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This information is not held by the Scottish Government. All NHS Board expenditure is recorded via the Scottish Financial Returns, which provides operating costs relating to the running of all services provided to patients across NHS Scotland, however, it does not show specific costs for conditions such as thrombosis.

The expectation is that the mothers in threatened extreme preterm labour, or those whose babies will require surgery, will be identified antenatally and will birth in the maternity unit alongside the NICU. The Scottish Perinatal Network has published guidance on in-utero obstetric transfer in these circumstances.

Local Neonatal Units (LNU’s) will continue to deliver intensive care and care for babies from 27+0 weeks that need stabilisation and treatment, and both nursing staff and medical staff will continue to have experience in delivering these aspects of intensive care. We have asked Regional Chief Executives to consider arrangements for ongoing professional development of staff where required within their Regional Implementation Plans.

Jenni Minto: The Scottish Government does hold the information on how much each NHS board spends on raising awareness of thrombosis.

Although the Scottish Government has not funded a national awareness raising campaign for thrombosis in recent years, in December 2023, Scottish Government social media health channels ran a series of online awareness-raising messages on the risks and symptoms of DVT.

In addition, the guidance available to the general public on NHS Inform on deep vein thrombosis is reviewed regularly to ensure it is up to date, with the most recent update taking place in July 2024.

To support clinicians, the Scottish Intercollegiate Guidelines Network (SIGN) are responsible for publishing new rapid guidelines, with SIGN 122 and SIGN 163(specifically in relation to the prevention and management of venous thromboembolism (VTE) and VTE in patients with COVID-19 respectively) both being available.

SIGN supports the implementation of these guidelines by; raising awareness; networking with national projects and clinical networks; and developing implementation support tools and resources alongside specific guidelines.

The Scottish Government have no current plans run a national awareness campaign for thrombosis, however we are engaging with stakeholders and intend to mark World Thrombosis Day in October via social media channels.

The terms of Special Adviser contracts of employment are reserved to the UK Government. Those contracts include a requirement that severance payments are made to special advisers where their employment is terminated in the circumstances where a First Minister demits office, or on the dissolution of Parliament prior to a Scottish Parliamentary election. The value of severance payment due is dependent on an individual’s length of service and range from the equivalent of 3 months’ pay up to a maximum of 6 months’ pay.However, payment of severance is subject to agreement that should an individual be reappointed as a special adviser, they will repay any severance pay less the amount of salary they would have been paid had they been employed during the period between the termination of the previous contract and re-appointment on a fresh contract. Therefore the amount of severance to be repaid upon reappointment varies depending on the length of time between termination of employment and later reappointment. The following table sets out for each of the last 5 years to July 2024, the net cost of severance payments once the approximate level of repayments received are taken into account for those who were reappointed:

Special Advisers in the Scottish Government are paid using the following Pay Bands and Pay Ranges which are effective from 1 April 2024:

The Scottish Government recognises the importance of ensuring equitable access to living kidney donation. All nine Renal Units in Scotland are currently supporting living kidney donation, with sixteen living donor co-ordinators in post across the Renal Units. In 2016, the Scottish Government supported the creation of the Living Donation Scotland Board, whose role, working with referring Renal Units and Transplant Centres, is to make it easier to access living donor kidney transplantation. The Scottish Government also supports the Renal Units in their work by hosting an annual event for staff to share good practice and learning.

In addition, the Scottish Government is taking a number of steps to make accessing kidney donation easier as set out in the Scottish Donation and Transplantation Plan: 2021-2026 . The plan makes clear that whilst it will not be feasible for everyone, the aim is to encourage all those who need a kidney transplant to consider and explore options for a living donor transplant as their first transplant.

To ensure that every recipient who would benefit from a kidney transplant receives standard information about living donation during transplant assessment, the Scottish Government provides living donor information packs and a range of resources through the Organ Donation Scotland website, including written information, video and clear pathway contact information access for recipients and donors. Annual living donation multi-media campaigns have also proven successful in increasing awareness for donors.

