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The membership of the Best Start Review Group and the Best Start Sub-Groups is published in Appendix E and Appendix F of the .

Dr Ian Wallace, at the time Medical Director at NHS Lanarkshire, was a member of the Best Start Review Group and the Neonatal Models of Care sub group.

The Best Start emphasises parents as key partners in caring for their baby and aims to keep mothers and babies, and families together as much as possible in the crucial early weeks, with services designed around them.

The new model of care aims to minimise the separation of families, and to support parents with babies in neonatal care. We have a number of measures already in place to support families:

• Providing accommodation for parents to stay on or near neonatal units;
• Roll out of the Young Patients Family Fund (formerly the Neonatal Expenses Fund) to support families with the costs of travel, accommodation and food whilst their baby is in neonatal care;
• and
• Repatriating babies to their local neonatal units as soon as clinically possible.

Under the new model of care mothers in suspected extreme pre-term labour are transferred before they give birth (in-utero) to maternity units in the hospitals that have neonatal intensive care units. Experience from the Early Implementer Boards indicates that this will happen in the vast majority of cases. On occasion when it is not possible to transfer mothers before they give birth, the baby will be stabilised and transferred to a NICU by the specialist neonatal transport service ScotSTAR, and the mother will be transferred to the maternity unit in the same hospital as her baby.

The locations of the three Neonatal Intensive Care Units was based on clinical evidence that the very smallest and sickest babies, including those born extremely premature (below 27 weeks), do best when they are cared for in larger specialist neonatal units which look after a lot of these babies, and have the right staff and services available on site to give them the very best care. The Best Start report recommended that we move to three of these units in Scotland, to meet the needs of our population.

The , published on 25 July 2023 describes the process undertaken to determine the three final Neonatal Intensive Care Units, and the feasibility analysis and testing that followed the conclusion of that process. Annex A of the Report includes the criteria and weighting used for the Options Appraisal Process. Based on the evidence, the criteria focused on collocated clinical specialist services.

To support all parents who have babies admitted to neonatal care the Young Patients Family Fund provides funds to cover the cost of travel, subsistence and any accommodation required.

The 5 reports from the Neonatal Early Implementers have been placed in the Scottish Parliament Information Centre (BIB number 64669).

The Best Start Report, published in 2017 followed a review of maternity and neonatal services in Scotland, and was based on research evidence, the views of clinicians and the views of service users. Based on data on birth data, the report recommended that we move to a model of three intensive care units in Scotland.

The process of determining which units should provide Neonatal Intensive Care followed an Options Appraisal process undertaken by an expert group, including clinical leads and service user representatives. The Royal Hospital for Children in Glasgow, Edinburgh Royal Infirmary and Aberdeen Maternity Hospital scored highest based on an agreed short list criteria, definitions and weighting. The group were asked to recommend three units and there was no consideration given to including a fourth unit.

The , published on 25 July 2023 describes the process undertaken to determine the three final Neonatal Intensive Care Units, and the feasibility analysis and testing that followed the conclusion of that process. Annex A of the Report includes the criteria and weighting used for the Options Appraisal Process. Annexes C and D of the report outline the data that supported the Options Appraisal process.

Further detail on the methodology and the scoring of individual units can be found as part of the following Freedom of Information request:

Information relating to Options Appraisal Report: FOI release - gov.scot (www.gov.scot)

The three NICU units; Royal Hospital for Children in Glasgow, the Aberdeen Maternity Hospital and the Edinburgh Royal Infirmary will serve the West, North and East regions of Scotland. Data on births in Scotland is published on the website for every year since 1991, broken down by NHS Board or council area of birth.

The Scottish Government is committed to an infrastructure solution to address landslip risks at the A83 Rest and Be Thankful and shares the urgency communities and businesses place on maintaining and improving connectivity of this vital route. At the recent Cabinet public discussion on 2 October in Inverary, the First Minister gave a firm commitment to a solution to the challenges at the Rest and Be Thankful, including a commitment for the funding.

Spending as set out in the Scottish Budget 2023-24 is confirmed which includes progressing the necessary detailed design work for the long term solution, currently progressing at pace. The detailed development and assessment of the preferred option will culminate in the publication of draft road Orders, compulsory purchase Orders and Environmental Impact Assessment Report for formal comment and we expect to publish draft Orders by the end of 2024.

Progress following publication of draft Orders will depend on the level and nature of any representations, including objections, to the published draft Orders. Procurement of a main works contractor for the permanent, long term solution can only commence upon completion of the statutory authorisation process.

The current estimated cost of the preferred option is approximately £405 million - £470 million (at 2023 prices). We will continue to develop and assess the scheme proposals in order to deliver the best value for taxpayers’ money.

Funding to take forward the construction stage of the long-term solution in future years will be determined as part of the annual Scottish Budget setting process and subsequent capital spending reviews.

The Scottish Government remains committed to medium and long term solutions to address landslip risks at the A83 Rest and Be Thankful.

Improvements to the existing Old Military Road through the Glen Croe corridor are being made to make it a more resilient diversion route until the long term solution to the problems at the Rest and Be Thankful is in place.

The current cost estimate for carrying out all phases of the medium term solution is £24million to £32million. Spending as set out in the Scottish Budget 2023-24, as approved by the Scottish Parliament, is confirmed and includes funding to commence the delivery of the medium-term improvements, which are expected to start later this year.

Funding to take forward the construction stages of Phases 2 and 3 of the medium term solution will be determined as part of the annual Scottish Budget setting process and subsequent capital spending reviews.

The statutory responsibility for delivering and commissioning services at a local level lies with local authorities, NHS boards and integrated health and social care partnerships. Publicly funded places in care homes are covered by the National Care Home Contract, which is negotiated annually between COSLA and Scottish Care. The information requested on the number of NHS funded beds that are currently empty is not held by the Scottish Government.