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A clinical refresh of the Scottish Referral Guidelines for Suspected Cancer has been completed with revised guidance published in January 2019. The Guidelines support primary care clinicians in ensuring those with symptoms suspicious of cancer are put on the right pathway at the right time, including possible skin cancers.

In December 2021, the Scottish Government published a refreshed Framework for Effective Cancer Management. This Framework provides NHS Cancer Teams with the tools to effectively manage USC patients from the point of referral to first treatment to improve patient experience and cancer waiting times. Tailored support will be provided to all NHS Boards to ensure the eight key elements are embedded, where relevant, across cancer pathways and specialties, including dermatology.

The Centre for Sustainable Delivery (CfSD) is working with a number of Health Boards to implement the Digital Dermatology app, which allows patients to interact with a clinician at a time convenient to them, without having to attend hospital. This will support dermatology teams in conducting more virtual appointments. CfSD also supports a Dermatology Pathways app and website which provides clinically validated pathway information to GPs and other health professionals for many of the most common skin conditions, with the aim of supporting access for patients who most need treatment in the most appropriate care setting. As part of this, CfSD is working with the British Association of Dermatologists to increase the number of pathways covered by this approach.

The Centre for Sustainable Delivery (CfSD) (and prior to this the Modernising Patient Pathways Programme within Scottish Government), have supported the rollout of the Digital Dermatology Appointment (DDA) system. This platform allows patients to interact with dermatologists by answering a series of questions and uploading images of their skin condition for the clinician to review. This system is used for both new and return patients. The system was offered for rollout to all Health Boards during COVID and to date is live in five Health Boards, with over 4000 patients having appointments this way.

In addition, the CfSD is actively promoting Active Clinical Referral Triage in Dermatology and encouraging the use of images to support this where this can be done safely. We are currently engaged in a piece of work to understand the use of images in referral pathways across all Scottish Health Boards and the output of this will support key work in 2022 to increase the use of images to support timely access to Dermatology care.

The NHS Centre for Integrative Care (CIC) is a facility that all NHS Boards across Scotland have the option of referring patients to for services not available locally.

The Scottish Government is providing £12.4 billion for frontline NHS boards, which is a £327 million (3.2%) increase. This is the first step to ensuring that frontline funding - which directly supports patient services - increases by at least £2.5 billion by 2026-27.

Over 50% of frontline spend will go towards community health services, delivering on our commitment to increase primary care funding by 25% over this Parliament, providing more care for people in a place and way that meets their needs.

The most recently published ten year percentage change tables show some upward incidence trends and downward mortality trends. This reflects improved survival.

We are committed to finding cancer early when the chance of survival and even cure is higher – this is reflected in our £44 million Detect Cancer Early (DCE) Programme. Melanoma was added to the Programme in 2016 following a robust options appraisal exercise (this included reviewing a wealth of data from incidence and survival to mortality and staging).

Since then, over £400,000 has been invested across NHS Scotland to support skin cancer CNS workforce, enhance image capturing and sharing, provision of equipment for GPs/ANPs i.e. dermoscopes and the development and delivery of lesion training programmes.

The information requested regarding whether the Health and Safety Executive (HSE) has invoked a Divisional Major Incident Response Plan, in relation to deaths due to hospital associated infection at the Queen Elizabeth University Hospital, is not centrally held by the Scottish Government.

Health and safety at work is a reserved matter. HSE has confirmed that the issues raised with them did not meet the criteria for a ‘Divisional Major Incident’ as outlined in their published response plans .

The information requested regarding whether the Health and Safety Executive (HSE) has carried out any investigation into deaths due to hospital-acquired infection at the Queen Elizabeth University Hospital is not centrally held by the Scottish Government.

Health and safety at work is a reserved matter. HSE has confirmed that their published policy is generally not to investigate hospital acquired infections . They have not investigated deaths at the Queen Elizabeth University Hospital that may have been caused by a hospital associated infection.

HSE did however carry out an investigation into concerns raised with them in December 2019 about the ventilation within two wards at the Queen Elizabeth University Hospital and the control of legionella in water systems across the hospital.

HSE was satisfied with the control of legionella but wrote to the Chief Executive of Greater Glasgow Health Board/NHS Greater Glasgow and Clyde requesting improvements to the ventilation systems. An Improvement Notice was served in relation to the ventilation system within Ward 4C.

Further information is available on the NHS GGC webpage: . The Improvement Notice is being appealed by the Health Board. However, HSE is satisfied that appropriate remedial action has been taken.

Following a successful three year pilot, in 2013 the four nations agreed to a 10 year grant to support those affected by the thalidomide drug. Over the last nine years the Scottish Government has issued a total of £11.512 million to the Thalidomide Trust, for distribution to Scottish survivors. A further £1.636 Million is projected for the final year (2022-23), bringing total funding to £13.15 million.

The pharmacy profession and the provision of pharmaceutical services are highly regulated, overseen by the General Pharmaceutical Council (GPhC). The GPhC's role includes upholding health and safety standards for the pharmacy workforce, as well as for patients.

The Scottish Government regularly meets with Community Pharmacy Scotland, the representative body for pharmacy owners, to discuss a range of topics including workforce issues, including health and wellbeing. This year the Scottish Government has made £12m available to support the wellbeing of the pharmacist workforce. This includes £8m from the NHS Recovery Plan to provide ongoing wellbeing support for the workforce – alongside an extra £4m to provide further support to address winter pressures.

The funding supports the 24/7 National Wellbeing Helpline, our National Wellbeing Hub, Coaching for Wellbeing and the Workforce Specialist Service, alongside tailored psychological interventions for staff, providing individualised wellbeing support focusing on people’s physical and emotional needs.

The Chief Pharmaceutical Officer for Scotland in a joint letter (8 December 2021) with the leaders from the pharmacy sector, including the Royal Pharmaceutical Society (Scotland), has written to all pharmacy teams outlining the range of wellbeing support available to pharmacy teams and encouraging them to access these resources for support when needed.

Following a successful three year pilot, in 2013 the four nations agreed to a 10 year grant to support those affected by the thalidomide drug. Over the last nine years the Scottish Government has issued a total of £11.512 million to the Thalidomide Trust, for distribution to Scottish survivors. A further £1.636 Million is projected for the final year (2022-23), bringing total funding to £13.15 million.

The Scottish Government receives annual funding from the UK Government as part of the Barnett consequentials, however no funding is specifically ‘ring fenced’ for Thalidomide.

Breakdown of Funding:

The Scottish Government is not considering the possibility of allowing Health Boards to take over the running of community pharmacies that are struggling to remain open. Community pharmacies, along with other primary care contractors, are wholly independent private entities providing NHS services on behalf the Health Board. Any challenges faced by community pharmacy contractors in delivering existing pharmaceutical care services should be discussed with the Health Boards who will be able to consider actions to support service provision.