Questions and answers

Question reference: S6W-20792

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Submitting member has a registered interest.
Date lodged: Wednesday, 23 August 2023
Current Status: Answered by Jenni Minto on 19 September 2023

To ask the Scottish Government, in light of the reported announcement by the UK Government in June 2023 of funding for the national roll-out of a targeted lung cancer screening programme across England, what plans it has in place for the roll-out of a national lung cancer screening programme in Scotland.

The Scottish Government has welcomed the recommendation of the UK National Screening Committee (NSC) that the UK nations should move towards implementing a programme of lung screening for those between 55-74 with a history of smoking. However, careful consideration and planning is required given the complexities of rolling out such a programme – the complexities of implementation were acknowledged by the NSC and resulted in the establishment of a four nations expert Lung Task Group.

The Scottish Government has now established a Scottish Expert Advisory Group (SEAG), which will assess the specific challenges and opportunities for a Scottish lung screening programme. The SEAG met for the first time in August, and represents an important first step in ensuring that a Scottish programme is developed with long term sustainability and effectiveness at its heart.

We have also provided funding for LungScot, the University of Edinburgh’s study into the feasibility of targeted lung health checks for high risk individuals. This work will support the considerations of the SEAG.

It is important to note that the complexity of the challenge means a national screening programme will take years rather than months to implement. However, lung cancer remains a national priority, which is why we have a dedicated chapter in our £114.5m National Cancer Plan, and last December we redesigned lung cancer diagnostic services to help ensure patients receive faster access to treatment.

Question reference: S6O-02535

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 13 September 2023
Current Status: Taken in the Chamber on 20 September 2023

To ask the Scottish Government what its response is to reports of significant issues in transporting prisoners from custody to court.

Question reference: S6O-02501

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Submitting member has a registered interest.
Date lodged: Wednesday, 06 September 2023
Current Status: Taken in the Chamber on 13 September 2023

To ask the Scottish Government what its response is to reported plans by NHS Greater Glasgow and Clyde to reduce the number of community link workers embedded in GP practices in deprived areas of Glasgow by one third, due to Scottish Government funding cuts.

Question reference: S6O-02479

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 30 August 2023
Current Status: Taken in the Chamber on 7 September 2023

To ask the Scottish Government whether it has conducted any analysis of how many deaths on the A9 could have been prevented if it had been fully dualled.

Question reference: S6W-19336

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Submitting member has a registered interest.
Date lodged: Wednesday, 12 July 2023
Current Status: Answered by Maree Todd on 8 August 2023

To ask the Scottish Government, further to the letter from the Cabinet Secretary for NHS Recovery, Health and Social Care on 27 April 2023, whether the two recently made permanent psychologist posts, providing specialist support for teenagers and young adults in NHS Greater Glasgow and Clyde and NHS Grampian, have the remit of providing support for young cancer patients across the whole of Scotland, or whether they provide support only for young cancer patients within those NHS boards, and, if it is the case that the two posts provide support across the whole of Scotland, what the total number is of young people that have access to their support.

The Managed Service Network for Children and Young People with Cancer (MSN CYPC) works with local Health Boards to ensure specialist age-appropriate care is delivered to children and young people with cancer across Scotland.

This includes the delivery of a national Teenage and Young Adult (TYA) Multi-Disciplinary Team (MDT) weekly meeting, where all young people should be presented at least once to ensure a holistic and coordinated approach to their treatment and care. This meeting includes a discussion of psychosocial needs, and the TYA specialist Clinical Psychologists are core members of the MDT.

The Grampian service supports around 15 referrals per year. This includes some patients from other Health Boards. The Greater Glasgow & Clyde service reviews around 96 referrals per year. 42% of the outpatients in the 2020-22 service report resided outside of the NHS Greater Glasgow & Clyde Health Board area.

Question reference: S6W-19888

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Submitting member has a registered interest.
Date lodged: Tuesday, 11 July 2023
Current Status: Answered by Jenni Minto on 8 August 2023

To ask the Scottish Government whether it has assessed the impact of any lack of investment in tackling any staff shortages, in chronic pain services in secondary care, on GP practices and the number of GP referrals to secondary care.

The latest data published by Public Health Scotland (13 June 2023) suggests that referrals to a chronic pain clinic are now back to levels seen prior to the COVID-19 pandemic. During the quarter ending 31 March 2023, 5,049 patients were referred, an increase of 5.5% on the previous quarter, when 4,787 patients were referred. Referrals are up by 4.3% compared to a year earlier, when there were 4,839 during the quarter ending 31 March 2022. The number of direct encounters for GPs is typically between 1.5 million and 1.8 million per month, and analysis via statistical process chart demonstrates that there has been no change in activity outwith normal variation for the period of March 2021 to April 2023.

