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A 2017 review of the use of sodium valproate in pregnancy by the European Medicines Agency (EMA) found that babies exposed to sodium valproate are at higher risk of malformations or developmental problems. Following this review, the EMA agreed new measures to avoid the use of sodium valproate in women and girls of child bearing potential. This included the adoption of a Pregnancy Prevention Programme.

On 7 January 2022, the Medicines and Healthcare products Regulatory Agency (MHRA) published the results of the Commission on Human Medicines (CHM) review of the safety of anti-epileptics in pregnancy. The CHM recommended that the MHRA should review whether the available data raises any new safety concerns or changes current understanding about the safety of other epilepsy medicines during pregnancy. The Scottish Government is continuing to work closely with the MHRA on issues around medicines safety, including those relating to sodium valproate.

Furthermore, the Scottish Government is funding the roll-out of a pilot Scottish Epilepsy Register in three NHS Health Boards (NHS Greater Glasgow and Clyde, NHS Tayside and NHS Lanarkshire). This will help identify patients taking sodium valproate, as well as any other anti-epileptic medicines, some of which may also have the potential to cause harm. Alongside the data we already collect on prescribing, this has the potential to form the basis of a Scotland-wide epilepsy registry and, with further adaptation, could collect outcome data. This can help support better shared decision making to reduce the risk of harm and improve delivery of and access to care and support.

In March 2018, the European Medicines Agency (EMA) issued new measures to limit exposure to sodium valproate in utero, including the adoption of a Pregnancy Prevention Programme.

Following this, new and strengthened information materials for healthcare professionals and patients have been issued, including an updated Summary of Product Characteristics and Patient Information Leaflet, new education materials for professionals, as well as updated packaging stamped with a new pictogram. Furthermore, updated guidance on the use of sodium valproate has been issued by both the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).

Prescribers in Scotland are expected to follow current drug safety information and the new measures in relation to sodium valproate to ensure women being prescribed this medicine are fully apprised of the risks and are able to make informed decisions.

Recovery certificates contained within the NHS Scotland Covid Status App adhere to the standard set by the European Commission, through the EU Digital Covid Certificate scheme which Scotland is a member of. This recognised standard does not allow for unsupervised self-reported LFD tests to be used to create a recovery certificate.

We are aware that there will be situations where those looking to travel will have tested positive for COVID-19 using an LFD test since 11 January 2022, when confirmatory PCR testing was no longer required. Further information is available from NHS Inform .

Travellers can use the text message and/or email from private PCR test results more than 10 days before travel as proof of recovery if an NHS PCR was not taken.

There are also some countries where a private supervised LFD test is acceptable and can be used instead of a PCR.

Different nations have different requirements for entry. That is why we encourage everyone to continue to check the entry requirements of the countries they intend to visit.

The amount self-funders pay for their care home costs is a contractual matter between the individual and their care home provider. This agreement is protected by consumer protection laws.

Guidance on Social Care is on the Scottish Government website: Social care support - Social care - gov.scot (www.gov.scot)

Further guidance on free personal and nursing care can be found here - Care Support and Rights.dot (scot.nhs.uk)

The Scottish Government issued a letter to adult care homes on
‎ 24 March 2022 outlining updates to guidance including visiting. The Scottish Government fully expects care homes and local health protection teams to support people living in care homes to have visits from loved ones, unless there are truly exceptional circumstances. During an outbreak, care home residents can see one of their three named visitors once a day. The letter with updated guidance can be found on the Scottish Government website via the following link: Annex 1 - Coronavirus (Covid-19): changes to guidance for adult and older people care homes - gov.scot (www.gov.scot)

The Scottish Government will continue to work with Public Health Scotland and the care home sector to review the remaining recommendations in adult care homes.

A national study on the impacts of climate change on NHS assets was undertaken by Health Facilities Scotland (HFS) in 2016. This included flood risk assessments of 240 key sites utilising SEPA flood risk data. A follow up review of the sites identified as being at high risk of flooding was undertaken by HFS in 2021 and recommendations were made to the respective NHS Boards.

In addition Health Boards are working to complete Climate Change Risk Assessment and Adaptation Plans for their areas later this year. This work includes identifying any sites at risk of flooding both now and in the future as a result of climate change and preparing plans to mitigate those risks.

As part of our civil contingencies risk assessment work, the Scottish Government’s Resilience Division works closely with resilience partners, including the Scottish Environment Protection Agency and the Met Office, to assess climate change risk. This work includes the development of the Scottish Risk Assessment (SRA), which is designed to supplement UK Government’s National Security Risk Assessment. Together these documents assist Scottish responders and policy makers in understanding the most significant civil contingencies emergencies which Scotland may face over the next two to five years. The current SRA includes six new risk assessments themed around major impacts from climate change, as well as a dedicated climate change overview chapter.

The Ready Scotland website – ready.scot – is a core part of our public-facing communications work to help make Scotland more resilient to emergencies. It provides up to date, accessible and comprehensive information on a range of threats and risks, including flooding, to help people in Scotland to prepare for and respond in ways that keep themselves safe and help others in their communities to stay safe.

The Scottish Government works closely with resilience partners to respond to and also prepare for significant incidents, providing information regularly through its own website and social media channels, and also working with resilience partners to disseminate information more widely.

This includes working with the Scottish Environment Protection Agency, Scotland's national flood forecasting and warning authority which runs Floodline Scotland and works closely with local communities to strengthen resilience, prepare for and reduce the impacts of increased flooding.

The Communications Sector, which includes resilience of the telecoms network, is reserved and the responsibility of the UK Government.

There are no specific obligations on telecoms operators to disclose assets that are at risk of flooding or a single point of failure to the Scottish Government.

However there is a broad requirement for telecoms operators to mitigate and minimise, in accordance with good industry practice, the number of single points of failure within the Network.

The Scottish Government works closely with the UK Government, telecoms operators and owners to ensure Scotland’s telecoms networks are resilient to a variety of risks, including flooding and other climate change related factors.

In 2020, we published the ‘Keeping Scotland Running’ Guidance Suite, which seeks to support the delivery of Scotland’s Critical Infrastructure Resilience (CIR) Strategy. This Guidance Suite comprises seven separate guidance documents designed to equip and enable CIR stakeholders to work together to build resilience across the critical infrastructure sectors in Scotland. Two of these guides specifically look at Building Resilience to Natural Hazards and Building Resilience to Climate Change (Adaption).

Our approach to building resilience to the impacts of climate change more widely is set out in the statutory Scottish Climate Change Adaptation Programme 2019-2024. One of the high level outcomes the Programme is structured around is that “Our society’s supporting systems are resilient to climate change”.