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To date, Scottish Ministers have delegated regional marine planning powers to three Marine Planning Partnerships, which are required by the Marine (Scotland) Act 2010 to include in their governance arrangements representatives with an interest in; the protection and enhancement of the region, its use for recreation and its use for commercial purposes.

The Scottish Government will shortly publish its response to the inquiry of the Scottish Parliament’s former Environment, Climate Change and Land Reform Committee into the development and implementation of regional marine plans in Scotland. This response will include recommendations to support partnerships to identify opportunities to improve community representation in regional marine planning and marine licensing decisions.

The first phase of a rail decarbonisation scheme to electrify the Fife route (Haymarket to Dalmeny section), is moving to construction.

Work on this estimated £55 million scheme will begin in June 2022 with the section between Haymarket and Dalmeny. It is due for completion by December 2024.

This scheme forms part of a rolling programme that is expected to see electrification extended to Dundee and Aberdeen.

Beyond this, further development work on the business cases for decarbonising the Borders Line has been approved to progress to the next design phase for partial electrification of the route using battery electric multiple units.

This continues the Scottish Government’s rolling programme of railway electrification, with work already in delivery on the East Kilbride and Barrhead routes.

Approval has also been given for a procurement competition to identify a preferred manufacturer and financier for new trains to operate decarbonised rail passenger services on the Fife and Borders routes .

As referred to in response to S6W-08593 on 1 July 2022, we were pleased to receive the report and recommendations from the National Partnership for Culture, and recognise that the broad themes in the report align with our priorities across Scottish Government. Scottish Government officials are working together across the Health and Culture portfolios to review the Health and Wellbeing recommendations. Our response to the National Partnership for Culture recommendations will be published shortly.

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

Sepsis improvement is a well-established part of Healthcare Improvement Scotland’s (HIS) Scottish Patient Safety Programme (SPSP). The SPSP launched a revised deteriorating patient driver diagram and change package in 2021 which includes sepsis as a core part of recognising and responding to deterioration.

On 27 May 2022, the SPSP issued a statement regarding the Society of Critical Medical Care’s Surviving Sepsis Campaign (SSC) and the Academy of Medical Royal Colleges (AoMRC) Statement on the initial antimicrobial treatment of sepsis. The statement outlines the SPSP’s revised approach to the identification and management of adults with sepsis.

Furthermore the Scottish Intercollegiate Guidelines Network (SIGN) are currently reviewing SIGN Guideline 139 – Care of Deteriorating Patients to include an updated section on sepsis.

Clinical guideline implementation is the responsibility of NHS Boards. The ultimate decision about a particular clinical procedure or treatment will always depend on each individual patient’s condition, circumstances and wishes and the clinical judgement of the healthcare team.

Following my response in January I can provide more detail around the issues pertaining to paediatric audiology in NHS Lothian. I am providing one response that covers all three questions.

The British Academy of Audiology (BAA) reports have been widely distributed amongst professionals, including all GP practices in NHS Lothian, ENT surgeons, community child health doctors, and speech and language therapists. NHS Lothian has had extensive communication with a range of partners including teaching staff and the Director of Education. As part of this process, those working with children who had any concerns about a child's hearing were encouraged to contact the Audiology department directly or to refer the child through the normal route.

The frequently asked questions, which was developed, has also been shared with specialised teams in education in the four local authority areas across NSH Lothian. My officials are also engaging with local authority heads of service for deaf education and NHS Lothian to address any additional concerns regarding support and education planning for families.

So far, 124 families have been contacted directly by NHS Lothian and offered a retest; 39 children have now had their retest with a further 11 with an appointment to date. From the 39 retested, 10 children have been found to have a new hearing impairment.

Officials continue to work closely with NHS Lothian regarding paediatric audiology, including communications. As highlighted, information has been widely circulated amongst professional staff groups working directly with children and their families, with clear mechanisms for children to be referred to the audiology department where there are concerns about their hearing. Indeed, NHS Lothian established a telephone line in December last year and this continues to be operational to make it easy for families to make direct contact with the Board about any audiology concerns, the board is also working closely with the National Deaf Children Society.

