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We will continue the use of existing and new and emerging testing and surveillance procedures to support early identification of future variants, including whole genome sequencing, wastewater surveillance.

The Scottish Government monitors the size of the challenge ahead by consideration of climate projections, flood mapping, modelling and analysis carried out by a number of key, expert partners such as the Met Office, SEPA and Scottish Water.

We recognise that our urban areas in particular face mounting challenges with surface water drainage and related flooding. This is why we must ensure that communities and places are water resilient and set-up for the climate challenges ahead. This will require a concerted effort across all sectors to ensure that new development is appropriately sited and designed and that existing buildings can transition to managing rainwater through blue green infrastructure instead of sewers reducing the pressure on our drainage systems.

Data on the investigation of suspected lung cancer by computerised tomography (CT) scan or use of CT as part of treatment is not held centrally.

The Communications Sector, which includes resilience of the telecoms network, is reserved and the responsibility of the UK Government.

There are no specific obligations on telecoms operators to disclose assets that are at risk of flooding or a single point of failure to the Scottish Government.

However there is a broad requirement for telecoms operators to mitigate and minimise, in accordance with good industry practice, the number of single points of failure within the Network.

The Scottish Government works closely with the UK Government, telecoms operators and owners to ensure Scotland’s telecoms networks are resilient to a variety of risks, including flooding and other climate change related factors.

In 2020, we published the ‘Keeping Scotland Running’ Guidance Suite, which seeks to support the delivery of Scotland’s Critical Infrastructure Resilience (CIR) Strategy. This Guidance Suite comprises seven separate guidance documents designed to equip and enable CIR stakeholders to work together to build resilience across the critical infrastructure sectors in Scotland. Two of these guides specifically look at Building Resilience to Natural Hazards and Building Resilience to Climate Change (Adaption).

Our approach to building resilience to the impacts of climate change more widely is set out in the statutory Scottish Climate Change Adaptation Programme 2019-2024. One of the high level outcomes the Programme is structured around is that “Our society’s supporting systems are resilient to climate change”.

The Ready Scotland website – ready.scot – is a core part of our public-facing communications work to help make Scotland more resilient to emergencies. It provides up to date, accessible and comprehensive information on a range of threats and risks, including flooding, to help people in Scotland to prepare for and respond in ways that keep themselves safe and help others in their communities to stay safe.

The Scottish Government works closely with resilience partners to respond to and also prepare for significant incidents, providing information regularly through its own website and social media channels, and also working with resilience partners to disseminate information more widely.

This includes working with the Scottish Environment Protection Agency, Scotland's national flood forecasting and warning authority which runs Floodline Scotland and works closely with local communities to strengthen resilience, prepare for and reduce the impacts of increased flooding.

A national study on the impacts of climate change on NHS assets was undertaken by Health Facilities Scotland (HFS) in 2016. This included flood risk assessments of 240 key sites utilising SEPA flood risk data. A follow up review of the sites identified as being at high risk of flooding was undertaken by HFS in 2021 and recommendations were made to the respective NHS Boards.

In addition Health Boards are working to complete Climate Change Risk Assessment and Adaptation Plans for their areas later this year. This work includes identifying any sites at risk of flooding both now and in the future as a result of climate change and preparing plans to mitigate those risks.

The Scottish Government issued a letter to adult care homes on
‎ 24 March 2022 outlining updates to guidance including visiting. The Scottish Government fully expects care homes and local health protection teams to support people living in care homes to have visits from loved ones, unless there are truly exceptional circumstances. During an outbreak, care home residents can see one of their three named visitors once a day. The letter with updated guidance can be found on the Scottish Government website via the following link: Annex 1 - Coronavirus (Covid-19): changes to guidance for adult and older people care homes - gov.scot (www.gov.scot)

The Scottish Government will continue to work with Public Health Scotland and the care home sector to review the remaining recommendations in adult care homes.

Dry powder inhalers(DPIs) make up 33% of the total in Scotland in primary care. In the last financial year (2020/2021), there were 4.5 million metered dose and 2.3 million dry powdered packs prescribed and dispensed via primary care and we have not seen a clear trend of those numbers changing and inverting.

Effectiveness of a powdered drug depends on a number of factors, including the inspiratory flow rate generated by the patient. For a significant proportion of patents, making the switch to a DPI will be successful, however, for some a DPI will not be suitable e.g. those with significantly impaired breathing. We would advocate regular medication reviews between the patient and GP at which time consideration should be given to switching to a DPI if deemed suitable for the individual patient’s circumstances

We recognise that hydrofluorocarbons used as propellant in metered dose inhalers prescribed for asthma and chronic obstructive pulmonary disease (COPD) can have a global warming potential of 1430 or 3220 times greater than CO2 depending on the type of gas used. Reducing the environmental impact of these inhalers is a priority.

A draft NHS Scotland Climate Emergency and Sustainability Strategy was published on 10 November 2021 and the consultation closed on 10 March 2022. This sets out the Scottish Government’s intention to publish an updated Scottish Quality Respiratory Prescribing guide which will focus on minimising patient over-use of inhalers through review and improving patient outcomes, using propellant free options where possible.

Other actions within the draft strategy include encouraging manufacturers to make inhalers with lower emissions and to support inhaler return to pharmacy schemes to help patients dispose of their used inhalers in a more environmentally friendly way.

Local Resilience Partnerships (LRPs) undertake multi-agency tabletop exercises involving flooding or severe weather scenarios as a matter of course. Local flood defence mechanisms are tested by resilience partners on a regular basis.

Ministers have not visited any care homes in their official capacity during the COVID-19 pandemic, but have closely monitored the situation throughout. Both the Cabinet Secretary for Health and Social Care and myself took office in May 2021, partway through the pandemic.

I was previously scheduled to undertake two care home visits, however these had to be postponed for safety reasons due to a COVID outbreak and the emergence of the SARS-CoV-2 variant Omicron. The safety and protection of residents and staff is paramount in such situations. In my role as lead for Social Care policy, I have regularly spoken to a range of stakeholders from the sector including family and sector representatives. I have also spoken to care home staff and managers. I will be rescheduling care home visits in due course.

Of the professional advisers:

• the National Clinical Director, last visited a Glasgow Care Home on 21 st February 2021 and prior to the pandemic made a visit to a care home in October 2019;
• the Chief Social Work Adviser has not visited any care homes in her official capacity during the pandemic. Prior to the pandemic she visited David Walker Gardens care home in Rutherglen on 5 th August 2019;
• the Chief Medical Officer, who was appointed in December 2020, has not visited any care homes in his official capacity during the pandemic.