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The Scottish Government plans to commission and publish a second independent expert study on trends in the prescribing of psychoactive medications for people with dementia before the end of 2020.

Transcranial magnetic stimulation is not routinely available in Scotland on the NHS. Local health boards are best placed to provide or arrange provision of any evidence based treatment and services.

The needs and treatment of every patient will differ depending on range of factors. Should a patient put forward an interest in transcranial magnetic stimulation as a part of their treatment plan, they should, along with their family discuss the full range of evidence based options with the consultant responsible for the patient's care.

Should it be required, the consultant can make a case to the respective health board for the treatment. This could include accessing the treatment somewhere else in the UK, including a different nation.

The information requested is provided in the table that follows.

Our commitment to early detection is reflected in our £42 million Detect Cancer Early (DCE) Programme that aims to increase the proportion of breast, bowel and lung cancers diagnosed early in Scotland.

(a) Social marketing has a key role to play in the early detection of lung cancer. Sir Alex Ferguson has fronted DCE’s marketing activity since 2013 to raise awareness of the benefits of early detection, while reminding people that lung cancer is no longer a death sentence. This has contributed to the 31.0% increase in stage one lung diagnoses in the most deprived areas of Scotland since DCE began. A new social marketing approach is now being explored with key stakeholders and leading clinicians to ensure the public stay alert to possible signs and symptoms and feel empowered to act early.

(b) To support primary care clinicians in diagnosing cancer early, DCE funded a clinical refresh of the Scottish Referral Guidelines for Suspected Cancer, with updated evidence published January 2019. Eight pathways were included in the refresh, including lung. In collaboration with Cancer Research UK and Macmillan Cancer Support, work continues across NHSScotland to ensure the guidance is fully disseminated and adopted.

Meanwhile, the Scottish Government is currently exploring what opportunities exist for Scotland to contribute to the emerging evidence base for lung cancer screening. Officials have recently met with academics, the Chair of the UK National Screening Committee, and the Scottish Screening Committee to discuss ongoing studies and trials, to identify where Scotland can best add value. These discussions are ongoing and any recommendations will be carefully considered.

The information requested is publically available in - ‘Cancer Incidence in Scotland 2017’ - published by Information Services Division in April 2019. This is available via the following link:

http://www.isdscotland.org/Health-Topics/Cancer/Publications/2019-04-30/cancer_staging.xlsx

In 2012 the Scottish Government commissioned and published a first independent expert study on trends in the prescribing of antipsychotic and other psychotropic medications for people with dementia, between 2001 and 2011. It showed that, from 2009, there had been a decline in the initiation of new antipsychotics and a moderately decreasing trend in antipsychotic use. To assess trends since then, the Scottish Government will commission and publish a further independent expert study on trends in the prescribing of antipsychotic and other psychotropic medications for people with dementia in all settings since 2011, in line with commitment 18 in Scotland’s National Dementia Strategy 2017-2020.

The Scottish Government’s first Dementia Standards (2011) are clear that people with dementia have the right to receive a full range of therapeutic interventions to help alleviate stress and distress and that psychoactive medications including antipsychotic medications should only be used if no alternative interventions are available. Carers should be fully involved in discussions on the use of such medications including their benefit and associated risks.

The 2018 National Institute for Health and Care Excellence dementia guideline includes an evidence-based assessment of the benefits and risks associated with the prescribing of antipsychotic medications to people with dementia. The guideline does not identify an increased risk of premature death from prescribing antipsychotic medication in these circumstances.

We are continuing to work with key stakeholders and partners, including COSLA, to refine the integrated plan ahead of publication later this year. We will revise future plans and adapt them accordingly as more information and better data becomes available.

The Scottish Government is committed to reducing use of single use plastics. The EU Single-Use Plastics Directive will lead to a ban on these items across the EU and we continue to look at how we can lead by example following our ban of single use beverage cups from the Scottish Government estate. Zero Waste Scotland provides a range of tools and supports that can assist any public sector organisation looking to make progress on these issues.

I refer the member to Scottish Parliament Information Centre (SPICe) Bib number: 60754

To meet the goal of increasing the numbers of GPs by 800 in the next ten years, we need to take a number of actions, including increasing the number of medical places at universities, and taking steps to encourage medical graduates to choose general practice. To that end, between 2015-16 and 2020-21 the Scottish Government will have increased the annual intake of medical places in Scottish universities from 848 to 1038 (190 places, a 22% increase) including funding Scotland’s first Graduate Entry Medical programme (scotGEM) and widening access places.

We have also announced 85 additional medical school places to be shared between three universities: Aberdeen, Edinburgh and Glasgow. The new courses will focus on general practice offering a new route for experienced healthcare professionals to enter medicine. 25 of these places will be available at the University of Edinburgh.