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The Scottish Government is tackling marine litter with actions detailed in our Marine Litter Strategy, which aims to address the amount of litter entering the marine environment, to achieve ecological, economic and social benefits. Our Strategy and action plan was refreshed in September 2022 and focuses on the most problematic types of marine litter including fishing and aquaculture gear, sewage-related debris, and plastic pellets. The Strategy drives forward our work and co-ordinates the efforts of our stakeholders and partners, working at a national and international level to help tackle this global problem.

At a Scotland-wide level, our many actions to prevent litter include: improving the management of end-of-life fishing and aquaculture gear to reduce litter and improve recycling rates, contributing to our circular economy; working across the four nations to ban the sale of wet wipes containing plastic; and developing international solutions to prevent spills of plastic pellets, which can be found on beaches and risk the health of marine wildlife. Litter removal actions include: funding the KIMO Fishing for Litter scheme, to assist the correct disposal of litter caught in fishing nets; and funding the Keep Scotland Beautiful Upstream Battle project, removing litter along rivers.

At a regional level such as Loch Long, we continue to work with key partners relating to the River Clyde catchment and west coast locations including Arrochar. The Upstream Battle project enables communities, businesses, and schools on the River Clyde to develop local solutions to reduce littering, and also support its clean-up. Litter is reduced and intercepted before it reaches the sea, and citizen science outputs will inform further riverine litter policy. We are engaging with Glasgow City Council to consider more options to increase litter removal from the River Clyde which we know is a major source of litter at Loch Long.

We understand that the provision of tailored mental health support remains challenging in some areas of respiratory care. We continue to work closely with health psychologists and other key stakeholders to determine how better support can be provided to people living with respiratory and other long-term conditions.

We have invested £51 million in our Communities Mental Health and Wellbeing Fund for adults since 2021, with approximately 3300 grants made to local projects across Scotland in the first two years alone.

A further £15 million was announced on 25 March 2024 for Fourth year of the Fund which means the Scottish Government has made £66 million available since 2021, the funding supports people facing socio-economic disadvantage, people- living with a long-term health condition or disability, older people and people disadvantaged by geographical location.

We also continue to provide a range of resources and raise awareness of how to support mental wellbeing through expanding the range of practical mental wellbeing resources available on our Mind to Mind, Parent Club and Young Scots mental wellbeing websites to complement other supports available in person and by phone.

Improved access to diagnostic tests remains a wider commitment for the Scottish Government and we are working closely with Primary Care colleagues to determine ways to improve spirometry.

The Scottish Government has established a Scottish Expert Advisory Group to support the work of the UK National Screening Committee Lung Task Group and inform the implementation of a targeted lung cancer screening programme for Scotland.

Introducing a new screening programme such as Chest and Lung CT scanning is inherently complex, and the required evidence and information must be fully developed before implementation begins. This is likely to take several years for each UK nation.

The Scottish Government-funded LungScot study, led by the University of Edinburgh, provided further information on the feasibility of lung screening and the influences of sociodemographic and other patient characteristics. The Scottish Expert Advisory Group is incorporating these findings into their business case which will inform the next steps towards implementation.

We continue to support a digital first, but not digital only approach across many of our respiratory programmes. Recommendations within the pulmonary rehab work have suggested widening access to online self-management tools and this is something we are actively considering.

NHS Inform provides information about respiratory conditions and other long-term conditions. The service offers information, advice and self-management tools on how to live well with their condition as well as including links to additional support and information provided by third sector partners.

Our updated Quality Prescribing Guide for Improvement keeps the person with respiratory conditions at the centre of their treatment and disease management and offers practical advice and options for tailoring care to the needs and preferences of individuals. A core component of this has been to create user friendly digital tools for both people living with lung conditions and healthcare professionals.

We have recently published the Quality Prescribing Guide for Improvement that aims to keep people at the centre of their treatment, and promote safe, evidenced based, sustainable prescribing.

The guide was developed by a wide range of stakeholders including experts in the field and lived experiences. The guide is intended to support clinicians across the multidisciplinary team and people living with respiratory conditions in shared decision-making and the effective use of medicines and offers practical advice and options for tailoring care to the needs and preferences of individuals

In 2022 the Scottish Government published the Rehabilitation and Recovery: A Once for Scotland Person-Centred Approach to Rehabilitation in a Post-COVID Era. Which sets out a framework for delivering innovative and inclusive rehabilitation for all.

It supports rehabilitation service providers to identify ways to deliver individualised, cross-sector rehab utilising existing services. It also supports community-based services and supported self-management.

The approach outlines Six Principles of Good Rehabilitation that can be applied across rehab services which are universal principles for delivering good and accessible rehabilitation for all, at the point of need.

We also have a specific work plan aiming to improve access to Pulmonary Rehab across Scotland and provided recommendations to NHS Boards in 2024.

The Respiratory Care Action Plan has another year left in its current lifespan. We will continue to implement the commitments in the Plan over the coming year, alongside our work to explore a new long term conditions strategy to ensure equitable and sustainable access to the services that all people with long term conditions need, while still allowing for targeted action on condition-specific care and support where appropriate. We will take the progress of this work into account as we consider the best way to continue work to improve care and support for people with respiratory conditions in the future.

The information requested is complex and not held centrally.

All information on prescribed and dispensed items are published and categorised by the British National Formulary chapter, in both monthly open data files and as part of the annual Dispenser Payments and Prescription Cost Analysis which was last released on 8 October 2024. This can be accessed on the Public Health Scotland website at Dispenser payments and prescription cost analysis - Financial year 2023 to 2024 - Dispenser payments and prescription cost analysis - Publications - Public Health Scotland.

The Centre for Sustainable Delivery (CfSD) based at the Golden Jubilee Hospital is developing national pathways for respiratory conditions including severe asthma, COPD and sleep apnoea. This work to improve patient journeys aligns closely with the Respiratory Care Action Plan and we are working with CfSD to understand the implications for wider respiratory policy.

We recognise the importance of having access to meaningful data in relation to respiratory services and assessing the impact of the Respiratory Care Action Plan.

We work with a wide range of stakeholders to ensure that the current programmes for improving respiratory care remain relevant and make an impact. We will continue to monitor progress through various groups, including via our third sector partners, to determine next steps for implementing the Plan.