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The core criteria for defining a stroke unit are well described in the academic literature, including in Langhorne et al (2002). Though the size and configuration of stroke units across Scotland may vary depending on local factors, most will be in a defined ward setting and have a specialist stroke multidisciplinary team.

Covid-19 has had an unprecedented impact on the world, NHS Scotland and stroke services. Each service will have responded in the best way that it could, depending on the specific issues affecting them.

The 2021 Scottish Stroke Improvement Programme Report (which includes 9 months of the pandemic) shows slight deterioration in performance against the stroke standards for stroke unit access (77% in 2020 compared to 82% in 2019).

While stroke unit access declined, achievement of standards in other areas, including brain imaging within 12 hours of arrival (86% in 2020 compared 84% in 2019), time to carotid intervention (61%; 59%) and mean thrombolysis door-to-needle (DTN) time (51 minutes in 2020 compared to 53 minutes in 2019), improved.

All of these aspects also have an important impact on recovery from stroke, and therefore it is not possible to isolate the recovery impact based on one standard (such as stroke unit access).

Work is ongoing to produce a progressive stroke pathway document by December 2021. This will take account of international evidence, including the World Stroke Organisation’s roadmap to delivering quality stroke care, to define what a progressive stroke pathway should look like in Scotland.

The progressive stroke pathway will, similarly to the roadmap, follow the continuum of care starting at the onset of a stroke event through the acute phase (emergency department and inpatient care), and stroke rehabilitation and long term supported recovery.

Following this, an implementation plan will identify any gaps between current capacity and the progressive stroke pathway vision, and outline clear actions to take.

Please find the requested information set out in the following table.

ScotGEM students are very specifically entitled to apply for a £4,000 per year ‘return of service’ bursary. This means for every year they take this they are committing to stay and work in NHS Scotland for a corresponding amount of years. Once the first cohort of ScotGEM students graduate in Summer 2022, we intend to evaluate the effectiveness of the ScotGEM bursary in retaining trainee doctors in hard to fill posts within our healthcare service. Further consideration to any extension can be made at that point.

The Scottish Government is grateful to everyone who has volunteered for COVID-19 vaccine trials in Scotland. The clinical trials participants have made an important contribution in tackling the coronavirus pandemic.

The digital application to record the COVID-19 vaccine will be available from 30th September. Clinical trial participants who have received a licenced product and are un-blinded will be able to access the application.

Other clinical trial participants will not have access to the application at this time. However, other measures are in place to provide proof of vaccination. This includes a letter of support and subsequently participants will receive a hard copy Record of Vaccination which contains security features and 1-D barcode.

This Record of Vaccination can be used across the UK. In due course, this will be replaced by a QR Record of Vaccination with a QR code.

The Scottish Government are committed to ensuring that these participants are not disadvantaged. Work is ongoing to ensure that vaccine status is correctly presented on the coronavirus vaccine database.

All those individuals who have participated in coronavirus vaccine clinical trials in Scotland, should have already received a letter from their Chief Investigator confirming their involvement. The letter allows them to attend events or access services throughout the UK in the same way as those who are fully vaccinated.

You may find more information on clinical trials on NHS inform: Coronavirus (COVID-19) vaccination status for clinical trial participants | The coronavirus (COVID-19) vaccine (nhsinform.scot)

There is no data held on reasons for missed or non attendance for COVID-19 vaccine appointments.

In the statistical report for 16th of June 2021, Public health Scotland published a one-off analysis of "did not attend" (DNA ) appointments for the time period between 1 February 2021 and 6 June 2021. In this they found that 18.2% of first dose appointments and 3.9% of second dose appointments had resulted in either a missed appointment or a cancellation. The full report is available here : COVID-19 Statistical Report - 16 June 2021 - COVID-19 statistical report - Publications - Public Health Scotland

The Mental Health in Schools Working Group have sought to establish a comprehensive approach to supporting children and young people’s mental health and wellbeing through schools. The publication of the whole-school approach framework provides guidance on setting mental health and wellbeing at the heart of the ethos and culture of schools.

