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The report of the Transvaginal Mesh Case Record Review underlined what was already an important agenda for the Scottish Government: to improve care and services for women who are experiencing complications as a result of a transvaginal mesh; and, to ensure that the NHS continually reinforces good practice in confirming and recording patient consent and the treatment offered to patients. Progress continues in a range of connected activities relevant to Professor Brittons’ recommendations.

The recommendations made align with the practice that is embedded in the operation of the Complex Mesh Surgical Service, and through NHS Scotland more generally. We continue to work with NHS colleagues to ensure that women can access the care that they need, are fully supported by their GP and other clinicians, and have access to information they need to make informed decisions about their care.

The Chief Medical Officer wrote to Health Board Medical Directors on 10 October to draw their attention to the report of the Review and to the failings it identified, and to require them to seek assurance through local clinical governance committees that measures are in place locally to prevent a recurrence of the failings identified, and to assure the quality of processes connected to patient consent and record keeping. With regards to more recent patient records she reviewed, Professor Britton herself noted she was encouraged by the improvement in practice, with increasingly robust consent processes in place.

Work continues in other areas including enhancing information available to patients, credentialing of clinicians in mesh removal and improved data gathering.

The Scottish Government therefore considers that it is taking appropriate action to embed the report’s recommendations with regards to healthcare services in Scotland.

Regional Land Use Partnerships (RLUPs) pilots have been asked to adopt a natural capital approach to their work. This allows the pilot regions to explore how regional opportunities and priorities for land use can enhance, protect, mitigate and adapt to areas of national importance such as biodiversity and climate change.

The Scottish Government is currently working with the RLUP pilot regions as we seek to understand and evaluate the progress of the pilot programme as a whole.

The National Complex Mesh Surgical Service assesses patient needs and, where appropriate and subject to shared decision making and informed consent, performs mesh removal surgery. To date, 135 mesh removal procedures have been undertaken by the Service. Many women make the choice following assessment and discussion with the specialist team to follow a conservative pathway of care and do not undergo surgery.

The needs of patients and their goals may differ and therefore their definition of success will vary too. The removal of mesh is often only part of the treatment journey, with further reconstructive surgery depending on clinical need taking place at a later date. Patients may also have other needs which require to be addressed by other members of the clinical team.

The service is required to comply with normal clinical governance mechanisms in place within NHSGGC to provide an assurance that the service being delivered is safe and of an appropriate quality.

Responsibility for delivery of Primary Medical Services rests with Health Boards and Health and Social Care Partnerships, and delivery plans should take account of local population health need. To assist local partners, in November 2023 the Scottish Government published The General Practice Access Principles [ General Practice Access Short Life Working Group: access principles - gov.scot (www.gov.scot) ]. This report sets out a clear framework for the core principles of how general medical services should be delivered. To support general practice, we have significantly expanded the primary care multi-disciplinary team workforce to support GPs and practice teams ensuring more people get the right care in the right place at the right time.

The Scottish Government is committed to investing more in General Practices servicing disadvantaged areas through targeted action like the Inclusion Health Action in General Practice project in Greater Glasgow & Clyde, with £1.3 million funding dedicated so far, and stabilising our Community Link Worker capacity in Glasgow, with £3.6 million funding already confirmed for three years from 2024-25 to 2026-27.

There have been no invitations to myself to visit Coalfields Regeneration Trust’s projects since his appointment. I would be happy to undertake such a visit, subject to diary availability. As part of his 2023 summer tour, I visited Fife including coalfields communities such as Cowdenbeath, supported through CRT’s Community Action Plans.

The Scottish Government’s Regeneration programmes work together to support resilient and sustainable communities, with communities directly involved in decisions on the future of their places. The Scottish Government values Coalfields Regeneration Trust’s (CRT’s) contribution to that approach. Since 1999, the Scottish Government has provided over £28 million in funding to CRT to invest in improving outcomes for coalfield communities.

In 2023/24 funding is being delivered within the context of the most challenging budget settlement since devolution. The Scottish Government is having to make difficult decisions while ensuring it does what is best for communities with the limited resources it has. This is impacting programmes across Government including the Empowering Communities Programme through which CRT is funded and which has been subject to a reduction in budget from 2022-23.

In addition to the dedicated funding for coalfield communities delivered through CRT, the Scottish Government also invests in wider regeneration programmes such as the Investing in Communities Fund and Regeneration Capital Grant Fund. These target our most disadvantaged and fragile communities and continue to support projects in our former coalfield communities.

Officials will arrange a meeting with the Scottish Stoma Forum after the Scottish Executive Nurse Directors (SEND) have considered the results of the information gathering exercise on the provision of stoma care and stoma specialist nurse coverage across Scotland's 14 territorial health boards.

There can be many reasons for delays in determining applications including requests for and submission of additional information, delays with responses from statutory consultees and the requirement for a legal agreement. The specific reasons for the time taken to determine individual major planning applications would be held by the individual planning authority making the determination.

The average timescale for all major applications determined without a processing agreement was 35.2 weeks in Q1 and Q2 of 2023-24. Due to the low number of applications involved, average determination timescales are volatile and can be affected by one or two lengthy cases. In the same period, 23 of the 57 major applications not subject to processing agreements were determined within the statutory timescale, and 46 of those 57 major applications determined within the same period were determined in a time faster than the national average.

I last met with representatives of Coalfields Regeneration Trust (CRT) on 14 September 2023 to discuss its funding level for 2023-24. Regeneration officials met with CRT on 27 November to build on discussions from that meeting and are in ongoing discussion with CRT.

I am not currently scheduled to meet with representatives from Coalfields Regeneration Trust (CRT). However, officials are in ongoing dialogue with CRT on all aspects of its programme and keep me fully updated. I will be happy to meet with CRT officials in the future, should this be helpful.