The Endometriosis Advisory Group (EAG) was established to support the action in the Women’s Health Plan to strengthen collaborative working between regional specialist endometriosis centres, territorial and special NHS boards and primary care providers, to drive improvement in patient pathways and achieve equitable access to care and treatment.

The EAG first met in April 2022 and have since been involved in communications on an ad hoc basis to assist in the understanding of the systems currently in place for endometriosis, from education to current practice and pathways.

As per previous years, in order to lessen the burden on NHS teams over the winter period from November 2022 to the end of February 2023 we commenced a light touch process to help monitor and prioritise communications. After this period of time we will reinstate communication and meetings with the EAG.

The EAG offer their expert advice and knowledge to help inform and guide policy processes and as such there is no formal findings or report which the EAG has produced.

We are jointly funding a £250,000 endometriosis research project with Wellbeing of Women and the recipient of the grant will be announced in March. The funding for the research will cover a period of 3 years, from financial year 2022/23, after which the findings will be published.

Additionally, in January 2023 our Chief Scientist Office announced funding for the ENDOCAN project, led by researchers at the University of Edinburgh, that will investigate whether a large scale, UK-wide trial to determine whether a cannabinoid can reduce endometriosis-associated pain. Funding of £299,509 has been committed to this 30 month project.

Currently 1 building on the core Scottish Government estate has a heat pump installed (Tweedbank)

Feasibility studied will be carried out in the first quarter of 2023/24 financial year to look at a range of renewable technologies for the estate, including air source heat pumps.

Timescale for installing air source heat pumps to suitable buildings:-

• 2023-24 – (1st quarter) - Feasibility studies will be carried out with business cases and funding applications submitted for suitable projects.
• 2023-24 – (2nd quarter) - Apply, design and install power cable upgrades if required or – if the incoming power needs to be increased from the supplier.
• 2023-24 – (3rd/4th quarter quarter) - Design, tender, appoint a contractor, planning permissions
• 2024-25 – Installation of ASHP, radiators, pipework.

Vapes and e-cigarettes are subject to the provisions of the Waste Electrical and Electronic Equipment Regulations 2013 (the WEEE regulations). As such, anybody who sells a vape or e-cigarette to a consumer has obligations including to accept the return of WEEE from private households subject to certain conditions.

Guidance for retailers subject to these obligations, including on how to join a scheme which will discharge this obligation on a retailer’s behalf, is available here: https://www.gov.uk/electricalwaste-producer-supplier-responsibilities

I have commissioned an urgent review of the environmental impacts and management of single-use vapes. Zero Waste Scotland will lead on the review, which will examine available evidence and consider potential options to tackle the issue.

The review will consider of a range of approaches and implementation considerations, including the role of local authorities and others in helping to ensure responsible recycling and disposal, as well as enforcement issues.

We will consider the evidence and expert advice and bring forward policy options in due course.

Since August 2021 the Scottish Government has funded 1140 hours of high-quality early learning and childcare (ELC) for all eligible children. Scotland is the only part of the UK to offer 1140 hours a year of funded ELC to all three- and four-year-olds - and eligible two-year-olds regardless of whether their parents are in work or not, putting children first. If families paid for this offer themselves, it would cost them around £5,000 per eligible child per year.

Drug Treatment and Testing Orders (DTTOs) are focused on drug treatment as the primary means of reducing offending behaviour, by reducing or eliminating drug dependency. DTTOs allow drug testing and regular court reviews as features of a community disposal, and their effective delivery involves ongoing medical and other support services.

Where DTTOs are available, their supervision is a matter for local authorities, working in collaboration with relevant health services to ensure that support and treatment is provided, and arrangements vary by local area. The Scottish Government therefore does not hold the information requested.

However, in response to the Drug Deaths Taskforce Report and as noted in the cross government action plan published on 12 January, the Scottish Government will carry out a review of DTTOs, community payback orders and other community sentencing options to assess how they have been used, their outcomes and whether they are the most effective mechanism to support an individual’s recovery and reduce recidivism rates. The aim is to report in spring 2023.

Throughout the 1140 hours expansion the Scottish Government has sought to improve conditions across the private, third and childminding workforce delivering funded Early Learning and Childcare (ELC). This includes our investment to support local authorities to set sustainable rates at a level that enables payment of the real Living Wage to those workers delivering funded ELC. Payment of the real Living Wage is a key measure in tackling in work poverty, and Scotland is the only part of the UK to apply this to the ELC sector.

Overview of Local Authority Funding and Support for Early Learning and Childcare Providers: 2022-23 , highlights that average rates paid to providers in the private and third sector to deliver funded ELC to 3-5 year olds have increased by 57% between 2017 and 2022, from £3.68 per hour in 2017-18 to £5.77 per hour in 2022-23.

The investment for the payment of sustainable rates has supported real progress in pay. For example, in 2016, before the ELC expansion to 1140 hours, the Financial Review of Early Learning and Childcare in Scotland estimated that approximately 80% of practitioners delivering funded ELC in private and third sector providers were paid less than the real Living Wage.

The Financial Sustainability Health Check , published in August 2021, reported that 88% of private and third sector providers delivering funded ELC intended to pay the real Living Wage to all of their staff from August 2021.

However, public funding and Scottish Government policy can only effect a certain amount of change in pay. The childcare market is a mixed economy - the August 2021 Financial Sustainability Health Check reported that funding for the delivery of funded ELC accounted for, on average, around 33%-45% of overall income for private childcare services – and employers in the private and third sectors are responsible for making their own decisions about pay and conditions.

We are working with partners and sector representatives, including through our Real Living Wage and Fair Work Implementation Group, to understand any barriers to paying the real Living Wage and to ensuring all childcare staff perform their essential work under terms and conditions which meet Fair Work criteria.

The Women’s Health Plan focusses on a specific set of priorities including enhancing care and support for those with endometriosis. Whilst chronic urinary tract infections (UTIs) are not specifically mentioned in the priorities for this iteration of the Plan, we recognise that many women are significantly affected by the condition.

In addition, we have commissioned the Health and Social Care Alliance to take forward a programme of work on lived experience in order to put the voices of women at the heart of the Plan.

We recognise that research is essential if we are to increase our understanding of endometriosis and develop new and effective approaches to the prevention, diagnosis, treatment and management of this debilitating condition. That is why we are jointly funding a £250,000 research project with Wellbeing of Women, which aims to develop improvements into treatment and management options for the condition.

We will raise awareness and support the implementation of the new Endometriosis Referral Pathway for NHS Scotland developed by the Modernising Patient Pathways Programme. The Pathway aims to ensure those with endometriosis receive individualised treatment in relation to their symptoms by improving earlier intervention and support within primary care, streamline referrals to secondary and tertiary care where required.

Our Endoscopy and Urology Diagnostic Recovery and Renewal Plan, backed by £70m investment, was published on 30 November 2021 and focusses on key areas such as Balancing Demand and Capacity; Workforce Training and Development; and Infrastructure Innovation and Redesign. This will be achieved through the implementation of key actions that are focused on reducing the waiting times back to the 6-week target during the life time of this Parliament.

In addition, in July last year, we introduced ambitious targets for NHS Scotland to address the backlog of planned care, undoubtedly exacerbated by the pandemic. We are working intensively with NHS Boards to maximise capacity and to clear remaining waits as soon as possible, with a specific focus on specialities and areas where there are larger amounts of people waiting, including Urology.