Through the ‘Framework for Pain Management Service Delivery – Implementation Plan’ we are promoting a more consistent approach to specialist services in each Health Board; we have invested in a new Pain Service Managers’ Network. This group is working through shared issues faced by specialist pain services such as resourcing and financial challenges and identifying opportunities to solve these through sharing of best practice and different ways of working. We have also established a national working group to make recommendations on how to reduce variation in the support that is provided in different local areas and improve how care for people with chronic pain is coordinated across community, primary and specialist services.

Additionally, we have carried out a review of the Scottish National Residential Pain Management Programme to help remobilise the service impacted during the pandemic, improve the quality of referrals from local Health Boards, and continue to explore how to widen access to highly specialist care from across Scotland. Funding for this service from the Scottish Government is over £600,000 this financial year 2023-24.

Question reference: S6W-19889

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Submitting member has a registered interest.
Date lodged: Tuesday, 11 July 2023
Current Status: Answered by Jenni Minto on 31 July 2023

To ask the Scottish Government for what reasons it has reportedly not allocated new money from its £19 billion health and care budget to NHS boards to treat the estimated 800,000 people in Scotland experiencing chronic pain.

Question reference: S6W-18477

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Submitting member has a registered interest.
Date lodged: Tuesday, 27 June 2023
Current Status: Answered by Jenni Minto on 27 July 2023

To ask the Scottish Government how much has been spent on (a) prescribed and (b) non-prescribed contraceptives in each year since 2018-19, broken down by (i) type of contraceptive and (ii) the number of contraceptives distributed.

The Prescribing Information System (PIS) holds information on medicines and devices dispensed in the community, and the Hospital Medicines Utilisation Database (HMUD) holds information on medication provided in secondary care settings. Contraceptives are accessed and supplied by a variety of routes and the extent to which these supplies are captured within PIS and HMUD varies by type of contraception. For example, oral contraceptives are largely prescribed by General Practice and dispensed by Community Pharmacies and so are well recorded within PIS, whereas Long-Acting Reversible Contraceptives (LARC) are more commonly provided through secondary care managed services such as Sexual Health Clinics and so are better represented within HMUD.

Over-the-counter non-prescribed contraception will not be included in either dataset; Public Health Scotland holds no data on this.

Costs are provided in table 1 below. However, a meaningful measure of the number of contraceptives issued across all drug groups is not possible. The length of cover provided by one product unit of contraception can vary from one day (e.g., one tablet) to up to ten years (e.g., one intrauterine device or IUD). Whilst measures of quantity are available within PIS and HMUD, these are for indicative purposes only and cannot be practically used to compare the amounts of different types of contraception distributed.

Table 1: Cost of contraceptives issued in PIS and HMUD from 2018/19 to 2022/23, by BNF paragraph

Year	BNF paragraph	Total cost
2018-19	7.3.1.0. Combined hormonal contraceptives	£2,481,077.97
	7.3.1.1. Combined hormonal systems	£76,961.55
	7.3.2.1. Oral progestogen-only contraceptives	£1,655,742.83
	7.3.2.2. Parenteral progestogen-only contraceptives	£3,801,664.99
	7.3.2.3. Intra-uterine progestogen-only device	£2,911,778.68
	7.3.3.0. Spermicidal contraceptives	£3,827.63
	7.3.5.0. Emergency contraception	£729,734.84
	21.4.0.0. Contraceptive devices	£40,162.22
2019-20	7.3.1.0. Combined hormonal contraceptives	£2,447,912.45
	7.3.1.1. Combined hormonal systems	£81,772.99
	7.3.2.1. Oral progestogen-only contraceptives	£1,751,465.69
	7.3.2.2. Parenteral progestogen-only contraceptives	£3,739,842.34
	7.3.2.3. Intra-uterine progestogen-only device	£2,980,340.96
	7.3.3.0. Spermicidal contraceptives	£2,799.65
	7.3.5.0. Emergency contraception	£887,595.65
	21.4.0.0. Contraceptive devices	£40,793.78
2020-21	7.3.1.0. Combined hormonal contraceptives	£2,062,640.35
	7.3.1.1. Combined hormonal systems	£71,294.88
	7.3.2.1. Oral progestogen-only contraceptives	£1,814,380.10
	7.3.2.2. Parenteral progestogen-only contraceptives	£2,596,546.10
	7.3.2.3. Intra-uterine progestogen-only device	£1,736,105.38
	7.3.3.0. Spermicidal contraceptives	£1,974.72
	7.3.5.0. Emergency contraception	£689,367.85
	21.4.0.0. Contraceptive devices	£19,629.36
2021-22	7.3.1.0. Combined hormonal contraceptives	£2,054,375.79
	7.3.1.1. Combined hormonal systems	£69,083.39
	7.3.2.1. Oral progestogen-only contraceptives	£1,805,823.06
	7.3.2.2. Parenteral progestogen-only contraceptives	£3,365,352.67
	7.3.2.3. Intra-uterine progestogen-only device	£2,856,637.26
	7.3.3.0. Spermicidal contraceptives	£2,293.69
	7.3.5.0. Emergency contraception	£963,038.59
	21.4.0.0. Contraceptive devices	£33,840.25
2022-23	7.3.1.0. Combined hormonal contraceptives	£2,013,008.31
	7.3.1.1. Combined hormonal systems	£66,692.32
	7.3.2.1. Oral progestogen-only contraceptives	£1,901,855.47
	7.3.2.2. Parenteral progestogen-only contraceptives	£3,469,198.81
	7.3.2.3. Intra-uterine progestogen-only device	£3,082,500.15
	7.3.3.0. Spermicidal contraceptives	£2,231.46
	7.3.5.0. Emergency contraception	£1,056,156.66
	21.4.0.0. Contraceptive devices	£30,427.78

