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The delivery of Keep Well health checks are no longer centrally overseen by the Scottish Government. It is up to local NHS Health Boards with their area practices to decide on administering these checks. The Community Links Worker programme has now been rolled out to practices particularly in deprived areas and offers support to individuals experiencing for example financial, housing and social isolation concerns. The Links Workers can refer back to GPs for a clinical assessment including for liver disease should any concerns arise.

The current guidance for General Practice is Appendix 22 - Community Infection Prevention and Control COVID-19 Pandemic which was first published on 29th June.

The pandemic has been the biggest shock our NHS has ever faced. It has necessitated the imposition of Infection Prevention Control measures in order to contain its spread, particularly prior to the vaccination programme being fully rolled out. These measures, which have recently been deescalated, changed the way GPs see their patients. As Covid has not gone away yet some precautions remain in place.

The Scottish Government wants to see greater availability of face-to-face appointments and is working with the BMA and RCGP to ensure this happens as quickly as possible. We are clear that where clinically necessary face-to-face consultations will always be available to those who need them.

We must continue to move toward a position where choice is being offered routinely, and the Scottish Government welcomes the GMC’s proposed changes to the Good Medical Practice guidance placing a greater emphasis on shared decision-making between GPs and their patients.

Many GP practices did offer patients video or phone consultations as well as in-person face-to-face consultations before the pandemic changed the balance and we expect a number of patients will wish to continue afterwards with video or phone consultations rather than travel to their GP practice. Ultimately, what is most important is that appointments are agreed through shared decision making, balancing patient choice and clinical judgement.

We agree that everyone should have fair and equitable access to high quality care. It remains an unwelcome reality that communities experience health, quality of life and even life expectancy differently across our society.

The Scottish Government is supporting rural, remote and island communities to address the unique health and social care challenges they face, ensuring that patients receive the right care, in the right place, at the right time. NHS Education for Scotland (NES) has been commissioned to write a business plan detailing how the Health Board will create and host the National Centre of excellence for rural and remote health and social care, which is due to be operational by spring 2023. The National Centre will coordinate, facilitate, fund and promote excellence under the following Four Pillars: ‘Recruitment and Retention’, ‘Ideal Practice and Evaluation’, ‘Training and Education’, and ‘Research and Innovation.’ This will ensure that the issues impacting remote and rural areas in Scotland are given the focused attention necessary to be addressed innovatively and effectively.

With regards to cancer services, our National Cancer Plan advocates a ‘Once for Scotland’ approach to cancer services and will help to ensure that access to care and treatment is equitable across Scotland. The Scottish HepatoPancreatoBiliary Network (SHPBN) is a key partner in improving cancer services to ensure equity of care for all patients living with liver cancer. Under the National Cancer Plan, the SHPBN has been awarded £653,000 over two financial years for the hepatocellular carcinoma (HCC) and pancreatic cancer (PC) Patient Pathways Improvement Project to redesign the pancreatic and liver cancer pathways. The key aims of this project are to shorten the time taken to stage and decide the best treatment for patients, streamline patient pathways and improve communication with patients, carers, primary care & health professionals.

Scottish Ministers and officials from the Scottish Government and Transport Scotland have been engaging closely with stakeholders in the hospitality, cultural and events sectors on the impact of the reduced Scotrail timetable. This has included discussions through the Events Industry Advisory Group. Officials have continued this engagement on the impact of the industrial action.

There have been a number of points of progress in implementing the recommendations of the Independent Medicines and Medical Devices Safety Review as they relate to devolved matters, in addition to steps taken to establish a Patient Safety Commissioner, since the Scottish Government published a delivery plan about the Cumberlege report in March 2021.

In relation to services for women who have experienced complications after the implantation of transvaginal mesh, there is now established in Glasgow a Complex Pelvic Mesh Removal Service. This service offers, where appropriate, mesh removal surgery. Women can also ask to be referred to an equivalent NHS England specialist centre or to an independent provider. All of these options are available free of charge, through the NHS.

The Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Act 2022 gained Royal Assent on 3 March. As a result women can now apply for the reimbursement of personal costs in relation to past qualifying mesh removal surgery which was arranged privately.

In relation to medical devices generally, work continues in NHS Scotland to improve the traceability of devices from manufacture to point of care, so that safety issues can be identified more quickly than is possible now and action taken to protect patients. Four Health Boards will also shortly participate in a pilot of a UK-wide Pelvic Floor Registry. This will allow the recording of all treatments for pelvic organ prolapse and stress urinary incontinence, as well as mesh removal procedures, and benefits will include rapid and efficient recall of patients in the event of an issue with a particular procedure or device.

The Government is also taking steps that seek to prevent harm as a result of sodium valproate and Primodos, and to offer those who have been impacted the care they need.

