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The Scottish Government recognises that primary and community care services should be developed to meet the needs of distinct localities, including those in our rural areas and islands. We have a range of levers to support rural and island areas, including Scotgem, golden hellos, rediscover the joy , a GP sustainability project, and our current work with NES to deliver GP fellowships and rural credentials. We also established the National Centre for Remote and Rural Health and Care to support health boards, HSCPS and individuals to improve capability in rural and island areas.

The Scottish Government estimates that the Employer National Insurance Contribution increase might cost between £520 and £580 million for directly employed public sector employees and a further £210 million for contracted out services and the third sector. For NHS contractors, including GPs, we estimate costs of £40 million.

If the chancellor does not fund that in full, it could be, that at best £380 million would be forthcoming; leaving a significant shortfall. We continue to press for clarification.

I refer the member to the answer to question S6W-30034 on 3 October 2024. 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

This data is not routinely collected however, the Report “Dismissed, ignored and belittled - The long road to endometriosis diagnosis in the UK” published by Endometriosis UK in March 2024 states that a survey of 4,371 people who have received a diagnosis of endometriosis shows ...52% had visited A&E at least once. 26% of respondents visited A&E 3 or more times with symptoms prior to diagnosis.

Our ambition is for a Scotland where health outcomes are equitable across the population so that all women enjoy the best possible health – throughout their lives. That is why endometriosis is one of the key priorities in the Women’s Health Plan and will continue to be so.

Information about the progress to date against each of the priorities in the Women’s Health Plan can be found in the Women’s Health Plan Final Report.

Through the NHS Inform Women’s Health Platform, we have made information on a range of health topics, including endometriosis, available to women online and in one place. Reciprocal connections have been made throughout the platform with other Scottish Government sites such as Parent Club and with third sector organisations including Endometriosis UK and Endo SOS helping to raise awareness of the condition and supporting women to access the information they need when they need it.

In March 2023 we delivered an engagement campaign in partnership with Young Scot to increase young people’s awareness of endometriosis. The campaign primarily targeted those aged 11 to 25 in Scotland and provided information on how to support a young person in the process of diagnosis or who may have endometriosis.

The Health and Social Care Alliance Scotland (the ALLIANCE) has continued to support the Women’s Health Plan through their dedicated lived experience programme. This has included the development of the conversation café toolkit to encourage information sharing and peer support on women’s health including menstrual health and endometriosis.

The Health and Social Care Alliance Scotland (the ALLIANCE) has continued to support the Women’s Health Plan through their dedicated lived experience programme, including a Women’s Health Lived Experience Stakeholder Group, to help us continue our conversation with women, and ensure women are meaningfully involved in decision making and priority setting going forward.

More information can be found in the ALLIANCE Final Report on Women’s Health Plan.

In March 2023 we delivered an engagement campaign in partnership with Young Scot to increase young people’s awareness of endometriosis. The campaign is aimed at those aged 11 to 25 in Scotland. The campaign includes information about endometriosis symptoms, provides information about available support and provides information on how to support a young person in the process of diagnosis or who may have endometriosis.

The figures below relate to Endometriosis research funding directly awarded following a competitive independent review process either through Chief Scientist Office’s (CSO) project funding committees, or fellowship funding panels.

This includes the 2022 Scottish Government collaboration with Wellbeing of Women on a £250,000 research call. The research is primarily being run by researchers at The University of Edinburgh and will look at a non-hormonal drug in the management of endometriosis-associated pain.

Most awards are multi-year. The figures below relate to the year in which the funding was committed rather than a breakdown by year of the spend profile for individual projects or fellowships

2007 0

2008 0

2009 0

2010 0

2011 0

2012 £110,198

2013 0

2014 0

2015 £27,639

2016 0

2017 0

2018 £162,651

2019 £30,000

2020 0

2021 0

2022 £394,510

2023 £349,999

2024 £623,028

Full details of CSO’s direct research funding awards are available from the CSO website Funded Research – Chief Scientist Office

We are committed to ensuring those living with endometriosis are able to access the best possible care and support and that they benefit from healthcare services that are safe, effective and put people at the centre of their care.

Through the delivery of the Women’s Health Plan we have worked to ensure that women have access to comprehensive information on endometriosis – including options for treatment.

We have; launched a Women’s Health Platform on NHS Inform which includes an endometriosis page with consistent, reliable and accessible information, including a short lived experience film, empowering women to make informed decisions about their health; worked with organisations such as the Health and Social Care Alliance Scotland, Young Scot and Endometriosis UK to raise awareness about the condition and deliver accurate and supportive information to the public; funded Endometriosis UK to produce a booklet and two webinars on treatments and self-management tips for managing endometriosis pain.

More information can be found in the Women’s Health Plan Final Report.

The number of full-time equivalent civil servants is broken down by policy area and condition as follows:

All health professionals should consider the mental health and wellbeing needs of their patient as part of their care and a support.

The Endometriosis Care Pathway for NHS Scotland aims to support healthcare professionals to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms. This includes advising practitioners to assess women’s individual support needs, taking into account their symptoms, priorities, desire for fertility, aspects of daily living, work and study, cultural background, and their physical, psychosexual and emotional needs.

Through the NHS Inform Women’s Health Platform, we have made a range of information on endometriosis available to women online.

This includes signposting to peer support groups and organisations such as Endometriosis UK who operate a free, confidential helpline run by trained volunteers who have a personal experience of endometriosis.

The platform also hosts a range of content on mental health with several self-help guides to help people manage their mental wellbeing including a menstrual health and mental wellbeing self help guide and another to support those living with chronic pain. There is also signposting to national helplines including 111, Breathing Space and The Samaritans for anyone who is struggling and needs someone to talk to.

We are committed to ensuring those living with endometriosis are able to access the best possible care and support and that they benefit from healthcare services that are safe, effective and put people at the centre of their care.