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A property owner who does not have access rights written into their title deeds, and those of their neighbour(s), to carry out repairs could seek to obtain the consent of their neighbour(s) to obtain such rights. A solicitor could provide advice and arrange for any necessary agreements to be drawn up. Once the documents were agreed, the changes could be registered in the property registers held by registers of Scotland.

Children and young people referred to child and adolescent mental health services (CAMHS) will generally be treated in the community. There may be times when it is necessary to admit them to hospital for specialist mental health treatment; should this be the case they would be admitted to one of the three regional CAMHS inpatient units, or the national unit for under 12s.

Requests may come from outwith the region because, while the three units work on a regional basis, each unit will also consider requests from the other regions. Children and young people may initially be admitted to one unit and then transferred to another; they may also be admitted to a non-NHS facility or a non-specialist NHS facility and then transfer to Dudhope, or be discharged to the community, or complete their treatment in that facility. Reasons for this may include bed availability, a clinical decision, or the preference of a young person and their family.

Over the period May 2015 to May 2016, there were 21 occasions when a young person could not be admitted to Dudhope young persons unit (YPU) due to the unavailability of a bed. On two occasions the request was for a bed for a young person who resided outside the north of Scotland region, whilst the remaining 19 occasions were requests to admit young people residing in the north of Scotland region.

The reason for beds being unavailable is either due to the unit being at full capacity (no physical beds available) or high patient dependency, making it clinically unsafe to admit any further patients.

Table 1 shows where patients were admitted to on the 19 occasions when a bed was not available at Dudhope young persons unit.

Table 1 – North of Scotland admissions to other YPU or adult facilities (May 2015 – May 2016)

NB. NHS Tayside are unable to advise what happened on the two occasions that a bed was requested from outwith the north of Scotland region.

The Scottish Medicines Consortium (SMC) provides advice to NHS boards in Scotland about the status of newly licensed medicines and new formulations and indications of established products following submissions from pharmaceutical companies. A manufacturer would need to obtain a marketing authorisation (product licence) for this treatment and make a submission to SMC. The sexual health and blood borne virus clinical leads network have established a pre-exposure prophylaxis (PrEP) short life working group to consider a range of issues associated with PrEP in the current context.

The Scottish Government is aware that pre-exposure prophylaxis has been approved for treatment in France, Australia and the United States of America.

Children and young people referred to child and adolescent mental health services (CAMHS) will be generally treated in the community. There may however be times when it is necessary to admit them to hospital for specialist treatment. Should this be the case they would be admitted to one of the three regional CAMHS inpatient units.

It is important that beds are available when required. In order to provide support this, a decision was taken by the north of Scotland NHS boards to build a new 12 bed unit in Dundee (Dudhope House) to replace the current 6 bed unit. This has increased the national bed base from 42 to 48 beds and improve the quality of the estate.

Dudhope House in Dundee followed an extensive consultation which considered the merits of basing a unit in Aberdeen, Inverness and the current facility in Dundee.

However we can confirm that the total Child and Adolescent Mental Health Services workforce is at a record level, having risen by 1.3% since March 2015. There are now 993.5 whole time equivalent posts across the sector, an increase of 29.9% since 2009. The number of clinical staff working in psychological therapies has increased by 1.1 per cent on last year, with 1,079.2 whole time equivalent posts across Scotland.

The Scottish Government is fully committed to providing the people of Scotland with the NHS services which meet their needs and maintain high standards of care.

We will publish a new ten-year mental health strategy later this year. The Scottish Government has a manifesto commitment to a 10-year plan to transform mental health in Scotland.

We have been investing heavily in mental health services for a number of years, and are using the additional package of £150 million over five years to boost support for areas which are absolute priorities for us, and which will deliver the transformation in mental health services we want to achieve – including for children and young people. We are investing:

£54.1 million to support further reduction in waiting times.

£10 million to support new ways of improving mental health in primary care settings.

A £15 million mental health innovation fund to support better access to Child and Adolescent Mental Health Service and to develop innovative approaches to delivering mental health services.

£1 million to support people with mental health problems to become more physically active manifesto commitment: mental and physical health treated equally; and £4.2 million to support people in crisis who turn to frontline services.

Our remaining package of funding will support the priorities in our forthcoming mental health strategy, to ensure we continue to improve access to services – including for children and young people. It will also focus on supporting early years and early interventions; improved support in primary care, and parity of esteem between physical and mental health so that we support people to keep well, whilst also providing treatment of the highest quality when it is necessary. We will take these decisions in conjunction with our stakeholders and partners.

Scottish Government funding have been investing heavily in mental health services for a number of years, and will use the additional package of £150 million to deliver the transformation in mental health services we want to achieve over the next ten years, including for children and young people. Elements of this funding will be specifically for Child and Adolescent Mental Health Service (CAMHS), and elements will indirectly support CAMHS through improving access to services and supporting prevention and early intervention which will have an impact on demand for CAMHS services, as below:

We are investing £54.1 million to support further reduction in waiting times for CAMHS and psychological therapies: http://news.scotland.gov.uk/News/Mental-health-funding-2139.aspx;

We are investing £15 million in a mental health innovation fund to support better access to CAMHS and to develop innovative approaches to delivering mental health services: http://news.scotland.gov.uk/News/Mental-health-innovation-1737.aspx and

We are investing £10 million to support new ways of improving mental health in primary care settings, which will support children and young people in the community and reduce pressures on CAMHS specialist services: http://news.scotland.gov.uk/News/Transforming-GP-and-mental-health-services-22bf.aspx.

Our remaining package of funding will support the priorities in our forthcoming mental health strategy, to ensure we continue to improve access to services – including for children and young people – but also increase support for early intervention and prevention, to support children and young people to stay well and only be referred to CAMHS when necessary.

NHS Scotland funding: The Scottish Government sets national direction of policy on mental health and provides funding to NHS boards and local authorities to support implementation of policy, which includes support for children and young people with mental health challenges.

NHS boards will report future spend on mental health including CAMHS to Information Services Division Scotland through existing mechanisms. We will expect future spend by NHS Scotland on mental health and CAMHS to the reflect national priority and need, and to reflect the additional investment the Scottish Government has made available.