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Wastage data is not currently published by Public Health Scotland. However we can confirm for NHS board operated vaccination clinics, wastage is well below our planning assumption of 5%, which is a precautionary approach for worst case scenario planning.

The Scottish Government held a meeting with key stakeholders, including Scottish Swimming, on 11 August to discuss water safety.

Discussions included the provision of lessons and also water safety education.

More discussions on how to move forward are scheduled for the coming weeks.

The Scottish Government currently only allows travellers returning from green and amber list countries to use NHS Covid-19 tests.

These home PCR kits are sold at a fixed price and can be booked through CTM, the UK Government’s booking portal for international travel.

Wales currently also only allow use of NHS Covid-19 tests, booked through CTM and have the same fixed pricing structure as offered in Scotland.

The Scottish Government has committed to the removal of all NHS dental charges in the lifetime of this Parliament.

All dental charges were suspended in the initial period of lockdown through to 31 October 2020. Pregnant women and nursing mothers who required urgent or emergency dental care would still be seen during this period.

By the end of July, all Health Boards had completed the audit of cases where individuals have been excluded from the cervical screening programme despite their records indicating they may have had subtotal hysterectomies before 1997. Further work was then carried out to collate and analyse the findings. By Wednesday 18 August, around 174 letters were issued by Boards to all those who have been identified as requiring to be re-instated in the programme, or to be offered a gynaecological appointment either because it is not clear from their records if the exclusion is appropriate, or because their age means they are no longer eligible for cervical screening.

In total, 484 records were reviewed. Of these:

• 204 individuals were found to have been correctly excluded and no further action is necessary.
• 39 individuals have been wrongly excluded and are still in the eligible age range for screening. These patients will be re-instated to the programme and asked to contact their GP practice to make an appointment for screening.
• 46 individuals have been wrongly excluded but are now no longer eligible for screening due to their age. These patients will be offered an appointment at a gynaecology clinic.
• 89 individuals’ records did not allow a determination to be made on the appropriateness of their exclusion. These patients will also be offered an appointment at a gynaecology clinic.
• A small number of individuals are no longer resident in Scotland. Efforts will be made to trace them, and they will be re-instated in the screening programme so that they will be invited again for screening should they return to Scotland.
• 100 individuals are now deceased. As noted in the statement given to Parliament on 24 June, a review is being carried out into the deaths of anyone who may have been excluded in error from the programme to verify whether cervical cancer was a main or contributory cause of death.

The care pathways in place for anyone written to in August are the same as for all those written to at the end of June. Jo’s Cervical Cancer Trust also continue to offer support through their helpline services. The helpline can be reached by calling 0808 802 8000 or emailing helpline@jostrust.org. If anyone believes they have had a subtotal hysterectomy and therefore thinks they should have received a letter, Jo’s Trust will also be able to redirect them to a Health Board contact.

We recognise the anxiety anyone receiving a letter will almost certainly feel, and we are sorry for that. It is important to stress that the risk of developing cervical cancer is extremely low – less than 1 in 100 women will develop it in their lifetimes.

As we have stressed throughout this incident, anyone who is experiencing symptoms of cervical cancer – that is anyone experiencing unusual discharge, or bleeding after sex, between periods or after the menopause – should make an appointment with their GP practice. More information on symptoms is available on NHS Inform.

I will provide a more detailed update to Parliament on this issue after recess.

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.

The regulations will expire on 20 September 2021, and, whilst the regulations are of course subject to review, it is anticipated that restrictions imposed by the regulations will still be required at that stage. Where possible, it is my intention to lay a new instrument at that time revising and consolidating all amendments to the existing regulations since they came into force in June 2020.

The Scottish Government does not centrally collect information or data relating to the use of Do Not Attempt Cardiovascular Resuscitation (DNACPR) forms.

As with all other clinical treatments, decisions about CPR should be based on the individual clinical circumstances and wishes of the patient, recorded appropriately and updated when medical circumstances change. This recording is done in hard copy on a DNACPR form, the existence of which is then recorded on an individual’s Key Information Summary. Such information is only shared for the purposes of direct care and is therefore not centrally collected.

The Scottish Government Do Not Attempt Cardiovascular Resuscitation (DNACPR) guidance makes clear that the overall responsibility for making an advance decision about CPR rests with the senior clinician who has clinical responsibility for the patient during that episode of care.

This guidance also makes clear that we expect healthcare professionals to discuss treatment options openly and honestly with patients, their families and guardians - where appropriate, to help ensure that they get the care that is right for them given their specific medical circumstances.

For convenience the guidance can be accessed at: https://www.gov.scot/publications/decisions-cardiopulmonary-resuscitation-integrated-adult-policy/.

Transport Scotland recognise the importance of tourism to the Scottish economy and the role that Dumfries and Galloway and the Scottish Borders serve within this sector as popular tourist destinations. As the current signs on the M74 are in a good state of repair no reviews are currently planned. For new tourist signs to be considered on the Scottish Trunk Road that highlight visitor attractions, applications from the tourist attraction must meet the criteria set out in Transport Scotland’s Trunk Road and Motorway Tourist Signposting Guidance document.

As concluded in the South West Scotland Transport Study, a new station at Beattock was one of the interventions recommended for the next stage of appraisal. This option is one of 58 potential new stations across Scotland that are being appraised as part of the second Strategic Transport Projects Review (STPR2).

The appraisal process for STPR2 is considering the performance of all options against the transport outcomes we are seeking, the Transport Planning Objectives, which are aligned to our National Transport Strategy priorities and outcomes. The interventions will seek to contribute to our vision of a sustainable, inclusive, safe and accessible transport system helping deliver a healthier, fairer and more prosperous Scotland for communities, businesses and visitors.

Therefore, we need to consider the social and economic benefits and impacts based on performance against these objectives and the five Scottish Transport Appraisal Guidance criteria, to determine the overall Value for Money. This also takes into account risks, uncertainties and other factors such as affordability, deliverability and the wider acceptability of options. This will be an important consideration given pressures on current and future public finances.

Also underpinning STPR2 is the Sustainable Investment Hierarchy where we will aim first to reduce the need to travel unsustainably, make better use of and enhance existing infrastructure, before investing in new capacity. This hierarchy is also central to Infrastructure Investment Plan. STPR2 will conclude later this year, with publication of recommendations for investment and an appropriate statutory consultation period.

Until the appraisal process is completed, it is not possible to make individual decisions on potential new stations such as Beattock.