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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.

While elective surgery has not halted in NHS Greater Glasgow and Clyde, there have been reductions in the number of elective surgeries being carried out in order to focus on cancer and other urgent cases.

The scale-down of elective routine surgery is under weekly review, and an increase in sessions is planned from week beginning 18 October; however, this will be dependent on staffing levels and COVID patient numbers.

The COVID pandemic has inevitably affected A&E attendance and the pressure is being felt across the UK. While Scotland continues to have the best performing A&E in the whole of the UK, our NHS staff are facing unprecedented pressures as they work tirelessly and consistently to respond to the pandemic whilst continuing to provide vital treatment and optimal patient care.

Demand on NHS Highland services has been, and continues to be challenged. This is largely due to limited bed capacity due to staffing pressures, and an increase in attendances to A&E by those who are much sicker and require higher levels of care.

We are in daily contact with NHS Highland and continue 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. We also invested an additional £12 million in the summer to support improvements, NHS Highland has used its allocation to increase capacity in community hospitals.

Additionally, to help alleviate pressures across the whole system we announced a substantial new investment of over £300 million in hospital and community care to support the NHS and social care system over winter. The new funding will support a range of measures to maximise capacity in hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care, helping to improve waiting times for people attending A&E.

All pandemic PPE procurement undertaken by public sector organisations has been conducted in line with the relevant public procurement legislation and policy. In addition, direct awards have taken place using procedures outlined in Regulation 33 within the Public Contract (Scotland) Regulation 2015.

Information on contracts awarded by the Scottish Government for PPE was included in the answers to PQs S6W-02211 and S6W-02212 on 28 September 2021.

Information on contracts let by other national public sector organisations is a matter for those bodies.

The Procurement (Scotland) Regulations require all public bodies to publish an award notice for all regulated procurements no later than thirty days after the award of the contract. These can be found on the Public Contracts Scotland website: www.publiccontractsscotland.gov.uk

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

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) .

Consideration for people who do not have digital access has been built into our vaccination programme from the start. Communication has gone out via non-digital channels and we have also undertaken a door-to-door paper leaflet drop with important information on vaccines. COVID-19 vaccine leaflets are available in audio, BSL, easy read and large print as well as other languages.

Those who do not have online access can call the COVID-19 National Helpline on 0800 030 8013. The helpline allows people to check and, where required, reschedule appointments. All information and services on NHS Inform are available via this phone line. We encourage people to double check their GP holds correct address details, to make sure that any appointment letter reaches them.

For those who are eligible for flu and/or COVID-19 booster vaccines, we have ensured that:

• Those aged 70 and over or those who are clinically extremely vulnerable will receive a vaccine invitation by post or may be contacted by their GP.
• Letters will be sent to those aged 60-69 years of age inviting them for vaccination from late October.
• When the online booking portal becomes available for those in stage 2, people who do not have access to digital booking will also be able to book their vaccinations via the COVID-19 National Helpline.

Our forthcoming national marketing campaigns for both flu and COVID-19 booster will direct people towards both the online booking system as well as the phone line so no one should be left out.

The previous International Travel Regulations were due to expire on 20 September 2021 but were instead revoked and replaced with new, consolidated regulations that came into force on that date. We have reviewed the border health measures closely over the last 28 days and have assessed that there continues to be a requirement for the regulations to remain in place to reduce the risk of imported transmission and safeguard public health in Scotland. The regulations continue to be an important and proportionate part of the Scottish Government response to managing the pandemic. As we have done throughout the pandemic, we will continue discussions with UK Government and the other devolved administrations and continue to seek to take a four-nations approach to future changes to regulations and the travel regime.

The Scottish Government is committed to the early detection of cancer. We are in currently in the process of establishing Scotland’s first Early Cancer Diagnostic Centres which will see the creation of a person-centred fast-track pathway for patients with non-specific symptoms (i.e. weight loss, nausea, fatigue) suspicious of cancer. These centres have been in operation since June 2021 and are continually taking patients with plans for equitable access across Scotland over the course of this parliament.

An estimate of the number of patients who have missed an early diagnosis of melanoma can be made by using data from the Public Health Scotland (PHS) Covid Wider Impacts Dashboard ( https://scotland.shinyapps.io/phs-covid-wider-impact/ ). The data indicates there were a total of 1,131 individuals with pathologically confirmed specimens for malignant melanoma of the skin between 1 April 2020 and the week ending 21 st February 2021. This was 398 individuals fewer than in the same period one year before.

Therefore, the data suggests there have been around 400 fewer melanoma diagnoses overall during the time of the COVID-19 pandemic.

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.