This approach is also reflected within the new professional learning resource, which has been specifically developed for use by school staff, as part of a strategic approach to enhancing understanding of supporting children and young people’s mental health and wellbeing in schools. The new professional learning resource is available online and can be used by any member of school staff.

The Scottish Government is taking a range of action to improve digital inclusion across Scotland, including in the Glasgow region.

We know that cost is one of the greatest barriers to getting online, closely followed by a lack of skills. Since May 2020 the Scottish Government has invested £48 million through the Connecting Scotland programme to provide a device, connectivity, and training and support to those on low incomes, allowing them to realise the full benefits of being online. Connecting Scotland is delivered in collaboration with key partners, including local authorities, COSLA, SCVO and third sector organisations, and telecoms companies. The recently published report Connecting Scotland - A Year in View demonstrates the scale of the investment and the impact of the programme so far. To date, Connecting Scotland has distributed almost 7,000 devices to organisations based in Glasgow. As set out in the Programme for Government, by the end of this Parliament, we will ensure Connecting Scotland has supported up to 300,000 households to get online, backed by £200 million of investment.

We are also making substantial investments in Scotland’s digital infrastructure, despite responsibility for broadband being reserved to the UK Government.

Our Reaching 100% (R100) programme – consisting of the £600 million R100 contracts, our Scottish Broadband Voucher Scheme and commercial coverage – will help to deliver universal superfast access across Scotland.

The Scottish Government engages with the UK Government through the British Irish Council digital inclusion workstream, and officials regularly engage with telecoms companies on digital inclusion issues.

The Scottish Government continues to work with and support Scotland's environmental regulator SEPA in tackling waste crime.

The introduction of the Regulatory Reform (Scotland) Act 2014 introduced additional enforcement measures for SEPA to utilise which included Fixed Monetary Penalties, Variable Monetary Penalties and Enforcement Undertakings. This has expanded SEPA's toolkit for tackling environmental offending and allows a greater range of remedies targeted at both punishment of offender and remediation of environmental harm.

SEPA participate in several multi agency initiatives such as the Scottish Organised Crime Task Force and the Joint Unit for Waste Crime, a cross UK initiative to allow greater collaboration and operational impact on serious waste crime , particularly those who operate cross border.

In respect of tackling the ongoing issue of litter, a review of the National Litter Strategy was completed in 2019 and published on the Scottish Government website earlier this year. The review provides a snapshot of the activities that took place between 2014 and 2019 and also outlines areas of success and good practice case studies. Work has begun to refresh this as a National Litter and Flytipping strategy, which will be published in early 2022. Enforcement will be one of the four key themes this strategy focusses on.

Data on waste crime convictions is available from SEPA's website ( www.sepa.org.uk/regulations/enforcement).

Under the Nature Conservation (Scotland) Act (2004), all public bodies in Scotland are required to further the conservation of biodiversity when carrying out their responsibilities. The Wildlife and Natural Environment (Scotland) Act (WANE Act) (2011) introduced a further requirement for all public bodies in Scotland to provide a publicly available report every three years, on the actions which they have taken to meet this biodiversity duty.

Protecting habitats, species and Scotland’s ecosystem services is an integral part of SEPA’s regulatory remit. All SEPA’s regulatory decisions take account of potential effects on biodiversity and opportunities for biodiversity enhancement. SEPA is responsible for setting standards in environmental licences that protect and help improve the state of water, land and air and the services that ecosystems provide. SEPA issues environmental licences under a range of regulations, including the following:

• Pollution Prevention and Control (Scotland) Regulations 2012
• Water Environment (Controlled Activities) (Scotland) Regulations 2011
• Waste Management Licensing (Scotland) Regulations 2011

SEPA’s Nature conservation procedure for environmental licensing ensures that its statutory duties to protect designated features in nature conservation sites are incorporated into all environmental licensing regimes in a consistent and auditable manner.