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Dry powder inhalers(DPIs) make up 33% of the total in Scotland in primary care. In the last financial year (2020/2021), there were 4.5 million metered dose and 2.3 million dry powdered packs prescribed and dispensed via primary care and we have not seen a clear trend of those numbers changing and inverting.

Effectiveness of a powdered drug depends on a number of factors, including the inspiratory flow rate generated by the patient. For a significant proportion of patents, making the switch to a DPI will be successful, however, for some a DPI will not be suitable e.g. those with significantly impaired breathing. We would advocate regular medication reviews between the patient and GP at which time consideration should be given to switching to a DPI if deemed suitable for the individual patient’s circumstances

We recognise that 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. Reducing the environmental impact of these inhalers is a priority.

A draft NHS Scotland Climate Emergency and Sustainability Strategy was published on 10 November 2021 and the consultation closed on 10 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.

Local Resilience Partnerships (LRPs) undertake multi-agency tabletop exercises involving flooding or severe weather scenarios as a matter of course. Local flood defence mechanisms are tested by resilience partners on a regular basis.

Ministers have not visited any care homes in their official capacity during the COVID-19 pandemic, but have closely monitored the situation throughout. Both the Cabinet Secretary for Health and Social Care and myself took office in May 2021, partway through the pandemic.

I was previously scheduled to undertake two care home visits, however these had to be postponed for safety reasons due to a COVID outbreak and the emergence of the SARS-CoV-2 variant Omicron. The safety and protection of residents and staff is paramount in such situations. In my role as lead for Social Care policy, I have regularly spoken to a range of stakeholders from the sector including family and sector representatives. I have also spoken to care home staff and managers. I will be rescheduling care home visits in due course.

Of the professional advisers:

• the National Clinical Director, last visited a Glasgow Care Home on 21 st February 2021 and prior to the pandemic made a visit to a care home in October 2019;
• the Chief Social Work Adviser has not visited any care homes in her official capacity during the pandemic. Prior to the pandemic she visited David Walker Gardens care home in Rutherglen on 5 th August 2019;
• the Chief Medical Officer, who was appointed in December 2020, has not visited any care homes in his official capacity during the pandemic.

Information on COVID-19 related hospital admissions is routinely collected and reported by Public Health Scotland (PHS) and is not held centrally by the Scottish Government.

As the Roads Authority, local authorities are responsible for the drainage of local roads and public highways under the Roads (Scotland) Act 1984 - including maintenance of road gullies. The Scottish Government does not hold information on how many local authorities prioritise high risk areas in their drain clearance schedules. Local Authorities are responsible for and best placed to respond to, need in their area.

The 2022-23 Local Government Finance Settlement of almost £12.7 billion represents a cash increase of almost £1.1 billion or 9.2 per cent which is the equivalent of a real terms increase of 6.3 per cent.

However, the Scottish Government’s policy towards local authorities’ spending is to allow local authorities the financial freedom to operate independently. As such, the vast majority of funding is provided by means of a block grant. It is the responsibility of individual local authorities to manage their own budgets and to allocate the total financial resources available to them on the basis of local needs and priorities.

Local authorities are independent corporate bodies with their own powers and responsibilities. It is up to each local authority how it manages its day-to-day business and decision making processes.

The Scottish Government does not take into account the length of roads for which a local authority is responsible when allocating funding to local authorities for flood risk management.

The Flood Risk Management (Scotland) Act 2009 provides the framework for effective management of flood risk.

As part of our civil contingencies risk assessment work, the Scottish Government’s Resilience Division works closely with resilience partners, including the Scottish Environment Protection Agency and the Met Office, to assess climate change risk. This work includes the development of the Scottish Risk Assessment (SRA), which is designed to supplement UK Government’s National Security Risk Assessment. Together these documents assist Scottish responders and policy makers in understanding the most significant civil contingencies emergencies which Scotland may face over the next two to five years. The current SRA includes six new risk assessments themed around major impacts from climate change, as well as a dedicated climate change overview chapter.

The Civil Contingencies Act 2004 places 7 duties on local authorities including duties to assess the risk of an emergency occurring, and to plan for such emergencies, and maintain those plans accordingly. Further guidance and best practice for categorised responders, including local authorities, on planning and preparing for emergencies is set out in our Preparing Scotland guidance.

In the Programme for Government for 2019-20, the Scottish Government committed to establishing a national body with responsibility for the oversight of the design, construction and maintenance of major infrastructure developments within NHS Scotland. The new body, NHS Scotland Assure, is hosted by NHS National Services Scotland and was launched on 1 June 2021. From that date, all NHS Board projects that require review and approval from the NHS Capital Investment Group (CIG) have to be reviewed by NHS Scotland Assure through its key stage assurance review process. Further information on the assurance can be found here: Key Stage Assurance Reviews (KSAR) | National Services Scotland (nhs.scot)

Information on COVID-19 related hospital admissions is routinely collected and reported by Public Health Scotland (PHS) and is not held centrally by the Scottish Government.