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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.

The requested information is not held centrally. NHS National Services Scotland, Information Services Division collect and publish sickness absence data at a national and board level once a year. Annual information from 2007 is available at the following link:

http://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-06-06/Sickness_Absence_M2017.xls .

Data showing the cases of exclusion for each local authority for the academic years 1999-00 -2002-03 is available on the Scottish Government website here:

http://www.gov.scot/Publications/2004/09/19874/42462

Data showing the cases of exclusion for each local authority for the academic years 2003-04 – 2016-17 is available in table 24 of the supplementary tables, on the Scottish Government website here:

http://www.gov.scot/Topics/Statistics/Browse/School-Education/exclusiondatasets/exclusionsdataset2017

Since 2010-11 the data has been collected biennially so no data is held for 2011-12, 2013-14 or 2015-16.

Cases of exclusion refers to the number of incidences of exclusion, not the number of individual pupils excluded, as a pupil can be excluded multiple times.

The Scottish Government works closely with the UK National Screening Committee (UK NSC). This independent expert advisory group advises Ministers and the NHS in the four UK countries about all aspects of screening policy using the international research evidence base and establishing pilot programmes where appropriate to collect additional evidence.

The UK NSC and the Scottish Government recognise that lung cancer is the most common cause of cancer death in the UK and, unless found at an early stage, the outcome is poor. Nevertheless, the UK NSC does not currently recommend a national screening programme for lung cancer because there is not yet enough evidence that this is a good approach to reduce the burden of the disease. In particular there are concerns around significant over-diagnosis leading to potentially invasive investigations in people who are well.

The policy is due to be reviewed again, taking into account the results of the NELSON randomised lung cancer screening trial. If there is any change to the policy this will be carefully considered by the Scottish Government.