Seòmar agus comataidhean

The High Risk Medicines Framework specifies some medicines and medicines groups and at the current time this does not include Parkinson’s medication. There is also a High Risk Medicines Discussion template that is not medicine specific and can be adapted and used by local teams to meet their needs. Parkinson’s medication can be reviewed and discussed within this framework to support local teams to discuss and prioritise improvement activities. All resources are reviewed regularly and the Scottish Patient Safety Programme (SPSP) welcomes further suggestions to add to or develop resources.

I refer the member to the answer to question S6W-17503 on 15 May 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

Reducing harm due to high-risk medicines has been identified as a priority by health boards across Scotland and the Scottish Patient Safety Programme (SPSP) has focussed on supporting teams to discuss and prioritise improvement activities related to high-risk medicines and high-risk situations around medicines.

The SPSP programme within HIS has developed a number of tools and resources which are publicly available via the Healthcare Improvement Scotland (HIS) website. These resources include the Non-Steroidal Anti-Inflammatory Drugs (NSAID) Safer Care Bundle, NSAID Communication Care Bundle, Medicines Sick Day Rule Cards, High Risk Medicines Framework and the High Risk Medicines Discussion Framework. All resources available on the HIS website are reviewed by the clinical team supporting HIS to ensure they remain up to date and beneficial, and are available for staff to use within their local settings.

Human activities have had a considerable impact in Scotland’s seas. Of the 21 marine regions reported in the Scottish Marine Assessment 2020 , where physical disturbance was assessed, 18 were predicted to have more than 15% of their area classified as highly disturbed and are considered to be in “poor condition”.

Our proposals to introduce Highly Protected Marine Areas (HPMAs) are intended to contribute to addressing this situation and improving the state of our sea bed across Scotland’s seas. However, enhanced marine protection is about more than tackling biodiversity loss and climate change – it is also about delivering societal benefits which must include benefits for coastal and island communities.

We are proposing that HPMAs protect ecosystems and the services they provide, including essential fish and shellfish habitats, which will deliver societal benefits, including for island and coastal communities. By being properly designed and located we believe these areas would provide long term and sustainable benefits for island and coastal communities.

Scientific studies indicate that fish stocks can increase in HPMAs, providing spill over benefits for fishers and making sure there are sustainable levels of fish and other marine products to be derived and benefitted from our seas. For example, a study by Lenihan et al in California has shown spill over benefits with increased stocks of spiny lobster.

We have conducted a range of initial impact assessments, including an initial Sustainability Appraisal (composed of a Strategic Environmental Report and a Socio-Economic Impact Assessment); a partial Island Communities Impact Assessment (ICIA) Screening Report; and a partial Business and Regulatory Impact Assessment (BRIA). We sought views on these as part of our initial consultation, which closed on 17 April. However, as was noted in the consultation, any specific potential impacts can only be considered in full once specific site proposals have been developed, following close stakeholder and community engagement.

The mental health and wellbeing of children and young people is an absolute priority for the Scottish Government and we continue to prioritise support for mental health and wellbeing in schools.

We support our local authority partners with £16 million in funding to ensure that every secondary school has access to counselling services to support delivery of the commitment. We also published a Whole School Approach Framework and a professional learning resource to assist school staff in supporting children and young people’s mental health in schools.

To help raise awareness of mental health and wellbeing, we currently support NUS Think Positive which sign-posts help for students, where colleges and universities can share good practice and where, through Student Mental Health Agreements, students’ associations and institutions collaborate on institutional mental health practices.

We will also be producing a Student Mental Health Plan which, by linking to our Suicide Prevention Strategy and the forthcoming Mental Health and Wellbeing Strategy, which will assist in bringing all aspects of mental health to the fore.

Reform of the employee contribution structure in the NHS Pension Scheme (Scotland) was postponed from 1 April 2023 because of ongoing concerns about the cost of living pressures affecting NHS staff. We will shortly publish a revised consultation on proposals to reform the contribution structure with effect from 1 October 2023.

The Scottish Government continues to invest in a range of mental health and wellbeing training and education materials to support all staff working with children and young people.

This includes the NHS Education Scotland (NES) Children and Young People's Mental Health and Wellbeing Knowledge and Skills Framework , published in 2021 and available to the entire children and families workforce through the Turas learn platform. The knowledge and skills framework is accompanied by a Digital Learning Map, which has been available since December 2022. This enables staff to access high quality training resources and plan their learning journeys; whilst assisting leaders in the development of learning and development pathways for staff groups.

Through the Scottish Government/COSLA Children and Young People’s Mental Health and Wellbeing Joint Delivery Board, NES worked with a range of stakeholder groups to identify ways to encourage wider use of the Knowledge and Skills Framework and Digital Learning Map. This work led to the development of new resources and improvements such as a training checklist, a ‘One Good Adult’ job description and an evaluation toolkit to make it easier for all professionals to make best use of the Framework and Learning Map.

In addition, in June 2021, Scottish Government launched a new professional learning resource available to all school staff as part of our Mental Health and Wellbeing: Whole School Approach Framework. This new resource, developed by the Mental Health in Schools Working Group, will help to ensure all school staff can recognise the range of mental health and wellbeing concerns that young people may experience and work effectively to support them.

Hospital Electronic Prescribing and Medicines Administration (HEPMA) has been rolled out in in seven Health boards including NHS Ayrshire & Arran, NHS Dumfries & Galloway, NHS Forth Valley, NHS Greater Glasgow and Clyde, NHS Lanarkshire, NHS Lothian and The State Hospital.

The six North of Scotland Boards have worked collaboratively together to develop a regional HEPMA and have implemented capability for the region. NHS Grampian, NHS Highland, NHS Tayside and NHS Orkney have gone live and are now planning for a wider roll out across each of their estate. Both NHS Shetland and NHS Western Isles are finalising preparations for go live in the coming weeks.

Work is underway to rollout HEPMA systems in the remaining Health Boards of NHS Borders, NHS Fife and the Golden Jubilee National Hospital. We expect these implementations to begin in 2024.

The following table shows Scottish Government staffing costs for Health Inequalities (HI) policy functions from 2020 to 2023, and the total over this period.

The Scottish Patient Safety Programme (SPSP) Medicines Collaborative was hibernated in 2020. Since then, the following elements have restarted:

• Non-Steroidal Anti-Inflammatory Drugs (NSAID) Safer Care Bundle
• NSAID Communication Care Bundle
• Medicines Sick Day Rule Cards
• High Risk Medicines Framework
• High Risk Medicines Discussion Framework

Two elements which have ceased are:

• Omitted medicines, which has moved to the Excellence in Care team
• Reducing Medicines Harm Across Transitions

Medicines safety continues to be a priority across Healthcare Improvement Scotland (HIS) and their current focus is on supporting the implementation of primary care pharmacotherapy services. This includes quality improvement work to ensure safe and timely access to medicines using resources from the acute prescribing and serial prescriptions toolkits. These toolkits have been developed in collaboration with primary care teams to ensure people have safe and timely access to medicines including regular, person-centred medication reviews. HIS also provides hands on implementation support to teams who can apply to join a seven week sprint programme. During this programme teams are supported to understand their local system and implement the tools and resources within the pharmacotherapy toolkits.