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Infection Prevention control (IPC) measures remain important in care homes but with high levels of vaccination and new treatments, the risk of serious illness from COVID-19 has decreased and the protective measures in adult social care including care homes have reduced in response to this.

IPC measures to prevent spread and manage a range of infections are common practice in care homes and will remain of upmost importance during COVID-19 outbreaks, in the same way as they do for other infectious pathogens such as influenza outbreaks. Care home staff have worked incredibly hard to adopt IPC guidance throughout the pandemic.

We are currently reviewing the guidance on the extended use of face coverings by staff in adult social care including care homes. The review is in partnership with ARHAI Scotland, SG Clinicians and Public Health Scotland and is considering the risk of Covid-19 transmission, the current rates within the community and the impact of removing this final layer of protection could have on transmission to vulnerable people, and staffing resources, alongside the human rights and wider harms to individuals in receipt of care or support including individuals whom live in care homes. It is anticipated that this review will be completed by the end of July. As it has been throughout the pandemic, guidance will be updated in line with the results of the review.

COVID-19 Financial Support for Adult Social Care Providers has been in place since the outset of the pandemic and was intended as time-limited financial support as services navigated and responded to COVID-19.

In both 2020-21 and 2021-22, the Scottish Government provided additional funding for COVID-19 costs in full. In 2022-23, the Health and Social Care Portfolio is required to accommodate all further COVID-19 activity, including additional Test & Protect and Vaccinations costs, without any further UK Government consequentials.

Recognising that flexibility is still required for responding to pandemic pressures, we have committed to continuing elements of financial support beyond 30 June 2022, this includes: the Social Care Staff Support Fund until 30 September 2022; and financial support arrangements for testing and vaccinations until the 31 March 2023. In addition, the current local PPE Hub arrangements will continue until 30 September 2022.

The Scottish Government welcomes the announcement that the former Dawnfresh site in Uddingston will continue to operate under new owners, Thistle Seafoods, and understands that the sale included the transfer of 40 employees. We strongly encourage the company to take forward its plans to develop and grow the business with Fair Work as a key driver for achieving sustainable and inclusive economic growth.

Scottish Enterprise, Scotland's national economic development agency, has engaged with Thistle Seafoods and is arranging a meeting with the company to understand its future plans for the business and will explore potential support, whilst outlining the expectations of businesses trading in Scotland including around Fair Work and Net Zero ambitions. In line with the Bute House Agreement, the Scottish Government will introduce a requirement on public sector grants recipients to pay at least the real Living Wage to all employees and to provide appropriate channels for effective workers’ voice, such as trade union recognition.

It is important to note that while employment law remains reserved to the UK Government, we will use our Fair Work policy to promote fairer work practices across the labour market in Scotland.

The Scottish Government vision is for Scotland to be a leading Fair Work Nation by 2025, where fair work drives success, wellbeing and prosperity for individuals, businesses, organisations and society. This includes tackling the drivers of workplace inequality for women and ensuring they are supported to enter and progress in all of Scotland’s workplaces.

Menstrual health and menopause are top priorities in our Women’s Health Plan, published in August 2021. Scottish Government has committed, through the Women’s Health Plan, to develop a menopause and menstrual health workplace policy, as an example of best practice, starting with NHS Scotland, and promote this across the public, private and third sector.

Our recently launched NHS Inform Women’s Health platform includes accessible information to help women feel more informed and confident about the menopause and includes information on menopause and the workplace, for those experiencing the menopause as well as line managers and employers. It also includes new and refreshed resources for girls and women on menstrual health including managing symptoms, PMS, conditions such as endometriosis and polycystic ovary syndrome.

The platform can be accessed at: https://www.nhsinform.scot/healthy-living/womens-health

Through our Fair Work First policy we are leveraging employers’ commitment to fair work by applying Fair Work criteria to public sector grants, other funding and contracts where it’s relevant and proportionate to do so. Through this we are asking employers to adopt fair work practices such as enabling workers to have an effective voice, tackling gender pay gaps and offering flexible working from day one of employment which can especially benefit women experiencing menstrual or menopausal issues while at work.

Local authorities are responsible for the recruitment and deployment of their staff. They have the autonomy to provide incentives to attract teachers to their area, and we know some have offered initiatives like free housing for an extended period.

During their probation year, Newly Qualified Teachers on the Teacher Induction Scheme (TIS) choose five local authorities where they are willing to work to complete their probation year, and are allocated a place balancing their choice with local need.

