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The latest data published by Public Health Scotland (13 June 2023) suggests that referrals to a chronic pain clinic are now back to levels seen prior to the COVID-19 pandemic. During the quarter ending 31 March 2023, 5,049 patients were referred, an increase of 5.5% on the previous quarter, when 4,787 patients were referred. Referrals are up by 4.3% compared to a year earlier, when there were 4,839 during the quarter ending 31 March 2022. The number of direct encounters for GPs is typically between 1.5 million and 1.8 million per month, and analysis via statistical process chart demonstrates that there has been no change in activity outwith normal variation for the period of March 2021 to April 2023.

Through the ‘Framework for Pain Management Service Delivery – Implementation Plan’ we are promoting a more consistent approach to specialist services in each Health Board; we have invested in a new Pain Service Managers’ Network. This group is working through shared issues faced by specialist pain services such as resourcing and financial challenges and identifying opportunities to solve these through sharing of best practice and different ways of working. We have also established a national working group to make recommendations on how to reduce variation in the support that is provided in different local areas and improve how care for people with chronic pain is coordinated across community, primary and specialist services.

Additionally, we have carried out a review of the Scottish National Residential Pain Management Programme to help remobilise the service impacted during the pandemic, improve the quality of referrals from local Health Boards, and continue to explore how to widen access to highly specialist care from across Scotland. Funding for this service from the Scottish Government is over £600,000 this financial year 2023-24.

I refer the member to the answer to question S6W-19557 on 26 July 2023. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

The Prescribing Information System (PIS) holds information on medicines and devices dispensed in the community, and the Hospital Medicines Utilisation Database (HMUD) holds information on medication provided in secondary care settings. Contraceptives are accessed and supplied by a variety of routes and the extent to which these supplies are captured within PIS and HMUD varies by type of contraception. For example, oral contraceptives are largely prescribed by General Practice and dispensed by Community Pharmacies and so are well recorded within PIS, whereas Long-Acting Reversible Contraceptives (LARC) are more commonly provided through secondary care managed services such as Sexual Health Clinics and so are better represented within HMUD.

Over-the-counter non-prescribed contraception will not be included in either dataset; Public Health Scotland holds no data on this.

Costs are provided in table 1 below. However, a meaningful measure of the number of contraceptives issued across all drug groups is not possible. The length of cover provided by one product unit of contraception can vary from one day (e.g., one tablet) to up to ten years (e.g., one intrauterine device or IUD). Whilst measures of quantity are available within PIS and HMUD, these are for indicative purposes only and cannot be practically used to compare the amounts of different types of contraception distributed.

Table 1: Cost of contraceptives issued in PIS and HMUD from 2018/19 to 2022/23, by BNF paragraph

The Scottish Milk and Healthy Snack Scheme (SMHSS) expands and improves on the UK Nursery Milk Scheme, which it replaced in August 2021. It is the only Scheme in the UK offering children a healthy snack of fruit or vegetables, in addition to milk, promoting better health outcomes for children through a nutritious and varied diet. For those children who cannot drink cow’s, goat’s or sheep’s milk for medical, ethical or religious reasons, the SMHSS offers a specified non-dairy alternative.

Most recent data from local authority partners (April 2023) shows uptake of around 3,300 registered childcare settings and around 140,000 children. Spend on delivering the SMHSS amounted to £6.9 Million in financial year 2021-22 and £13.8 Million in financial year 2022-23.

The Scottish Government had made clear our commitment to supporting Gillian Mackay MSP on her Abortion Services Safe Access Zones (Scotland) Bill. The First Minister and I met Ms Mackay to reaffirm that commitment during the First Minister’s first week in office.

I meet regularly with Ms Mackay to discuss the Bill, and to offer support and input at each stage of the process, most recently the publication of the consultation analysis and final Bill proposal. This support will continue as the Bill is introduced to, and progresses through, Parliament.

All funding for services delivered by the community pharmacy network, including for Pharmacy First Scotland, is paid directly to independent community pharmacy contractors as part of the remuneration arrangements. No funding is paid directly to Community Pharmacy Scotland.

NHS Pharmacy First Scotland funding forms part of the overall remuneration package. These details are published annually on the SHOW website - SHOW - Scotlands Health On the Web - Publications

The remuneration Global Sum was set at the following in each year from 2018-19

2018-19 - £180.959 million

2019-20 - £183.559 million

2020-21 - £188.148 million

2021-22 - £197.977 million

2022-23 - £205.489 million

The NHS Pharmacy First Scotland service was launched in 2020-21. Funding allocated from the remuneration Global Sum for each year since was as follows:

2020-21 - £25.8 million

2021-22 - £27.5 million

2023-23 - £30.8 million

The pharmaceuticals sector plays a crucial role in the growth and development of the life sciences sector and as a result is a key contributor to the growth and development of the Scottish economy.

The manufacturing of pharmaceuticals sector is an important source of entrepreneurial activity, supporting GVA and employment throughout Scotland. The pharmaceuticals sector is a key driver of innovation and productivity in the economy with a GVA per head of employment of £200,700 in 2020, more than 3 times the Scottish average.

Scotland’s National Innovation Strategy was published on 6 June 2023 and it identifies a number of key areas where Scotland has a competitive advantage and a strong research and business base. Health & Life Sciences is one of these areas and one of four broad innovation themes on which future activity will focus. The Scottish Government is fully committed to supporting the further growth and scaling of one of the biggest life sciences clusters in Europe and the pharmaceutical industry will play a crucial part in the sector’s development of world leading excellence, bringing in investment and creating jobs and opportunities across the country.

The Scottish Government's recently published National Innovation Strategy identifies Scotland's Health and Life Sciences sector as an innovation priority area, and outlines a tailored cluster approach to each of the innovation priority areas in order to scale innovative activity to drive economic outcomes, attract additional investment and elevate Scotland's impact on a global stage. The National Innovation Strategy further outlines encouragement and support for the breadth of Scotland's businesses to innovate, helping our business base to adopt the innovative technologies and processes that will help increase their resilience and capacity for growth. The Standing Committee on Pandemic Preparedness has also underlined the importance of continued support for innovation in life sciences and public health research in its Interim Report, published in August 2022. A strong and resilient life sciences sector, with highly innovative clusters involving our business and research base, will help Scotland be able to respond to upcoming challenges including any potential future pandemics.

As our spring campaign officially ended on 30 June, the level of stock held in Scotland is minimal, after a programme where we delivered over 490,000 doses. The number of doses currently held by NHS Scotland is calculated to be around 96,000.

In addition there remains residual stock allocated to Scotland within the ownership of UKHSA (UK Health Security Agency) that has not been drawn down by NHS Scotland health boards.

The pharmaceutical industry continues to successfully support pandemic preparedness and resilience in Scotland, as described in the answer to question S6W-19343 on 11 July 2023.

All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers