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The tobacco control action plan – Raising Scotland’s Tobacco-free Generation – published in June 2018 focuses on addressing health inequalities and targeting smoking rates in the communities where people find it most difficult to quit. As smoking rates are higher in our less well-off communities, the Scottish Government sets each Health Board an annual target to focus efforts there. This approach has seen a year-on-year increase in the proportion of quit attempts made from these areas. In 2017-18 sixty two percent of all quit attempts made through NHS Scotland came from our most deprived communities. This approach has significantly narrowed the health inequality gap, and has been recognised by Cancer Research UK as a model the whole of the UK should adopt.

On 9 April 2018 we launched a four-month campaign to encourage those thinking of quitting to use our re-branded Quit Your Way stop smoking services. The purpose was to motivate smokers in areas where smoking rates are highest to use our free, local NHS services, which can significantly increase their chances of making a successful quit.

Dr Alex Munnoch is the leading surgeon who performs liposuction as a treatment for Lipoedema in Scotland. He and his team are based at Ninewells Hospital, Dundee. Dr Munnoch is a leading international expert on Lymphoedema and Lipoedema.

Due to the number of liposuction operations Mr Munnoch is required to carry out to maintain his skill set, there is no demand for a second surgeon in Scotland.

The overall budget for the Take It Right Outside campaign was £1,200,883.06. The expenditure per financial year was:

13-14: £319,954.12

14-15: £310,098.57

15-16: £570,830.37

Through pre and post campaign tracking there was a 13% reduction in second hand smoke inducing behaviour. The percentage of respondents who said they never smoke inside the home increased from 39% to 48%. The campaign tracking in 2015 identified that 52% of campaign recognisers had taken some form of action as a result. Potential actions included: stopped second hand smoke inducing behaviour; stopped smoking in the home; tried to stop smoking.

Researchers can apply to the Chief Scientist Office (CSO) for funding. The CSO's Translational Clinical Studies Committee and Health Improvement, Protection and Services Research Committees each meet twice per year to consider funding applications. Details of the application process are published on the CSO website: http://www.cso.scot.nhs.uk/funding-2/ .

Applications looking at the underlying causes, diagnosis and treatment of Lipoedema are welcomed. In common with all other applications, these would go through the CSO's standard independent peer review process.

Through the Chief Scientist Office, the Scottish Government contributes around £10 million annually to allow Scottish-based researchers to apply for funding to the UK-wide research programmes from the National Institute for Health Research. These schemes are open to applications looking at the underlying causes, diagnosis and treatment of Lipoedema.

All Lymphoedema clinics, which is where patients with Lipoedema go to see a specialist, will alert the referrer to the Clinical Practice Guide module and encourage awareness by sharing links and information.

The National Lymphoedema Care in Scotland Short Life Working Group (SLWG) was commissioned in 2015 by the Chief Medical Officer to review and deliver the recommendations identified in the Scottish Medical and Scientific Advisory Committee (SMASAC) report to improve Lymphoedema care which was led by Sir Lewis Ritchie.

The Group met on a quarterly basis from 2015 to November 2016. Meetings were held at both Scottish Government Buildings and NHS Hospitals within Edinburgh. Group meetings were timetabled in two hour slots. Members of the Group included Lymphoedema specialists from all NHS Boards, Scottish Government Policy officials and National Education for Scotland Representatives.

The main objectives of the meetings were to deliver the recommendations within the SMASAC report. The group recognised the need to prioritise and raise the profile and focus on delivery of best model practice across the spectrum of Lymphoedema services for both primary and secondary cancer and non-cancer related Lymphoedema and ensure that services are in place for those affected at all ages.

Outcomes achieved included developing an integrated care pathway to highlight areas that require to be considered to support improvement work. This has been informed by a tiered model of care. A comprehensive service audit to identify both good practice and service gaps was also collated and is now shared with all NHS Boards.

It was agreed at the SLWG meeting on November 2016 that the group had met the recommendations of the SMASAC report as far as was within their remit and that a SIGN guideline was the most comprehensive conclusion to meet the outstanding recommendations. A SIGN application was developed by the group and submitted to SIGN in December 2016 requesting specific guidelines be produced for Lymphoedema.

SIGN have just recently advised that while at present they do not feel there is enough scope to develop a guideline they will potentially take forward the development of a best practice guide. SIGN will update on progress and timescales for delivery of the guide.

The current status of the SLWG therefore is that the group will now be closed as the recommendations have been met and SIGN have agreed to progress the guideline.

My announcement that I will personally appoint Whistleblowing Champions will have no direct impact on proposals to establish an Independent National Whistleblowing Officer for NHSScotland (INWO), as this will be a fully independent function.

Legislation will be introduced so the Scottish Public Services Ombudsman (SPSO) can take on the role of the Independent National Whistleblowing Officer for NHSScotland (INWO). We are in ongoing discussions with the SPSO, and anticipate the role will become operational in 2019.

Alongside this, we will be working with stakeholders to develop the new dedicated Whistleblowing Champion roles.

Existing Whistleblowing Champions will have the opportunity to apply for these dedicated roles in an open, fair and transparent appointments round. They would also have the option of remaining in their current posts as Non-executive Directors, should they prefer to do so.

We will be working with stakeholders to develop the new dedicated Whistleblowing Champion roles, including the timescales for appointments.

I have recently published the Waiting Times Improvement Plan which states that we will pursue use of the independent sector in a structured and prioritised manner. Over the next 12 months we will develop a National Contract, based on clinical priorities, to make a more efficient and strictly limited use of the independent sector’s contribution to help deal with capacity issues. This will provide short-term capacity while longer-term NHS capacity is put in place in line with the plan.

Any measures on planning or licensing for tobacco-control would require full public consultation.

As set out in the 2018 tobacco-control action plan, we are first gathering evidence on, and considering the impact of, price strategies and reducing tobacco outlet density. If that gives us clear evidence that restrictions on these would reduce the harms and inequalities associated with smoking we would then consider ways to implement change. The action plan states that Regulations to introduce compliance conditions to the existing retail registration scheme could be an option for making change. The action plan refers to licensing and national planning guidance as other options that might also be considered.

Grant funding provided by the Scottish Government is subject to the lead business area being satisfied as to the standing and relevant experience/expertise of the recipient and any delivery partners. Scottish Government internal guidance highlights that this assessment must include a review of the organisation’s governance processes. Each business area should confirm that the organisation has sufficient and appropriate governance arrangements in place and that assessment should include among other elements the Human Resource processes and procedures of the intended recipient.

Following this assessment each business area should also consider how the grant recipient might support the achievement of the Scottish business pledge and fair working practices within the organisation as part of any grant offer.