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The National Institute for Health and Care Excellence (NICE) multiple technology assessment (MTA) final guidance is currently expected to be published on 20 March 2024.

As the Scottish Medicines Consortium (SMC) is partnering with NICE in the assessment of these medicines, the SMC will publish recommendations aligned with the final NICE guidance thereafter for Health Boards in Scotland to consider.

The Scottish Government remains committed to supporting people with cystic fibrosis (CF) to benefit from medicines which help them to live fuller lives, for longer. That is why we introduced a memorandum of understanding (MoU) with the manufacturer, Vertex Pharmaceuticals, in 2018. As part of the MoU, there was an expectation that Vertex would resubmit each of their CF medicines to the Scottish Medicines Consortium (SMC) for a health technology appraisal (HTA). To progress this, the SMC is collaborating with the National Institute for Health and Care Excellence (NICE) on a multiple technology appraisal (MTA) of Vertex’s CF medicines, including Kaftrio ® .

While the NICE MTA is ongoing, I can confirm that all existing and new patients in Scotland who are on, or who are started on a CF medicine will continue to have access to that CF medicine after NICE and the SMC issue their final recommendations. This will be irrespective of the outcome of the appraisal and will cover any need to subsequently switch to a different CF medicine.

If any CF medicine is not recommended in the final MTA guidance, clinicians in Scotland will be able to request the use of that medicine on a case-by-case basis for any new patients using the Peer Approved Clinical System (PACS) Tier Two process. National guidance explicitly states that Health Boards should not take account of the cost of medicines when considering applications using the PACS Tier Two system.

My officials engage with the pharmaceutical industry on a range of matters, including the development of new medicines, and keep me updated as required.

The Chief Pharmaceutical Officer last met with Vertex Pharmaceuticals on 6 December 2023 and continued to impress upon them the importance of offering a revised price to address the concern that the current price of the cystic fibrosis (CF) medicines covered by the multiple technology appraisal (MTA) exceeds what the NHS would consider reasonable. She also discussed the ongoing availability of clinical trial CF medicines, including when a trial is stopped.

As part of work being undertaken to develop the new Palliative Care Strategy, we are gathering and analysing evidence to tell us what actions should be taken to achieve the aim of ensuring that everyone in Scotland receives well-coordinated, timely and high-quality palliative care, care around death, and bereavement support based on their needs and preferences.

We have set up a number of working groups, bringing together stakeholders with expertise in priority areas for action, and these groups are developing recommended actions for inclusion in the strategy for discussion with the Strategy Steering Group (SSG) at its next meeting.

At the September meeting of the SSG there was discussion on the progress of the working groups and work being done to better understand people’s lived experiences of palliative care, as well as the proposed structure and timeline for the Strategy. A minute of the meeting will be available on the SG website, at https://www.gov.scot/groups/palliative-and-end-of-life-care-strategy-steering-group/ , once this has been agreed by the group.

To ensure that people get the financial support that they are entitled to as quickly as possible, adult disability benefit applications from people with a terminal illness in Scotland are fast-tracked. We also ensure that those who are terminally ill automatically receive the highest rates of assistance that they are entitled to, with no award reviews. They are eligible for this support straight away, with no qualifying period.

The new palliative care strategy will seek to understand and respond to the social determinants of people’s experiences towards the end of life, including financial insecurity and housing.

The new Palliative Care Strategy aims to ensure that everyone in Scotland, regardless of location, receives well-coordinated, timely and high-quality palliative care, care around death and bereavement support based on their needs and preferences, including support for families and carers.

We are aware of the importance of ensuring that the Strategy takes account of the differing needs of people living in rural and island areas, and of the particular challenges in these areas. Work is currently being undertaken to understand the lived experiences of users of palliative care services in rural and island settings. We have also asked our working groups, who are feeding into the Strategy, to give particular consideration to the impact that any actions they are recommending may have on rural and island areas.

We recognise the significant impact on people, businesses and communities in areas affected by storm Babet. The Scottish Government is committed to playing its part in helping them through this horrible experience which has destroyed so many people’s property and belongings.

We recognise the significant impact on people, businesses and communities in areas affected by storm Babet. The Scottish Government is committed to playing its part in helping them through this horrible experience which has destroyed so many people’s property and belongings.

A Mortality Special Interest Group (SIG) currently exists with a remit to monitor and analyse mortality trends in Scotland. This is a collaborative group chaired by Public Health Scotland (PHS) and includes representation from key organisations including the Scottish Government, National Records of Scotland and representation from Directors of Public Health.

More information on the Mortality SIG can be found on the PHS website .

There are currently no plans for the Scottish Government to set up any further committees or groups on excess deaths.

We are developing a new palliative care strategy to achieve the very highest standards of care right up to the end of life, and to ensure high-quality palliative care wherever and whenever it is needed.

As part of work being undertaken to develop the strategy, we are working with Public Health Scotland to get a better understanding of population-level palliative care needs, now and in the future. This includes consideration of the research that has been carried out by Marie Curie.