Shortages of medicines are an ongoing part of the day to day management of the NHS. Hormone Replacement Therapy (HRT) medicines and all other medicines experience supply issues for varying times and for varying reasons, including difficulty in sourcing core ingredients, divestment by pharmaceutical manufacturers and international market volatility. Many shortages are short in nature.

There are over 70 HRT products available in the UK. There have been ongoing supply problems with some products, some are irregular supply while others are a longer term shortage. The Scottish Government first issued (26 August 2019) NHS Circular PCA(P) (2019) 18 on HRT supply issues. Regular Medicines Supply Alert Notice (MSAN) are issued for any HRT product experiencing supply problems. All MSANs are published at SHOW - Scotlands Health On the Web - Publications

A serious of UK wide Serious Shortage Protocols (SSP)were introduced for the following HRT products

Premique® low dose 0.3mg/1.5mg modified release tablets

Oestrogel® pump-pack 750mcg/actuation gel,

Ovestin® 1mg cream,

Sandrena® 0.5mg and 1mg gel sachets,

Lenzetto 1.53mg transdermal spray

Each SSP is individually developed and authorised clinically, to enable community pharmacists and dispensing doctors to dispense a different strength or formulation or alternative medicine or appliances in accordance with the protocol, rather than having to refer prescribing decisions back to the original prescriber. These protocols are time limited. SSPs can be found at SHOW - Scotlands Health On the Web - Publications .

We continue to press the UK Government to seek a lasting resolution to HRT supply issues as quickly as possible.

The Scottish Government is taking steps to make it cost-effective for smaller projects to sell carbon credits under the Woodland Carbon Code, which will benefit crofters given crofts are generally much smaller units of land. It is recognised that the finance that could be available through the sale of carbon credits under the Code could make the difference between projects being viable or not viable. The Woodland Carbon Code Secretariat at Scottish Forestry has developed a ‘streamlined’ application process for small woodland creation projects (up to 5 hectares) which simplifies the prediction of carbon sequestration, reduces the requirement for regular plot surveys and has fewer requirements throughout the validation and verification process.

Projects can also be ‘grouped’ together by a project developer for validation and verification which further reduces cost. This removes some of the cost and administrative barriers for smaller projects. This could open the opportunity for crofters to form informal “co-operatives” where they wish to embark collectively on validating and verifying their projects, but any crofters wishing to do this would should contact Scottish Forestry or one of the WCC project developers for further guidance.

Scottish Forestry has also been working with both crofting and farming tenants through the Integrating Trees Network through a series of webinars allowing both crofters and tenant farmers to ask questions and find out more information about tree planting.

Action 12 of our Learning/Intellectual Disability and Autism: Towards Transformation Plan committed to explore the establishment of mandatory autism and learning/intellectual disability training for all NHS staff. We will consider how this applies across multi-disciplinary settings and use the evaluation findings from the Oliver McGowan Mandatory Training pilot to inform our approach to learning disability and autism training in Scotland.

The Scottish Government has also commissioned NHS Education for Scotland (NES) to develop the NES autism training framework as a tool for services and learners, alongside funding a Learning Disability Team at NES to improve the knowledge and skills of the health and social care workforce.

In 2019, there were 191 unexplained deaths. In 2020, there were 202 unexplained deaths.

This information is published annually in the Vital Events Reference Tables published by National Records of Scotland. Data for 2019 and 2020 can be found in table 6.01 here: Vital Events Reference Tables 2020 | National Records of Scotland (nrscotland.gov.uk)

Please refer to the cause of death category "R96-R99 - Other ill-defined and unknown causes".

Data for 2021 is not yet published. The Vital Events Reference Tables for 2021 are due to be published in June and will be available on the NRS website.