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Scottish Government officials met with NHS Scotland Board Chief Executives on 12 December where they discussed agency nurse staffing as one of their priority actions. This follows detailed engagement with Boards regarding the arrangements currently in place for contracting agency staffing, the outputs of which are being used to inform targeted improvement activity in this area.

Data on ADHD assessments and waiting times is not centrally held for adults or for children and young people.

Although it is the responsibility of local Health and Social Care Partnerships to put in place services to meet local needs, including the needs of adults with ADHD, the Scottish Government is engaged in work to improve access to ADHD diagnosis in Scotland.

For children and young people, we have published a National Neurodevelopmental Specification for Children and Young People which makes it clear that support should be put in place to meet their needs at the earliest opportunity, rather than be dependent on a formal diagnosis. For many children and young people, such support is likely to be community based, and should be quickly and easily accessible. We are currently funding five tests of change to test and implement specific aspects of the National Neurodevelopmental Service Specification and Forth Valley is one of these areas.

For adults, the final report on the adult neurodevelopmental pathway trials, including the findings and recommendations of the trials, was published in March 2023. We have accepted the recommendations and we are working with the National Autism Implementation Team on implementation.

The Scottish Government is advised on food safety and hygiene matters by Food Standards Scotland (FSS). Retained Regulation 853/2004, Annex II, Section I and Schedule 5 of the Food Hygiene (Scotland) Regulations 2006 allow for the slaughter of poultry on-farm and the supply of un-eviscerated birds to approved establishments for delayed evisceration. This procedure is allowed providing such production is ‘authorised’ by FSS. No consideration has been given however to extending this to beef and lamb sectors, as there is no provision to permit this within the Regulations.

The Scottish Government is clear that stoma patients should expect an equitable level of care wherever they reside in Scotland, and the responses received from the recently concluded information gathering exercise on the provision of stoma care and stoma specialist nurse coverage across Scotland's 14 territorial health boards will be an important step in achieving that when it is considered by the Scottish Executive Nurse Directors (SEND) in early 2024.

We recognise the significant contribution that Scotland’s unpaid carers make to our communities. It is very important that people who are caring for others know how to access carer support, and that professionals know how to direct people to support.

Under the Carers (Scotland) Act 2016, Local Authorities and Integration Authorities are responsible for supporting carers, according to their individual needs, and commission Third Sector organisations to provide much of that support on their behalf. This includes providing or signposting to counselling and other services that are available to them locally. Much of this vital support is delivered through local carer centres.

We are investing £88.4m per year in local carer support through local authority Carers Act funding.

Over the last 4 years we have seen a big expansion in specialist perinatal mental health services in Scotland so that all 14 Health Boards now have specialist perinatal mental health services to support women and babies. We have also developed enhanced Mother & Baby Unit provision and established new infant mental health and Maternity and Neonatal Psychological Interventions services across Scotland.

Currently provision within inpatient and community perinatal mental health services spans pregnancy and the first postnatal year. There may be some circumstances where patients may be seen beyond the 12 month period. This decision rests with the local perinatal mental health team and should be based on what a patient needs and what the service can realistically provide given current caseload, waits, and capacity.

It is important to identify the service which is most helpful for the patient, which may sometimes be a Community Perinatal Mental Health Team but could also be an infant mental health service, Maternity and Neonatal Psychological Interventions (MNPI) or adult mental health services. We are committed to taking an integrated approach to service provision, so that there are no barriers to ensuring that women and infants get the most appropriate service for their needs and can easily transition between services as that need changes.

We are approaching the end of the first year of implementing the National Carers Strategy (published in December 2022). The implementation of the strategy is monitored by the Carers Rights and Support Steering Group (CRSSG), made up of representatives from national and local carer organisations, statutory sector representatives and unpaid carers - so that carers are directly involved in measuring and monitoring the impact of the strategy during its lifespan.

The CRSSG agreed 43 actions to be prioritised for Year 1. The actions cover a broad range of topics including COVID-19 and cost of living as well as outlining employment, financial and mental health support. Examples of actions that have been progressed this year include:

• We distributed £560,000 to carer centres in 2022-2023 to improve local capacity for carer support.
• We funded the Carers Parliament and the Young Carers Festival in 2023, with record numbers attending the Young Carers Festival this year. We will continue to fund events which enable carers to engage directly with decisionmakers.
• We have engaged with carers in 2023 to produce the National Dementia Strategy, the Mental Health and Wellbeing Workforce Action Plan, the Mental Health and Wellbeing Strategy and we have involved carers in the review of the National Outcomes and the National Care Service co-design. We will continue to engage with carers to ensure their voices are heard and reflected in policy across the Scottish Government.
• We are continuing to fund and promote increased uptake of the Carer Positive employer accreditation scheme, with 264 employers now signed up who are responsible for 493,000 employees (as of November 2023).
• Social Security Scotland successfully launched the initial pilot for Carer Support Payment in November 2023, with the benefit to be available nationally by autumn 2024. The benefit is a key milestone in improving support for unpaid carers and will be available to many carers in full-time education who cannot currently get Carer’s Allowance.
• Through the Communities Mental Health and Wellbeing Fund, we invested £15 million in 2022-23 in community-based initiatives to promote good health and wellbeing and tackle the mental health issues for people, including unpaid carers.

The Strategy is kept under review so that we are able to respond to changing circumstances and ensure progress towards meeting the actions contained within it.

Under the Carers (Scotland) Act, all adult and young carers have the right to a personalised plan to identify what is important to them, which may include counselling and emotional support, according to their individual circumstances. Future needs for bereavement support can be considered as part of the process and any eligible needs for support must be met.

Local authorities must also have a carer information and advice service, usually delivered via local carer centres, to help all adult and young carers access support in their area. This must include information and advice on counselling and bereavement support available to carers, not necessarily carer-specific services. In addition to information and advice services, many local carer centres provide their own counselling and support services which can include group/peer support and bereavement support.

The Scottish Government is investing £88.4m per year in local carer support through local authority Carers Act funding.

As part of the process to develop the Scottish Government/COSLA Mental Health and Wellbeing Strategy, we undertook a literature review and engaged with stakeholders, people with lived experiences and the Equality and Human Rights Forum to gather evidence and better understand marginalised groups’ experiences of mental health. This included unpaid carers, and professional bodies, third sector and equalities organisations representing their interests.

This evidence has been published in the Scottish Government Mental Health Equality Evidence Report accompanying the Delivery Plan, with a specific section on carers at chapter 12. This evidence was invaluable in undertaking a robust Equality Impact Assessment and shaping the Strategy and subsequent Delivery and Workforce Action Plans.

Food Standards Scotland (FSS) are preparing to launch a 3 month consultation on a proposed amendment to the Home Slaughter Guidance, following which responses received will be considered as part of the ongoing review and FSS intend to publish the outcome of the consultation and any revised guidance in 2024.