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Escalation addresses complex issues and an element of judgement will always be required. The timeline will be driven by the actions within NHS Forth Valley’s Improvement Plan and their associated timelines. My expectation was for the Improvement Plan to be developed and presented to the Assurance Board for scrutiny at its first meeting, with a focus on completing immediate actions by the end of the year.

The overall aim of escalation and the related package of scrutiny and intervention put in place is to support any NHS Board, including NHS Forth Valley, to deliver the required improvement and address the underlying issues effectively and sustainably so that they can be safely de-escalated as swiftly as possible.

The Assurance Board, which has been established to bring direct SG oversight of NHS Forth Valley’s escalation, will provide advice to the Director General about the future escalation status of NHS Forth Valley, including criteria for de-escalation.

NHS Forth Valley has been unable to demonstrate the necessary governance, leadership and culture required to drive sustainable improvements in poor performance.

The Scottish Government has established an Assurance Board, chaired by Christine McLaughlin, co-Director of Population Health. The Assurance Board is supporting NHS Forth Valley in determining what steps are necessary to ensure the delivery of high quality governance, leadership and culture in, and in doing so is intended to support improvements in performance in out of hours, unscheduled care, mental health, and integration.

The ongoing work to address the underlying issues impacting poor performance is even more crucial as NHS Forth Valley faces one of the toughest winter periods ever experienced.

Addressing the wellbeing needs of the Health and Social Care workforce is now even more crucial than it was prior to Covid-19 and is key to both retaining our GP workforce as we press ahead with our commitment to increase the GP population in Scotland by at least 800 additional GPs by 2027.

Staff wellbeing is front and centre of our efforts to support the recovery of health and social care services. If we want our NHS and social care to provide the best care for us, we need to make sure we take care of them. The NHS Recovery Plan highlights that the recovery of staff is intrinsic to our collective ambitions for renewing our NHS, and highlights measures to support the physical, mental and emotional needs of the workforce.

The draft Energy Strategy and Just Transition Plan is due to be discussed at Cabinet shortly, after which we’ll be able to confirm a date for an imminent publication for consultation.

The increase in recorded sexual offences is not unique to Scotland but is part of a global trend. Multiple factors appear to have contributed to this rise including increased reporting of historical offences. Some of this increase is also attributable to greater recognition of online sexual offending driven in part by action we have taken to outlaw new forms of harmful sexual behaviour such as non-consensual disclosure of an intimate image or film.

We will continue to prioritise support for victims of sexual crime, as well as work to identify ways to prevent such offending through the implementation of our Equally Safe strategy. We recognise that sexual offences are particularly traumatising for victims and have invested significantly to improve support for survivors. That is why our Delivering Equally Safe fund is providing approximately £9.5m in funding to support survivors of rape and sexual assault and we are also investing an extra £6m over the next three years in Rape Crisis Scotland’s National Advocacy Project to fund a key support worker in every centre in Scotland.

We know that there is more we can do to ensure that Scotland’s justice system is one in which the victims of serious sexual offences can have confidence. We are considering the recommendations made by the Lady Dorrian Review into improving the Management of Sexual Offence Cases and, through our recent Consultation and cross-sector engagement, are exploring in detail if and how these recommendations can be implemented.

My response to the UK Government consultation in March made clear that any credible and effective package of conditionality tests must include both domestic and international dimensions - extending to at least all of the six tests outlined in the consultation document.

The First Minister also called on the UK Government for a four nations’ discussions to agree on a final Climate Compatibility Checkpoint process which was ignored. The UKCCC said that any effective and credible climate compatibility checkpoint for offshore oil and gas licensing must extend beyond new licensing rounds to also cover fields that are already consented but not yet in production.

It is extremely disappointing that the Climate Compatibility Test proposed by the UK Government is limited to new exploration, and that the bar has been set so low in terms of the Test itself. It is particularly unfortunate that the Climate Compatibility Checkpoint fails to consider the impact of emissions associated with the use as well as the production of fossil fuels on the world’s climate commitments made in Paris and reaffirmed in the Glasgow Climate Pact.

It is a lightweight version of the Test consulted upon earlier this year.

NHS Scotland provides expectant mothers with all clinically recommended scans during the course of their pregnancy.

Anyone choosing to have scans elsewhere, for any purpose, should choose a provider regulated by Healthcare Improvement Scotland and satisfy themselves that the sonographer is a suitably qualified and registered healthcare practitioner.

The Scottish Government has taken forward a range of measures to support the efficient delivery of Scotland’s Redress Scheme, which is survivor led with feedback encouraged and acted upon.

The scheme was established to provide acknowledgement and tangible recognition of the harm that has been caused to those who experienced abuse in care, with the commitment that it would be less adversarial and swifter than civil court action. The redress payment reflects part of that tangible recognition and is not considered compensation in the same way as a sum awarded by a court.

In direct response to feedback about timescales the number of case workers has increased from 12 in December 2021 to 23 in November 2022, and as a result we will see swifter allocation of completed applications to case workers from January.

The operating model was changed in April 2022 to ensure all applications received are initially triaged by the case work team and applicants are then advised what further information is required to progress their application. With applicants consent, case workers make referrals to the Redress Support Service to progress applications where additional information is required. This can include support from organisations specialised in record searches. To date, 834 referrals have been made to this service.

A group has been established which is considering ways in which we might be able to improve the process of applicants accessing care records as it is recognised that some applicants are having challenges in this area.

The Survivor Forum, which was established in March, has reported on its first survey and feedback on the scheme has been provided to both the Scottish Government and Redress Scotland, the independent decision making body. The forum will also increase its activity and engagement with applicants in early 2023, providing further opportunities to provide feedback on what is working well and what could be done better or differently.

We made an additional £40 million available to improve Child and Adolescent Mental Health Services (CAMHS) last year, with £4.25 million of that specifically dedicated to clearing waiting list backlogs by March 2023.

We are also targeting tailored support towards those Boards with the longest waits, providing access to professional advice, to ensure that they have robust improvement plans in place and are monitoring progress closely.

We have taken positive steps to increase and maximise the available Mental Health Workforce, at all levels across Scotland. We will continue to work with the Royal College of Psychiatrists to explore further potential recruitment and retention opportunities.

The Scottish Government is currently developing the Mental Health and Wellbeing Strategy and the Mental Health and Wellbeing Workforce Plan which we will publish in 2023.

Our justice recovery fund of £53.2 million in 2022-23 supports continued recovery, renewal and transformation activity across the justice system. This includes funding increased court and staffing capacity for the Scottish Courts and Tribunals Service, which has contributed to a fall of 12,000 in the number of scheduled trials between January and the end of October 2022.

Justice agencies have been clear that recovery from the impacts of the pandemic will take several years, and initiatives are underway to address backlogs and streamline processes in different ways. For example, a pilot of a new approach to managing summary cases began in Dundee, Hamilton and Paisley Sheriff courts in September. It is designed to make long term improvements to how the system works for its users, facilitating early disclosure of evidence and early judicial case management, reducing the number of unnecessary summary hearings, and ultimately reducing the time it takes cases to reach conclusion.