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In response to the pressures on NHS services caused by the pandemic over the past 18 months, the First Minster launched the NHS Recovery Plan, on the 25 August. The Plan sets out the Scottish Governments key headline ambitions and actions to be developed and delivered now and over the next 5 years.

While it is important to stress that recovery is the immediate task, this Plan is fundamentally about ensuring that the process of recovery focusses on alternatives pathways of care that allow people to be treated more quickly closer to home and also delivers long term sustainability. The plan is backed by more than £1 billion of investment over the next five years.

The figures provided below include patients waiting to have their initial appointment with a consultant (new outpatient) and patients who were waiting to be admitted for treatment (inpatient or day case) within select specialties relating to the question.

In the field of orthopaedic medicine, trauma is categorised as a severe injury to the elements of the musculoskeletal system (muscles, joints, ligaments, bones, and soft tissue). These trauma injuries are often the result of a sudden accident, such as a fall or car accident, and so the patient requires immediate medical attention. Consequently, no waiting times are provided here.

Table 1 shows the total number of patients waiting for a new outpatient appointment across NHS Scotland at 31 May 2019, 31 May 2020 and 31 May 2021, broken down by specialty. Note that 95 th percentile waits have been provided rather than the longest wait as a more robust measure. This is due to the likelihood of the longest wait for each specialty being a data quality issue as opposed to a true waiting time.

Table 1: Total waiting for a New Outpatient appointment and 95 th percentile waits, 31 May 2019, 31 May 2020, 31 May 2021; NHS Scotland

The Scottish Stroke Care Audit does not currently directly measure level of disability at the time of hospital discharge. The stroke improvement team rehabilitation sub group is currently considering future updates to measure rehabilitation service delivery, patient outcomes and experiences.

Rehabilitation is a person centred process. People with ongoing impairment and activity limitations following a stroke are assessed by a multidisciplinary team and their wishes and needs are agreed individually as part of their rehabilitation plan. All patients who require stroke rehabilitation should be offered it. Rehabilitation may be delivered via a variety of inpatient, early supported discharge and community teams

Housing to 2040 is Scotland’s first long-term housing strategy. It sets out the Scottish Government’s vision for housing by 2040, that everyone has access to a safe, warm, affordable and energy efficient home that meets their needs, located in the place they want to be. The strategy needs to be agile and able to respond to future changes, and is in alignment with the Shared Policy Programme agreed with the Scottish Green Party. The updated commitments will be reflected in the governance process and monitoring framework plan for Housing to 2040 that will be established later this year.

The decision about which treatment to prescribe is a clinical decision made by the prescriber in discussion with the patient, taking into account the individual’s condition and medical history.

Guidance is available to assist prescribers and Scottish Government is in the process of reviewing its “Quality Prescribing for Chronic Pain – A Guide for Improvement” which will include information on addressing the issue of over-treatment with a focus on self-management and non-pharmaceutical treatment of long-term conditions, highlighting the issue of high strength opioid medicines misuse and encouraging clinicians to discuss concerns openly with patients.

Over the period covered by the University of Aberdeen study, steroid injections (a commonly used therapeutic option for Osteoarthritis awaiting surgery) were reduced on advice from Royal College of Rheumatology due to the risk of activation of latent Covid 19 and risk of immunosuppression and susceptibility to the virus, this could have led to an increase in opioid pain medication prescriptions to compensate. Analysis from Public Health Scotland (PHS) shows a marked reduction in the number of corticosteroid injections between March 2020 and April 2021 before returning to previous levels. Analysis from PHS, however, does not indicate an overall increase in opioid pain medication prescriptions over the same period.

We will publish the conclusions and recommendations of the City Centre Recovery Task Force this autumn.

We expect businesses to take appropriate action to minimise the risk of transmission (to other employees and to customers) where a member of staff tests positive. Employers should also take appropriate steps and work with Test & Protect to identify any potential close contacts. We expect employers to support staff to self-isolate for the full period required, acknowledging that working from home may be an option.

The Scottish Government, along with public, private and third sector partners and the Scottish Trades Union Congress (STUC) issued a joint statement outlining fair work expectations in July to support the transition out of lockdown. Among its provisions were that no worker should be financially penalised for following medical advice, that any absence relating to COVID-19 should not affect future sick pay entitlement or other entitlements like holiday or accrued time, and that any absence related to COVID-19 should not result in formal attendance related warnings or be accumulated with non-COVID related absences in future absence management figures.

The proposal in the draft Heat in Buildings Strategy, published by the Scottish Government for consultation in February 2021, to establish a Green Heat Finance Task Force has been widely welcomed by stakeholders. This Taskforce, which will be established by the end of 2021, will forge a new partnership approach between the Scottish public sector, heat decarbonisation experts and the financial sector to explore potential new and value for money innovative financing mechanisms for both at-scale and individual level investment in zero emissions heat. The Scottish Government and Scottish Futures Trust will provide co-secretariat support for the independently chaired Taskforce. Membership and Terms of Reference for the Taskforce will be published by the end of 2021.

The following table shows the number of people diagnosed with dementia and referred for post-diagnostic support from a named Link Worker in financial years 2018/19 and 2019/2020. Information on people diagnosed with dementia who are not referred for PDS is not available centrally.

For 2018/19, 8,021 people equates to approximately 43.4 % of those estimated to have been diagnosed with dementia in that year. Of those referred in 2018/19 for post-diagnostic support, 75.1% received a minimum of one year’s support. Full 2019/2020 figures will be published next year.

Table 1: Number of people diagnosed with dementia and referred for post-diagnostic support by financial year of diagnosis: Scotland: 2018/19 to 2019/20

In the Draft Heat in Buildings Strategy, published in February 2021, we committed to undertaking research to understand the extent to which the deployment of secondary technologies alongside zero emissions heating systems could help to optimise operational performance, minimise energy consumption and reduce end user fuel costs. This research is underway, and seeks to understand the technical feasibility and cost effectiveness of heat batteries, electric batteries, and thermal storage cylinders when installed alongside a range of zero emissions primary heating technologies; both independently of and in conjuncture with microgeneration technologies such as solar PV and solar thermal. We expect to publish this research in early 2022.