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It is essential that care home staff and residents are comfortable in their environment and this includes mitigating against the effects of heat. Care providers including care homes are therefore expected to take steps to ensure that the environment is suitable for both staff and residents. This is outlined in the Health and Social Care Standards which set out what people should expect when using a Health or Social Care service in Scotland. Standard 5.21 requires care homes to “provide plenty of natural light and fresh air and that lighting, ventilation and heating can be properly adjusted”. The Care Inspectorate regularly assess a care home against their application of the Standards.

In view of the recent high temperatures, the Care Inspectorate issued advice to all care providers of adult services about steps that should be taken to maintain safe temperatures and mitigate the effects of heat. This included ensuring people are kept cool, well hydrated and drinking plenty of fluids and using cold compresses to keep people cool. The information provided also included a link to the recent UK Governments’ Department for Health and Social Care and Health Security updated heatwave advice for Health and Social Care staff. It includes advice both on caring for people most at risk during a heatwave, and on organising others who provide care. This advice is available here: www.gov.uk/government/publications/heatwave-plan-for-england/supporting-vulnerable-people-before-and-during-a-heatwave-for-health-and-social-care-professionals

Public Health Scotland’s COVID-19 - information and guidance for social, community and residential care settings, provides detailed advice on the importance of good ventilation in indoor spaces to reduce the risk of COVID-19 spreading. The guidance also sets out steps to safely maintain adequate room temperatures for the comfort of staff and residents. This includes maximising fresh air during hot weather, wherever possible through natural ventilation - opening windows, vents and doors (excluding fire doors). Where buildings have mechanical ventilation systems, these can maximise the amount of fresh air being introduced and minimise the recirculation of air in rooms and throughout buildings. This advice is available here: www.publichealthscotland.scot/publications/covid-19-information-and-guidance-for-social-community-and-residential-care-settings/covid-19-information-and-guidance-for-social-community-and-residential-care-settings-version-22/

The Health and Safety Executive ventilation in the workplace guidance also provides practical steps on improving ventilation. This advice is available here: www.hse.gov.uk/ventilation/overview.htm . The UK Health Security Agency recommends keeping room temperature to at least 18ºC as temperatures below this can affect health, especially in those who are 65 years or older, or have a long-term health condition and they published information ahead of the recent heatwave here: ukhsa.blog.gov.uk/2022/07/14/staying-safe-in-extreme-heat/

The Care Inspectorate has produced guidance for service providers around design, planning and construction considerations for new or converted care homes for adults. This guidance includes information on ventilation of adult care homes and is available here: Care Homes for Adults – The Design Guide.pdf (careinspectorate.com) .

At the time of the Scottish Budget, the Scottish Government estimated that up to 30,000 properties would potentially be eligible to claim the Retail, Hospitality, and Leisure relief in 2022-23, subject to a business-level cap on the value of relief.

The non-domestic rates income figures for each year, broken down by local authority, are available in Scottish Local Government Financial Statistics, at https://www.gov.scot/collections/local-government-finance-statistics/#scottishlocalgovernmentfinancialstatistics . The figures can be found in the respective annual publications, in Table 1.15 for 2016-17 and 2017-18, Table 1.14a for 2018-19 and 2019-20, and Table 2.14 for 2020-21.

The most recent figures, as of 1 June 2021, are available in Table 6 of the Non-Domestic Rates Relief Statistics 2021 publication, at https://www.gov.scot/publications/non-domestic-rates-relief-statistics-2021/ .

There are 15 prisons located throughout Scotland, 2 of which are managed privately.

Responsibility for providing prison healthcare was transferred from Scottish Prison Service (SPS) to NHS in 2011, and as such the Scottish Government does not hold data on the mental health workforce.

Data such as the number of staff in post or vacancies is collected on specific job roles but not within specific settings such as prisons.

While the Scottish Government provides funding for recruitment under Action 15, workforce and service planning is conducted by Integration Authorities according to the needs of their populations.

Under Action 15 of the Mental Health Strategy 2017-27, 54.4 whole time equivalent (WTE) mental health posts have been recruited to in our prisons.

