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I refer the member to the answer to question S6W-01751 on 6 August 2021. 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 .

In October 2019 the Scottish Health Technology Group (SHTG) recommended that: “Where patients understand and are willing to accept the demands, risks and uncertainties of treatment, autologous haematopoietic stem cell transplant (AHSCT) should be considered as a treatment option for patients with relapsing-remitting multiple sclerosis (RRMS) who have evidence of significant inflammatory disease activity that has not responded to adequate treatment with licensed high-efficacy disease modifying therapies (DMTs).”

Following comprehensive clinical assessment, relevant diagnostic testing and consideration by a specialist multi-disciplinary team, AHSCT can be offered to MS patients from Scotland where they meet this criteria and when it is clinically judged that the benefits of treatment outweigh the risks. In these circumstances such patients can be referred by their NHS Consultant for this specific treatment at a specialist centre in England.

Stem cell transplantation is currently undertaken in Scotland for other clinical reasons, however specific expertise in its use for the treatment of MS is still developing. In order to ensure that patients receive the highest level of safe, patient-centred care, clinical consensus is that this is currently best delivered by one of the most experienced centres globally, located in Sheffield. Although delayed by the need to focus resources on COVID-19, key stakeholders within NHS Scotland are continuing discussions regarding a potential Scottish pathway for this treatment.

AHSCT is an intensive treatment which carries a very high risk of infection for many weeks, due to severe immunosuppression as part of the treatment pathway. In March 2020 the Association of British Neurologists (ABN) recommended postponing this treatment in patients with MS until the risk of coronavirus receded, due to the potential for severe illness in those with compromised immune systems. As of November 2020, the ABN advises its use only in exceptional cases of relapsing disease.

Please find the requested information set out in the following table:

Initial estimates suggest that 5,786 invitations have not yet issued to people affected by the pause, but it should be stressed that this will be for a range of reasons, including participants being excluded from the programme after it restarted, or taking the opportunity to be screened at their GP ahead of their scheduled prompt to make an appointment. Data on patients who had their routine cervical screening test delayed and have (a) now received a test, (b) referred for further investigation is not routinely available at present.

Public Health Scotland will release their annual statistical report on the cervical screening programme on 1 September 2021.

Ear wax removal services are available through the NHS.

How to treat ear wax is a clinical decision; ear syringing is not the current preferred procedure and is no longer routinely provided by clinicians.

The NHS has continued to provide services to patients throughout the pandemic. However, due to the pressures of the pandemic some routine condition management has needed to be paused but only in those instances where it is safe to do so.

The information requested is not held centrally by the Scottish Government or by Public Health Scotland.

Information relating to the number of patients awaiting a colposcopy and their length of wait would be held by individual Health Boards.

Table 1 shows the average daily number of Whole Time Equivalent (WTE) Contact Tracers scheduled to work on the COVID-19 Test and Protect service each week from 1 May. These are projected workforce figures taken from management information submitted by Health Boards in weekly returns and therefore do not necessarily represent final deployment figures. Wider support and administration staff are not included in these returns.

The Scottish Government does not hold data centrally on the proportion of these staff who are secondees or redeployed; the secondment and deployment of staff is a matter for each board.

Table 1. Whole Time Equivalent Contact Tracers working for the COVID-19 Test and Protect service in each week from 1 May 2021

Enforcement of the Coronavirus Regulations is a matter for the Chief Constable and Police Scotland.

The latest data available on Police Scotland’s website shows that as of 14 July 2021, 16,993 fixed-penalty notices have been issued and 971 arrests have been made under these regulations.

The published figures are not broken down to show the reasons for issuing of fixed-penalty notices or arrests; the presentation and format of Police Scotland data, is an operational matter for the Chief Constable.

Since May 2020 the Scottish Government has published projections of infections, hospitalisations and ICU admissions in its weekly publication Modelling the Epidemic in Scotland . These projections also feed into internal Scottish Government models on the demand of the Test and Protect system, including the tracing workforce, to enable operational planning.

The path of the pandemic has been highly complex and uncertain over the last 16 months and this is reflected in the complexity and uncertainty of the modelling. We make the best judgements we can on the data in front of us and the advice we have. Right now, as often in the past, our judgement is that the best path for us in Scotland is to make progress carefully and cautiously, and that is what we are doing.

The contact tracing system has not changed its approach regarding the time frame used to identify close contacts.

Those testing positive who have attended a complex or high-risk setting during their infectious period, or who have travelled in the last 14 days, are contact traced and then referred to their local Health Board, who will make a risk-based decision on whether ‘backwards’ contact tracing is appropriate to enable Test and Protect to identify where the index case might have contracted the virus. This ‘pre-infectious period’ covers the 5 days prior to the infectious period.

Separately, the timeframe of 48 hours before symptom onset or a positive test, plus the 10 days after, relates to the infectious period of a positive person. This is based on clinical advice and has been the position since Test and Protect was launched in May 2020. Close contacts identified during this timeframe are offered public health advice by Test and Protect to prevent potential onward spread of the virus.