Questions and answers

Question reference: S6W-33809

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Answered by Jenni Minto on 3 February 2025

To ask the Scottish Government, further to the answer to question S6W-32162 by Jenni Minto on 23 December 2024, what steps it is taking to improve the early identification of endometriosis symptoms by primary care providers, in order to reduce any reliance on A&E visits.

The Endometriosis Care Pathway for NHS Scotland supports healthcare professionals to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms.

The pathway is clear and advises healthcare professionals to suspect endometriosis in women who present with one or more symptom (including in young women aged 16 and under).

Clinicians are advised to assess women’s individual information and support needs and take into account their circumstances, symptoms, priorities, desire for fertility, aspects of daily living, work and study, cultural background, and their physical, psychosexual and emotional needs.

All NHS Boards should be taking steps to implement the pathway.

To support health care professionals to improve their knowledge and understanding of endometriosis, NHS Education for Scotland (NES) has launched an e-learning module on menstrual health available on Turas Learn. It is open access to anyone working in NHS Scotland and in particular aimed at those working in primary care.

Further training resources have also been provided through the Women’s Health Masterclass on endometriosis which provided information on diagnosis, treatment and current research on endometriosis, raising awareness of the Pathway with attendees. The resources from this event are also available on Turas Learn.

Additionally, we are have funded the Royal College of General Practitioners (RCGP) to develop new training resources on endometriosis for members, which will be available in the coming months.

Question reference: S6W-33803

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Answered by Jenni Minto on 3 February 2025

To ask the Scottish Government, further to the answer to question S6W-32175 by Jenni Minto on 23 December 2024, what proactive steps are being taken to ensure that women with endometriosis receive timely fertility advice, rather than waiting until conception difficulties arise; what percentage of women currently diagnosed with endometriosis have been referred to fertility specialists, and what the current average waiting time is for referrals to these services.

Data regarding post-diagnosis referral to fertility services is not held by the Scottish Government.

As set out in the Endometriosis Care Pathway for NHS Scotland, clinicians should consider women’s individual needs in order to determine treatment, for example symptoms, aspects of daily living and whether fertility is a priority for that individual. The Pathway notes that discussions regarding fertility should happen in the first presentation and that management and long-term impact including fertility should be discussed during initial assessment.

Question reference: S6W-33807

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Answered by Jenni Minto on 3 February 2025

To ask the Scottish Government, further to the answer to question S6W-32157 by Jenni Minto on 23 December 2024, what specific metrics or indicators are being used to track the success of initiatives within the Women’s Health Plan for endometriosis care.

Information about the progress to date against each of the priorities in the Women’s Health Plan can be found in the Women’s Health Plan Final Report.

As we move into the next phase of the Women’s Health Plan, we will consider how best to monitor and evaluate progress over time, which includes engagement with women who have lived experience of endometriosis.

As set out in the Women’s Health Plan, we know that there is a lack of data on women’s health – including endometriosis. Improving data has been one of the key priorities of the first phase of the women’s health plan, to understand the data that are available, the gaps and how we might address them.

The recently published data landscape review sets out a range of publicly available data on the health of women in Scotland and highlights where there are gaps which need to be addressed, including endometriosis. This is just the start of our work to improve women’s health data. Further work will be undertaken to explore the data sources and gaps in more detail.

Question reference: S6W-33811

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Answered by Jenni Minto on 3 February 2025

To ask the Scottish Government, further to the answer to question S6W-32169 by Jenni Minto on 23 December 2024, how it plans to ensure that there is continued investment in endometriosis research beyond the specific research calls listed.

We are committed to ensuring those living with endometriosis are able to access the best possible care and support and that they benefit from healthcare services that are safe, effective and put people at the centre of their care. Endometriosis will continue to be a priority as we develop the next phase of our Women’s Health Plan.

The Chief Scientist Office’s project and fellowship funding schemes continue to welcome applications from across the clinical spectrum, including in Endometriosis.

This funding source is well known across the women’s health research community. Applications looking at the diagnosis, treatment and management of Endometriosis are welcomed and (in common with all other applications) go through CSO’s rigorous independent expert review process to allow funding decisions to be made.

We have recently increased the number of research funding programmes run by the National Institute for Health and Care Research (NIHR) open to researchers in Scotland from 4 to 9 Scottish Researchers to be able to access further NIHR research funding – Chief Scientist Officeand have worked to ensure researchers across Scotland are aware of these opportunities. Most of these programmes are open to research across the clinical spectrum, including in Endometriosis.

CSO continues to fund the NHS Research Scotland Reproductive Health and Childbirth Network which supports the delivery of a number of Endometriosis-related clinical studies across the NHS hereStudy Portfolio | NHS Research Scotland | NHS Research Scotland.

Question reference: S6W-33806

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Answered by Jenni Minto on 3 February 2025

To ask the Scottish Government, further to the answer to question S6W-32172 by Jenni Minto on 23 December 2024, what specific data points are being collected to track long-term outcomes; how often any such data will be reviewed, and for what reason it has not reintroduced routine screening for endometriosis, in light of the reported delays in diagnosis.

