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On top of the £1.9 billion provided to support COVID pressures in health and care this year, as set out in the statement, the £300 million represents additional investment to specifically support winter pressures.

This is funded from health and social care consequentials.

There are no plans to undertake an immediate metastatic breast cancer audit. Our focus currently remains on maximizing available clinical capacity to see patients. Our £114.5m National Cancer Plan has a range of measures aimed at benefitting all cancer patients, including implementation of a single point of contact resource that will support patients throughout their pathway, and after discharge, including those with secondary breast cancer. We are however giving further clinical consideration to possible audit work in this area while recognising the ongoing severe pressures in our NHS.

I recognise that there are now a number of apps supporting the Covid response in Scotland, however none of the pre-existing apps (e.g. Protect Scotland) offered the ability to provide secure, authenticated access to an individual’s health record. For this reason, a separate app was required.

Officials also explored whether it was possible to extend the use of the existing NHS App from England – where people in England can access their Covid Status – into Scotland. However, the NHS App was originally designed for a very different purpose, it is linked to GP practices in England and requires use of the separate NHS Login which only exists in England and Wales. In discussion with NHS Digital it became clear it was not a feasible option. This is because the timescales involved in joining the NHS App, coupled with the fact Scotland holds its vaccination data in a different way to England and would mean we would lose control over our own scheme.

People in Wales cannot use the NHS App either, they are currently limited to the shared England/Wales online portal accessible with an NHS Login.

Whilst the certificates that are in use in Scotland have been designed to the same international standards as the rest of the UK, and our paper certificates all follow the same template in the UK to ensure consistency, it is appropriate that we design a scheme that is right for Scotland, works in our context, and offers us the flexibility to adapt to our changing circumstances.

As set out in the Programme for Government 2021 - 22, published on 7 September 2021, the Scottish Government is committed to establishing a dignified and compassionate miscarriage service by the end of 2023.

Work is underway to progress this commitment, which aims to support the development of individualised care plans after a woman’s first miscarriage, take forward specific recommendations made in the Lancet series on miscarriage published on 26 April 2021 and ensure women’s services in Health Boards have dedicated facilities for women who are experiencing unexpected pregnancy complications.

We continue to monitor closely and assess this next phase of the pandemic. The current package of statutory measures is considered an appropriate public health response to the incidence or spread of infection in Scotland in line with our strategic intent to suppress the virus to a level consistent with alleviating its harms while we recover and rebuild for a better future. We have acted to give as much clarity and consistency as possible to individuals, businesses, and sectors within society, and we will continue to do so. The fact that COVID-19 continues to be a threat – to individual health and to the capacity of our health system – is the reason why our existing mitigations remain in place.

However, we are keeping these measures under review, with regular reviews scheduled every three weeks. As part of this process, we will consider whether any existing mitigations need to be strengthened in light of what the data is telling us.

Cabinet Secretaries and officials have renewed efforts to engage with sectoral stakeholders to re-invigorate stronger messaging on the need to comply with existing baseline measures. This means taking all possible proactive steps to promote and reinforce baseline measures, the promotion of advisory precautionary measures and sector specific good practice in all sectors.

We are committed to meaningful engagement with UK Government and with the devolved governments. The Scottish Government has frequent and ongoing engagement across the Four Nations. The First Minister has been taking part on a weekly basis in four nations ministerial calls – until the UK government cabinet reshuffle last month these were chaired by the Chancellor of the Duchy of Lancaster (as Minister for the Cabinet Office) and they were also attended by first ministers from the other devolved governments. We are now re-configuring these calls with Mr Gove in his new role as Minister for Intergovernmental Relations. The Cabinet Secretary for Health and Social Care also takes part in weekly meetings with counterparts from the UK Government and other devolved governments. We are working extensively with the UK and Welsh Governments and Northern Ireland Executive and seeking to make decisions on a ‘Four Nations’ basis where possible and appropriate. However, it is wholly right and appropriate that we respond to the virus in a way that is right for Scotland, that works in our context and offers us the flexibility to adapt to our changing circumstances. Similarly, UK Government is entitled to make their own decisions on measures that they introduce in England, but it is important to remember that these decisions apply in England only. This includes on Plan A and Plan B.

We welcome the MS Society’s Neurology Now report as an important document highlighting the issues for people with MS and wider neurological conditions throughout the COVID-19 pandemic. I am pleased to say that I recently met with officials from the MS Society to discuss the findings of the report and the ongoing development of MS services in Scotland.

Let me assure the member that the Scottish Government is committed to ensuring that all people living in Scotland with MS are able to access the best possible care and support, and benefit from healthcare services that are safe, effective and person-centred. As you may be aware, we are investing £4.5 million over 5 years to implement our Neurological Care and Support – National Framework for Action. This Framework aims include improving the provision of co-ordinated health and social care and support, developing sustainable workforce models and ensuring high standards of care for people living with neurological conditions, including MS.

Over the past year we have invested over £300,000 to projects which improve the health and wellbeing of people with MS in Scotland.

Regarding a reporting framework to measure improvement, we have commissioned NHS Healthcare Improvement Scotland to work with NHS boards, integration authorities, the third sector and people with lived experience to assess progress in implementing the General Standards for Neurological Care and Support. Undertaking this work will identify areas of improvement across NHS Scotland and help to drive forward better standards of care for people with neurological conditions.

We are working closely with colleagues in Public Health Scotland to develop systems that will collect key data to inform service planning, delivery of clinical standards, and improvement across Scotland. In the first instance we have commissioned an audit of prevalence for neurological conditions from primary care system and we anticipate this data collection will begin during 2022.

We are also working with the Neurological Alliance of Scotland to distribute the first national patient experience survey specifically for people with neurological conditions.

Public Health Scotland collects waiting times data for neurology, which informs current practice in relation to service improvement. We are aware that the pandemic has impacted on waiting lists for neurology clinics and are currently implementing programmes to mitigate this situation. We are working with NHS boards through the Centre for Sustainable Delivery to implement more efficient ways of working such Patient Initiated Review and Active Clinical Referral Triage. These can be applied in various neurological conditions.

Regarding the cost of treating neurological conditions, service areas within NHS health boards carry their own budgets and associated financial improvement plans to manage and improve efficiency of their spend across specialties. Neurology spend data is collected as part of the annual Costs Book exercise published by Public Health Scotland, and we continue to work with health boards and consider data issues as part of this.

I refer the member to the answer to question S6W-02466 on 28 September 2021 which explained that t he First Minister’s former Chief of Staff resigned on the suspension of parliament for the 2021 Scottish Parliament election in line with the Special Advisers Code of Conduct and model contract. I n line with GDPR requirements, the Scottish Government does not provide personal data such as the levels of payments made to individual staff.

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