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The Scottish Government expects all NHS Boards in Scotland to adhere to current guidelines and follow best practice when providing psychosocial care for people with chronic kidney disease.

We published our new Mental Health and Wellbeing Strategy on 29 June 2023. The Strategy sets out a long-term vision, and a set of outcomes, for the mental health and wellbeing of the population. We will subsequently publish a Delivery Plan in the Autumn to set out the work we will do over the coming years to make progress towards those outcomes and set out how we will measure that progress.

This will include consideration on how the Strategy will set ambitions and actions to support people living with long term conditions like chronic kidney disease. One of our key outcomes for the Strategy is to ensure people with mental health conditions, including those with co-existing health conditions, experience improved quality and length of life, free from stigma and discrimination

In order to achieve this, we will work with partners to develop actions that will see improved provision of services and support to people with long-term physical health conditions for their mental health and wellbeing.

Clinical guideline implementation is the responsibility of NHS Boards. The ultimate decision about a particular clinical procedure or treatment will always depend on each individual patient’s condition, circumstances and wishes, and the clinical judgement of the healthcare team.

The Scottish Government expects NHS Boards and clinicians to adhere to current guidelines to ensure timely diagnosis and treatment of chronic kidney disease in accordance with authoritative sources such as the National Institute for Health and Care Excellence (NICE) and the UK Kidney Association (UKKA).

The UK National Screening Committee (UK NSC), an independent advisory group which makes recommendations on all screening programmes in the UK, have never recommended routine breast screening for women over 71 years. The Committee has concluded that there is not clear evidence that the benefits of screening women in this age group outweigh the potential risks of harm.

Nonetheless, prior to the COVID pandemic, women over 71 could self-refer to be screened if they chose. As the service continues to recover from the pandemic, Women aged 71-74, and those over 75 with a history of breast cancer, are once again eligible to self-refer for a screening appointment. There continues to be a pause in self-referral appointments for women aged 75 and over without a history of breast cancer.

The Scottish Government understands the wish to widen self-referrals to include those over the age of 75 without a history of breast cancer. However, before doing so we need to understand the impact of current self-referral appointments on wait times for women between 50-70 for whom screening has clear benefits. These impacts are under regular review by the breast screening programme board.

The Scottish Government is committed to ensuring that all people living with kidney disease are able to access the best possible care and support, and benefit from healthcare services that are safe, effective and put people at the centre of their care.

Psychosocial support is an element of person-centred care and covers the need to consider a wide range of factors that affect a person’s wellbeing. We recognise that primary care is the first and often the main point of contact for many people in their diagnosis and care journey. Our strengthening of Scotland’s primary care workforce through the recruitment of multi-disciplinary teams is making it easier for people to access frontline care local to them. We have now recruited over 3,000 professionals including community nurses and physiotherapists, with increased funding of £170m this year to support further development of multi-disciplinary teams in primary care.

We will continue working to identify how to drive up standards of care in chronic kidney disease care, using data from the Scottish Renal Registry, in order to maximise the care, treatment and quality of life for everyone living with the disease across Scotland.

We recognise that the physical impact of living with kidney disease can have a significant impact on a person’s mental health and wellbeing. Living with an incurable, long-term condition can be deeply distressing. The Scottish Government’s new Mental Health and Wellbeing Strategy, due for publication shortly, will set out a long-term vision, and a set of outcomes, for the mental health and wellbeing of the population.

One of the key outcomes for the Strategy is to ensure people with mental health conditions, including those with co-existing physical health conditions, experience improved quality and length of life. In order to achieve this, we will work with partners to develop actions that will see improved provision of services, including talking therapies, and support to people with long-term physical health conditions for their mental health and wellbeing.

In addition to this, the National Education Scotland and Scottish Government developed The Matrix: A Guide for Delivering Evidence-based Psychological Therapies in Scotland to support NHS Boards in planning the range, volume and quality of psychological therapies required to meet Scottish Government commitments. The Matrix is due to be refreshed in 2023 but already includes a section specifically on chronic kidney disease and includes a recommendation for talking therapies for those with moderate to severe mental health problems.

Food Standards Scotland recommends following a healthy balanced diet as represented by The Eatwell Guide . Doing so will increase consumption of vegetables, pulses and wholegrains and will likely reduce the consumption of less healthy food and drink. The Eat Well Your Way website supports people to make small and manageable changes to improve their diet.

Scottish Government is supporting a range of actions set out in our 2018 Diet and Healthy Weight Delivery Plan to encourage people to include more vegetables, pulses and wholegrains in their diet.

For example, we fund the Healthy Living Programme which helps 2,400 convenience stores to increase the range, availability, quality and affordability of fresh produce and healthier products from other categories, especially in areas of higher deprivation.

We also provide funding to Community Food Networks to promote a range of services such as cooking classes, benefit checks, ‘grow-your-own’ food groups, cafés and food pantries.

Our Parent Club website provides free advice on healthy eating, as well as low-cost recipe ideas to support people and families prepare healthier meals.

The review has now been completed and the report is currently being finalised. Following this, the report will be published later in 2023.

The Scottish Government is committed to improving care for people with chronic kidney disease through a number of activities which are aligned with the recommendations set out in Kidney Research UK’s Changing the Future for Chronic Kidney Disease in Scotland report, published in December 2022 with input from Scottish Government clinical advisors and partners.

We are raising awareness of the symptoms, causes, diagnosis and prevention of kidney disease by providing and promoting information on chronic kidney disease for patients and their families on NHS Inform .

Our Donation and Transplantation Plan was published in 2021 and sets out a dedicated priority to increase living donation and reduce the wait for a kidney transplant. This includes a number of recommendations to improve care, including developing resources and information to promote living donation , changing clinical practice in renal units, increasing direct engagement with patients and their families, and developing new guidance on staffing to support living donation.

We also continue to support the work of the Scottish Renal Registry which promotes excellence in renal care in Scotland including audits on the delivery of renal replacement therapy. The most recent report from the registry was published by Public Health Scotland in October 2022 and provides vital information for Health Boards, service managers and individual clinicians to improve care and standards for people with chronic kidney disease.