As stated in question S6W-32172 more information on women’s health data can be found in the recently published data landscape review. It sets out a range of publicly available data on the health of women in Scotland and highlights where there are gaps which need to be addressed. This is just the start of our work to improve women’s health data. Further work will be undertaken to explore the data sources and gaps in more detail.

The Endometriosis Care Pathway for NHS Scotland supports healthcare professionals to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms.

While there is no specific routine screening for Endometriosis, the pathway is clear and advises healthcare professionals to suspect endometriosis in women who present with one or more symptom (including in young women aged 16 and under).

Clinicians are advised to assess women’s individual information and support needs and take into account their circumstances, symptoms, priorities, priority for fertility, aspects of daily living, work and study, cultural background, and their physical, psychosexual and emotional needs.

All NHS Boards should be taking steps to implement the pathway.

Question reference: S6W-33798

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Answered by Tom Arthur on 31 January 2025

To ask the Scottish Government, further to the answer to question S6W-32178 by Tom Arthur on 19 December 2024, what percentage of employers in Scotland have adopted the Menopause and Menstrual Health Workplace Policy, and what specific action it is taking to ensure that self-employed women with endometriosis are not excluded from workplace support initiatives.

The Menopause and Menstrual Health Workplace Policy, launched on 31 October 2023, is for NHS Scotland. There are 22 NHS Scotland Boards, who have all adopted this policy (each being separate employers). There are 124,032.8 whole time equivalent (WTE) female staff working across NHS Scotland and women represent 77.1% of the NHS Scotland workforce as of September 2024.

The policy has supporting resources, including line managers, workplace adjustment guides, and signposting to more information on symptoms and conditions including endometriosis. These are intended for use more widely across a variety of employment sectors and are available on the National Wellbeing Hub, which is accessible to the public and self-employed women.

For self-employed women workplace support via income replacement benefits such as Employment and Support Allowance and Universal Credit, which provide financial support to people of working age who are unable to work due to illness, are fully reserved to the UK Government. However, our Adult Disability Payment provides financial support to recognise the additional costs of living with a disability or long-term health condition.

The health and wellbeing of women at work is a key element of fair work and we know that lack of support for women experiencing menstrual or reproductive health conditions can have a detrimental impact on their employment.

Our Fair Work First Guidance provides good practice examples for supporting women and allowing them to maintain their careers. For example, access to flexible working is of vital benefit to workers who may need to balance work with managing health conditions. Asking employers to offer flexible working from day one of employment has been a principle of Fair Work First since October 2021.

Question reference: S6W-33799

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Answered by Jenny Gilruth on 31 January 2025

To ask the Scottish Government, further to the answers to questions S6W-32184 and S6W-32185 by Jenni Minto on 23 December 2024, how many young people engaged with the campaign; what measurable outcomes were achieved, and what steps have been taken to ensure that menstrual health, including endometriosis, is integrated into the school curriculum as part of standard health education.

A campaign report evaluating the campaign on Endometriosis for young people in Scotland was provided by Young Scot in April 2023 which measured young people’s engagement with the campaign.

High engagement was achieved across the campaign webpages through social media and paid marketing:

2.3 million impressions which is the number of times a user sees a piece of content, regardless of whether they interact with it;
56,000 social media engagements which represents number of people interacting with the social media accounts and content; and
84,000 video views which reflects the number of times the video content was watched.

With regard to ensuring menstrual health, including endometriosis is included in the school curriculum, I refer the member to the answer to questions S6W-30034, on 3 October 2024, and S6W-32189, on 23 December 2024. 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

Question reference: S6W-33378

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Thursday, 16 January 2025
Current Status: Answered by Neil Gray on 28 January 2025

To ask the Scottish Government, further to the expansion of guidance on breast screening protocols by risk category in 2023, and as set out in the Scottish Cancer Network's Breast Cancer Clinical Management Pathway, what support has been provided to NHS boards to provide screening to women aged 25 to 30 who are identified as very high risk, as per the updated guidance.

The Familial Breast Cancer pathway which is hosted by the Scottish Cancer Network’s Clinical Management Pathway website is a consensus document which is not a rigid constraint on clinical practice, but a concept of good practice against which the needs of the individual patient can be considered by health care professionals.

Surveillance for high-risk breast cancer is the responsibility of NHS Health Boards and are managed locally by health care professionals. The inclusion of a treatment or approach within a consensus document is not a guarantee of immediate access.

Question reference: S6W-33379

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Thursday, 16 January 2025
Current Status: Answered by Neil Gray on 24 January 2025

To ask the Scottish Government how it is monitoring NHS boards' adherence to the Scottish Cancer Network's Breast Cancer Clinical Management Pathway guidance on breast screening protocols by risk category, following the update to the guidance in 2023.

The Scottish Government does not specifically monitor the individual use of the familial breast cancer consensus document’s ‘framework for undertaking germline genetic testing and risk assessment for breast cancer’ which is hosted on the Scottish Cancer Network website. For other formally approved Clinical Management Pathways, assurance is sought via the NHS Boards’ Annual Delivery Plan review process.

Question reference: S6O-04281

Asked by: Rachael Hamilton, MSP for Ettrick, Roxburgh and Berwickshire, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 22 January 2025
Current Status: Taken in the Chamber on 30 January 2025

To ask the Scottish Government when it last met with Borders College.

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