The Scottish Government is working with the Medicines and Healthcare products Regulatory Agency (MHRA) on the establishment of UK-wide medicine registries. The first of these will be an anti-epileptic medicine registry and we are working to ensure that it is accessible and transferable in a Scottish context in the first instance.

We are also funding the use of a Scottish Epilepsy Register in three Health Boards (NHS Greater Glasgow and Clyde, NHS Tayside and NHS Lanarkshire). This will help identify people taking sodium valproate, as well as any other anti-epileptic medicines which have the potential to cause harm. This work is on track to have dispensing and mortality data linked to an electronic dashboard in NHS Greater Glasgow and Clyde by summer 2022. Data on improved safety for people prescribed sodium valproate will be available to share later this year and, following this, we will look to support the adoption of this system in other Health Boards.

The Scottish Government’s Teratogenic Medicines Advisory Group, chaired by the Chief Pharmaceutical Officer, is looking specifically at what further measures can be taken to prevent wider harm as a result of sodium valproate and it will then consider other medicines with teratogenic potential. The MHRA is also currently considering the need to further strengthen regulatory measures for sodium valproate and Scottish Government officials are continuing to work closely with them on that to ensure that this is taken forward on a UK-wide basis.

Work is underway to establish specialist services for those harmed by sodium valproate in Scotland and officials are now in early discussion with Health Boards to consider what services are currently available, identify any gaps and then commission a service delivery model.

We also continue to press the UK Government on the issue of redress, which is a recommendation for the UK Government to consider due to the reserved nature of medicine regulations.

As set out in the Heat in Buildings Strategy, £33 billion is the estimated total gross capital cost of converting our entire building stock, domestic and non-domestic, to zero emissions heat. This estimate is purely indicative and based on a single technology pathway, with cost assumptions derived from the best available evidence including research published by the Climate Change Committee. The Scottish Government continues to keep cost estimates under review, incorporating new evidence as it becomes available.

The 2019 Scottish House Condition Survey (SHCS) estimates that 56% of social housing is in EPC band C or better. This is the most recent data available from the SHCS.

Following the suspension of face-to-face interviewing in March 2020 to help prevent the spread of COVID-19, there was no SHCS data collection in 2020. The 2021 SHCS was carried out by an external-only inspection, supplemented with alternative sources of data (e.g. from the Energy Performance Certificate) and the householder providing information to surveyors via telephone.

This approach was designed to provide as reliable as possible estimates of key statistics, including on fuel poverty, energy efficiency and external repairs, while maintaining no contact with the household. No data was collected on internal aspects such as room repairs and aspects of housing standards.

It is expected that the key findings from the 2021 SHCS will be published in February 2023.

The 2022 SHCS returned to full in-home surveying in April 2022.

I recognise that the industrial action by the RMT and ASLEF unions is having an impact on the culture sector at a time when it has been seeking to recover from the Covid19 pandemic.

Scottish Ministers and officials from the Scottish Government and Transport Scotland have been engaging closely with stakeholders in the culture and major events sectors on the impact of the industrial action.

The ScotRail planning team successfully managed to develop and schedule additional late night services specifically for Friday and Saturday nights across several key routes:

• Edinburgh – Glasgow Queen St
• Edinburgh – North Berwick / Kirkcaldy / Fife
• Stirling – Edinburgh / Glasgow Queen St
• Glasgow Central – Ayr / Gourock / East Kilbride / Neilston
• Aberdeen – Inverurie

There is positive progress being made on pay negotiations with ASLEF in Scotland, and I am hopeful that additional services will be added in the near future.

The Scottish HepatoPancreatoBiliary Network (SHPBN) is a key partner in improving cancer services and ensuring equitable access to treatment for liver cancer patients. Under the National Cancer Plan, the SHPBN has been awarded £653,000 over two financial years to redesign the pancreatic and liver cancer pathways. The key aims of this project are to shorten the time taken to stage and decide the best treatment for patients, streamline patient pathways and improve communication with patients, carers, primary care & health professionals.

Care for people towards the end of life has always been an important priority for the Scottish Government, and Scotland is already widely recognised for providing high-quality palliative and end of life care. There is always more we can do to improve our services and therefore we are committed to producing a new strategy for palliative and end of life care to achieve the very highest standards of care right up to the end of life, and ensure that everyone who needs it can access seamless, timely and high quality palliative care.

I recognise that the industrial action by the RMT and ASLEF unions is having an impact on the culture sector at a time when it has been seeking to recover from the Covid19 pandemic.

The Scottish Government has provided financial support to the culture sector to support their recovery from the pandemic. This includes £3.2m for a recovery fund for independent cinema and £20.8m for a recovery fund for cultural organisations.

Officials are continuing to monitor the situation closely, including through engagement with organisations representing hospitality, cultural and events stakeholders.