out above based on delivery. We are working closely with health boards to monitor progress.

The Scottish Government remains committed to improving the care and wellbeing of people through the best use of digital technologies. We work closely with NHS National Services Scotland (NSS), who manage the rollout of the new national GP IT System, ‘Vision’ supplied by Cegedim Healthcare Solutions. Our focus always is on patient safety and the resilience of such systems. The recent performance issue referred to was quickly identified as due to bandwidth capacity and was quickly resolved, since when there has been stable and consistent service for GP practices using Vision.

Decisions on prescribing medicines are a matter of clinical judgement for the prescribing clinician in consultation with their patient. These should be based on individual clinical need, informed by relevant advice such as that issued by the General Medical Council (GMC) and guidance for the medicine.

The Scottish Government’s Menopause Clinical Reference Group, Chaired by Dr Heather Currie, has discussed the prescribing of testosterone for women in menopause. This group is exploring supplementary guidance for healthcare professionals on prescribing testosterone for loss of libido in menopause, in line with the British Menopause Society and National Institute for Health and Care Excellence (NICE) guidance.

The Scottish Government grant to the University of Glasgow for this purpose funds one PhD studentship and a number of small projects. The projects are currently at different stages, outputs from some of the projects are expected before the end of the year and all are expected to be completed by Spring 2025.

The successful candidate for the PhD studentship took up their post in January 2024 and the projects and PhD studentship are both wholly managed by the University of Glasgow.

As is standard with high quality research, it is anticipated that the findings will be published in relevant peer reviewed journals.