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The number of staff working in NHS Grampian has increased by 20.7 per cent since Sept 2006, to over 13,520 Whole Time Equivalent (WTE). This includes a 6.9 per cent increase in numbers of Qualified Nurses and Midwives, which have risen to 4,099.1 WTE.

NHSScotland Boards are required to have the correct staff in place to meet the needs of the service and ensure high quality patient care. They have fully delegated powers in relation to employment issues. The Scottish Government works closely with Boards to support their efforts in staff recruitment. The creation of posts and filling of individual vacancies will depend on the service needs of each Board, taking account of national and local priorities.

We are investing £11 million in new recruitment activity and in the creation of a National Centre for Workforce Supply. The Centre will offer NHS Boards expert advice on labour market intelligence and coordinate recruitment campaigns, providing vital additional support to health board recruitment teams.

We are also taking forward a comprehensive programme to support recovery and build further capacity. The programme will include measures to increase international recruitment, retain staff and attract more returners to the service. The Scottish Government will continue to work with partners to explore options and opportunities that allow us to best support our registered staff.

The Vaccination Transformation Programme (VTP) is funded via the Primary Care Improvement Fund, which began in 2018 and will have provided £250 million to health boards up to the end of financial year 2022. The extended flu programme and COVID-19 vaccination programme (including boosters) are outside the scope of this fund, however work to deliver these programmes has helped to build Health Board capacity to vaccinate and complete the VTP.

We have awarded a grant of £0.5 million to Care and Repair Scotland to provide additional support in relation to the new standard for fire alarms in all Scottish homes. Care and Repair Scotland will provide a report on the use of the grant funding at the end of the current business year.

The Scottish Government advises anyone who has experienced domestic abuse or sexual violence to report crimes committed against them, regardless of the impacts of Covid-19. Police Scotland remain committed to proactively target perpetrators and protect victims and their families from domestic abuse or further harm.

Domestic abuse cases continue to feature in the court programme as a key priority, with a view to mitigating the impact of the pandemic on timescales for these types of cases. £50m of Scottish Government Covid recovery funding was allocated this year and the recruitment and training of extra justice staff has enabled additional court capacity recently. This will support the process for reducing the backlog in criminal cases through the collaborative Recovery programme.

The Scottish Government meets regularly with Scottish Women’s Aid to discuss their concerns, and to outline the approach being taken to addressing the impact of the pandemic on all court cases. We understand the pandemic has extended waiting lists for support and have allocated £4.5 million split between Scottish Women’s Aid and Rape Crisis Scotland to address this issue.

National Referral Mechanism data is released by the Home Office Single Competent Authority.

Information is published quarterly and in an end of year summary. Data relating to 2020 and 2021 can be found at https://www.gov.uk/government/collections/national-referral-mechanism-statistics .

MHOs are critically important as they protect and safeguard the rights of vulnerable people with mental health conditions.

MHO workload pressures have no doubt been exacerbated by the COVID pandemic, but we are aware of a number of issues that are having an impact. These include significant numbers of applications for guardianship orders under Adults with Incapacity legislation, supporting hospital discharges when there is an issue with incapacity, as well as the challenges of working on detention and compulsory treatment orders during the pandemic. MHOs also provide ongoing advice for other professionals, users of services and carers about the use of mental health legislation when planning care and treatment.

While it is the responsibility of local authorities to ensure they have the appropriate levels of MHOs in place, we have been working, with COSLA, local authorities, the Scottish Social Services Council and others since 2019 to improve MHO capacity across Scotland.

We are committed to addressing a shortfall in the MHO workforce by 2023 as part of our wider Integrated Health and Social Care Workforce Plan (2019) and we are investing £1.5 million over 2019-2022 to support Local Authorities and Health and Social Care Partnerships in training additional MHOs. Additionally, we are currently evaluating with COSLA options to support new MHO posts and decisions will be made in due course.

I have asked Teresa Medhurst, Interim Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

Addictions Prevalence Testing has been reviewed and renamed Drug Trend Testing. Along with the testing of individuals being admitted and liberated from SPS custody in a given month, results from Rapiscan machines will also be analysed as part of Drug Trend Testing (DTT) in the SPS. DTT will take place in January 2022.

The Mental Health in Schools Working Group have sought to establish a comprehensive approach to supporting children and young people’s mental health and wellbeing through schools. The publication of the whole-school approach framework provides guidance on setting mental health and wellbeing at the heart of the ethos and culture of schools.

This approach is also reflected within the new professional learning resource, which has been specifically developed for use by school staff, as part of a strategic approach to enhancing understanding of supporting children and young people’s mental health and wellbeing in schools. The new professional learning resource is available online and can be used by any member of school staff.

The decision about which treatment to prescribe is a clinical decision made by the prescriber in discussion with the patient, taking into account the individual’s condition and medical history.

Guidance is available to assist prescribers and Scottish Government is in the process of reviewing its “Quality Prescribing for Chronic Pain – A Guide for Improvement” which will include information on addressing the issue of over-treatment with a focus on self-management and non-pharmaceutical treatment of long-term conditions, highlighting the issue of high strength opioid medicines misuse and encouraging clinicians to discuss concerns openly with patients.

Over the period covered by the University of Aberdeen study, steroid injections (a commonly used therapeutic option for Osteoarthritis awaiting surgery) were reduced on advice from Royal College of Rheumatology due to the risk of activation of latent Covid 19 and risk of immunosuppression and susceptibility to the virus, this could have led to an increase in opioid pain medication prescriptions to compensate. Analysis from Public Health Scotland (PHS) shows a marked reduction in the number of corticosteroid injections between March 2020 and April 2021 before returning to previous levels. Analysis from PHS, however, does not indicate an overall increase in opioid pain medication prescriptions over the same period.

The Scottish Government recognises that the lack of a national platform for group therapy has been challenging for services, that is why we have been working with the software developers, Attend Anywhere, to develop their platform Near Me as suitable solution to undertake patient facing group video consultations. Developers are currently testing the Alpha version of the Near Me group platform and it is anticipated that a Beta version (testing by clinicians) of the system will be available for testing with patients in November with full release shortly thereafter.

Meantime, we have issued guidance for NHS Scotland on the use of video consultation for group therapy using existing platforms, available from the Technology Enabled Care Scotland webpage. Use of Video Consulting in Group Settings for Mental Health Guidance | TEC Scotland