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We know that the global pandemic and the lockdowns implemented to restrict the spread of the virus have had significant impact on many people with learning disabilities who were unable to access the support and community connections that they usual rely upon.

Assessments were carried out before any measure were put in place, to ensure this was the appropriate action to save lives, and during and after the restriction period to assess the impact on people’s mental health.

We have been working with partners and those with lived experience to deliver our Learning/Intellectual Disabilities and Autism: Towards Transformation Plan, which was published in March 2021. This includes actions to shape supports, services and attitudes to ensure that the human rights of people with learning disabilities are respected and protected and that they are empowered to live their lives, the same as everyone else.

We fund the Scottish Learning Disability Observatory (SLDO) to carry out research, including on the impact of the pandemic. We will continue to work closely with the SLDO to fully understand the actions required to address the research findings.

The Scottish Government and COSLA are engaging via a new leadership and engagement framework that puts people’s voices and experiences firmly at its heart. The first topic chosen by people with lived experience was mental health, following the impact of the pandemic. People with a learning disability have conducted their own peer research, including accounts of how the pandemic affected them and their families. They are currently progressing solutions and improvements based on their experiences.

We have also commissioned Healthcare Improvement Scotland to gather and provide insights into different approaches to the redesign of learning disability day services in recognition of the challenges the COVID-19 pandemic has created. In October 2020, the New Models of Learning Disability Day Support Collaborative was launched. The collaborative works with Health and Social Care Partnerships to develop their current service provision in line with Keys to Life outcomes whilst taking into account learning from working through the pandemic.

The Scottish Government recognises the importance of day services to adults with learning disabilities, their families and carers. Decisions about individual services are made by local authorities. However, the Scottish Government maintains regular contact with local authorities to encourage and support the re-opening of services. The Cabinet Secretary for Health and Social Care wrote to all local authorities and Health and Social Care partnerships on 25th May 2022 requesting that they undertake a survey of registered day centre services in their area with a view to identifying which services have re-opened, which have only partially opened (or opened with reduced capacity), and why. The purpose of this was to gain insight into the challenges around re-opening and capacity to inform the development of Scottish Government policy advice and guidance.

The findings from the survey identified that Covid-19 restrictions such as physical distancing, which were in place at the time were a barrier to services returning to full capacity. Covid-19 guidance for building-based day services was updated in both May and September and there is no longer a requirement for physical distancing between services users or staff. The survey also identified challenges in relation to the workforce. These exist across social care and work is under way to improve recruitment to the sector. This has included funding to extend the Myjobscotland website, the creation of a recruitment portal with the Scottish Social Services Council (SSSC), and working with Department for Work and Pensions (DWP) colleagues to host a series of social care job fairs across Scotland.

The survey will be repeated in November 2022 in order to establish how much progress has been made towards increasing capacity since the original survey was undertaken.

We expect all NHS Boards to have robust governance arrangements in place, including those for risk assessment and business continuity; as informed by, and consistent with, national policies and frameworks. NHS Lanarkshire has confirmed that, as part of their routine winter planning work, they have been engaging with local planning partners to ensure all eventualities are carefully considered.

The new powers provided by the Transport (Scotland) Act 2019 enable local authorities to determine what is best for their own areas. I recognise that not every authority will want to run their own bus services, some may opt for a partnership or franchise approach. It is important that the options within the Act are fully explored to ensure they are appropriate for the area and are sustainable for local authorities' long term. Work is currently ongoing with local authorities and COSLA to determine how best to allocate funding in light of the emergency budget review.

As you know, we are also undertaking a Fair Fares Review to ensure a sustainable and integrated approach to public transport fares as we recover from the pandemic. As part of the Review, we are considering both the availability of services and the range of discounts and concessionary schemes, which are available on all modes including bus, rail and ferry. We will also consider options that maintain and increase affordability for those who need it most, taking cognisance of the relative changes to the overall cost of travel.

The provision of NHS Pharmaceutical Care services is the responsibility of territorial Health Boards. Any concerns by members of the public on pharmacy closures and accessing services should be raised with the Health Board.

The arrangements under which applications may be made to open new pharmacies are long-standing and the current process is detailed in the NHS (Pharmaceutical Services) (Scotland) Regulations 2009. When an application to open a pharmacy is made, NHS Boards are required to establish a Pharmacy Practices Committee to act on their behalf in considering applications for entry to the Pharmaceutical List. In considering the application the Board will consider the pharmaceutical services already provided in the area, the pharmaceutical services to be provided and any representations received by the Board and also any other information available which is relevant to the consideration of the application. During this process, members of the public can be consulted on the need for additional community pharmacy capacity in their local area.

An application shall be granted by the Board only if it is satisfied that the provision of pharmaceutical services at the premises named in the application is necessary or desirable in order to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises are located. The Scottish Government is not involved in deciding applications for pharmacies to be added to the Pharmaceutical List.

Following the opening of the consultation published on 4 July 2022, setting out the measures proposed for the next Land Reform Bill, a programme of six public meetings took place. In addition, an online event was held on Thursday 22 July, which was open to all and which attracted participants from across Scotland.

