³ÉÈË¿ìÊÖ

Any decision to introduce changes to a national screening programme in Scotland is guided by the recommendations of the UK National Screening Committee (UK NSC), an independent expert advisory group which advises all four UK nations on screening policy. The UK National Screening Committee is expected to make a recommendation on the use of cervical self-sampling in the screening programme later this year.

The Scottish Government recognises the potential of cervical self-sampling to improve uptake of cervical screening. In Scotland, a working group has been established to consider potential models to understand any changes that would be required to the screening programme to support an initial roll-out. This work will be influenced by the on-going work of the UK NSC and emerging global research.

We have established a £10 million long COVID Support Fund, which aims to support NHS Boards to increase the capacity of existing services providing support to people with long COVID, develop these into more clearly defined pathways and to provide a more co-ordinated experience for those accessing support.

We have also commissioned NHS National Services Scotland to establish a National Strategic Network for long COVID. This brings together representatives from NHS Boards across Scotland to provide a forum for the exchange of learning and best practice in delivering supporting and services for people with long COVID.

In May 2023 we published an analysis of survey responses from NHS Scotland Boards on their arrangements for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) care. This is accessible at . The report highlights examples noted by NHS Boards of where practice developments relating to ME/CFS and long COVID respectively may have mutually supportive benefits for patient care, and the management of other long term conditions which share common symptoms.

The resource for Mental Health and Wellbeing in Primary Care Services was published in June 2022. The resource was developed to support staff working as part of a multi disciplinary team within GP settings. The resource provides a directory of additional sources of help, which patients can access, to complement the support, assessment and treatment they receive from the team. It brings together a range of national resources and tools that support and improve mental health and wellbeing. Section 7 of the resource contains links to sources of support specifically for Perinatal and Parent Support. The resource was promoted via the Mental Health in Primary Care National Oversight Group, Mental Health in Primary Care Leads and NHS Board Mental Health Leads.

The Scottish Government recognises the document is not exhaustive and there will be a number of local resources and tools that staff will also want to use. The resource can be found at the following link the link for the resource .

In addition to this wider work, there is also a resource dedicated to promoting third sector perinatal and infant mental health services. This resource is available to provide information to families and professionals, including in primary care, to raise awareness of over 110 local third sector services. In the last year the resource page has received 2,693 views. Inspiring Scotland have been promoting the tool on X and in their recent newsletter which reaches NHS staff as well as wider partners. The resource can be found here: .

The Scottish Government have regular and consistent engagement with representatives of the care sector.

Recent engagement has explored resilience, viability, surge pressures, fair work, Healthcare Framework for Adults Living in Care Homes, workforce challenges and support, including NCS design and Workforce Charter.

The Scottish Government has worked with NHS Education for Scotland (NES) to develop ‘Perinatal mental health curricular framework : a framework for maternal and infant mental health’. This framework sets out the different levels of knowledge and skills required by members of the Scottish workforce who have contact with mothers and their babies, to enable them to support mothers, babies and their families to have positive well-being and good mental health during the perinatal period.

The Scottish Government has also worked with NES to advance training on Perinatal and Infant Mental Health. Training in evidence-based approaches and interventions is delivered to staff across sectors and across practice types including informed, skilled, enhanced and specialist, as appropriate to their role.

This includes education and training within Perinatal and Infant Mental Health through e-learning modules which are available on TURAS, covering seven topic areas of essential knowledge. We have also worked with NES to create a specialist Perinatal and Infant Mental Health Learning Programme which allows NES to track the progress of staff in Specialist Perinatal and Infant Mental Health Services including Mother and Baby Units, Community Perinatal Mental Health Teams and Maternity and Neonatal Psychological Interventions.

During 2024-25, NES will continue to promote training at all levels across the sectors that support the development of positive relationships and attachment in the early years. This will be achieved through increasing workforce capacity to deliver evidence-based parent-child relationships focused interventions and approaches from the antenatal period, through infancy and across childhood.

The Perinatal and Infant Mental Health Managed Clinical Network Scotland (PIMHNS) has developed a workstream ‘Parents as Patients’ to develop guidance around joined-up working (i) between perinatal/infant mental health services and other mental health services (e.g. general adult mental health, unscheduled care, liaison mental health), and (ii) between perinatal/infant mental health services and other relevant medical care services (particularly primary care and acute hospital care). The important role of the third sector will feature in both. Initial meetings of two Short Life Working Groups (SLWG) have taken place to progress these workstreams, along with amending the existing care pathways which were published in 2021 ( ) .

Both SLWGs will focus on the themes of:

• Interfaces – to cover both care between specialist and general or universal services. This would also include principles of joint working and good practice.
• Education and training – to address knowledge of parent infant relationships and infant mental health needs as well as child protection issues and risks in relation to childbearing.

The final guidance and updated care pathways are due to be published in the final quarter of the financial year.

The Scottish Government recognises that social prescribing can be an effective method of improving an individual’s physical, mental and social health. It plays an important role in helping us achieve our commitment to prevention, holistic care and Realistic Medicine. Our Primary Care Community Link Worker programme has been in place since 2014 and a 2017 commitment to create 250 Community Link Worker posts in general practice has been achieved.

Due to the wide range of activity which is described as social prescribing, there are many Scottish Government policies and resources which play a role in supporting its delivery. For example, we recognise the important role played by local organisations in supporting the health and wellbeing of their communities and we are working with the community and voluntary sector to look at how we can enhance the capacity of the sector to help those organisations address the challenges they face. The ongoing development by the ALLIANCE of the ALISS online database helps to provide information on community resources and our Green Health Partnership programme led by NatureScot helps to promote the connection between health and the natural environment.

We recognise that there may be a need for more national guidance to support Community Link Workers. We are currently considering how to take that forward in relation to the Community Link Worker programme in Primary Care. While this work will focus on Link Workers in Primary Care, we hope that there will be wider learning that may be able to be shared with the wider social prescribing community.

The Scottish Government remains committed to keeping the NHS true to its founding principles – publicly-owned, publicly-operated, and free at the point of need.

Health Boards might arrange treatment for some patients outwith NHSScotland for clinical reasons in exceptional circumstances. In all patient cases, the originating Health Board retains responsibility for the funding, consultation, diagnosis and treatment of their patients.

Guidance on establishing the responsible commissioner has been issued to NHS Boards from the Scottish Government to ensure services are always provided in the best interests of the patient: .

Healthcare Improvement Scotland (HIS) is the national authority for the development of evidence-based advice, guidance and standards for health and care professionals. All Independent Healthcare Service providers, are required to register with HIS who regulate such services in Scotland. It is a matter for HIS to detail specific guidance available, however more information is set out on their website: .

The Scottish Government is: rolling out a new Community Glaucoma Service, which supports eligible patients with lower risk glaucoma and treated ocular hypertension to be discharged from hospital and registered with accredited community optometrists; and delivering UK-leading changes to the undergraduate optometry degree model, which will enable students to graduate as Independent Prescriber optometrists.

In relation to at-home diagnostic and treatment services, community optometry practices that provide NHS eye examinations to eligible patients in a domiciliary setting receive a General Ophthalmic Services eye examination fee as well as an additional visiting fee.

The Primary Care Multi-Disciplinary team may include local physiotherapy services, community mental health services and community links worker services. These services can often be seen safely and effectively without a prior GP referral.

Through our Phased Investment Programme, which will strengthen the evidence base on the national context for implementation of primary care multidisciplinary teams, we will consider any existing barriers to effective multidisciplinary team working, including any barriers regarding patient pathways to services.