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Funding allocated to Alcohol and Drug Partnerships (ADPs) is for both alcohol and drug treatment services. In 2022-23, £106.8 million was made available to ADPs, increasing to £112.9 million in 2023-24. This funding is used to ensure that local services meet the needs of people who experience alcohol and drugs harms.

On 7 September 2023 I supported a Member’s Debate Motion calling for investment in alcohol services - outlining the Government’s plan to reduce harm from alcohol misuse. The plan includes measures to improve access to treatment and support, including through stabilisation and crisis management, expansion in local assertive outreach services and increasing the availability of residential rehabilitation placements. The plan also includes working with partners and stakeholders to implement alcohol treatment standards – building on the forthcoming UK-wide Clinical Alcohol Treatment Guidelines which are currently out for public consultation until 8 December 2023.

The Scottish Government is currently considering all of the recommendations made as part of the Independent Review of Audiology Services in Scotland.

We will provide an update to Parliament on next steps in due course.

Care and support for people with chest, heart and stroke conditions or long COVID is being provided across the full range of services being delivered by our NHS. This includes local primary care teams, community-based rehabilitation services and referrals for further investigation delivered in secondary care settings where needed.

The Scottish Respiratory Advisory Committee identified three initial priorities for implementation of the Respiratory Care Action Plan (2021) which were; child to adult transitions, access to data and pulmonary rehabilitation. The child to adult transitions sub-group has produced recommendations which will be shared shortly. We have recently commissioned Public Health Scotland to begin scoping work to develop a respiratory audit programme, and we are working closely with services across Scotland to deliver improvements in pulmonary rehab.

We are making progress on delivery of our Heart Disease Action Plan (2021) and have recently completed a scoping exercise with cardiac rehabilitation services to identify priority areas for improvement.

Since publication of the Stroke Improvement Plan in June, the Scottish Government has appointed a Consultant Stroke Physician as Clinical Lead for Stroke to lead on its implementation. We are developing a bundle of rehabilitation measures for inclusion in the Scottish Stroke Care Audit and are also developing measures of patient experience of rehabilitation.

We have established a £10 million long COVID Support Fund to support NHS boards to increase the capacity of existing services, develop these into more clearly defined local pathways and provide a more co-ordinated experience for people living with long COVID. We made an initial £3 million available from the fund over 2022-23, and a further £3 million is being made available from the fund over this financial year.

The Scottish Government is considering all of the recommendations made as part of the Independent Review of Audiology Services in Scotland.

Although it is NHS Boards who are responsible for ensuring staff receive the appropriate training and ongoing development to be able to undertake their role safely and effectively, in response to the concerns highlighted by the Independent Review the Scottish Government has provided Health Boards with £26,000 to support further training in auditory brainstem response (ABR) assessment for staff working in paediatric audiology services.

The Scottish Government expects that where Health Boards are aware of any patient who has been adversely affected by any poor-quality infant auditory brainstem response (ABR) assessment, the relevant Health Board follows up with the patient and their family to provide appropriate support, reassurance and advice on next steps.

Studies looking at the impact of respiratory infections on those with lung conditions have often demonstrated that this cohort are at greater risk of hospitalisation. We recognise that people with lung conditions often have pre-existing reduced lung function and if they become infected with COVID-19 or flu, are at a disadvantage from the onset.

As set out in Priority 5 of our Health and social care: winter preparedness plan 2023-2024, “Protecting people who may be most impacted by severe illness, hospitalisation or death from Covid-19 and flu, through vaccination, is a key means of protecting individuals from illness and reducing demand on our health and social care systems.”

Our successful vaccination programme means many people previously considered at highest risk of infection and severe disease, and the wider population, are now far less likely to become seriously ill from Covid-19 or flu.

However, a group of people do remain at high risk – primarily people who have a weakened immune system. These people should continue to follow the advice of their GP or specialist clinician, who best know their health condition and circumstances.

The Scottish Government is committed to ensuring that all adults who require rehabilitation have timely access to the right information and services by the end of 2025 through our Once for Scotland Rehabilitation Approach. This is supported by NHS Boards and Health and Social Care Partnerships, encouraging cross-sector working with third and leisure sectors to support community-based services and supported self-management. We are working with key partners to deliver this, and various measures are already in place to support delivery for people with chest, heart and stroke conditions.

Scotland’s national health information service, NHS Inform aims to provide the people of Scotland with accurate and relevant information to help them make informed decisions about their own health and the health of the people they care for.

NHS Inform provides health information for people living with long COVID, chest, heart and stroke conditions, including advice on management of common symptoms, health-related anxiety and when to seek further information from healthcare professionals.

The Best Start Implementation Programme Board was tasked with taking forward implementation of the recommendations within Best Start. The Programme Board set up the Perinatal Sub Group and asked it to take forward the Neonatal Intensive Care work, including an options appraisal process to identify the final three units. The Perinatal Sub Group comprises clinical experts, including the chair of the Scottish Neonatal Consultants Group, the chair of the Scottish neonatal nurses group, the Scottish Clinical Lead for neonatology, the Scottish clinical representative from the National Neonatal Audit Programme, the neonatal consultant lead for the neonatal transport service, senior management representation from the Scottish Ambulance Service, a Head of midwifery, the Scottish Clinical Lead for Obstetrics, the Chief Executive of the neonatal charity, Bliss and is chaired by a Health Board Medical Director and Deputy Chief Executive.

The Expert Group that agreed the short list criteria and weighting for the options appraisal comprised the following experts (representing roles that held at that time):

• Helen Mactier, consultant neonatologist and Honorary Secretary of President of British Association of Perinatal Medicine (BAPM)
• Gopi Menon, consultant neonatologist and President of BAPM
• Alan Fenton, Consultant Neonatologist, immediate past President of BAPM, and Chair of Independent Advisory Group for the National Neonatal Audit Programme;
• Corinne Love, Consultant Obstetrician, Scottish Government Senior Medical Officer;
• Eddie Doyle, Senior Medical Advisor, Scottish Government Paediatrics and Neonatal.

The New Model of Neonatal Care is aimed at the most premature and sickest of babies and is based on a review of evidence carried out by Dr Anna Gavine, Dr Steve MacGillivray and Prof Mary Renfrew of the University of Dundee and a summary of the evidence review is published within The Best Start ( Appendix H ).

The evidence showed that outcomes for very low birth weight babies (VLBW) are better when they are delivered and treated in Neonatal Intensive Care Units with full support services, experienced staff and a critical mass of activity (expert recommendation defines this as care for a minimum of 100 VLBW babies a year).

This evidence has since strengthened with the publication in 2021 of the British Association for Perinatal Medicine (BAPM) Framework for Practice , which sets out optimal arrangements for neonatal intensive care.