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Medicines reach community pharmacies, hospitals, GP practices through a supply chain that is privately operated on a UK-wide basis, from manufacturers in the UK and overseas to wholesale warehouses and distributors. The NHS itself does not have a significant logistical role in the supply chain for medicines.

The supply of medicines, including medicines shortages, is a reserved matter and therefore the responsibility of the UK Government’s Department of Health and Social Care. The Scottish Government works closely with the UK Government on all related medicines supply issues and there are well-established and robust processes in place to communicate, address and mitigate any risks to patients as result of any medicines supply issues that occur.

The Scottish Government and NHS Scotland National Procurement have regular engagement with key stakeholders including Health Boards and Community Pharmacy Scotland on any medicines supply related issues to ensure the provision of medicines for patients in both primary and secondary care settings across Scotland.

We have committed to the development of a new National Pharmaceutical Agency (NPhA), to improve links between the life sciences industry and the NHS, and ultimately improve patient care.

Initial scoping work has taken place, with further scoping work required to inform any planning for the future establishment of a NPhA. This work has been paused due to resource constraints.

The Scottish Government is committed to ensuring that everyone who needs it can access well-coordinated, timely and high-quality palliative care, care around dying and bereavement support regardless of geographical location.

As part of the development of the Scottish Government’s draft strategy, ‘Palliative Care Matters for All’, the Strategy Steering Group and a number of expert working groups carried out surveys to map palliative care delivery across Scotland, including in rural and island communities. This report can be accessed at www.gov.scot/publications/palliative-care-strategy-palliative-care-matters/.

This work has been helpful in providing a clearer picture of the delivery and accessibility of palliative care services and support across Scotland and has helped to inform the actions set out in the draft strategy. The final palliative care strategy is due to published later this year.

The Scottish Government is committed to ensuring that women across Scotland have timely access to reproductive health services. Work continues on the actions set out in the Women’s Health Plan 2021 and the Sexual Health and Blood Borne Virus (SHBBV) Action Plan 2023-26 to ensure that anyone accessing contraception, or deciding to terminate their pregnancy, is provided with fully accessible and person-centred pathways, with information provided to allow for informed decisions to be made about their own sexual and reproductive health.

As part of the SHBBV Action Plan, the Scottish Government has committed to visiting all 14 Health Boards. During these visits the Scottish Government will be recognising the challenges that Boards are facing and the good practice being delivered. This time will also be used to explore areas for collaboration between Boards, both nationally and regionally, especially within rural areas. Officials’ visit to NHS Grampian is scheduled for May 2025.

The evaluation of early medical abortion at home (EMAH) in Scotland was published in March 2023, demonstrating high levels of effectiveness of EMAH, but noting some variations in service delivery across the country. The Scottish Government has taken various actions forward with the Scottish Abortion Care Providers network following this to improve and increase consistency of EMAH services for women across Scotland, and particularly in rural areas, including by providing improved patient information.

An updated medical abortion approval was signed in December 2024, allowing women to take abortion medication in residential or temporary accommodation if clinically appropriate, particularly benefitting patients who may live significant distances from hospitals or clinics.

The Scottish Government is working with Health Boards and Public Health Scotland to monitor access to services, including analysis of annual statistics. As part of the commitment to ensure services are accessible to all, officials regularly discuss barriers to these reproductive health services with Health Boards, including NHS Grampian, to inform possible improvements to services for patients in rural locations.

The Scottish Government recognise that people in rural areas can experience particular challenges in relation to their mental health and wellbeing.

Decisions around the provision of mental health services is a local responsibility, planned by Integrated Joint Boards and delivered through a mixture of NHS, local authority and third sector organisations. Mental Health services will vary depending the local population needs and will be guided by clinical decision making.

While we expect service decisions to be taken locally, we have invested £66 million in our Communities Mental Health and Wellbeing Fund for adults since 2021. The Fund has a strong focus on prevention and early intervention and prioritises a range of ‘at risk’ groups including those people disadvantaged by geographical location (particularly remote and rural areas) with over 900 awards being made to community projects supporting people disadvantaged by geographical location (including rural areas) since its inception.

Initial diagnosis of visual impairments largely takes place in community optometry practices following patient presentation to the service. We are not aware of access concerns to the service at this time.