Source: Public Health Scotland, PIS, HMUD

Reference: IR2023-00531

Notes:

For PIS:

1. Includes items prescribed and/or dispensed in Scotland

2. Excludes items prescribed and/or dispensed in England

3. Includes all prescriber types

4. Includes dispenser types: dispensing doctors, appliance suppliers, community pharmacists

5. Includes items dispensed by locations contracted to dispense NHS prescriptions i.e. excludes items dispensed by private dispensers.

6. Excludes private prescriptions

7. Costs are based on Gross Ingredient Cost (GIC), excluding broken bulk

8. Information on items prescribed but not dispensed is not currently held by PHS, Prescribed Items are based on items which have been prescribed, dispensed and subsequently submitted for payment.

9. Data is based on BNF Hierarchy and not clinical usage.

For HMUD

10. Includes all transaction from pharmacy stock control systems to clinical areas

11. Excludes internal stock transfers from one store location to another

12. Costs are based on the transaction costs recorded by the pharmacy stock control system.

Question reference: S6W-18483

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 27 June 2023
Current Status: Answered by Natalie Don on 25 July 2023

To ask the Scottish Government (a) what the uptake has been of and (b) how much has been spent on its Milk and Healthy Snack Scheme in each financial year since 2021-22.

The Scottish Milk and Healthy Snack Scheme (SMHSS) expands and improves on the UK Nursery Milk Scheme, which it replaced in August 2021. It is the only Scheme in the UK offering children a healthy snack of fruit or vegetables, in addition to milk, promoting better health outcomes for children through a nutritious and varied diet. For those children who cannot drink cow’s, goat’s or sheep’s milk for medical, ethical or religious reasons, the SMHSS offers a specified non-dairy alternative.

Most recent data from local authority partners (April 2023) shows uptake of around 3,300 registered childcare settings and around 140,000 children. Spend on delivering the SMHSS amounted to £6.9 Million in financial year 2021-22 and £13.8 Million in financial year 2022-23.

Question reference: S6W-18480

Asked by: Sandesh Gulhane, MSP for Glasgow, Scottish Conservative and Unionist Party
Submitting member has a registered interest.
Date lodged: Tuesday, 27 June 2023
Current Status: Answered by Jenni Minto on 24 July 2023

To ask the Scottish Government how much funding has been allocated to (a) NHS Pharmacy First Scotland and (b) Community Pharmacy Scotland in each year since 2018-19.

All funding for services delivered by the community pharmacy network, including for Pharmacy First Scotland, is paid directly to independent community pharmacy contractors as part of the remuneration arrangements. No funding is paid directly to Community Pharmacy Scotland.

NHS Pharmacy First Scotland funding forms part of the overall remuneration package. These details are published annually on the SHOW website - SHOW - Scotlands Health On the Web - Publications

The remuneration Global Sum was set at the following in each year from 2018-19

2018-19 - £180.959 million

2019-20 - £183.559 million

2020-21 - £188.148 million

2021-22 - £197.977 million

2022-23 - £205.489 million

The NHS Pharmacy First Scotland service was launched in 2020-21. Funding allocated from the remuneration Global Sum for each year since was as follows:

2020-21 - £25.8 million

2021-22 - £27.5 million

2023-23 - £30.8 million

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