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The Scottish Government recognises that certain inhalers have a particularly harmful impact on the environment. This is an area where rapid change is possible and reducing the environmental impact of inhalers must be a priority.

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.

A draft NHS Scotland Climate Emergency and Sustainability Strategy is out for consultation until 10 th 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.

Scottish Government officials met with officials from the Department of Health and Social Care (DHSC) on the 10 February 2022 to discuss the outcome of the roundtable meeting with experts in the clinical field, including from NHS Scotland, held on 19 January 2022 on the use of pulse oximeters.

The outcome is that after considering current available evidence, it is agreed that pulse oximetry continues to be a vital diagnostic device to support remote monitoring of oxygen saturations in the blood and is a useful part of an assessment and monitoring protocol in patients of all skin tones.

The scientific and clinical expert advice is that any loss of confidence in oximeters, leading to a reduced use of devices poses a significant health risk of subsequent harm from undetected deterioration in vulnerable ethnic groups and therefore the continued use of pulse oximeters should continue to be strongly endorsed to patients and clinicians.

Although it was noted that to date there has been no report of patient harm linked to measurement inaccuracies in the UK, it is recognised that further research is required and this is being conducted through an ongoing National Institute for Health Research (NIHR) commission on the diagnostic accuracy of pulse oximeters and how this varies with darker pigmentation and skin tones.

In Scotland, Technology Enabled Care (TEC) Scotland has adopted a conservative approach to the interpretation of pulse oximeter readings to take into account potential discrepancies when used on people with darker pigmentation and skin tones. The NHS Scotland COVID-19 Remote Monitoring Pathway, developed by clinicians and underpinned by digital support, continues to provides additional clinical guidance in the use of pulse oximeters in Scotland.

The Scottish Government will continue to work with the DHSC to ensure that medical devices are safe and effective for all and consider any recommendations coming out of this work that are relevant to the NHS in Scotland.

The Scottish Government expect all stock within the Private Rented Sector to meet any energy efficiency standard set by regulations or to have a valid exemption. The Heat in Buildings Strategy confirms our intention to introduce, subject to consultation, such regulations, where that is technically feasible and cost effective from 2025. We plan to consult during 2022 on these regulations, and this will include details of any exemptions including those linked to cost, tenant rights, what might be technically feasible, and matters relating to compliance and enforcement.

In general, private landlords or letting agents will advertise available properties through a range of ways including online property website portals, property centres, letting agencies and student accommodation services. The Scottish Government does not provide direct advice or support to people who are looking to find a suitable property to rent. General advice regarding renting from a private landlord is however available at Renting property from a private landlord - mygov.scot . Where a person is unable to access suitable accommodation in the private rented sector, individuals should approach their local authority housing department for support if they are homeless or to go onto the housing list. Registered Social landlords can also be approached to go onto the housing list.

The Scottish Government’s Chief Scientist Office is funding an on-going research project to examine how to best identify those at highest risk of lung cancer in the Scottish population. They are subsequently offered a medical check on their ‘lung health’, and screening using Computed Tomography (CT) if their risk of cancer is assessed as high. Results and learning from this work will be appropriately considered once available, and any decisions taken regarding wider rollout.

Any decision on whether or not to introduce a new national lung screening programme in Scotland is guided by the recommendations of the UK National Screening Committee (UK NSC), an independent expert advisory group which advises all four nations of the United Kingdom on screening policy.In 2007, the UK NSC recommended against the introduction of a lung cancer screening programme; however, it is currently reviewing this and will take into account new evidence that has emerged since the previous recommendation.

We do not have a definite timescale for when the NSC will publish its findings, but we are expecting an update in the coming months. Following completion of this review, the UK NSC will make a new recommendation. If the recommendation is to introduce lung cancer screening then the Scottish Screening Committee, in consultation with medical experts in this field, will advise Scottish Ministers on the most appropriate course of action for Scotland.

The current guidance can be found on the Central Alerting System (CAS). In the largest clinical trial (RECOVERY RS) CPAP reduced the risk of death or intubation (need to go on a ventilator). CPAP can be delivered via a tight fitting facemask, helmet or hood. Smaller clinical trials of helmet/hood CPAP have suggested that it may have equivalent benefit to facemask CPAP but more data analysis is planned. High flow nasal oxygen is a form of non-invasive respiratory support which can be used to facilitate breaks from CPAP and is better tolerated (more comfortable) than CPAP, but doesn’t improve outcome on its own. Whether facemasks, helmets or hoods are used in clinical practice is a decision left to individual boards and units, however they can be ordered if needed and many boards stock them routinely.

The Scottish Government recognises the severe impact the necessary measures to protect public health during this pandemic has had on businesses, particularly those in the travel sector.

The easing of some international travel restrictions has renewed confidence in international travel and we continue to work with the industry on what further steps the Government can take to further support the recovery of the sector.

On 10 February 2022, the Cabinet Secretary for Finance and the Economy announced £3.5 million for outbound travel agents as part of a package of further support for businesses impacted by the measures introduced to control the spread of Omicron.

The Scottish Government has set up a Commission to undertake a review of learning in Scotland’s land-based and aquaculture sectors, to provide opportunities and qualifications through early years, school, college, university and work-based learning - including apprenticeships - for more people, and specifically more women and young people, to work with and on the land, particularly in green skills.

This review will provide recommendations on how to attract more people into these sectors. The Commission will provide independent, evidence-based advice and recommendations to Scottish Ministers by December 2022.

In addition, the Scottish Government’s Skills Action Plan for Rural Scotland (2019-21) sets out our strategic approach to support the skills needs of the rural economy by addressing skills shortages, talent retention and attraction, and demographic challenges through enhanced work-based learning pathways and by increasing access to education and skills provision in rural areas.

The Scottish Government also provides funding support to Lantra Scotland. Lantra is the Sector Skills Council for Scotland’s land-based, aquaculture and environmental conservation sectors, aiming to ensure that these sectors can meet their skills needs and have the right people and promotion of learning opportunities for new entrants. Lantra promote the land-based sector as a rewarding career choice, and help to ensure that learning and training provision address industry requirements and skills gaps.

Lantra’s "#NoTwoDaysTheSame in Land-based and Aquaculture" provides the opportunity for school students to find out about the wide range of careers available in the land-based and aquaculture sectors and how young people can get there. It is delivered in partnership with Developing Young Workforce Live.

I refer the member to the answer to question S6W-06217 on 16 February 2022. 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

As Covid-19 case numbers fall, the Scottish Government is fully focused on supporting the remobilisation of orthopaedic services impacted by the challenges of the pandemic. We understand how difficult it is for those waiting for treatment. Orthopaedic services are recommencing, with NHS Boards undertaking clinically-prioritised urgent cases at present.

The National Treatment Centre Programme, which represents an investment of over £400 million in a network of new, elective and diagnostic treatment centres, will add extra capacity for hip and knee replacements across Scotland and support the recovery and resilience of orthopaedic services in the future.

The consultation report and response to last year’s consultation on changes to energy standards and associated topics will be published in March 2022. This will report on the standards for new buildings to be implemented later this year.