There is currently no community provision for audiology in Scotland. Diagnosis is performed within secondary care settings and typically on referral from wider health networks and services. Consideration of audiology capacity – within existing NHS hospital services – is being taken forward in response to the findings of the Independent Review of Audiology. In addressing the Review’s recommendations, audiology has been designated a clinical priority area, with improvement work being progressed through the National Planning and Delivery Board arrangements, led by the Chief Operating Officer – NHS Scotland.

The Scottish Government is committed to supporting and enabling people to be more physically active. Mean sedentary time at work is monitored through data gathered from the annual Scottish Health Survey. The Scottish Government work closely with Public Health Scotland, The Physical Activity for Health Research Centre (PAHRC), and other experts to understand the latest research on the negative health impacts of sedentary behaviour.

It is important to make sure that the start date of the annual flu programme reflects the expected peak of flu circulating to ensure maximum vaccine efficacy.

The 2024 Winter Flu and Covid programme (FVCV) launched on 9 September with the child flu programme. This was the earliest the programme in Scotland could start the child programme, due to vaccine supply deliveries.

Vaccination of adult flu groups began on 16 September, with the main flu and COVID-19 co-administration launching on 23 September. As per previous winter programme, Boards used the first two weeks of the main programme to focus on our most vulnerable citizens, notably residents in care homes for older adults and the housebound. Community appointments then began on 7 October.

These launch dates were based on two factors;

1.Advice from the Joint Committee on Vaccination & Immunisation (JCVI): The JCVI advice noted that Health Departments should ideally aim to vaccinate their adult flu population in October and November, in order to vaccinate the eligible population prior to the beginning of the flu season, and to minimise the impact of vaccine waning.

2.Availability of COVID-19 vaccine supply: The vast majority of COVID-19 and flu vaccines are co-administered (currently 95.2% as of 26 January), for maximum convenience for people who are eligible for both. As such we had to wait for COVID-19 vaccine supplies to be available in Scotland to start that main phase of the programme, and 23 September was the earliest possible date.

During planning for its winter programmes, the Scottish Vaccination & Immunisation Programme (SVIP) takes multiple, complex factors into account when arriving at programme dates. These include JCVI advice on programme timings and cohort eligibility, the risk of emerging new COVID-19 variants, flu and COVID-19 vaccine supply availability and clinic capacity within the system.

These factors change annually, meaning that programme start dates will shift and therefore a direct comparison is difficult.

Responsibility for fire safety and monitoring at Battery Energy Storage Systems (BESS) sites rests with the duty holder/site owner. Many BESS locations are unmanned and monitored remotely, meaning there is typically no immediate life risk. Some BESS sites may have welfare facilities for workers during short, irregular shifts (outside of construction or decommissioning phases), and certain buildings on these sites may fall under the Fire (Scotland) Act 2005 in terms of general fire safety. However, these sites are normally not subject to fire risk regulations due to the processes taking place on site.

SFRS adheres to the National Fire Chiefs Council’s guidance for Battery Energy Storage Systems (BESS), developed with the safety of both the public and emergency responders in mind.

A dedicated working group within SFRS will continue to monitor the increasing number of BESS applications and their development, alongside the Service’s role in the planning, consultation, and progression of these sites.

SFRS’ protection efforts focus on four key areas:

• The impact of life safety in the event of a fire.
• A risk-based approach to safety.
• Emerging intelligence, including operational insights and partner communications.
• Post-fire audits and analysis.

A strong focus on prevention and the adherence to industry safety standards is essential for managing risks. The SFRS specialist fire safety enforcement and community safety teams will continue to collaborate with partner agencies, and their highly skilled firefighters are ready to deploy standard and specialised national resources to any incident as needed.

The phasing of the permitted development rights (PDR) work programme has been kept under review to ensure that it reflects – and helps to promote – the Scottish Government's strategic priorities. As a priority, Phase 3 of the review focussed on PDR for domestic and non-domestic renewable energy equipment. The amended scope of Phase 3 reflected the cost and climate crises, and the need to ensure the planning system plays its part in helping to support households and businesses to adapt their properties.

We still expect to revisit the PDR related to private ways / hilltracks at a future point. This is a complex issue of interest to a wide range of stakeholders with differing perspectives, and requires very careful and detailed consideration.