Seòmar agus comataidhean

As part of our recovery from the Covid-19 pandemic, we are reassessing all our priorities to take a systematic, person-centred approach to planning and delivering health and social care services for the people of Scotland.

As we go through a process of realignment, we are taking time to ensure all our strategies are designed around the people using and delivering health and social care services and working together to improve health outcomes. This is even more pertinent for those living with a rare disease.While we expected to publish our Action Plan in the spring, the Rare Disease Action Plan will now be published once this work is complete to ensure maximum impact for the people who need it. This will result in a stronger, interlinked action plan that has a real impact for people with a rare disease.

We will continue to work with Scotland’s Rare Disease Implementation Board and other key partners to progress work that will improve the lives of people in Scotland living with rare diseases.

The act of drink spiking is utterly abhorrent and the Scottish Government remains absolutely committed to continue working with partners to tackle this unacceptable behaviour. Police Scotland have recorded over 492 crimes of ‘Drugging’ and ‘Administering a substance for sexual purposes’, since October 2021, and continue to work closely with Scottish Government to monitor the situation. These can be broken down as follows:

In line with the Scottish Government’s Programme for Government commitment to ‘create a new brand marque, and build on existing campaign activity, to enhance Scotland’s international reputation’, the new single nation brand marque for Scotland was introduced as part of the Brand Scotland ‘Scotland is Open’ international marketing campaign and in support of Scotland’s domestic and international presence at COP26 in Glasgow, capitalising on this key international moment.

The current arrangements, which were implemented at the start of the pandemic, will remain in place. The Scottish Government is currently reviewing the provision of early medical abortion at home, and expects to make an announcement on this soon.

Whilst there is no legal definition of elder abuse, the World Health Organisation has defined it as ‘a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person' ( Elder abuse (who.int) ). They note this can cover several types of violence, including but not limited to physical, sexual, psychological and financial abuse or neglect.

In general the Scottish Government does not hold information centrally on levels of elder abuse, as the Official Statistics on police recorded crime and criminal proceedings do not include details on whether the victim was an older person, or their relationship to the perpetrator. Police Scotland are in the process of introducing a new system to record crime, which once fully operational may allow for more detailed analysis within Scotland’s recorded crime statistics (including victim age for each type of crime committed). Going forward, statisticians will keep users of crime statistics informed of developments, as the new system rolls out during 2022 and 2023.

Some information on the age of victims and their relationship to perpetrators is available from topic based Official Statistics, including for example police recorded Domestic Abuse and Homicide. In 2020-21, victims of domestic abuse aged 60 and over had a rate of 12 incidents per 10,000 population (compared to 119 incidents for all ages). This has remained broadly stable over the past five years. Between 2016-17 and 2020-21 there were 36 victims of homicide in Scotland aged 60 or over. Of these, over two-thirds (69% or 25 victims) were known to the perpetrator (including partners or ex-partners, relatives and acquaintances). Furthermore the Scottish Crime and Justice Survey (SCJS) can provide estimates of some measures by age, however this only covers adults living in private households and excludes other settings such as care homes. In 2019/20, 6.9% of those aged 60 and over experienced crime in Scotland (including those not reported to the police), compared to 11.9% for all aged 16 plus. The victimisation rate for those aged over 60 has shown no change since 2014/15.

Some data is also available from the Care Inspectorate, which operates a complaints procedure for registered care services. For example in 2019/20 there were 35 upheld complaints about protection of people in care homes for older people. Further information on this process is provided in Care Inspectorate reports Complaints Annual Report 2019-20 final 12012021 (1).pdf (careinspectorate.com) and their published board papers (June 2021) Board_1706202_Final_Published.pdf (careinspectorate.com) .

While the Scottish Government’s role is to set the strategic policy for the NHS in Scotland, NHS Boards and healthcare professionals locally have responsibility for both service delivery and people’s care. NHS Boards are expected to ensure that patients, including those who require care and support for ME/CFS, have access to a range of professionals to provide the appropriate management of their condition.

We recently commissioned an independent organisation to engage with third sector and clinical stakeholders and people with lived experience, to discuss how we move forward in implementing the National Institute for Health & Care Excellence (NICE) guideline recommendations on ME/CFS in Scotland, and in identifying priorities for service improvement. We are currently preparing to publish the final stakeholder consultation report and are considering its findings.

I was pleased to meet with #MEAction Scotland representatives in March 2022, to hear their views on improving the access to care and support for people affected by the condition.

The Scottish Government, through the Chief Scientist Office and NHS Research Scotland, has invested approximately £40 million per year in clinical research infrastructure since 2012. This funding supports Health Boards, researchers, clinicians and industry to improve the quality, efficiency, coordination and impact of clinical research, and provides state of the art facilities to conduct clinical trials.

The Scottish Budget for 2022-23 confirms funding of £4 million to deliver the Young Patients Family Fund.

The Chief Scientist Office (CSO) provides funding to support and facilitate high quality applied research across a wide health and care remit

CSO Approach to Funding – Chief Scientist Office (scot.nhs.uk)

This includes funding in support of research in areas of public health, or health and care where delivery may be outside of clinical settings

CSO's annual budget from 2012-13 to 2022-23 is provided below:

2012-13 £67.9 million

2013-14 £68.3 million

2014-15 £68.5 million

2015-16 £66.8 million

2016-17 £64.8 million

2017-18 £64.4 million

2018-19 £67.2 million

2019-20 £69.9 million

2020-21 £69.9 million

2021-22 £75.4 million (includes £3.5 million non-recurring COVID-19 funding)

2022-23 £78.4 million

The Young Patients Family Fund provides valuable financial support to eligible visitors of inpatients up to the age of 18. There are currently no plans to extend eligibility for outpatient treatment.