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Within Transport Scotland, we only have FTE records available from 2016, due to data retention policies. From 2016 to December 2022, Ferries existed as a team within the Aviation, Maritime, Freight and Canals (AMFC) Directorate. I have provided the FTE separately for both the Ferries team and the AMFC directorate as a whole. From December 2022, a new Ferries Directorate was formed, this FTE figure is shown below. All figures are as at March of each year.

The Scottish Parliament approved the Deposit and Return Scheme for Scotland Regulations in 2020. The Regulations are wholly within devolved competence. There is an agreed and published process between UK Government and devolved governments for excluding certain areas from the UK Internal Market Act.

We have been following that process for excluding the deposit return scheme regulations from the Internal Market Act and this has been the subject of discussion with the UK Government for many months. I will keep Parliament updated on the exclusion process.

On single-use vapes, we expect Zero Waste Scotland to submit its report on the review of the environmental impacts and management of single-use vapes in May, and we will consider its findings. Should our preferred course of action require an exclusion we will follow the agreed process.

The Scottish Government remains engaged with the review process, however, the responsibility for the implementation of the recommendations falls to NHS Highland, working closely with the local community, NHS 24, the Scottish Ambulance Service and other agencies as recommended in Professor Ritchie’s original review.

Preparation for outbreaks of infectious disease is an ongoing part of health protection. That work is led by the Cabinet Secretary for Health and Social Care but the breadth of response required to respond to pandemic events is laid out in the 2022 Strategic Framework Update for COVID-19 and the four-harms approach to decision-making used by the Scottish Government for the COVID-19 pandemic.

The Scottish Government regularly engages with the UK Government and the other Devolved Administrations on a range of risks including pandemic preparedness. The Scottish Government works closely with the cross-government Pandemic Disease Capabilities Board to keep Scotland’s readiness up to date.

Statistics relating to the waits patients experience for a new outpatient attendance and inpatient or day case appointment at NHS Board and specialty level are published by Public Health Scotland (PHS) up to 31 st December 2022 and can be found using the following links:

New Outpatients - https://publichealthscotland.scot/media/18024/newop_feb23.xlsx

Inpatients/Daycases - https://publichealthscotland.scot/media/17838/ipdc_feb23.xlsx

The statistics published in the tables above include the median and 90th percentile waits in days for:

• New outpatients waiting (‘1.1 Table’)
• New outpatients seen (‘1.2 Table’)
• Inpatients/day cases waiting (‘2.2 Table’)
• Inpatients/day cases seen (‘2.1 Table’)

We continue to work intensively to clear long waits, which have been exacerbated by the impact of the global pandemic and are determined to provide NHS Boards with support necessary to drive improvements. This includes targets announced in July 2022 to address the backlog of planned care, maximising theatre productivity, optimising Golden Jubilee National Hospital capacity, and the delivery of the £1 billion NHS Recovery Plan to support sustainable improvements and new models of care, such as the National Treatment Centre Programme.

We are also working with the Centre for Sustainable Delivery (CFSD) and boards to embed regional and national working to ensure that long waiting patients can access treatment more quickly.

The Scottish Government is aware that, following the publication of the independent external review, 4 of the recommendations have been delivered in full. These include resolving local provision of urgent care in Glenelg & Arnisdale and Raasay, in-patient hospital provision, workforce capacity and capability for the Scottish Ambulance Service and a Centre of Excellence for learning, education and training has been established.

Evusheld ® was developed and tested before the emergence of the Omicron variant. The RAPID C-19 group and the COVID-19 UK expert panel have considered a full range of evidence, including clinical trial data, in vitro (in the lab) analysis and observational studies, and have advised that there is insufficient evidence available to support procurement and deployment of Evusheld ®. As a result, there is currently no established NHS supply arrangement for Evusheld ® in the UK.

