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The National Optimal Lung Cancer Diagnostic Pathway provides boards with best practice examples to improve lung cancer diagnostic pathway efficiency. Adoption of the optimal diagnostic pathway will take time as boards begin to redesign their services, funding has been aligned to this work to help support boards implement diagnostic pathway improvements over time. Not all patients that move through diagnostic pathways will have cancer, however data form Public Health Scotland shows that we continue to treat around 1,000 lung cancer patients in NHS Scotland on average each quarter. Data on the number of lung cancers treated in Jan - March 2023 will be published by PHS on 27 June 2023.

The Scottish Government is committed to an infrastructure solution to address landslip risks at the A83 Rest and Be Thankful and shares the urgency communities and businesses place on maintaining and improving connectivity of this vital route.

The identification of the preferred route option through the Glen Croe valley on 2 June 2023 is a very important milestone in finding a solution to this long-standing problem. The proposed new debris flow shelter will help protect the road and road users from future landslides.

Work is now being taken forward at pace to further develop our proposals, including the detailed development and assessment of the preferred route option along with the preparation of an Environmental Impact Assessment, draft Road Orders and draft Compulsory Purchase Orders. Transport Scotland will continue to look to expedite the programme where possible as we take forward the next stage in the process with a view to publishing draft Orders by the end of 2024 for formal consultation.

Progress thereafter will depend on the level and nature of any representations, including objections, to the published draft Orders. Should objections be received following publication of draft Orders then a public local inquiry may be required to consider all unresolved objections. The Scottish Government is duty bound to properly follow the correct statutory procedures which rightly include the opportunity for local communities to input and have any objections received resolved appropriately.

Procurement of a main works contractor for the permanent, long term solution can only commence upon completion of the statutory processes.

We’re taking a wide range of actions to tackle the drug deaths crisis. Through the National Mission on drugs we have:

• Continued to expand Residential Rehab, more particularly over the course of this parliament, we are working to increase overall residential rehabilitation capacity by 50% which is an increase from 425 beds to 650 beds. Through our work on pathways into rehab and investment in capacity, we aim to increase the number of statutory funded placements by 300% over this parliamentary term so that in 2026 at least 1,000 people are publicly funded for their placement.
• Provided £15m a year funding to community and grass-roots organisations that supported over 300 projects across Scotland, including 48 projects in the most recent funding round last month.
• Continued to drive implementation of the MAT Standards. All Health Boards, IJBs and Local Authorities have returned delivery plans and will be regularly reporting on progress to the Drugs and Alcohol Policy Minister.
• Announced a target focused on increasing the number of people in community based opioid substitute therapy to 32,000 by April 2024.
• Progressed work on introducing safer drug consumption facilities, facilitating development of a proposal which is now being considered by COPFS.
• Continued to expand the National Naloxone Programme to ensure naloxone is easily available to anyone at risk of overdose.
• Established the National Collaborative to ensure that the voices of those with lived and living experience are at the centre of policy and decision-making.
• Published a rapid review into mental health and substance use services , including recommendations to improve service delivery and support other work such as implementation of the MAT standards.
• Published our response to the Drug Death Taskforce Report , detailing over 80 actions, supported by significant new spending commitments of over £68m for the remainder of this parliament.

Last year we published National Mission on Drugs: annual report 2021 to 2022 which sets out the progress made between January 2021 and 31 March 2022 by national government, local government and third sector partners towards reducing drug deaths and improving the lives of those impacted by drugs in Scotland.

The second annual report on the progress of the National Mission 2022 to 2023 is due to be published this summer.

Chronic lymphocytic leukaemia is categorised into 3 stages. Generally, if a patient has stage A, the condition is monitored and treatment is not recommended. This is because there is no benefit in receiving treatment at this stage, and it can cause significant side effects.

For the Academic Year 2022-23, the Scottish-Government recommended intake target to paramedic education programmes was 335 students. Similarly, for the Academic Year 2023-24, the Scottish-Government recommended intake target to paramedic education programmes is 335 students.

Following reports at the end of 2022 that nitazenes, a new form of synthetic opioid, had been detected in a drug related death in Scotland, Scottish Government officials have worked closely with Public Health Scotland (PHS) colleagues to monitor and better understand this new substance of concern.

Through work done with PHS to improve our public health surveillance system, an alert was issued through their RADAR (Rapid Action Drug Alert and Response) system in January in relation to nitazenes, highlighting the risks and dangers associated with these substances, but also providing information for people who take drugs as well as setting out actions which drug and alcohol service staff could take. This alert was further updated on 29 March. A copy can be found here - RADAR Alert 2023/04, Nitazene type drugs in Scotland - Publications - Public Health Scotland .

As a result, drug and alcohol services, health care settings and high-risk settings, like prisons, have all been urged to follow harm reduction advice for opioids and polydrug use and to increase and optimise the availability of naloxone to people they support.

Following the identification of this new substance in drug related deaths in Scotland, and a recommendation from the RADAR toxicology sub-group, post-mortem screening in Scotland has been expanded to ensure that toxicology providers are now routinely testing for nitazenes and, in selected cases, retrospective post-mortem testing has also been conducted.

Due to the potential for nitazenes, and other new psychoactive substances, to be present in the wider drugs supply, we are committed to delivering drug checking facilities in Scotland to enable us to respond faster to emerging trends in the drug supply. We anticipate that license applications to the Home Office, to grant permission for the establishment of these facilities in Glasgow, Dundee and Aberdeen, will be submitted in the coming months.

The Scottish Government has made available £3 million of funding to the Centre for Sustainable Delivery (CfSD), hosted in NHS Golden Jubilee, to support implementation of the optimal lung cancer diagnostic pathway. CfSD is responsible for supporting the design and delivery of optimal cancer diagnostic pathways in NHS Scotland, and has been working with Boards across Scotland to enhance current services and direct investment to the areas with greatest need.

£10 million of funding was directed to support Cancer Waiting Times improvements in our NHS across 2021-22, with a further £10m made available to Boards in 2022-23 to continue to support Cancer Waiting Times. Health Boards across NHS Scotland direct spend towards the most challenged areas, which included additional clinics for new patients and follow-ups.

Funds in 2022-23 were largely directed towards breast, colorectal and urology specialties – three of the most challenged 62 day pathways. Significant funds went towards up-skilling nurses and investment to support extended working days and weekend working to increase capacity.

NTCs require an appropriate mix of new and experienced staff to operate safely and efficiently. Management information provided by NHS Education for Scotland (NES) shows that at 31 March 2023, 502 people were employed in an NTC. This figure excludes those staff delivering pre-existing NHS services which have been relocated to NTC sites. 130 (26%) are new entrants meaning they are undertaking their first role in NHS Scotland. Whilst these figures from NES are classed as management information at this stage, NES will continue to work with data providers to develop these as Official Statistics. The next step in this process will be to release these statistics within the NHS Scotland workforce publication as Experimental Statistics in December 2023. NTC workforce data will be reported every six months thereafter.

I refer the member to the answer to question S6W-18750 on 15 June 2023. 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 .