Finally, following a pilot project, the Renal Education and Choices at Home (REACH Transplant) programme was implemented in 2022. REACH Transplant is funded by the Scottish Government and has involved the appointment of both a REACH transplant programme lead and ten REACH Transplant nurses across Scotland, based in each Renal Unit. The REACH Transplant nurses work with local nephrologists to identify those at an early stage who may need a kidney transplant in the future. A visit is organised with the recipient and their support network in a place of their choice to provide information on living kidney donation and to support the recipient to discuss living donation. The aim of this tailored support and timely referral for living donor transplantation is to increase the likelihood of pre-emptive transplantation by overcoming barriers and ensuring equity of treatment choice.

Current targets for nursing and midwifery controlled funded places have been set for 3 years. Prior to that, targets for controlled places were set annually. The multi-year targets were set in 2022 after extensive engagement with key stakeholders. Those stakeholders included NHS Boards, NHS Board Planners, NHS Education for Scotland (NES), Council of Deans Health Scotland, Scottish Executive Nurse Directors, RCN, RCM, Unite, Unison and internal Scottish Government policy teams.

A multi-year intake was agreed to provide stability across partners including higher education institutions.

Both quantitative and qualitative data were considered when arriving at the controlled intake targets for each student group. A modelling exercise was carried out by NES to support decision-making and this information was made available to all stakeholders ahead of the engagement process. Stakeholders were also invited to share their own data in advance as well as being invited to discuss their insights on vacancies, establishment figures and clinical placement capacity.

The Scottish Government does not provide universities with planning assumptions for neonatal nurse places as these are decided within NHS Boards in order to match the resource requirements in the Board and training needs of their staff.

In line with the actions set out in the Scottish Government’s Donation and Transplantation Plan: 2021-2026 , a short-life working group has been set up to consider the issue of “timely transplantation” and to discuss perceived barriers to pre-emptive living donor kidney transplant and timely listing for deceased donor transplant. The group is currently gathering data and will report at the December 2024 meeting of the Scottish Donation and Transplant Group, which brings together key stakeholders.

In addition, as part of the Living Donation Scotland initiative, link nephrologists from each Renal Unit meet at an annual living donation event supported by the Scottish Government. A key objective is to work with nephrology colleagues to document transplant suitability on all electronic patient records in their patient groups so the multi-disciplinary team is aware of the individual pathway and progress, and this is now supported by the Renal Education and Choices at Home (REACH Transplant) nurses in each Renal Unit.

Transplant patients can experience a variety of emotions following their transplant and as a result the Scottish Government recognises the importance of psychological and emotional support. In order to better understand patients’ experiences, the Scottish Government carried out a patient survey on organ transplant aftercare and support between September and December 2023, receiving 569 responses from patients in Scotland, including 192 from those who had received a kidney transplant. The survey asked about patients’ experience of psychological and emotional support both before and after transplant; about the sources of such support; about patients’ preference for where to receive this support; and about whether they had any further comments about what would have improved their experience.

The Scottish Government is currently analysing the responses to the survey with the intention of publishing the analysis by the end of the year. Working with the Scottish Donation and Transplant Group, which brings together key stakeholders, and NHS National Services Division as commissioners, the Scottish Government will consider whether further actions might need to be taken in this area and how best to ensure patients get what they need.

The Scottish Government recognises the importance of access to interdependent services, including those provided by allied health professionals such as physiotherapists, in order to optimise kidney transplant outcomes.

Under the Scottish Government’s Donation and Transplantation Plan: 2021-2026, a working group on transplant recipient aftercare has been set up. Access to physiotherapy services, which are generally provided when needed both via the Transplant Units themselves and by referring centres, has not so far been identified as an issue of particular concern for chronic kidney disease patients who have received a transplant in Scotland. We will continue to monitor the situation closely including by means of the working group.