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The Scottish Government recognises that access to social care services can vary significantly depending on where people live.

Through the Care Reform (Scotland) Act and the work of the NCS Advisory Board, we are taking decisive steps to end the postcode lottery and deliver care based on need, not geography.

The Care Reform (Scotland) Act introduces wide-ranging reforms that enshrine rights in law. Key measures include:

• Anne’s Law which recognises family and friends of care home residents as essential contributors to their care—not merely as visitors, but as integral members of the care team
• Introducing a statutory right to breaks for unpaid carers
• Expanding access to independent advocacy
• Improving information sharing across care settings
• Establishing a National Chief Social Work Advisor and National Social Work Agency
• Reforming procurement routes for the third sector

The interim NCS Advisory Board brings together people with lived experience of care, frontline workers, service providers, and representatives from local government and the NHS. Their role is to advise on how we build a fairer, more responsive system that puts human rights and equity at its core.

The Board will work alongside established national programmes to drive improvement and ensure that services are consistent, fair, and high-quality, regardless of where people live in Scotland.

The Scottish Government recognise the invaluable role of the social care workforce. Whilst not an employer, we continue to work closely with COSLA and key partners to progress joint commitments in the National Workforce Strategy and recently published Service Renewal Framework, which both support efforts to recruit and retain social care staff.

For the 2025-26 financial year, the Scottish Government will be investing £125 million to enable adult social care workers in the third and private sectors to be paid at least the Real Living Wage. This takes the estimated total investment to deliver this policy to £950 million.

The workstreams of the Joint Social Services Taskforce have achieved real change to improve the workforce experience, through supporting career opportunities and staff development, these include:

• creation of a portable national induction framework;
• development of a social care career options tool;
• publication of an earn and learn blueprint;
• agreement of the introduction and trial a new Care Technologist role; and
• publication of our Funding Landscape resource.

Additionally, we continue to provide funding for the NES Social Care Centre for Workforce Supply (CWSS), who support employers ethically and sustainably recruit international works, who play a vital role in our care sector workforce. The CWSS are working with the Home Office to engage with displaced workers in England and promote opportunities to move to social care roles in Scotland.

Collectively these actions make it easier for employers to recruit and retain staff.

The Scottish Government’s decision-making throughout the COVID-19 vaccination programme has been guided by the expert clinical advice of the Joint Committee on Vaccination and Immunisation (JCVI).

In its statement of 8 April 2024 the JCVI stated it no longer advised an offer of COVID-19 vaccination for unpaid carers and household contacts of people with immunosuppression. As a result, unpaid carers and household contacts of people with immunosuppression were removed from the programme as of winter 2024-25. This position is consistent across all UK nations, and remains unchanged for winter 2025-26.

The reasons the JCVI no longer advised the inclusion of these groups are:

• that the indirect benefits of vaccination (vaccinating an individual in order to reduce the risk of severe disease in other people) became less evident compared with previous years due to high levels of population immunity;
• the fact that vaccines provide moderate protection against severe COVID-19 for a few months;
• protection against mild symptomatic infection is much more limited in terms of peak protection and duration of protection and that with the evidence available, protection against transmission is extremely limited.

In its statement of 14 November 2024, the JCVI once more updated its advice on eligibility for COVID-19 vaccination and for winter 2025-26 the following groups remain eligible:

• Residents in care homes for older adults
• All adults aged 75 years and over
• Individuals aged 6 months and over who are immunosuppressed (as defined in the 'immunosuppression' sections of tables 3 and 4 in the COVID-19 chapter of the Green Book).

The statement advised that the COVID-19 vaccination programme should now move to JCVI's standard cost effectiveness assessment, as per other routine vaccination programmes.

Furthermore, over the last four years, population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since it first emerged. This has led to a more refined approach to the targeting of the COVID-19 vaccination programme, with a focus on individuals where there is good evidence of a high risk of hospitalisation and/or mortality.

The Scottish Government encourages those eligible to take up the offer of COVID-19 vaccination.

Although we have overall responsibility for health and social care policy in Scotland, the statutory responsibility for delivering, commissioning, providing appropriate social care capacity at a local level lies with local authorities, NHS boards and integrated Health and Social Care Partnerships.

It is, therefore, vital that these local authorities assess local population needs and target their investment where it’s needed to improve the social care infrastructure and access to care within their relevant area for current and future population needs.

The Scottish Government is committed to ensuring that care is delivered as close to home as possible, recognising that strong family and community connections are vital to individuals’ health and wellbeing. Local authorities should take this into account when planning and commissioning care packages, prioritising arrangements that support proximity to loved ones and familiar environments.

We are committed to developing a sustainable health and social care system in Scotland that ensures people get the right care, in the right place, at the right time.

This information is available in the Care home census for adults in Scotland - Statistics for 2014 to 2024 - Care home census for adults in Scotland - Publications - Public Health Scotland (PHS).

2025 information is not yet available, but PHS intend to have this published on the 30th September.

Ensuring the sustainability of NHS dental services is a priority for Scottish Government, which is why we introduced dental payment reform in November 2023 to make it more attractive for dentists to provide NHS services, by paying fees that better reflect the current market rates of providing dental services to patients. The 2025/26 Scottish Budget further reinforces our commitment to NHS dentistry, with an increase of almost 15% in funding for primary care dental services agreed. This takes total funding to over half a billion pounds for the first time and means that over the course of this Parliament, we will have increased investment in primary care dental services by 33%.

Scottish Government has also made provision in the 2025-26 budget for grant awards, such as the Scottish Dental Access Initiative (SDAI) grant, which pays out up to £100,000 for establishing, relocating or extending NHS dental practices in eligible areas; and the Recruitment and Retention allowance, which allows new trainee dentists to qualify for ‘golden hello’ payments of up to £37,500 in the first three years of practice.

I refer the member to the answer to question S6W-39790 on 1 September 2025. 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.

It should also be noted however that as the majority of dentists are independent contractors, they are free to decide whether or not they wish to provide NHS services.

While, this is an operational matter for train operating companies, the Scottish Government expects that all operators in Scotland provide best possible assistance to all passengers, as appropriate.

For ScotRail specifically, the Scottish Government continues to specify a requirement that all its services should have a second staff member on board to assist passengers. This may include embarking or alighting from a train for passengers with mobility issues. This applies to all journeys at any time of day, evening and night.

The NAIT guidance has not been reviewed since publication.

However, we have begun work to look at the issue of shared care agreements for adults with ADHD which would simplify the process for medication to be prescribed by GPs following a private diagnosis.

We will review NAITs’ guidance to reflect the outcome of this work.

Decisions on the care and treatment of patients are always matters of professional judgement for the responsible practitioner having considered the needs of their patient and relevant clinical guidelines.

The Endometriosis Care Pathway has been developed for NHS Scotland and adapted from National Institute for Health and Care Excellence (NICE) guidelines. The pathway aims to support healthcare professionals to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms. Both the Pathway and NICE guidance recommend clinicians consider the patient’s circumstances including their age, symptoms, priorities and emotional needs. They also include advice on, referral to a paediatric and adolescent gynaecology service, or paediatric service, depending on local service provision. Clinicians may refer to NICE and ESHRE guidelines when following the endometriosis care pathway.

Following changes to the NICE guidance a review of the pathway will be part of the 2025-26 workplan for the CfSD Gynaecology Specialty Delivery Group.

The Scottish Government is committed to ensuring those living with endometriosis can access the best possible care and support. That is why endometriosis is a priority in the Women’s Health Plan and will continue to be so.