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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.

Information on COVID-19 related hospital admissions is routinely collected and reported by Public Health Scotland (PHS) and is not held centrally by the Scottish Government.

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.

First-dose vaccine appointments for children aged 5-11 at higher risk from Covid-19, or who are a household contact of someone who is immunosuppressed, began scheduling from late January 2022. Appointments for first doses for all 5-11s are scheduled from 19 March with older children invited first and families invited together wherever possible. NHS Lanarkshire have reported adequate supply having run a number of paediatric clinics to date and continue to offer vaccines to those who are eligible. If the member has received individual queries regarding supply, I would ask them to write to me with details for further investigation.

Under the Sewerage (Scotland) Act 1968 Scottish Water has the public drainage duty and is responsible for the drainage of foul flows and rainwater run-off (surface water) from roofs and any paved ground surface within the property boundary for normal rainfall events. It should be noted that the majority of the public sewer network across Scotland is a “combined sewer” network which takes both foul flows and surface water into a single pipe. The current drainage systems serve our towns and cities well for the majority of rainfall events. However, below-ground piped systems have a fixed capacity, which means that during severe rainfall events, flooding can occur because the capacity of some or several parts of the drainage system is exceeded. Climate change and increasing areas of impermeable surfaces (also known as urban creep) means that more rainwater is currently entering the sewerage network than it was designed for in a number of places.

The complex nature of flooding across Scotland, with many agencies responsible for different aspects of the flooding, sewerage and drainage systems in communities, means that a partnership approach is vital for reducing the risk of flooding. As a ‘responsible authority’ under the Flood Risk Management Scotland Act 2009, Scottish Water will continue to work with local authorities who have a responsibility for roads drainage as well as being the designated Flood Authority, managing the risk of flooding from surface water. The main platform to achieve surface water management will be through the development of Surface Water Management Plans (SWMP) which are required to be developed for areas which have been identified as having a high risk of surface water flooding through the SEPA Flood Risk Management Plans.

These plans will then inform future investment strategies and decisions for the relevant organisations to ensure a co-ordinated approach is taken forward across each Local Authority area.

Of course, over 36,000 sewer blockages a year are caused by customers flushing inappropriate items such as wet wipes; these blockages will also result in flooding. Scottish Water has launched its Nature Calls campaign to raise awareness of the issues and call for a ban on wipes containing plastic. Further information is available at https://www.scottishwater.co.uk/About-Us/News-and-Views/2022/02/230222-Nature-Calls-Launch-NEW .

We aim to ensure the arrangements in place covering spending decisions on flood risk management are transparent.

In 2016, agreement was reached between Scottish Ministers and COSLA on a new strategic funding plan for flood protection schemes. The agreement guarantees that until 2026 the level of flooding capital grant in the local government settlement is set at a minimum of £42 million per annum. A further £150 million for flood risk management was confirmed in 2020. Support to local authorities in a given year is included in the Scottish Budget that is considered and approved by the Scottish Parliament. The annual allocations are set out in the relevant Local Government Finance Circulars.

The Flood Risk Management (Scotland) Act 2009 provides the framework for effective management of flood risk. In January 2022, SEPA published 14 regional Flood Risk Management Plans (FRMP) for the period 2022-2028. Approved by Scottish Ministers, they have been prepared in collaboration with all 32 local authorities, Scottish Water and other organisations with a responsibility or interest in managing flooding. They have also been shaped in consultation with the public.

These plans complement the separate local flood risk management plans that will be published later this year. The local plans will explain in more detail how the actions set out in the 14 FRMPs will be delivered. They are published by the local authority who is nominated as the lead local authority for the Local Plan District.

These arrangements give local authorities the certainty they need to deliver the broad range of actions set out in the regional and local plans, recognising local needs and priorities.

The Energy Sector which includes resilience of the electricity network is reserved and the responsibility of the UK Government.

The Scottish Government works closely with the UK Government, electricity network operators and owners to ensure Scotland’s energy 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).

The National Planning Framework 3 (NPF3) and Scottish Planning Policy (SPP) also contain planning policies on managing flood risk and drainage. This includes specific policies which deal with the development management and development planning aspects of managing flood risk.

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”.

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.

In the Programme for Government for 2019-20, the Scottish Government committed to establishing a national body with responsibility for the oversight of the design, construction and maintenance of major infrastructure developments within NHS Scotland. The new body, NHS Scotland Assure, is hosted by NHS National Services Scotland and was launched on 1 June 2021. From that date, all NHS Board projects that require review and approval from the NHS Capital Investment Group (CIG) have to be reviewed by NHS Scotland Assure through its key stage assurance review process. Further information on the assurance can be found here: Key Stage Assurance Reviews (KSAR) | National Services Scotland (nhs.scot)