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That is a fair question to ask. Of course I would look to see where we can provide even more support. I make the point, which I know is well understood by colleagues around the table, that the long Covid fund is on top of the £18 billion in this financial year and £19 billion in the next financial year that we are giving to the NHS and social care, a chunk of which is given to our health boards. It is worth saying that our front-line spend per head is higher in Scotland than it is in other parts of the UK. It is £323 per person higher than it is in England, for example.

I keep going back to the Lanarkshire model because I have seen it first hand, and I have spoken to some people who have benefited from that service. When that rehabilitation service was up and running, people did not wait for the allocation from the £10 million long Covid fund; they used their health board allocation to create that team—to recruit and hire those multidisciplinary team members who are providing that support to long Covid sufferers. I hope that that gives you some reassurance.

Agreed.

We have looked at other long Covid clinic models around the UK, such as the Hertfordshire model, which Dr Sandesh Gulhane has mentioned previously. I go back to the Scottish intercollegiate guidelines network and NICE guidelines on long Covid, which say that one model would not fit all areas. I think that we all accept that.

I agree strongly with the RCGP’s written evidence to the committee on that. I will quote it directly. It says that long Covid

“often requires generalists skills to treat, but most can be fully managed in primary care, and the GP is best placed to provide this holistic approach.”

It goes on to say:

“there is an increased risk that patients presenting with Long Covid symptoms may have instead another cardiac or respiratory condition which may have similar or even identical symptoms. Patients need a GP assessment and investigation”—

this is the important part—

“rather than being funnelled inappropriately into a clinic that is designed for one condition, and then require further investigation and alternative management.”

I have never been opposed in principle to long Covid clinics—I have said that from day 1. That is why I have asked my team to look at the Hertfordshire model, for example. In effect, they try to cut out the middle person. We have GPs and, if they have the appropriate referral pathways through the implementation support note that take people directly to a Covid rehabilitation service in, for example, Lanarkshire—that is the example that I keep using—that is a better model than a GP having to refer someone to a long Covid clinic that would then have to refer them on to another pathway. I am not opposed to long Covid clinics in principle; I am trying to allow local health boards to design services to meet their local need.

That is a really good question. We have learned a lot from the vaccine programme; we have had to really understand where uptake has been lower and what we can do to respond to that—for example, by putting mobile clinics in areas of higher deprivation, and in mosques, gurdwaras and temples. We have to take the learning from the vaccine programme and make sure that it goes right across the various parts of health and social care. The UK-level survey data indicated that what John Mason said is absolutely right, which is that prevalence of self-reported long Covid is greatest among people who are aged 35 to 69 years, who are female, who live in more deprived areas and who work in social care. That goes back to Jackie Baillie’s point, as well.

We know that the data exists, and I guarantee to John Mason that what we are doing in health and social care is often focused on areas where there are issues of accessibility and lower take-up. That is something that we have learned very well from the vaccination programme, so we are making sure that it is embedded right across our health and social care approaches.

We have to do our best to use the data that we have. For example, the World Health Organization commissioned a study—which a certain John Mason will know about—that showed that the vaccination programme saved well over 20,000 lives in Scotland. Given the recent autumn and winter booster vaccination programme, I am certain that that number has gone up. We need to rely on data and evidence and try to counter some of the misinformation. I am afraid that there are some people whom we will almost never be able to convince, but we can convince the vast majority, and that work will continue to rely on the strong evidence base for the vaccination programme.

We should also use as many different people as possible in society to get the message out. People might not trust politicians—shock, horror!—but we should make sure that we empower clinicians, as well as the people who have benefited from the vaccine, to speak about the benefits. Of course, all of us should make sure that we speak about the benefits of the vaccine and vaccination programme, as well.

There was no need for that, Ms Baillie. [Laughter.]

There could be an advantage from such coalescing, but I do not think that it is necessary. I see from the Lanarkshire model that we have had well over 500 referrals—585 or thereabouts—so there is a rich data source.

Ashleigh Simpson would like to say more on that.

I thank you for your question and, indeed, Jane Ormerod for her comment. She, too, has been at those meetings at which I have met people suffering from the effects of long Covid.

In your question, you have expressed the purpose of the national strategic network, in which people who provide local services, those with lived experience and our clinical experts are making contributions to get the level of consistency that we require. I am certain that the committee will have pored over the detail of the funding allocation for each NHS board. From that, you will see that many health boards are looking to have a single point of access and to develop the pathways better. It is clear that they are looking at where such an approach is working well—NHS Lanarkshire provides a good model in that respect—and are trying to get that level of consistency, but Jane Ormerod is not wrong: there is a lack of consistency and a difficulty in accessing pathways.

That is why the implementation support note is so important. It ensures that when somebody goes to their GP—who will be the first port of call for the vast majority of people, if not everyone—the GP will have a flowchart, telling them where the referral pathways should be and what other support services will be available. Work on that is under way; indeed, it is one of the key areas that the funding will support.

I take Jane Ormerod’s point entirely. We are trying to strike a balance here; we are looking for national consistency, as that is important, but that does not mean taking a one-model-fits-all approach. I can highlight a great example from NHS Highland. We all know about the geography of the Highlands and how disparate the population is; NHS Highland has a good virtual model that is working well, and which it is developing further, but clearly, the model has been developed for that health board and is suitable to local needs. There will not be a blanket approach, but Jane Ormerod is correct to say that there must be consistency in access to pathways.

That is a really good question. Recruitment undoubtedly is, and continues to be, a challenge. What we are doing is making it clear to health boards that the £10 million funding, which comes on top of their core allocation, will be available over the next few years. We know that there are some issues with recruitment, but we are working—and will continue to work—with the boards to see what more we can do about those challenges.

The challenges will be different from board to board; our colleagues in NHS Grampian, for example, will face different challenges from those in NHS Greater Glasgow and Clyde. The recruitment challenges are one of the reasons for the full £3 million not being spent this year, but I have made it very clear to health boards that the £10 million will still be available over the next few years.

Yes, in short. Initially, £3 million was allocated, and there was an underspend of, I think, £1.1 million of that. We then went out to third sector organisations because health boards could not spend that money because of recruitment challenges. We have given a clear and absolute guarantee that the profile of the £10 million of funding might well change and might not be just over £3 million per year.

To answer your question in short, that money is part of that underspend.

I think that it has to be spent in this financial year. Certainly, they have to begin the work on spending it in this financial year. Forgive me: I can get you absolute clarity on that post the committee meeting. In essence, the organisations are building on projects that they already have under way.