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The Scottish Government recognises the great value of the UNESCO World Heritage Convention, and the impact which this celebrated international recognition can offer to both individual sites, as well as to the wider national natural, culture and heritage sectors. Through our sponsorship of Historic Environment Scotland, advice and guidance is delivered to support many local organisations and groups across the country, to develop and deliver appropriate maintenance plans and sustainable business models for a wide variety of sites.

When the UK Government decided to review and invite new applications to the UK’s World Heritage tentative list, the Cabinet Secretary for Culture, Constitution and External Affairs wrote to Nigel Huddleston MP, Parliamentary Under Secretary of State at the Department for Digital, Culture, Media and Sport to ensure that there would be representation from all UK nations on the independent panel of heritage experts who will be reviewing the applications.

Expressions of interest were due to be submitted by 6 May, with a full application form due by 15 July so that the expert panel can fully assess each application for suitability for inclusion.

The answer to question S6O-01292 does not directly reference any data on heat pumps. However, the answer to the supplementary question does:

"the experience that we have and the comparable data that we have from countries that already have a long history of using heat pumps and heat networks show that they will be effective in Scotland"

The research being referenced here was commissioned by the Scottish Government through ClimateXChange and was published under the title “Heat pump use in Scotland - an evidence review” in October 2021. The paper can be found here:

https://www.climatexchange.org.uk/research/projects/heat-pump-use-in-scotland-an-evidence-review/

Although responsibility for forensic testing falls within the remit of the Scottish Police Authority (SPA), the Scottish Government continues to work closely with SPA and other partners in the criminal justice system to ensure that testing capacity is resilient and able to meet demand in the longer term. To assist with the development of a longer term solution, Craig Naylor, Her Majesty’s Chief Inspector of Constabulary in Scotland (HMICS), has agreed to undertake an urgent review, which will concentrate on the end to end processes for obtaining, analysing and reporting drug driving blood sample results - and identify solutions to capacity in the longer term. We would expect its findings to also consider any investment that will be needed to meet future demand. HMICS plan to complete the review by the end of the year.

The Scottish Government fully supports the enforcement efforts of Police Scotland and the Scottish Police Authority (SPA) in tackling the scourge of drug driving to help make Scotland’s roads safer. However, it is for the Procurator Fiscal’s office to confirm the position on any other crimes which are being impacted by capacity issues in forensic testing.

With regard to testing for drug driving, while this falls within the remit of the SPA, it should be noted that more than 5,600 drug driving tests have been conducted in Scotland since new legislation was introduced in 2019. We have sought and received assurance that urgent action is underway to address the capacity issues in relation to drug driving in both the immediate and longer-term.

The European Health Insurance Card (EHIC) scheme allows EU citizens visiting Scotland, including volunteers, to access immediately necessary NHS healthcare at no charge, other than for certain dental and ophthalmic treatments in common with the general population. The EHIC scheme also makes provision for the treatment of long term conditions, such as kidney dialysis or oxygen therapy, which can be arranged with NHS Boards in advance of travelling to Scotland.

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.