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In Scotland, the Scottish Medicines Consortium (SMC) appraises the clinical and cost-effectiveness of newly licensed medicines. The SMC has a transparent and robust process that is fully described on its website. It is worth noting that any SMC appraisal is undertaken independently of Scottish Ministers and is based on the clinical and cost-effectiveness of a medicine at a population level.

The SMC’s process allows companies to present a cost-effectiveness case which sets out the predicted health benefits of their treatment (including one-off treatments) over a person’s lifetime, and the SMC’s assessments follow standard methodology for such calculations. In addition, in the assessment of innovative medicines for rare conditions (including gene-edited precision medicines where a single treatment may have lifelong benefit), the SMC process involves additional flexibilities as outlined on its website. By way of an example, in 2021, the SMC was the first health technology appraisal body in the UK to accept a one-off gene therapy for spinal muscular atrophy.

The Scottish Medicines Consortium (SMC) provides advice to NHS Scotland on a ‘once for Scotland’ basis about the value for patients of newly licensed medicines, including innovative cell and gene therapies such as one-off gene-edited treatments for debilitating inherited conditions.

For example, in 2021, the SMC was the first health technology appraisal body in the UK to accept a gene therapy for spinal muscular atrophy. This ensures that NHS patients have equal access to innovative medicines that are clinically and cost-effective. The SMC has a transparent and robust process that is fully described on its website.

The Quarantine mailbox provides a holding area for email messages that are automatically identified as potentially harmful (e.g., potential phishing and malware messages). 

The IT Helpdesk initially sent out emails to all users to raise awareness of the Junk and Quarantine storage areas when it was introduced and most recently in 2020.  Since then, the screens at the BIT Engagement desk at Holyrood have been used to remind Members about the existence of the Quarantine area, and staff have been available to offer advice and assistance on accessing the folder.

Staff in the BIT Office are currently investigating a means of more actively alerting Members and other users of the email system to any quarantined email messages.  The alerts will take the form of a weekly roundup email reminding users to release or delete items as appropriate.

On 6 October 2023 Student Awards Agency Scotland wrote to colleges and universities confirming the 2023-24 Higher Education (HE) Discretionary Funds allocations and guidance. The funds were issued to the sector during the week commencing 9 October 2023. Approximately £8m has been issued. Colleges and universities were notified on 17 th October that a further £4m will be issued in April 2024.

The Scottish Government will not directly save money as a result of the reduction to employer contribution rates to the Strathclyde Pension Fund. Instead, it is the individual employers, including local authorities, who will save.

The amount each scheme employer will save will depend on their pensionable pay-bill and the employer pension contribution rate they are required to pay. These rates have not yet been set for employers outside of the Main Employer Group (MEG) (the 12 local authorities participating in the Fund and arm’s length external organisations).

In very broad terms, the Strathclyde Pension Fund has estimated the overall financial impact on employer contributions in the MEG, to be a £366m saving in years 1 and 2, and £51m p.a. thereafter.

Bereaved families should not have to wait to receive final confirmation of the cause of death and it is imperative that information about their loved one is provided as soon as possible. As the Lord Advocate noted in her response to S6W-21281, there have been delays in reporting post-mortem results, which is unacceptable. She also recognised that collaborative work has been done to resolve the delays, and that significant progress is expected within the next few weeks.

The Lord Advocate has responsibility for the investigation of all sudden, suspicious, accidental and unexplained deaths in Scotland – including providing bereaved families with the final confirmation of the cause of death of a loved one following receipt of the post mortem report. The Lord Advocate set out her position on post-mortem toxicology delays in her answer to question S6W-21281.

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

Improving Scotland’s health data capabilities remains a key objective in improving outcomes for patients. We are continuing to progress work to implement changes to how we improve data collection on medicine use and outcomes. Changes to existing systems or any new systems take time to develop and implement and we continue to work with Scottish Government colleagues, industry, NHS Scotland and academia to evolve our approach to medicines data.

In relation to the first action, capturing medicines use for patients in all clinical settings, there are several relevant work programmes underway. Hospital Electronic Prescribing and Medicines Administration (HEPMA) has been rolled out in eleven Health Boards and work is underway to rollout HEPMA in the remaining Health Boards. The medicines data from all Health Boards who have HEPMA deployed have been used throughout the COVID-19 pandemic to inform clinical practice and drive improvements. The Digital Prescribing and Dispensing Pathways programme is on track to replace the current paper prescription in Scotland with an entirely digital approach to capturing prescribed and dispensed medicines by the end of this parliamentary term.? There is also progress with the development of a national Homecare (medicines prescribed via hospital specialists and delivered direct to patients at home) medicines dataset whereby third-party suppliers are providing regular data (monthly) to Public Health Scotland (PHS). These data have also been used to support COVID activities and work is progressing to enhance the quality and completeness of data flows.

Action two, including medicine indication in all prescribing systems , is more complex, requires in most of the cases retrospective addition of indication data and is reliant on IT system changes. We are seeking to progress this as part of our wider work programme.

Action three , to create a national laboratory data resource , this is also reliant on work being progressed further in response to the other actions from the report, and we will consider further in due course.

In relation to action four, to improve recording of patient outcomes of medicines , we have funded the Cancer Medicines Outcomes Programme (CMOP) which has developed a robust and reliable process to understand the effectiveness and safety of cancer medicines in routine care in Scotland. We are also funding PHS to establish a National Medicines in Pregnancy surveillance asset. This asset will support monitoring and reporting to progress improvements in the safe use of sodium valproate and other teratogenic medicines in Scotland by identifying and linking medicines exposure with outcomes data sets.

In response to action five, to create a Scottish Medicines Intelligence Unit , the Scottish Government funded CMOP programme has enabled capability building and intelligence in the use of our national SACT (cancer medicines) dataset and this is generating evidence to support the evaluation of the use of and clinical outcomes from all new medicines approved through the Scottish Medicines Consortium Health Technology Assessment process.