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A multi-agency Lyme Borreliosis Group is coordinating a number of initiatives to raise awareness of Lyme disease among health professionals. This includes producing webinars aimed at front-line clinicians, making information available on the NHS Education Scotland website, delivering presentations at community pharmacy events, presenting at the Scottish Health Protection Network symposium held in November 2016, and including information about Lyme Borreliosis in the NHS Education Scotland General Practice newsletter. It is hoped that the Group will be able to consider the Royal College of General Practitioners' online course, and its appropriateness for Scotland, in the coming months.

The Resuscitation Council (UK) 'Guide to AEDs' is designed to provide information on AEDs. This includes that there should be signs in premises directing people to a defibrillator, as answered in S5W-08858.

The Resuscitation Council (UK) have produced new, standard Automated External Defibrillator (AED) signage. The aim of this is to ensure more people understand what AEDs are used for and are encouraged to use them. Further information on the Resuscitation Council's (UK) 'A Guide to AEDs' (April 2017) and copies of signage can be accessed at;

Guide to AEDs: https://www.resus.org.uk/publications/a-guide-to-aeds/

Standard signs for AEDs: https://www.resus.org.uk/defibrillators/standard-sign-for-aeds/

Transport Scotland's position is that the very low probability of someone suffering Cardiac Arrest whilst passing an AED sign, does not warrant the introduction of specific road signing.

Road signs must comply with requirements detailed within the Traffic Signs Regulations and General Directions and accompanying guidance in the Traffic Signs Manual to ensure ease of understanding. The use of any non-standard signs by either local authorities or individuals is discouraged and technical approval for the use of any non-standard signage would require to be sought.

Further, to reduce the risk of driver confusion, current guidance is to minimise the number of road signs to only those necessary.

a) The answer provided regarding S5W-08134 gives information on work that the Scottish Ambulance Service (SAS) is progressing to map and maintain Public Access Defibrillators (PADs), so they can be more effectively deployed as part of the response to an Out-of-Hospital Cardiac Arrest (OHCA). This is a positive first step towards developing a more complete understanding of PADs across Scotland, which is one of the SAS's commitments in Scotland's OHCA Strategy.

The SAS have run a comprehensive communications and engagement campaign to encourage PADs registration. The campaign was designed to promote and encourage registration at local level.

The SAS will continue to promote the registration of PADs, including liaising with organisations such as local councils and Community First Responder groups and through social media and the media. The OHCA Strategy Reference Group agreed that partner organisations should promote registering PADs.

b) Your letter of 19 April, with Reference 2017/0017049, was allocated for answering on 11 May and Ms Robison provided a reply on 22 May 2017.

The number of PADs for each council area in Scotland is listed in Table 1 below. The figures are not routinely held, however, and have been collected in response to the Member's request. The figures represent only a snapshot as of 16 May, with 885 PADs registered with the SAS across Scotland and in no way should be considered to represent the total number of defibrillators in the country. More are being registered every day and as such this figure is increasing on a daily basis. While there is no statutory obligation on their custodians to do so, the work of the SAS to promote awareness of the importance of registering PADs, and how to do so via the SAS website, continues to progress. This will enable the development of a more informed and accurate picture of the distribution of PADs across Scotland in future.

We view these answers as consistent with paragraph 1.2(d) of the Scottish Ministerial Code.

Table 1

Our informal discussions involved a number of public bodies, local authorities and members of the onshore wind industry. The organisations were not consulted on the content seen in the draft Onshore Wind policy Statement and cannot be assumed to be in approval of it, therefore it would be inappropriate to name them.

It must be stressed that this is a consultation and feedback both for and against the approach will be carefully considered before any further steps are taken.

All NHS boards have strategies in place to help improve the quality, clinical and cost effectiveness of prescribing. These include GP and pharmacist medicines reviews and reviews of repeat prescribing. Strategies are also supported by local and national publicity campaigns.

The Scottish Therapeutics Utility (STU) is a software package to help general practices identify areas of potential medicines waste within their repeat prescribing systems. This product is provided free to NHS boards by the Scottish Government’s Effective Prescribing and Therapeutics Branch. STU offers a fresh approach to reviewing repeat medication which accounts for 80% of dispensed medicines.

