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The Scottish Government is working with stakeholders on the review and development of various guidance to inform pain management services.

As outlined in the updated chronic pain implementation plan, the national clinical guidelines for Scotland (SIGN 136), and polypharmacy guidelines are currently being updated.

We are also working with Healthcare Improvement Scotland to deliver a national approach to specialist interventions for chronic pain and to consider the creation of national standards for chronic pain management.

The Scottish Government believes it is important to work with a wide range of clinical, lived experience and third sector representatives in developing chronic pain policies. This includes the Faculty for Pain Management (FPM) Our clinical lead for chronic pain policy has recently joined its committee and we sought input from the FPM in our stakeholder engagement in the summer of 2023.

The Scottish Government last had specific discussions with the FPM in 2020 to understand if there were any safety concerns around receiving chronic pain interventions, including steroid injections, and an individual’s immune response to COVID-19.

As part of the updated chronic pain implementation plan, we are working with Healthcare Improvement Scotland to deliver a national approach to specialist interventions, which may cover steroid injections, for chronic pain. This process will review effectiveness, safety, cost effectiveness, and incorporate the views of patients and clinicians.

As part of the reception process into prison, everyone has a consultation with an NHS healthcare professional within 24 hours of arrival, using a nationally agreed admission process.

Public Health Scotland (PHS) is currently in the process of updating its guidance on opt-out testing for blood-borne virus (BBV) in prisons with the intent to publish a revised document in the coming months. This updated guidance will recommend routine opt-out testing for new admissions and check and test for transfers between establishments. PHS is taking a cross-programme approach to opt out testing for BBV in prisons, and other justice settings, and works with Alcohol & Drug Partnerships, prisons, police custody and the national justice networks to ensure a coordinated approach.

In addition the Medication Assisted Treatment (MAT) standards include a requirement for opt-out testing in justice settings (including prisons) and PHS will gather intelligence on local policies and pathways for opt-out testing in prisons as part of an improvement approach to help implement the standards. The MAT programme will also publish a toolkit for the implementation of the MAT standards in justice settings and this will complement the BBV opt-out testing guidance.

In 2019, Scotland committed to the ambitious goal of eliminating HCV as a public health concern five years ahead of the World Health Organization’s global target of 2030. Since then, we’ve seen considerable progress with major achievements across multiple indicators. Unfortunately the COVID-19 pandemic slowed the rate of progress, however we continue to work with NHS Boards and other services to press towards our shared goal of HCV elimination.

Public Health Scotland’s annual HCV surveillance report is scheduled for release on 3 December 2024 and we are working with PHS to assess our position against the indicators. We will provide an update on progress towards our elimination goal in due course.

The Scottish Government has fully committed to ensuring that treatment services are available for all forms of substance use. The MAT standards are an essential part of the National Mission on Drugs, to save and improve lives.

The National Mission focuses on actions and initiatives to address the harms associated with drugs, but these can and do support people affected by all substances including alcohol. For example, through an increase in residential rehabilitation places; initiatives to tackle the stigma directed by people affected by substance use; and an increased understanding of the co-occurring nature of problem substance use and mental health issues.

A National Specification for treatment and recovery services is also currently in development, which aims to provide clarity on the range of substance use support services that should be available in local areas. The Specification will help local services set out future strategic plans to deliver on their commitment to reduce alcohol and drug harms and deaths, improving the lives of those impacted by alcohol and drugs.

In addition, the Scottish Government is supporting the UK Government on reviewing and updating the UK clinical guidelines for alcohol treatment: consultation document - GOV.UK (www.gov.uk) to introduce new approaches to treatment that will apply to a broad range of settings including primary care, hospital and justice settings.

The See Hear Strategy is supported by Scottish Government See Hear funding of £320,000 yearly, shared across each local authority area and based on population size, to deliver local implementation of the Strategy. This is in addition to Section 10 grant awards made in 2024-25 and totalling £102,475 to support sensory loss projects that meet recommendations in the Strategy.

Future funding of the Strategy will be subject to the outcome of the Scottish Budget which is due to take place on 4 December.

I also refer the member to the answer to question S6W-22870 on 22 November 2023 which details the amount of funding used to support the Strategy since its publication in 2014. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at /chamber-and-committees/written-questions-and-answers.

The current See Hear Strategy which was published in 2014 still exists to support children and adults who have deafness, sight loss and dual sensory loss to access the support and social care they need.

See Hear Leads, within local authorities, are in place to help drive progress across priority areas within each local partnership.

Since March 2023 policy officials have been engaged in extensive discussions with stakeholders, delivery partners and people with lived experience to hear what has been working well and any challenges people with Sensory Loss were facing in living a good life. Discussions are taking place across Scottish Government to identify other areas of policy work which can help resolve some of those challenges. The publication date of the refreshed strategy will be announced in due course.

The Scottish Government is committed to support Health and Social Care Partnerships and their local services deliver on our National Mission to save and improve lives affected by problem drug use. This includes the implementation of harm reduction initiatives including needle and syringe programmes and improved access to opioid substitution therapy (OST).

Our broad principle is that if providing safe equipment to a person is likely to reduce the risk of harm to themselves or others, there should be no question of that provision. We continue to provide direction and funding to local areas to implement the Medication-Assisted Treatment (MAT) standards, and Standard 4 in particular states that everyone at risk, including those who inject drugs, should be able to access a wide range of harm reduction services – for example, needles and syringes, injecting risk assessments, wound care and naloxone.

Services across Scotland have developed flexible and targeted approaches to supplying Injecting Equipment Provision (IEP) by introducing more mobile and more flexible approaches (such as IEP vans) that actively go out to areas where they know people will use them.

The Medication Assisted Treatment (MAT) Standards, published on 31 May 2021 aim to improve access, choice and support to OST and to a range of linked support such as primary care, mental health treatment and advocacy for other services. Public Health Scotland reports annually on how local areas are achieving this. Its Benchmarking Reports are published each June and these include details of how access to OST and access to drug harm reduction measures are improving in local areas.

As with Health Services across Scotland and the rest of the UK, NHS Ayrshire & Arran are experiencing sustained pressure on their Urgent Care Services with some patients waiting longer than we would wish. I recognize that NHS Ayrshire & Arran’s A&E performance in June was below the level I and the Board expect. It is important to note that fluctuation in performance figures is not unusual. Monthly figures for July show that Ayrshire & Arran’s performance increased by more than five percentage points and was the Board’s highest monthly performance this year.

Through our Urgent and Unscheduled Care Collaborative Programme we continue to support NHS Boards, including NHS Ayrshire & Arran, to improve patient flow through acute sites and reduce A&E delays. Key actions include: strengthening arrangements to avoid unnecessary hospital admissions such as Same Day Emergency Care services; optimising Flow Navigation Centres; enhancing the discharge process - focusing on discharge planning; and reducing length of stay.

The design of road infrastructure is influenced by the loading from heavy goods vehicles and the legislation for the weights and dimensions of these vehicles is reserved to the UK Government. Regular engagement on potential changes to vehicle weights and dimensions is held between officials in Transport Scotland, and the Department for Transport. It is known that increasing axle weights causes increased wear and tear on carriageways and could result in the requirement to re-assess the load carrying capacity of bridges.