The National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC, as part of Healthcare Improvement Scotland (HIS)) have agreed to maintain the collaboration that started through RAPID C-19 by collaborating on a single health technology appraisal (STA) of Evusheld ® for the prevention of COVID-19. NICE and the SMC will produce separate guidance and advice documents, but the recommendations will be aligned. Draft guidance was published on 16 February 2023, and does not recommend its use. Final guidance on the STA is expected to be published in June 2023.

Programme for Government 2021/22 committed an additional £20 million investment, over the life of this Parliament, for the Detect Cancer Earlier (DCE) Programme to improve early detection rates. So far investment has been made into the development of a new behaviour change campaign to reduce fear of cancer, launched 6 March 2023.

Through the Programme, there’s a firm focus on lung cancer which remains a national priority. This funding has included supporting implementation of Scotland’s optimal lung cancer diagnostic pathway (published December 2022); exploring the role of artificial intelligence in expediting those identified as higher risk; continuation of the University of Edinburgh’s LUNGSCOT study; and establishing a National Bronchoscopy & EBUS Training Programme for NHS Scotland.

A new earlier diagnosis vision is expected to launch in Spring 2023, as part of Scotland’s new cancer strategy – this will be supported by a 3 year action plan, the delivery of which will be supported by this Detect Cancer Earlier (DCE) Programme investment.

Preliminary findings from the EAVE II study, led by Public Health Scotland in collaboration with the University of Edinburgh, were published in a preprint article on 7 March 2023. This article presents preliminary analysis of the number of adults aged 18 and over presenting with long COVID in general practice. It uses routinely collected clinical data from almost the entire adult population in Scotland.

Please note that these findings are preliminary and have not yet been peer-reviewed.

This study estimates that, depending on the outcome measure used, between 0.02% to 1.8% of the participant cohort had long COVID at some point over the course of the study (March 2020 to October 2022). The total number of cases identified each year have not been published with the preprint article. However, findings suggest that there was a general increase in new long COVID cases between September 2020 to April 2022, interrupted by a temporary decline between February and May 2021. Findings suggest a general decline in new long COVID cases from April to October 2022. The outcome measures used include, but are not limited to, diagnosis recorded via clinical codes. The article notes that these figures represent a probable under-recording of cases.

For comparison, the estimated prevalence of self-reported (as opposed to clinically diagnosed) long COVID in Scotland from the ONS Covid-19 Infection Survey was 3.53% (95% confidence interval: 3.23% to 3.83%) for the four week period ending 1 October 2022, which is the four-weekly estimate most closely aligned with the end of the study period.

Preliminary findings from this analysis suggest that, across NHS health boards, cases of long COVID were largely proportionate to population shares. However, findings suggest that NHS Greater Glasgow and Clyde saw a disproportionately large share of cases, and NHS Lothian saw a disproportionately small share of cases.

Please refer to the preprint article for further details: Identifying Long Covid Using Electronic Health Records: A National Observational Cohort Study in Scotland .

The Scottish Government continues to work with its partners and key stakeholders, including Public Health Scotland, health boards, and across the Four Nations to prepare Scotland to identify and respond to future infectious disease and pandemic threats. This work builds on existing health protection approaches, including the 2011 UK Influenza Pandemic Preparedness Strategy , and a now enhanced respiratory surveillance programme.

National preparedness arrangements include stockpiles of clinical consumables, PPE, medicines, a contract for access to a pandemic influenza vaccine – and a national pandemic influenza service at 4 Nation level to distribute antivirals. NHS Boards have pandemic flu plans based on guidance – and are also expected to plan locally on a multi-agency basis with Resilience Partnerships and/or HSCPs. The Coronavirus (Recovery and Reform) (Scotland) Act 2022 was passed last year, giving the Scottish Government new powers to respond to public health emergencies. This includes provisions for education, higher and further education, care services, housing, justice.

The Scottish Government established the Standing Committee on Pandemic Preparedness to bring together scientists and technical experts to advise the Scottish Government on the future risks from pandemics and how best to approach these. The final report will be presented later this year.