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There are currently local processes in existence in NHS Boards to facilitate access to off-patent drugs. A Short Life Working Group was established in 2017 to look at off label cancer medicines. The work of this group supports one of the key ambitions of our national cancer strategy, that is, to maximise the opportunities of increasing access to off patent drugs. One of the aims of the Group is to produce guidance on a national approach to the prescribing of these medicines to ensure consistency across Scotland.

The Scottish Sacral Nerve Stimulation Service for Urinary Dysfunction is provided by NHS Greater Glasgow and Clyde (GG&C) Board for all of NHS Scotland as a national specialist service commissioned by National Services Division (NSD).

There are less than 5 patients who have been assessed and are waiting for a permanent implant.

There are 24 patients who are waiting for an outpatient appointment. Due to the potential of identifiable information, this information cannot be provided broken down by individual NHS Board.

The NHS Reform (Scotland) Act 2004 places a statutory duty on NHS Boards to involve people to whom healthcare services are being, or may be, provided in the planning and development of those services, and in decisions significantly affecting their operation.

The Scottish Government's CEL 4 (2010) guidance to NHS Boards on "Informing, Engaging and Consulting People in Developing Health and Community Care Services", which is available online at , sets out that NHS Boards should seek to involve people at an early stage and throughout the process. It states that people and communities who may be affected by a proposed service development or change should be given information about the clinical, financial or other reasons why change is needed and which may limit possible choices. It includes guidance on involving affected people and communities and public stakeholders in developing and appraising options and includes specific processes for major service change, where a full public consultation is required.

While the guidance does not specify what information NHS Boards must and should provide to locally elected representatives in particular, we would expect the relevant Board (informed as required by advice from the Scottish Health Council) to engage with them at an early stage and throughout the process.

A Short Life Working Group was established in 2017 to look at off label cancer medicines. The work of this group supports one of the key ambitions of our national cancer strategy, that is, to maximise the opportunities of increasing access to off patent drugs. We expect a proposal on a national approach to be completed by the Spring.

We launched a consultation in 2017 entitled “Improving Parking in Scotland” which sought views on how parking is currently managed and enforced across the country. The responses are currently being analysed to inform our policy on how best to manage and enforce parking in Scotland, and will help develop provisions for the Scottish Government’s Miscellaneous Transport Bill. The Bill and supporting guidance will then be presented for consideration by the Scottish Parliament in this Parliamentary session.

There is no direct correlation between referrals of Sacral Nerve Stimulation (SNS) treatments for faecal incontinence and urinary incontinence.

SNS for urinary dysfunction is one of a number of treatment option available to improve the quality of life of patients. The NICE guidelines state that patients are accepted for assessment for SNS when they have not responded to behavioural guidance, other physical techniques or standard drug therapies; and have not improved or have a contra-indication to other treatments, such as the use of Botulinum Toxin, for their urinary symptoms.

When the service was designated in 2010, literature at the time suggested a 1 in 3 conversion rate of testing to permanent implant, which was approximately 15 permanent implants per year. The funding for the service was based around this information at the time.

Whilst the numbers that have gone on to permanent implant have exceeded the 1 in 3 conversion rate, the costs of the service have always been meet within the funding for National Specialist Services.

The review of pathology and laboratory medicine services forms a strand of the NHS National Services Scotland Shared Service programme of work. A strategy paper outlining the future direction of laboratories in Scotland was presented to the NHS Chief Executives Group on 8 August 2017 and this was subsequently approved. Three projects have progressed as part of the Shared Services laboratories programme; IT Connectivity, Data and the design of a Distributed Service Model.

The review of IT Connectivity and Data will be complete by the end of March 2018 with recommendations to be submitted to the NHS Chief Executives Group on 10 April 2018. Work continues with nominated laboratory leads from the three regions to align the national and regional work plans to design a Distributed Service Model for laboratories in Scotland.

Laboratory medicine is critical to NHS in supporting the delivery of high quality patient care. There is an opportunity to use the significant resources available to Health Boards to deliver laboratory services in a way that is more efficient, effective, equitable, resilient and affordable.

All mainland NHS Boards are able to provide advice by phone to women living in Northern Ireland who are considering travelling to Scotland to access abortion services . Contact information can be accessed at; .

The Scottish Government recognises that women travelling from Northern Ireland face a range of barriers in accessing abortion services in Scotland. Work is on-going to explore what the Scottish Government could do to address these barriers