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Our aim is to at least halve the disability employment gap (DEG) by 2038. The number of disabled people (16-64 years) in full-time employment in Scotland is estimated to have increased from 180,000 in Jan-Dec 2016 to 217,600 in Jan-Dec 2020; with the number of disabled people in part-time employment increasing from 96,500 in Jan-Dec 2016 to 117,600 in Jan-Dec 2020.

A Fairer Scotland for Disabled People: Employment Action Plan outlined the initial actions we would take to help meet the ambition to at least halve the DEG. The action plan includes commitments that relate to direct delivery of employability support and where data is currently available regarding the number of disabled people supported to achieve employment, this is provided below:

• Fair Start Scotland (FSS) latest statistics (published 23 Feb 22) show that 44% (18,352) of participants reported having a disability and 63% (26,316) reported having a long-term health condition. 31% of disabled people on FSS has so far started a job (4,065);

• No one Left Behind, including the Parental Employment Support fund (PESF) has supported 2,160 parents. 13% of parents reported having a disability (280) (experimental statistics).

The plan also includes a range of other cross cutting measures tackling the structural barriers that prevent many disabled people from entering and/or sustaining fair work, such as:

• supporting young disabled people and transitions delivered through the Young Person’s Guarantee;

• improving and increasing accessibility of public transport delivered through the Accessible Travel Framework;

• supporting employers to improve their recruitment and retention practices for example through the Public Social Partnership Apt; and

• seeking to maximise opportunities to support disabled people’s employment through available regulatory tools and mechanisms, such as the sustainable procurement duty.

When considering the population level disability employment gap clear progress has been made since we set out our ambition. The narrative updates are provided of the impact of these actions in our Year one and two progress reports .

Information on the routes of referral for metastatic breast cancer patients is not held centrally.

The Scottish Cancer Registry does not hold the kind of tracking information required to be able to report on secondary breast cancer. Therefore, Public Health Scotland cannot answer this question.

I refer the member to the answer to question S6W-01706 on 24 August 2021. 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

Information on the routes of referral for metastatic breast cancer patients is not held centrally.

Clinical guideline implementation is the responsibility of NHS Boards. The ultimate decision about a particular clinical procedure or treatment will always depend on each individual patient’s condition, circumstances and wishes, and the clinical judgement of the healthcare team.

Scottish Intercollegiate Guidelines Network (SIGN) guidelines have primacy in Scotland however NHS Boards and Integration Authorities may also choose to consider National Institute for Health and Care Excellence (NICE) guidelines in the planning and delivering services. Where there is not a current SIGN guideline in place Boards are expected to use other guidelines, such as NICE.

The decision to create, update and/or replace any SIGN guideline is not made by Scottish Government, it is made independently by the Evidence Directorate Work Programme Committee in Healthcare Improvement Scotland (HIS). Proposed guidelines under consideration can be found on the SIGN website: Our guidelines (sign.ac.uk) .

Table 1 presents the number of patients covered by the Treatment Time Guarantee (TTG) waiting for a hip or knee replacement procedure within an inpatient or day-case setting by NHS Board at 31 st December 2021.

Table 1: Number of patients waiting for a hip or knee replacement procedure 1,2 as an inpatient or day case at 31 st December 2021, by NHS Board.

A procurement process is underway for a web-based PROMS system to track the condition of long-waiting patients. Information and resources are being updated on NHS inform, and some joint work is ongoing with Versus Arthritis.

Earlier this year, the Scottish Government announced an extra £240,000 through the Chronic Pain Winter Support Fund to help 13 Scottish Government-funded projects across Health Boards, third-sector and other partners to enhance the support available for people with chronic pain. The money will go towards a range of services for people experiencing painful conditions, including those with knee pain, and also provide support to help people remain physically active.

The Scottish Government and COSLA published a National Workforce Strategy on 11 March 2022. This Strategy sets out a new framework to shape Scotland’s Health and Social Care workforce over the next decade; which places training, wellbeing, job satisfaction and the principles of Fair Work at its heart.

The Scottish Government has not engaged with this organisation specifically but a collaborative partnership approach has been taken to develop the Strategy. We have engaged with key partners across Health and Social Care, including NHS Boards, Local Authority representation, third and independent sector and staff-side representation through the National Workforce Planning Group and the Scottish Partnership Forum.

Moving forward with implementation of the strategy, we have committed to continuing to work jointly with partners across Health and Social Care.

The Strategy commits to publishing new workforce growth projections in the autumn, once we have had the opportunity to consider Health Board and Health and Social Care Partnerships' three year workforce plans. The staffing needs for services and professional specialties across NHS Scotland will be, in partnership with stakeholders, factored into the development of those projections.

Tables 1 and 2 present the number of patients covered by the Treatment Time Guarantee (TTG) waiting within an inpatient or day-case setting by NHS Board at 31 December 2021, and the number waiting over 1, 2 and 3 years for a hip or knee replacement procedure, respectively.

Table 1: Number of patients waiting for a hip replacement procedure 1,2 as an inpatient or day case at 31 st December 2021, broken down by NHS Board of treatment and length of wait.