Polypharmacy guidance issued by the Scottish Government aims to ensure priority patients prescribed multiple medicines are reviewed to ensure they receive the most appropriate and effective pharmaceutical care. This guidance is supported by additional national prescribing strategies focussing on Diabetes, Respiratory and Chronic Pain prescribing.

The Supporting Children's Learning Code of Practice is currently being revised. It is anticipated that the revised Code will be published by the end of 2017.

The approach that was agreed and consulted upon is that the National Flood Risk Assessment (NFRA) and the identification of Potentially Vulnerable Areas (PVAs) will be reviewed and re-published within each six year planning cycle. Whilst Scottish Ministers have a power under the Flood Risk Management (Scotland) Act 2009 (the Act) to direct SEPA to review and, where appropriate update the document which identifies PVAs at other times outwith this six year cycle, there are no plans to use this power.

The Act created a new framework for the assessment and management of flood risk to reduce the risk of flooding from all sources, as far as is reasonable, taking full account of environmental, economic and social priorities. This meant moving away from short-term reactive decisions based on the latest flood event, and embracing long-term proactive planning and investment decisions.

The current legislation requires SEPA to review, update where appropriate, and submit to Scottish Ministers the document identifying the PVAs by 22 September 2018.

Reducing health inequalities is one of the biggest challenges we face. To tackle this, we recognise that the root of health inequalities can be found in income inequalities – inequalities which are exacerbated by the UK Government’s policies of austerity and welfare reform.

Within my own portfolio, sport and physical activity are key to maintaining a healthy lifestyle, and so contribute to tackling health inequality. Our Active Schools programme provides opportunities for sport and physical activity before school, during lunchtime, and after school. Our national agency for sport, sportscotland, invested £80 million in the programme over the period 2007 to 2015, with up to another
£50 million planned in the period 2015 to 2019.

Action 12 in the Mental Health Strategy 2017 - 27 commits to supporting the further development of the National Rural Mental Health Forum to reflect the unique circumstances presented by rural isolation. The Government has also noted the results of a recent survey by Support In Mind and Scotland’s Rural College (SRUC). We welcome the survey's focus on people's experiences of mental health and wellbeing in rural and remote areas, which is impacted by a range of factors.

More generally, the Scottish Government sets national direction of policy on mental health and provides funding to agencies – including NHS Boards and Local Authorities – to support implementation of policy.

The management of local actions in implementing national policy, and decisions on local spending priorities, are the responsibility of relevant local agencies. This includes assessing the needs of local populations. It is therefore the responsibility of NHS Boards and local authorities to work with their partners and regularly review spending decisions to ensure they deliver fit for purpose services which respond to the needs of their local population, including children and young people in rural areas with mental health issues.

Awareness of child and adolescent mental health in schools has been improved by, amongst other things, our commitment to encouraging the establishment of explicit links between schools and child and adolescent mental health (CAMHS) specialists as well as the development of a web-based toolkit (http://handsonscotland.co.uk) aimed at improving the confidence of teachers and others in responding to the mental health needs of children.

Education Scotland continue to roll out Scotland’s Mental Health First Aid for Children and Young People. The aim of this is to train staff within secondary school communities to increase their confidence in approaching pupils who they think might be struggling with a mental health problem. This training should complement the range of mental health strategies that are already in place within the local authorities and the support should target the school communities that need it the most first.

A mental health link person is available to every school, this has been achieved in a variety of ways using various models working to meet local needs. The link worker may be a CAMHS clinician or another speciality such as a primary care worker. However the named link person will be able to contact specialist CAMHS services for advice if they have any concerns about a pupil.

In April 2016 Aberdeenshire council in association with NHS Grampian, Police Scotland and Aberdeenshire voluntary action published their Mental Health and wellbeing strategy 2016-2019 (http://www.girfec-aberdeenshire.org/wp-content/uploads/2015/03/GIRFEC-Mental-Health-Wellbeing-Strategy-final-e-version.pdf). The strategy focuses on ensuring that appropriate services are available to children, young people and their families throughout Aberdeenshire.