Seòmar agus comataidhean

There are two specialist centres open in Edinburgh (based at the Centre for Reproductive Health at the University of Edinburgh and the Royal) and in Aberdeen (Royal Infirmary). It is the responsibility of local NHS Boards to ensure patients are able to access the appropriate care for endometriosis funded through existing NHS budgets.

Scottish Government has been working closely with the West of Scotland to progress the business case and establish a centre in the West. NHS Greater Glasgow & Clyde have confirmed their costs are in line with other centres.

Health inequalities are a symptom of wider social inequalities. That is why the Scottish Government is taking action to address underlying causes, including ending poverty, fair wages, supporting families, and improving our physical and social environments.

We are also reforming public health. In June 2018, with COSLA, we published Public Health Priorities for Scotland. Creating a Scotland where we all eat well and have a healthy weight and level of physical activity is one of these six interlinked priorities. In 2019 we will establish of a new national public health body, which will have a leading role in supporting work to tackle health inequalities.

The Diet and Healthy Weight Delivery Plan is clear in its ambition to significantly reduce diet related health inequalities. The wide range of actions includes population level measures and targeted interventions such as:

- restricting the in-store marketing and promotion of foods high in fat, salt and sugar but with little or no nutritional value in order to reduce the public health harm associated with poor diet.

- Food Standards Scotland’s Out of Home strategy which includes better information for consumers, currently out for consultation.

- Early intervention and targeted support for children, young people and families delivered by Health Boards and their partners to help them to achieve a healthy diet and weight.

The Public Health Priorities can be accessed here: https://www.gov.scot/publications/scotlands-public-health-priorities/pages/0/

The Diet and Healthy Weight Delivery Plan can be accessed here: www.gov.scot/ISBN/9781787810556 .

In July 2018, the Scottish Government published ‘A healthier future: Scotland’s diet and healthy weight delivery plan’. The plan sets out our vision for everyone in Scotland to eat well and have a healthy weight, and our ambitions to halve childhood obesity by 2030 and significantly reduce health inequalities.

ISD currently publishes annual statistics on the proportion of children in Primary 1 in schools across Scotland who have healthy, high, and low body mass index (BMI). As part of the Diet and Healthy Weight Delivery Plan we have committed to exploring current practice, evidence and cost-effective options for improving the tracking, support and data beyond Primary 1. This work is underway and we will make decisions about next steps later this year.

The Diet and Healthy Weight Delivery Plan can be accessed here: www.gov.scot/ISBN/9781787810556 .

The Body Mass Index of Primary 1 Children in Scotland School Year 2017/18 publication is available here: https://www.isdscotland.org/Health-Topics/Child-Health/Publications/2018-12-11/2018-12-11-P1-BMI-Statistics-Publication-Report.pdf

I refer the member to the answer to question S5W-21109 on 7 February 2019. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx.

Due to the withdrawal of services by Healthcare Environmental Services Ltd, interim contingency arrangements have been put in place to ensure NHS Scotland services to the public are maintained. These arrangements, procured centrally by NHS National Services Scotland, for the NHS across Scotland, were initiated on 7 December 2018.

Services are being provided by around 15 companies under temporary contracts. Collection of waste from NHSScotland priority sites (large hospitals) is being undertaken by three licensed waste carriers covering the whole of Scotland. These are - Northwards Ltd, John Mitchell Haulage (Grangemouth) Ltd and W H Malcolm (Linwood) Ltd. Contracts are in place with specialist companies to provide community collections from smaller sites, including GPs and Community Pharmacists.

In total there are over 4,000 community sites being supported. Waste is collected and transported directly to authorised (licence or permitted) facilities in Scotland and England.

The West of Scotland dedicated BSGE Accredited Severe Endometriosis Service is expected to be up and running from April 2019 and is being funded through local NHS Health Boards. It will bring together work that was previously dispersed across different sites. The following table sets out the planned uplift from existing services, as well as additional funds that will enable supporting surgical support to ring fence capacity, which will be used to establish this centre.

This information regarding endometriosis and other pelvic pain conditions is not held centrally.

The Scottish Government has commissioned the development of a Core Minimum Dataset (CMD) to be collected by all specialist pain services, and a series of Quality Performance Indicators (QPIs).

These will be evidence-based, use routinely-collected data where possible, and have been subject to two consultation exercises. We are currently working with ISD to establish methods of integrating the necessary data collection into NHS IT systems, with a view to piloting this as soon as this is ready.

Once the data from CMD and QPIs are available, we will be able to report baseline and outcome characteristics of patients attending pain services (including cause and severity of pain, and its impact); and the nature and quality of service provision. This will include people with endometriosis and other pelvic pain conditions where they are seen by a specialist pain service but not any that are being treated by gynaecologists out with the pain service.

We will also be able to compare services between regions and changes over time, as well as evaluating the effectiveness of service improvement initiatives. Further information is available at the NHS Research Scotland Website: http://www.nhsresearchscotland.org.uk/research-areas/pain/sub-page-2

The West of Scotland boards are responsible for establishing the specialist centre for endometriosis. I understand that the centre has allocated £24,000 to fund a part time Clinical Nurse Specialist for 22.5 hours a week.

The West of Scotland boards are responsible for establishing the specialist centre for endometriosis. Activity is modelled on an expected demand of 20 cases per year. This equates in broad terms to a maximum of 2 cases per month.

There are two specialist centres open in Edinburgh (based at the Centre for Reproductive Health at the University of Edinburgh and the Royal) and in Aberdeen (Royal Infirmary). A specialist centre in the West of Scotland is expected to be operational by April 2019. It is the responsibility of local NHS Boards to ensure patients are able to access the appropriate care for endometriosis, including ensuring appropriate access to trained specialist surgeons is in place. Scottish Government does hold this information.