³ÉÈË¿ìÊÖ

We welcome the MS Society’s Neurology Now report as an important document highlighting the issues for people with MS and wider neurological conditions throughout the COVID-19 pandemic. I am pleased to say that I recently met with officials from the MS Society to discuss the findings of the report and the ongoing development of MS services in Scotland.

Let me assure the member that the Scottish Government is committed to ensuring that all people living in Scotland with MS are able to access the best possible care and support, and benefit from healthcare services that are safe, effective and person-centred. As you may be aware, we are investing £4.5 million over 5 years to implement our Neurological Care and Support – National Framework for Action. This Framework aims include improving the provision of co-ordinated health and social care and support, developing sustainable workforce models and ensuring high standards of care for people living with neurological conditions, including MS.

Over the past year we have invested over £300,000 to projects which improve the health and wellbeing of people with MS in Scotland.

Regarding a reporting framework to measure improvement, we have commissioned NHS Healthcare Improvement Scotland to work with NHS boards, integration authorities, the third sector and people with lived experience to assess progress in implementing the General Standards for Neurological Care and Support. Undertaking this work will identify areas of improvement across NHS Scotland and help to drive forward better standards of care for people with neurological conditions.

I refer the member to the answer to question S6W-02466 on 28 September 2021 which explained that t he First Minister’s former Chief of Staff resigned on the suspension of parliament for the 2021 Scottish Parliament election in line with the Special Advisers Code of Conduct and model contract. I n line with GDPR requirements, the Scottish Government does not provide personal data such as the levels of payments made to individual staff.

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

Our clear ambition is that no one should be inappropriately delayed in hospital once they are clinically ready for discharge. However, given the current challenges health and social care partnerships are experiencing in relation to recruitment of care staff, and the increased level of needs people are presenting with, we need to set a realistic trajectory for reduction. Our intention is therefore to see a return to the position seen between the Summer of 2020 and Spring of 2021, freeing up at least 500 beds for winter.

I refer the Member to the contents of the letter issued to her by the First Minister on 4 October. A copy will be placed in the Parliament's Reference Centre (Bib number 62800).

An analysis of the obtained from the two toxicology providers in Scotland – NHS Grampian which provides approximately 10% of the analysis capability and Glasgow University which provides the rest – is set out in the tables below.

It should be noted however that the extent of toxicological analysis required will depend on the individual circumstances of each case and the extent and nature of substances that are found. Factors such as the need to research the effects of unusual drugs or instruct separate analysis for insulin quantification will result in toxicological reports taking longer to be finalised. 

Additionally, in determining the final cause of death, completion of the toxicological report is only one part of a process which involves a number of separate organisations before a final post mortem report can be issued.

Depending on the circumstances surrounding a death, the pathologist(s) may require a number of further investigations to be completed – including further toxicological analysis as well as input from other experts in the fields of neuropathology or histopathology for example – and the findings of all those enquiries must then be carefully considered by COPFS before a cause of death is confirmed.

GU TOXICOLOGY TURNAROUND TIMES

NHS GRAMPIAN TOXICOLOGY TURNAROUND TIMES

COPFS and the University of Glasgow agreed an Improvement Plan to reduce the toxicology waiting times. This plan defined performance targets and required the University of Glasgow to provide data to COPFS on a weekly basis. The required data was to highlight the laboratory’s progress with outstanding cases and new cases.

The Improvement Plan has been successful; the toxicology waiting times are now reduced and there is no delay in provision of those reports to the pathologists who require them to finalise the post mortem report.

An indication of the effectiveness of the improvement plan is that, in the week of 25 September 2020, there were 1351 open toxicology cases with University of Glasgow and in the week of 26 September 2021 there were 351 open toxicology cases.

In 2019 COPFS began to experience delays in the provision of toxicology reports from the University of Glasgow, the main contractor for this service. This was further compounded during 2020 due to the pandemic.

Once a toxicological report has been finalised, it is then considered by the pathologist(s) who conducted the post mortem, and thereafter a final post mortem report is issued to the appropriate team in COPFS, who require to review it in detail before the next of kin can be informed of the final cause of death.

Working with Glasgow University, COPFS put various measures in place to address both the backlog and the increasing number of new deaths requiring toxicological analysis. The measures included agreeing a new format of abbreviated report for some cases, and an Improvement Plan which set out weekly performance targets and ensured focused progression with both the backlog of cases and newly reported cases.

Successful implementation of the Improvement Plan in particular means that there is now no backlog of toxicology reports and toxicology analysis is being completed in the majority of cases within 8 weeks.

The Scottish Government is committed to the early detection of cancer. We are in currently in the process of establishing Scotland’s first Early Cancer Diagnostic Centres which will see the creation of a person-centred fast-track pathway for patients with non-specific symptoms (i.e. weight loss, nausea, fatigue) suspicious of cancer. These centres have been in operation since June 2021 and are continually taking patients with plans for equitable access across Scotland over the course of this parliament.

An estimate of the number of patients who have missed an early diagnosis of melanoma can be made by using data from the Public Health Scotland (PHS) Covid Wider Impacts Dashboard ( ). The data indicates there were a total of 1,131 individuals with pathologically confirmed specimens for malignant melanoma of the skin between 1 April 2020 and the week ending 21 st February 2021. This was 398 individuals fewer than in the same period one year before.

Therefore, the data suggests there have been around 400 fewer melanoma diagnoses overall during the time of the COVID-19 pandemic.

The Scottish Government recognises vaccines approved for use in the UK regardless of where they were administered to determine whether a person has completed their primary dose or whether they require additional doses to be fully vaccinated.

Those who have been vaccinated out-with the Common Travel Area (CTA) should obtain proof of their vaccination status from the country they received their vaccination. For domestic certification purposes, we will accept proof of vaccination from across the UK and Crown Dependencies as well as from members of the EU Digital Covid Certificate Scheme.

For those who have proof of vaccination status from out with the CTA and the EU, domestic certification rules for international visitors will align with current border rules. Visitors from international countries out-with the CTA and EU scheme will require to provide the same proof of vaccination status that is accepted for entry to the UK.

Those who have received a final dose of a UK approved vaccine in Canada at least 14 days before travel are currently recognised as fully vaccinated and can use their proof of vaccination for domestic certification purposes. More information on this can be found at: .

GP practices are independent contractors and therefore decisions relating to telephony are at their discretion. On top of practices’ core funding allocation, the Scottish Government is making an additional £600,000 funding available this year for the Health Boards to allocate to GP practices for the purpose of upgrading or replacing telephony systems.