At each of these events I, and my officials, made presentations setting out what the SG aims to achieve with the next Land Reform Bill. One of our key objectives is to ensure that communities benefit from investment in Scotland's natural capital, whether directly through ownership of land, or through engagement and co-operation with landowners.

Those attending the meetings included individuals, businesses, owners of farms and estates and their land managers and legal representatives, charity and third sector organisations, local authorities, and academic and research organisations/institutions.

One of the five ‘pillars’ of the Community Wealth Building framework is “Land and Property: Growing social, ecological, financial and economic value that local communities gain from land and property assets”. This objective is reflected not only in the measures we put forward in the Bill, but will also be realised through our commitment to double the funding available through the Scottish Land Fund for communities to acquire land and land assets.

Public Health Scotland’s surveillance programme monitors the progress of COVID-19, flu and other respiratory infections, (including RSV), and reports regularly on the ongoing impact of those infections during the winter months. This has been incorporated into detailed modelling that has been used to support development of our winter resilience plan.

For all scenarios we know that effective and timely delivery of the seasonal flu and COVID-19 vaccines is crucial, and our winter vaccination programme is now well underway. The degree of protection wanes over time, which is why booster vaccination is needed to maintain the best protection against COVID-19 and flu, especially for those at highest risk. We continue to do all we can to encourage and support every single eligible person to come forward, ultimately, the decision to get vaccinated has always been, and remains, a matter of personal choice. We are working to ensure that more than two million eligible people in Scotland are offered and able to receive vaccines, in turn helping to protect the public and relieving pressure on the NHS.

Introduction - Winter Vaccination Programme 2022 to 2023: COVID-19 and seasonal flu deployment plan - gov.scot (www.gov.scot) .

The Scottish Government published its winter resilience plan on 4 October. This sets out a range of actions we are taking to support our health and social sector throughout the winter period - Health and social care: winter resilience overview 2022 to 2023 - gov.scot.

The COVID-19 Four Harms group continue to meet fortnightly to review and consider the overall threat level of Covid-19 in Scotland guided by evidence provided by the Chief Medical Officer. The group are ready to respond to any surge in infections, outbreaks or variant of concern and have contingency planning in place.

For all scenarios we know that effective and timely delivery of the seasonal flu and COVID-19 vaccines is crucial, and our winter vaccination programme is now well underway. As of 30th October 2022, 2,420,721 Autumn/Winter Vaccines have been administered in Scotland – 1,214,300 COVID-19 vaccines and 1,206,421 adult flu vaccines. Over 87% of older adult care home residents, and 80% of over-65s have received their COVID-19 booster thus far.

We continue to monitor RSV as part of the Public Health Scotland’s surveillance programme and currently have no evidence to suggest that we are facing an RSV epidemic this winter. NHS Board winter plans take into account the predicted surge of seasonal flu, RSV and Norovirus activity that can happen between October and March and have adequate resources in place to deal with potential outbreaks across this period.

The Scottish Government wants everyone to receive the best possible care and treatment from our health and care services. We have set out the wider policy within which NHS Scotland is expected to deliver services, and we expect all NHS Boards to continue to provide high quality care that is safe, effective and person-centred. Across our health service, pharmacists, the ambulance service, NHS 24, GPs and hospital staff are working hard to ensure that patients get the care they need.

In common with health services across the UK and globally, NHS Scotland is working under significant pressure as the pandemic continues to affect services, and we expect this winter to be one of the most difficult the NHS has faced. While these challenges persist, people who are unwell should always seek help.

The Scottish Government’s Winter Resilience Overview sets out £600m of investment to support winter resilience across our health and care system. These measures across will help ensure people get the right care they need at the right time and in the most appropriate setting. We will also expand our workforce, particularly registered nurses, to assist with the expected increase in workload.

On 2 November, we launched the Right Care Right Place media campaign as part of the wider Stay Well This Winter messaging. We want the public to better understand the healthcare services available to them so they can make more informed choices about the right care in the right place for their specific health care needs.

The Scottish Government has used the powers at its disposal to build a fairer and more progressive Income Tax system in Scotland that raises vital additional revenue for the Scottish Budget. This has helped us commit to investing £2 billion for climate action in the 2022-23 Budget, alongside a clear commitment in the Resource Spending Review to prioritise public spend to deliver climate action over the course of this parliament.

We are committed to working across society to deliver lasting action that secures a just transition to a climate resilient, net zero Scotland - one that delivers on our social, economic and climate goals to build a better and more equal Scotland. Our Framework for Tax, published in December 2021, sets out our goals for a fairer, greener and more prosperous Scotland for everyone. Amongst other strategic aims, the Scottish Government has committed to use the tax levers at our disposal to deliver a sustainable and inclusive economic recovery and support new, good green jobs, businesses and industries for the future.

Decisions on tax policy for 2023-24 will be set out in the Scottish Budget, which will take place on 15 December. We will reflect on the recommendations in this report, alongside engagement with a broad range of stakeholders, in setting our tax policy for the year ahead.