Seòmar agus comataidhean

I refer the member to the answer to question S6W-20618 on 19 September 2023. 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 .

The Environmental Health Policy Co-ordination Group was formed in October 2022 and, as per the Terms of Reference aims to meet monthly, subject to member availability and other diary commitments. Since its inception in October 2022, the group has met 9 times. The Environmental Health Officer (EHO) vacancies and workforce shortages are a standing agenda item for each meeting.

The group consists of representatives from a number of Scottish Government directorates, Food Standards Scotland, COSLA, the Society of Chief Officers of Environmental Health in Scotland and SOLACE. Other participants such as those representing education have been invited as determined by subject matter and agenda items.

Scottish Government advise that all practices should apply the uplift to staff pay unless there are extenuating circumstances. We have resourced the average practice to afford a 6.5% increase for staff pay because we believe this is what practices will need to increase pay by to retain staff who could take up Agenda for Change posts. However practices are not obliged to follow our advice and pay is ultimately a matter between GP Partners and employees.

We recognise that all parents want to ensure their baby gets the safest care possible, and would expect that we organise care to ensure that this happens. The Best Start aims to keep mums and babies together as much as possible. If there is a high risk of the baby needing intensive care after birth then antenatal care will be planned with the input of a specialist maternity team, and with the expectation that the woman will be admitted to a maternity unit in a hospital with a NICU on site when it is time to give birth.

If a woman is in suspected extreme pre-term labour, she will be transferred by ambulance to a maternity unit in a hospital with a NICU on site, to deliver the baby there. If there is not sufficient time to transfer the woman before birth, the baby will be born in her nearest hospital and given immediate short-term intensive care on site to stabilise the baby, before being transferred to a NICU by the specialist neonatal transport service ScotSTAR when it is safe to do so.

The same level of care will also be provided to the mother who, once stable enough, will also be transferred to the maternity unit within the same hospital as her baby.

Under the new model of care, mothers in suspected extreme pre-term labour will be transferred to give birth in hospitals that have neonatal intensive care units. Those maternity units will have expanded capacity to receive those women.

It is recognised that it will not always be possible to transfer mothers before they give birth. In those cases, as has been established practice for many years, our specialist neonatal transfer service (ScotSTAR) will transfer those babies by air or by road in specialist ambulances equipped to care for neonates, accompanied by neonatal staff.

The Scottish Perinatal network has developed and published guidance for all Boards across Scotland to support identification and transfer of mothers in suspected extreme preterm labour. Experiences of testing the new model of neonatal intensive care showed that the vast majority of mothers in suspected pre-term labour were identified and transferred before giving birth.

Women from NHS Lanarkshire would normally be transferred to the Queen Elizabeth University hospital in Glasgow. Should that unit be at capacity, it may it be necessary to transfer those women to Edinburgh, or to Aberdeen, and parents will be involved in those discussions.

Journey times from Wishaw to Aberdeen will vary depending on the time of day and urgency of the transfer.

I refer the member to the answer to S6W-23794 on 29 December 2023. 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 .

As part of the next phase of the work Scottish Government have commissioned Consulting firm RSM-UK to undertake detailed modelling work to fully map the capacity requirements across the system to inform capacity building and implementation of the new model.

The Scottish Ambulance Service will be included as part of the modelling work. We expect that mothers in threatened extreme early labour, or those whose babies will need surgery, will be identified pre-birth and will birth in the maternity unit alongside the NICU. The Perinatal Network has been leading some work, and recently published guidance on transfer in these cases.

Where cot capacity has been reached then clinical judgement with parental involvement will determine the best receiving unit.

Neonatal cot capacity is managed on a network basis through a daily call attended by all Neonatal Units. The data provided is then collated and is used to identify any sustained or acute pressure on intensive care cots.

The availability of beds is not solely down to the availability of neonatal cots, but also maternal beds and the availability of specialists to support both mother and baby. This ensures that for any woman or baby who requires immediate delivery, suitable arrangements are made. The perinatal teams across Scotland, including ScotSTAR who coordinate such transfers work hard to negotiate and create space when required.

The vast majority of mothers in extreme preterm labour will be transferred before giving birth, and the normal destination for Lanarkshire mothers will be Queen Elizabeth University Hospital in Glasgow.

In the small number of cases where it is not possible to transfer mothers before they give birth, as has been established practice for many years, our specialist neonatal transfer service (ScotSTAR) will transfer those babies in specialist ambulances equipped to care for neonates.

The formal transfer of care from a midwife to a health visitor will usually happen between 10-14 days after birth. Scotland's Universal Health Visiting Pathway (UHVP) also directs health visitors to utilise the antenatal contact (between 32-34 weeks of pregnancy) to commence the transition process and to initiate a joint visit with a midwife where additional need is identified.

The Scottish Government has not undertaken specific analysis of the effectiveness of these practices. However, a Scottish Government commissioned evaluation of the full UHVP (2021) found evidence that some health visitors and parents viewed the antenatal contact as crucial in building trusting relationships with families and enabling early identification and response to health needs.

The Scottish Government routinely discusses a range of matters with the Bank, including its approach to governance, risk and procedures for managing conflicts of interest. The Bank’s investment decisions are overseen by an Investment Committee who rigorously and objectively assess each business case on its commercial merits.