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As part of the 2023-24 COVID-19 and flu winter vaccination programme NHS Scotland delivered over 3.57 million winter vaccines, including 1,387,766 COVID-19 vaccines, 1,647,596 adult flu vaccines and 538,580 child flu vaccines. Uptake dropped across almost all groups, but remained strong in the highest risk groups, with over 85% of care home residents and almost 85% of those aged over 75 vaccinated for both vaccines, the groups mostly likely to be admitted to hospital with these illnesses. We continued to surpass the World Health Organisation’s flu target of 75% uptake for those aged 65 and over, achieving 79.8%.

The primary aim of the vaccination programme remains the prevention of severe illness and the vaccine offer is to those most likely to directly benefit from vaccination, particularly those with underlying health conditions that increase their risk of hospitalisation. The data from last winter’s programme shows that uptake remained strong within these eligible groups and meets the primary aim of the winter programme.

There were however certain groups where uptake was far lower than expected, for both COVID-19 and flu, notably pregnant women, frontline health and social care workers and those at clinical risk, although uptake in those with a weakened immune system was better than for more general at risk conditions.

The emergence of the new, and theoretically more dangerous variant BA.2.86 in late summer 2023 resulted in us deciding to pull forward the programme to protect those at higher risk. We appointed those at higher risk into all and any spare appointments at the start and middle of the programme, meaning that those at lower risk, who had been prompted to book, found it hard to find spare appointments until November and December. It is difficult to quantify, but we believe that some individuals may have not come forward due to this difficulty.

The Scottish Vaccination and Immunisation Programme (SVIP) has already undertaken various pieces of work to understand why overall uptake has decreased and we have incorporated that learning into our planning for this winter campaign. Communicating why annual revaccination (or bi-annual in the case of COVID for higher risk groups) remains necessary and important is key, as is reiterating the value of these vaccines, and the real health risk to some people in contracting these viruses over the winter period.

We will continue to work closely with Public Health Scotland and the NHS Boards to ensure the successful delivery of Scotland’s vaccination programmes.

The Scottish Government welcomes the innovation, continuous improvement and efficiency that Health Board delivery teams have demonstrated to make best use of resources and funding throughout our national vaccination programmes, which remain a key public health intervention.

The Scottish Government provided £80 million on an National Resource Allocation formula (NRAC) basis to cover local Board vaccine delivery costs for the full financial year 2023/24.

These funds were allocated to the following programmes, the largest of which was the winter Seasonal Flu & COVID-19 booster programme:

• Spring 2023 COVID-19 programme
• 6 months – 4 years at risk COVID-19 programme
• changes to the COVID-19 primary rolling offer
• COVID-19 vaccination out-with seasonal programmes for the clinically extremely vulnerable and for travel or visa purposes
• Winter Seasonal Flu & COVID-19 booster programme 2023

Boards also used this funding to deliver across the full range of other vaccine programmes. A breakdown of investment provided to each Health Board is as follows.

The Cabinet Secretary for Health and Social Care met with the Chair of the Scottish Hospice Leadership Group and Hospice UK on 8 August to discuss long-term planning and funding for the commissioning of hospice care as part of an agreed visit.

I am also meeting the Chair of the Scottish Hospice Leadership Group and Hospice UK on 18 September to discuss these matters further.

The Scottish Government continues to work with Integration Joint Boards (IJB) chief officers and independent hospices to support longer term sustainable planning and commissioning for the sector.

However, it is for Integration Joint Boards (IJBs) to govern, plan and resource adult palliative care in their areas, including independent hospice care, using the delegated budgets under their control. We would encourage hospice colleagues to continue to engage with IJBs to help ensure that the needs of the local population are met.

In the last five financial years Scottish Government has provided the following funding to South of Scotland Enterprise:

South of Scotland Enterprise – Budget Allocations 2020-2025

Since the publication of the 'Transforming Nursing Roles: Advanced Nursing Practice - Phase II' paper in 2021, NHS Education for Scotland (NES) has taken the lead for this work.

The minimum qualification of a PG Dip Advanced Practice is required by NHS Scotland employers for all new Advanced Nurse Practitioners (ANPs) and the specific clinical competencies identified for advanced nursing practice in acute, primary care/community, mental health, paediatric acute and neonatal settings are used as the standard for practice. In addition, a final 'sign-off' against these competencies, evidenced by a portfolio is required by most employers.

The introduction of 3.75 hours of non-clinical time per week has been implemented widely and enables ANPs to maintain and progress their knowledge and skills through a variety of continuing professional development activities.

The NES frameworks for clinical supervision were launched in 2023 and 2024 and support the clinical supervision needs of ANPs https://learn.nes.nhs.scot/3580/clinical-supervision.

In addition, the NES Advanced Practice Toolkit was revised in 2023 and provides a repository of relevant resources and weblinks for advanced practice for all professions. https://learn.nes.nhs.scot/63343.

We are supporting NHS Boards through our Urgent and Unscheduled Care Collaborative Programme to improve patient flow through our acute sites and reduce A&E delays. Key actions include: strengthening arrangements to avoid unnecessary hospital admissions such as Same Day Emergency Care services; optimising Flow Navigation Centres; enhancing the discharge process - focusing on discharge planning; and reducing length of stay.

Where new development proposals come forward, Scotland’s Fourth National Planning Framework (NPF4) ensures that the impacts of proposals on communities and nature, including cumulative impacts, are important considerations in the decision-making process. All applications are subject to site specific assessments.

Where the Electricity Works (Environmental Impact Assessment) (Scotland) Regulations 2017 apply to relevant applications made to Scottish Ministers, the effects of a proposed development on population and human health may, if appropriate and on a case-by-case basis, be considered in the overall assessment.

The Scottish Government recognises the positive contribution older people make to their communities and recognises the value in bringing generations together. We aim to enable better access to a range of services for older people as and when they need them. We want to ensure people are financially secure and supported as they age.

Through our Equalities and Human Rights Fund, we are investing over £2.2 million in support of older people’s organisations and age equality projects that deliver positive outcomes for older people. Generations Working Together (GWT) were offered £615,250 over three years through the Equality and Human Rights Fund. GWT is the nationally recognised centre of excellence supporting the development and integration of intergenerational work across Scotland. This funding aimed to tackle ageism through intergenerational activity across Scotland and to increase understanding and learning around the field of intergenerational practice.

Generations Working Together are key stakeholders in our Older people’s Strategic Action Forum (OPSAF) and the Social Isolation and Loneliness Advisory Group (SIALAG).

In addition, our Social Isolation and Loneliness Fund of £3.8m which was launched in 2023 over 3 years, supports intergenerational projects. Over the past year 2929 older people and 400 young people have benefitted from the services provided by the funded projects.

Battery storage will play a role in the future energy mix of Scotland. As set out in our draft Energy Strategy and Just Transition Plan, battery storage offers fast responding, dispatchable power when required. They also provide a number of ancillary services required to maintain stability within the electricity networks.