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Treatment for anaphylaxis may take place in primary care, in accident and emergency departments and in hospitals. Statistics provided by ISD shows the number of patients aged (a) under 16 years and (b) 16 years and over, who were discharged from hospital following treatment for anaphylaxis.

Table 1: Patients treated in hospital for a diagnosis of anaphylaxis in NHS Scotland; 2007 to 2018

Listed below are the six public inquiries constituted under the Inquiries Act 2005 since 2007. There have been a variety of other reviews and non-statutory inquiries for which costs are not held centrally.

NHS Inform is Scotland's national health information service that aims to provide people with accurate and relevant information to help them make informed decisions about their own health. This includes information about symptoms, diagnosis and treatment for anaphylaxis - .

Community pharmacists provide information, advice or assistance to people on the use of and any risks associated with medicines, and medical devices to prevent harm. This includes people who require an Adrenalin Auto Injector (AAIs) device.

Paediatric allergy services are organised through the Children’s and Young People’s Allergy Network Scotland (CYANS), which is a National Managed Clinical Network that focuses on improving health service provision for children and young people with allergies in Scotland.

NHS Inform provides information about the causes, treatment and prevention of anaphylaxis, including the possibility that someone suffering from anaphylaxis may go into cardiac arrest. We are committed to improving out-hospital cardiac arrest outcomes and, since 2015, over 508,000 people across Scotland have been equipped with cardiopulmonary resuscitation (CPR) skills. National public health campaigns have also been run to raise the overall awareness of using CPR skills.

In wider terms the Scottish Government is taking action to prevent anaphylaxis, for example in a move towards the introduction of full ingredient listing, with allergens emphasised, for foods sold on a Prepacked for Direct Sale basis, Food Standards Scotland is currently undertaking public consultation to inform the development of draft regulations, supporting technical guidance and a robust impact assessment for new Scottish regulations that are due to come into force in Autumn 2021.

We expect NHS Boards to adhere to current guidelines on the treatment of anaphylaxis from authorative professional sources such as the Resuscitation Council UK and National Institute for Health and Care Excellence (NICE).

The Scottish Government recognises the need to ensure that health and social care professionals have the knowledge, skills and confidence to provide high quality palliative and end of life care, relevant to their role.

In April 2018, we published a new palliative and end of life care Educational Framework that can be used in all health and social care settings to support staff who care for those with palliative and end of life care needs in their professional development. This can be found at: .

The Scottish Government recognises the need to ensure that health professionals have the knowledge, skills and confidence to provide high quality palliative and end of life care, relevant to their role.

In April 2018, we published a new palliative and end of life care Educational Framework that can be used in all health and social care settings to support staff who care for those with palliative and end of life care needs in their professional development. This can be found at: .

The Scottish Government continues to provide funding to NHS Education for Scotland (NES) and the Scottish Social Services Council (SSSC) to support training associated with the Framework across relevant health and social care settings.

The Scottish Government is clear about the priority we place on ensuring people can access high quality palliative and end of life care.

Our Strategic Framework for Action on Palliative and End of Life Care sets out our ambition that we want those who would benefit from palliative and end of life care to have access to it by 2021. This ambition was re-affirmed in our Health and Social Care Delivery Plan which was published in December 2016.

Good care at end of life requires collaborative, multi-disciplinary support, which is why Integration Authorities have been given statutory responsibility for meeting this need. Integration Authorities regularly report on their progress using the 23 indicators ( ) that support the statutory outcomes set out in the Public Bodies (Joint Working) (Scotland) Act 2014.

The indicator currently used nationally to gauge progress on improving the availability of palliative and end of life care is the percentage of last six months of life spent in the community. Since the publication of the Health and Social Care Delivery Plan in 2015-16, the percentage of time spent at home or in a community setting continues to increase from 86.7% to 88.1%. This is an encouraging shift as it equates to, on average an extra five days within the last six months of life being supported at home or in a community setting. However, we recognise that this indicator is not sufficient on its own. We are working with partners in local systems and health and social care professionals to improve our understanding of the quantity and quality of palliative care across Scotland.

Providing high quality, person centred care for people towards the end of life is an important priority for the Scottish Government.

We want people to get the care and support that is right for them and enable them to stay in their local community for as long as possible. Our ambition to ensure people get the care that is right for them in a community setting is reflected in our budget this year, which provides investment of more than £700 million to support social care services and speed up the pace of integration. We are on track to deliver our commitment that more than 50% of frontline NHS spending will be shifted to community health services by the end of this Parliament.