Potential extension of the Waverley line, to Carlisle via Langholm, and other route variations, was appraised as part of the second Strategic Transport Projects Review (STPR2). Whilst the outcome was that the extension of the line was not included within the 45 draft recommendations, there does remain a path for regional or local rail projects to come forward, and Transport Scotland will consider these subject to a strong business case being developed in accordance with Scottish Transport Appraisal Guidance (STAG) and suitable funding being available. The Scottish Government have committed up to £5 million through the Borderlands Inclusive Growth Deal to enable regional partners to assess the benefits and challenges of extending the Borders Railway, and continue to work with partners to implement that commitment.

Through the Borderlands Inclusive Deal the Scottish Government have allocated up to £5 million to assess the benefits and challenges of extending the Borders Railway. That funding will be released on the achievement of agreed milestones, in line with the usual business case and governance processes that apply to all growth deal projects. As this is a joint funding commitment, the Scottish Government are currently awaiting the outcome of internal UK Government discussions on governance procedures to be able to align advice to partners and move things forward.

There are additional treatment options for selected groups of people with COVID-19 who are thought to be at high risk with a prioritised clinical condition, as well as those taking part in registered clinical trials related to COVID-19. The high risk group does include those with rare neurological conditions such as:

• multiple sclerosis
• motor neurone disease
• myasthenia gravis
• Huntington’s disease

The decision on whether to prescribe a medicine for a patient is entirely for their clinician. Information on the arrangements for direct access to COVID-19 treatments in Scotland can be found at: Coronavirus (COVID-19): Treatments | NHS inform .

High risk individuals who have been diagnosed with chronic neurological disease are now included in the clinical risk group of the autumn/winter booster programme as advised by the Joint Committee on Vaccination and Immunisation (JCVI).

The following groups will be offered an additional booster dose from Sept 2022:

• residents in a care home for older adults and staff working in care homes for older adults
• frontline health and social care workers
• all adults aged 50 years and over
• those aged 5 to 49 years in a clinical risk group, including pregnant women
• those aged 5 to 49 years who are household contacts of people with immunosuppression
• carers aged 16-49 years

Letters will be sent out to the first eligible groups next month with appointments beginning in Sept. Discussions on the details of the delivery timetable are underway with health board partners. More information will be made available in due course.

The Scottish Government expects NHS Boards to provide the best possible care for those who have experienced a stroke, including thrombolysis where considered clinically appropriate.

The Scottish Stroke Improvement Programme (SSIP) report, published on 28 June and available at: https://www.strokeaudit.scot.nhs.uk/index.html , notes a clear effect of the waves of COVID-19 on hospitals.

Stroke admission numbers often fell during the early waves of the pandemic, with patients possibly avoiding seeking medical attention due to the COVID-19 pandemic, and this may help explain the increase in stroke admissions between 2020 and 2021. The trend of increased stroke admissions between 2020 and 2021 is not unique to NHS Lothian and was observed across Scotland.

The proportion of patients who received thrombolysis in NHS Lothian in 2021 (8.9%) was broadly in line with the proportion of stroke patients who received thrombolysis across Scotland (9.1%).

As of 19 July 2022 we had issued 79 letters to people receiving Personal Independence Payment to let them know the transfer of their award to Adult Disability Payment has begun. These cases were selected as part of our small Personal Independence Payment to Adult Disability Payment pilot. Once Adult Disability Payment launches nationally on 29 August, we will begin selecting large numbers of Disability Living Allowance and Personal Independence Payment awards for transfer.

We have also developed and are delivering a strategic communication and engagement plan for case transfer. This includes a series of stakeholder roadshows to key stakeholders as well as stakeholder newsletters. We have also included case transfer messaging in our Adult Disability Payment communications such as media releases, opinion pieces, social media posts on Scottish Government and Social Security Scotland channels and paid for marketing campaigns that have run in the pilot areas. Paid for activity has covered radio, social media, digital and print. We will continue implementing this communication and engagement plan as the case transfer process continues.