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There is currently no centrally held data for the number of people entitled to an adult respite care break. The new Carers Census will collect data from Carer's Centres and local authorities about Carers who have an adult care support plan, whether they have a need for a respite care break and whether they received a respite care break. Initial data will be available later in 2018.

This specific information is not held centrally.

Integration Authorities are responsible for strategic planning of adult social care services. Since April, Integration Authorities also have new responsibilities under the Carers (Scotland) Act 2016 for local carer strategies setting out carer support available locally, including short breaks, and an assessment of demand. They are also responsible for publishing short breaks services statements providing information about short breaks available for both carers and those they care for.

Data from the Respite Care Survey 2014-15 ( http://www.gov.scot/Publications/2015/12/6824 ) shows that:

• 31% of respite weeks were for overnight care such as in a care home; 65% was daytime respite care and 4% was provided as a direct payment.
• Older people aged 65+ were more likely to use overnight respite. 36% of older people using respite services had overnight respite care compared to 23% of those aged 18-64 and 31% of children.
• 89% of overnight respite nights took place in a care home setting, 4% at the person’s own home and 7% in another setting.

No analysis has been carried out specifically on the impact of adult respite care on the number of primary care admissions. Section 4.6.7 of the “Scotland’s Carers” publication published 24 March 2015 talks about the impact of short breaks or respite. The Carers Act Monitoring and Evaluation Group is currently carrying out an Evaluability Assessment and this will be looking at what data currently exists on respite and what the priorities are for further analysis going forward.

The Carers (Scotland) Act 2016 took effect on 1 April 2018. Adult carers now have the right to an adult carer support plan to identify their personal outcomes so that their eligible needs are supported. Local authorities must consider whether support to a carer should take the form of, or include, a break from caring.

Integration Authorities also have new responsibilities under the Act to:

• establish and maintain an information and advice service for carers; and
• publish short breaks services statements providing information about short breaks available for both carers and those they care for.

The Scottish Government is supporting local delivery of these duties by:

• Publishing statutory guidance to accompany the Act which covers the provision of short breaks and provides examples of what a short break may consist of;
• Publishing a Carers’ charter which provides clear, accessible information on carers rights under the Act;
• Funding of the Coalition of Carers in Scotland (COCIS) to produce a leaflet on short breaks under the Act for use by local authorities;
• Funding Shared Care Scotland to maintain an online short breaks directory that local authorities can access;
• Supporting the development of a short breaks services statement template by a group of local authority representatives and Shared Care Scotland.

The Scottish Government has also provided over £23 million between 2010-11-2017-18 for the voluntary-sector Short Breaks Fund, administered by Shared Care Scotland and the Family Fund. We have committed a further £3 million for 2018-19.

The Carers (Scotland) Act 2016 took effect on 1 April 2018. Provisions include the right to an adult carer support plan to identify each adult carer’s personal outcomes so that their eligible needs are supported. Local authorities must consider whether support to a carer should take the form of, or include, a break from caring.

The Scottish Government supports local authorities with their duty to offer eligible adult carers a short break as part of the implementation of the Carers (Scotland) Act 2016 by:

• including an additional £66 million in the 2018-19 budget to support additional expenditure by local government on social care, including for implementation of the Carers Act;
• Publishing statutory guidance to accompany the Act which covers the provision of short breaks and provides examples of what a short break may consist of;
• Funding of the Coalition of Carers in Scotland (COCIS) to produce a leaflet on short breaks under the Act for use by local authorities;
• Funding Shared Care Scotland to maintain an online short breaks directory that local authorities can access;
• Supporting the development of a short breaks services statement template by a group of local authority representatives and Shared Care Scotland.

Numbers of Consultants working in Surgical Specialities have increased by 41.7% during the lifetime of this government.

Information on consultant vacancy figures, of which consultants working in surgical specialities is a sub category, is published by ISD Scotland and is available at the following web links:

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2018-03-06/Consultant_Vacancies_D2017.xls .

and

http://www.isdscotland.org/Health-Topics/Workforce/Publications/2012-11-27/Consultant_Vacancies_S2012.xls?40942485 .

Information on how many NHS surgeon positions remained unfilled in each year since 1999, broken down by NHS Board, is not centrally held. Specific local information may be available from individual NHSScotland Boards.

The following table shows the numbers of deaths from (a) external causes which cause hypoxia and (b) fetal hypoxia. It is not practical to provide figures for deaths from all the other diseases in which hypoxia may play a part.

Deaths for which the underlying cause was either (a) an external cause of hypoxia or (b) fetal hypoxia, registered in Scotland from 1999 to 2016.

The Scottish Government supports development of trauma-informed services and work is underway to raise awareness of the impact of trauma and adverse childhood experiences amongst various sectors.

Education Scotland has developed a range of professional learning resources and support materials to support implementation of nurturing approaches across Scottish schools. These include the document “ Applying Nurture as a Whole School Approach ”, a framework for self-evaluation of a Nurturing approach in schools and Early Learning and Childcare settings. https://education.gov.scot/improvement/documents/inc55applyingnurturingapproaches120617.pdf . All materials complement development of trauma-informed schools, offering guidance on meeting the needs of all children and young people but particularly those who have experienced early adversity and trauma.

Education Scotland are developing additional professional learning materials which give further guidance and support for children who have experienced early adversity and trauma, and curricular materials to help children and young people develop an understanding of early adversity and trauma. It is hoped that these will be available in the academic session 2018-19.

In June 2017, a report was published by the multi-disciplinary Scottish Adverse Childhood Experiences Hub, hosted by NHS Health Scotland, to inform thinking about the impact of adverse childhood experiences within education. http://www.healthscotland.scot/media/1517/tackling-the-attainment-gap-by-preventing-and-responding-to-adverse-childhood-experiences.pdf In March 2018, a conference was held by Education Scotland, NHS Health Scotland and the Scottish Government to share best practice on addressing adverse childhood experiences in education.

http://www.healthscotland.scot/events/2018/march/relationships-and-resilience-addressing-childhood-adversity-to-support-childrens-learning-and-wellbeing

In May 2017, NHS Education for Scotland and the Scottish Government published “ Transforming Psychological Trauma: A Knowledge and Skills Framework for the Scottish workforce ”. The Reference and Implementation Group for this Framework now includes representatives of Education Scotland and it is currently developing a training plan to support the workforce to put necessary trauma training in place. This Group will consider how this work can be applied in schools, including how it fits with existing practice around nurturing approaches and development of trauma informed practices in schools.

The Scottish Government provided funding to NHS Lothian in 2017 to support the addition of a VOICES survey component into an evaluation of several other methods of capturing bereaved carer feedback. This work is being taken forward by NHS Lothian and is supported by the City of Edinburgh Health and Social Care Partnership, and by Marie Curie.

Extensive preparatory work is required to conduct this study and this is underway. Navigating this process and identifying potential barriers and solutions to the effective administration of such surveys will be one of the key lessons from this project.

The Scottish Government looks forward to receiving the findings of the study in due course.

The information requested is not held centrally. This information may be available from NHS Boards.

We are continuing to develop the Health Visiting Services to deliver a consistent enhanced service to all families and grow the workforce to meet additional demands. The Universal Health Visitor Pathway, published in October 2015, outlines a core home visiting programme as a minimum standard to be offered to all families with children under 5 years of age. The pathway is being implemented by NHS Boards on an incremental basis as new health visitors are recruited, and it is expected that full implementation will be achieved by 2020.