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The NHS Scotland National Access Policy states that Health Boards should review reasons why patients may DNA or cancel appointments in order to take necessary steps to address issues and barriers as necessary including what support can be provided by Health Boards to reduce non-attendance. The policy can be found at The NHSScotland National Access Policy - gov.scot (www.gov.scot) .

Public Health Scotland data up to 30 September 2023 showed the Did Not Attend (DNA) rates for New Outpatients has reduced by 1% over the last year - from 7.7% on 30 September 2023 to 6.7% in the most recent quarter. While DNA rates for inpatient and day-cases has been consistently at 0.7% in each quarter over the same period.

We recognise the importance of transparent and regular communication with patients, which is why we have included a standard package of communications that all Health Boards should be providing in the revised Waiting Times Guidance . This includes what patients should expect and their responsibilities while they are waiting for their appointment, test or treatment.

The Scottish Government regularly holds cross-portfolio meetings to discuss matters related to public health. The overall governance for cross-portfolio engagement on population health and its drivers is the Care and Wellbeing Portfolio. The most recent cross portfolio meeting under this governance was the Place and Wellbeing Programme Board (which sits within the Care and Wellbeing Portfolio) which last met on 7 December. Matters discussed included progress on how health and social care bodies can operate as effective anchor institutions and contribute to improved public health, as part of the wider community wealth building agenda.

The Care and Wellbeing Portfolio Board, which provides oversight of a portfolio of work to improve population health; address inequalities and improve system sustainability, last met on 26 July 2023.

At that meeting the Board considered joint work across Economy/Health and Social Care Portfolios and Public Health Scotland on economic inactivity and the impact it has on Scotland’s economy and population health. The Board also discussed the Verity House Agreement and the shared priorities of tackling poverty, transforming our economy through a just transition to deliver net zero and, delivering sustainable, person-centred public services. 

The Board next meets on the 24 January 2024 and is scheduled to consider long term planning around population health.

Additionally, the Scottish Government has regular cross-portfolio meetings about wider determinants that contribute to improving public health - including the Tackling Child Poverty Programme Board, the Fair Work Oversight Group and the Ministerial Population Taskforce.

The Scottish Government is aware that the National Supply Disruption Service (NSDR) has been managing a shortage of 10-year copper coils since June, which affected multiple suppliers and was due to a manufacturer running short of copper. Alternative devices are available, including an alternative 10-year and 5- year copper coil. The NSDR advise that production of the 10 year coil has now resumed.

Advice to clinicians was published by the Faculty of Sexual and Reproductive Healthcare (FSRH) and can be found here: FSRH Statement: Update on national copper IUD shortages - Faculty of Sexual and Reproductive Healthcare

The Scottish Government (SG) is clear that tackling alcohol related harm remains a key public health priority, including in relation to children and young people. To assess trends on an ongoing basis a number of sources are considered, including this SG report and the Alcohol Use Disorders Identification Test (AUDIT). The SG continues to utilise, and further develop, public health surveillance data to better understand drug and alcohol trends, particularly amongst younger people.

The 2018 Alcohol Framework sets out the SG's commitment to put the voice of children and young people at the heart of developing preventive measures on alcohol harm. In line with this specific engagement, projects with children and young people have been undertaken in the development of both the continuation and new level of MUP and the public consultation on potential measures to restrict alcohol advertising and promotion in Scotland. In addition to this the SG is investing £1.5 million in Planet Youth, sometimes referred to as the Icelandic Model, which is an evidence based model for substance use prevention.

This information is not held centrally.

Tackling health inequalities and improving population health remain clear, ongoing aims of the Scottish Government, that directly support our cross cutting missions of Equality, Opportunity and Community. We continue to pursue and promote a “health in all policies” approach as we recognise the building blocks of good health require concentrated action across government to maximise income and address socio-economic factors.

We are making progress and have prioritised tackling key drivers for poor health, including poverty and deprivation through a range of measures. This includes investment of £3bn across a range of programmes to support low income households, delivering the Scottish Child Payment, delivering Best Start Bright Futures to tackle child poverty, free school meals and the council tax reduction scheme. We are also delivering Community Link Workers and Welfare Rights Advisors to offer advice on housing, social security and employability issues within GP practices across our rural and deprived communities.

We are also taking forward work to support and encourage positive health behaviours and assuring the impact of our interventions are appropriately considered. This includes conducting Health Inequality Impact Assessments across our Diet and Healthy Weight Delivery Plan, our Alcohol Framework and any future policy planning as we implement our Tobacco and Vaping Framework.

The Scottish Government will continue to work closely with its partners, including Public Health Scotland, at a national and local level to explore ways to drive improvements in health and embed health considerations within wider future policy making. Over the coming months, we will be working closely with our partners across the health and social care system, local authorities and wider stakeholders to develop long term planning for population health and integrated health and social care services.

Increasing the availability of long acting reversible contraception (LARC) is identified as a priority in both the Women’s Health Plan (2021) and our recently published Sexual Health and Blood Borne Virus Action Plan. The Scottish Government is committed to working with Health Boards and the Women's Health Champion to improve access to LARC.

There has been no national formal assessment of contraceptive education however the Scottish Government is committed to ensuring that people across Scotland have timely access to contraception, and to information which allows them to make informed decisions about their own sexual and reproductive health. This is recognised as a priority in our recently published Sexual Health and Blood Borne Virus (SHBBV) Action Plan, and we have allocated multi-year funding to a range of projects in both community and NHS settings that will help to deliver this goal. The projects include developing new information resources, such as a national sexual health microsite on NHS Inform, as well as supporting staff training and development around contraception. Details of these projects were published alongside the SHBBV Action Plan on 28 November 2023.

The Scottish Government’s Long Acting Reversible Contraception (LARC) Short Life Working Group meets quarterly and includes representation from midwifery, including the Royal College of Midwives.

We are working with the Scottish Postpartum Contraception Network (SPCN), which is a multidisciplinary group of healthcare professionals including midwifery, obstetrics, sexual health, pharmacy, public health and clinical researchers. Since 2022, the Scottish Government has funded SPCN’s work on expanding access to postpartum contraception (including LARC) across Scotland. An additional £101,000 (over 3 years) has recently been allocated to SPCN to deliver a project focused on developing training and information resources, and improving equity of access to postpartum LARC.

Neither the Scottish Government nor NHS 24 currently hold that information due to the anonymous nature of NHS inform which doesn’t ask for, or collect, any personal information.

However, working with NHS 24 we are in the process of developing a formal review of NHS inform, recognising it as a national asset that is currently visited over 10 million times per month to ensure that it continues to meet future requirements and continues to support improved choice and access to services.

As part of this review work, we will engage with the public and take an evidence-based approach and commence a robust Equality Impact Assessment to ensure the service is inclusive.