The Scottish Government intends to publish the Implementation Plan for the Framework for Pain Management Service Delivery in summer 2022. As advised in a letter to the Convenors of the Cross Party Group on Chronic Pain on 15 June, Ministers intend to meet with patient representatives of the Group once it has been published.

Extensive engagement of people with lived experience was carried out at all stages to develop the Framework. This includes through representation on the National Advisory Committee for Chronic Pain and a national survey of people with chronic pain and their carers. We have also sought input from other stakeholder groups during the development of the Framework including NHS staff, service planners and third-sector partners. This has included work to bring together the diverse clinical disciplines involved in pain management in order to inform and support activities to improve chronic pain services.

The draft Framework also underwent public consultation with a high level of responses from people with chronic pain and other stakeholders. We are grateful for the views and ideas shared through the consultation which have been used to inform the Aims and Actions we will set out in the forthcoming Implementation Plan. Officials will provide a draft of the Plan to Ministers within the coming weeks and publication is anticipated shortly after this.

I refer the member to the answer to question S6W-09303 on 5 July 2022. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

There are a number of measures in place to ensure that ancient and veteran trees are protected, including as protected areas for nature, which engage statutory mechanisms to protect sites of ecological interest, such as ancient woodlands.

Protection for woodland is also in place via felling regulations under the Forestry and Land Management (Scotland) Act 2018. It is only in exceptional circumstances that a felling permission would be granted for an ancient woodland, such as public safety or improving woodland condition. Where felling permission is not applicable, the Control of Woodland Removal Policy only permits removal of existing woodland where it would achieve significant and clearly defined additional public benefits.

Scottish Planning Policy 2014 (SPP) seeks to protect and enhance ancient semi natural woodland as an important and irreplaceable resource, together with individual trees. SPP states that Tree Preservation Orders (TPO) can be used to protect individual trees and groups of trees considered important for amenity or their cultural or historic interest. Draft NPF4 is currently considering how to strengthen protection.

We recognise the important role ancient and veteran trees play in our ecosystems, which is why we have committed to support work to restore and expand Scotland’s precious Rainforest habitat.

The Scottish Ancient Woodland Inventory records the location of ancient and other long established semi-natural woodlands, and local authorities record TPO’s for protection purposes. We know this Inventory has an important role to play in ensuring we can identify where protection is needed, which is why we have committed to establish a new National Register of Ancient Woodlands, building on the existing inventory.

The intelligent Liver Function Testing pathway (iLFT) used in Dundee, Tayside has been identified as best practice of early detection of liver disease.

It uses an automated, algorithm-based system to further investigate abnormal liver function test results on initial blood samples from primary care.

The Scottish Government has identified the iLFT pathway as eligible for adoption across NHS Scotland as part of its Modern Outpatient Programme.

The Tayside iLFT group is collaborating with other NHS Scotland Boards to assist with the implementation of iLFT within their laboratories and primary care services.

The existing National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of cirrhosis recommends that very heavy daily drinkers (men drinking up to 50 units per week or women 35 units per week) should be screened for cirrhosis using one of the newer non-invasive diagnostic technologies.

NICE suggests FibroScan and in 2020 published a Medtech innovation briefing around its use in primary care settings, but blood tests for fibrosis markers are also accurate and should be available to any clinician.

The Scottish Government currently has no plans to increase the use of FibroScan and enhanced liver fibrosis (ELF) tests in primary care in order to improve the early diagnosis of liver disease.

However, the Office for Health Improvement and Disparities is developing UK Clinical Alcohol Treatment Guidance, which is expected to include the issue of liver disease. These are expected to be published for consultation later this year. Once finalised, the Scottish Government will consider recommendations regarding early diagnosis of liver disease.

In 2020, the latest year for which data are available, there were 912 chronic liver disease deaths in Scotland. Of these, 759 were alcohol-related liver disease deaths. Data are not available for obesity related liver disease deaths.

Liver diseases are generally avoidable or treatable if diagnosed at an early stage and stigma often prevents people from accessing treatment; 75% of people are currently being diagnosed at a stage when it is too late for lifestyle changes or intervention.

We take a whole population approach to reducing alcohol consumption and the risk of alcohol-related harms across the population and that’s why we’ve taken a range of actions to reduce the availability, attractiveness and affordability of alcohol.

We are also taking action to reduce the impact of poor diet on people’s health which is also a significant and growing contributor to liver disease. We are taking wide-ranging action to support healthier choices, as set out in our 2018 Diet and Healthy Weight Delivery Plan , and have set a challenging aim to halve childhood obesity by 2030 and significantly reduce diet related health inequalities.