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We recognise the extreme pressure facing the Scottish Ambulance Service due to the Covid-19 pandemic, and our thanks go out to the paramedics, technicians and wider ambulance staff for the continued work they are doing in exceptionally challenging circumstances.

Last month, the Scottish Government announced an additional package of support for the Scottish Ambulance Service, backed by an additional £20 million, which will help increase capacity and improve response times and staff wellbeing.

On 7 September 2021, the Scottish Government published the 2021/22 Programme for Government which confirmed that the Scottish Government will start work on a detailed prospectus for an independent Scotland. The Scottish Government is now determining how this work will proceed and the resourcing it requires, as we do for delivering all commitments in the Programme for Government. It is the role of the civil service to support delivery across the full range of Government commitments.

The number of staff working in NHS Grampian has increased by 20.7 per cent since Sept 2006, to over 13,520 Whole Time Equivalent (WTE). This includes a 6.9 per cent increase in numbers of Qualified Nurses and Midwives, which have risen to 4,099.1 WTE.

NHSScotland Boards are required to have the correct staff in place to meet the needs of the service and ensure high quality patient care. They have fully delegated powers in relation to employment issues. The Scottish Government works closely with Boards to support their efforts in staff recruitment. The creation of posts and filling of individual vacancies will depend on the service needs of each Board, taking account of national and local priorities.

We are investing £11 million in new recruitment activity and in the creation of a National Centre for Workforce Supply. The Centre will offer NHS Boards expert advice on labour market intelligence and coordinate recruitment campaigns, providing vital additional support to health board recruitment teams.

We are also taking forward a comprehensive programme to support recovery and build further capacity. The programme will include measures to increase international recruitment, retain staff and attract more returners to the service. The Scottish Government will continue to work with partners to explore options and opportunities that allow us to best support our registered staff.

The Vaccination Transformation Programme (VTP) is funded via the Primary Care Improvement Fund, which began in 2018 and will have provided £250 million to health boards up to the end of financial year 2022. The extended flu programme and COVID-19 vaccination programme (including boosters) are outside the scope of this fund, however work to deliver these programmes has helped to build Health Board capacity to vaccinate and complete the VTP.

The Scottish Government recognises vaccines approved for use in the UK regardless of where they were administered to determine whether a person has completed their primary dose or whether they require additional doses to be fully vaccinated.

Those who have been vaccinated out-with the Common Travel Area (CTA) should obtain proof of their vaccination status from the country they received their vaccination. For domestic certification purposes, we will accept proof of vaccination from across the UK and Crown Dependencies as well as from members of the EU Digital Covid Certificate Scheme.

For those who have proof of vaccination status from out with the CTA and the EU, domestic certification rules for international visitors will align with current border rules. Visitors from international countries out-with the CTA and EU scheme will require to provide the same proof of vaccination status that is accepted for entry to the UK.

Those who have received a final dose of a UK approved vaccine in Canada at least 14 days before travel are currently recognised as fully vaccinated and can use their proof of vaccination for domestic certification purposes. More information on this can be found at: Coronavirus (COVID-19): international travel and managed isolation (quarantine) - gov.scot (www.gov.scot) .

We are working with NHS Scotland Health Boards to put in place delivery models for the 2021-22 seasonal flu vaccination programme to suit local circumstances, whilst maintaining a COVID-19 safe environment and maximising efficiency.

If someone is unable to attend for their flu vaccination, they can rearrange their appointment to a more convenient time or location on line at Rearrange your flu vaccine appointment | The flu vaccine (nhsinform.scot). If invited by their GP practice or local Health Board, they should rearrange their appointment with them directly. If cancelling the appointment, the Flu Vaccination Helpline on 0800 030 8013 can assist with this.

The Case Record Review is underway. Introductory interviews with the participants are close to completion. More than half of the participants have received an ‘information gathering’ form from the Administrator. Following return of this form, Clinco, a commissioned contractor involved in the retrieval of patient records, will request the appropriate case records from Health Boards. This process is already underway for a number of participants.

As is standard practice, data sharing agreements are required for the release of medical records. Agreements are in place already for a number of Health Boards and it is expected that agreements will be in place in relation to all relevant Boards shortly.

Health Board Accountable Officers have been kept abreast of developments with the Case Record Review through the Short Life Working Group on mesh complications.

NHS National Procurement has confirmed that arrangements have been made to make Ronapreve available in Scottish Hospitals.

Commissioning guidance was issued to Health Boards on 17 September, and work is ongoing to ensure that Ronapreve can be administered as quickly as possible where clinically appropriate.

The requested information is not centrally held. NHS Education for Scotland publish annual data on joiners/leavers, but this information is not available by reason or destination.

Information on joiners/leavers by staff group for each financial year can be found on the following link:

https://turasdata.nes.nhs.scot/media/tnvdmmwd/turnover_m2021_updated.xlsx

Ambulance services around the UK, as well as the wider NHS, are experiencing unprecedented demand – largely because of COVID but also due to a combination of increasingly complex cases, staffing challenges and exceptionally busy emergency departments.

That is why we have already taken significant action both prior to and since the pandemic to put in place measures to ensure all Health Boards including NHS Lothian and our Ambulance service have a full range of support.

In July, NHS Lothian received their share of the additional £12 million provided to Health Boards to support non-COVID emergency care. This funding will be utilised to boost staffing and capacity levels to reduce waiting times for urgent and emergency treatment.

To address the unacceptable ambulance waits, we announced an additional package of support for the Scottish Ambulance Service, backed by an additional £20 million, which will help increase capacity and improve response times and staff wellbeing - this includes assistance from over 100 military personnel.

We continue to be in daily contact with NHS Lothian to support improvement work within the Board and the Health & Social Care Partnerships to minimise delays for patients no matter where they are in the system.

The Scottish Government regularly reviews performance data from the Scottish Ambulance Service which includes data on response times across the country.

This information is normally reviewed weekly, however, given the current pressures being experienced we are receiving twice daily sit reps from the Service on performance.

Like all areas of Scotland, and indeed throughout the UK, we are aware that some patients are experiencing delays in response times from the ambulance service. This is why we have already taken significant action both prior to and since the pandemic to input measures to ensure our Ambulance service has the full resources and range of support in place to deliver services.

We announced an additional package of support for the Service, backed by an additional £20 million of investment, which will help increase capacity and improve response times and staff wellbeing, including assistance from over 100 military personnel.

We have also previously taken action to help with the situation, including an additional investment of £20m as part of the £1bn NHS Recovery Plan. This investment comes from continued involvement with the SAS Demand and Capacity programme which this Government has been involved in since its inception in 2019. It will deliver almost 300 additional Ambulance Service staff by April 2022.

This breaks down as 69 staff in the North of Scotland, 139 in West of Scotland and 88 in the East of Scotland. The additional staff are a mixture of paramedics, newly qualified paramedics (NQPs) and technicians. Extra ambulances and vehicles will also be introduced over the coming months, including two in Edinburgh.