Seòmar agus comataidhean

I refer the member to the answer to question S5W-35029 on 25 February 2021. 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

The Stroke and Heart Disease Improvement Plans (2014) recognises the importance of specialist rehabilitation and the need for the delivery of services to support people living with stroke and heart disease and their families.

We expect NHS Boards to appropriately plan and deliver high quality, safe effective and person centred services including stroke rehabilitation services and to regularly review these to maintain the high levels of quality and safety that people in Scotland expect and deserve.

We continue to work in partnership with NHS boards, the voluntary sector and a range of providers across health and social care to help ensure people who have experienced a stroke receive access to the care and support they need to help them return to independent living.

The National Advisory Committee on Stroke (NACS) has established a Rehabilitation sub-group to focus on improving the delivery of stroke rehabilitation, both in hospital and the community and advise on how rehabilitation can best be delivered as part of a progressive stroke service.

The Scottish Stroke Care Standards are regularly reviewed in line with current evidence and updated guidelines. We monitor the implementation of these standards through the Scottish Stroke Care Audit to ensure that stroke patients in Scotland are receiving high quality care. Relevant guidelines relating to stroke care are also being taken into account in the development of a definition of a Progressive Scottish Stroke Unit.

As with all published guidelines, the strength of the evidence considered as part of the RCP guidelines is detailed in that document. There should be no difference in the robustness of the evidence relating to Scotland, though some discussion of commissioning of services, and of the particular structure of health systems may be based on NHS England structures and therefore may not be entirely relevant to a devolved health system.

It is important to note that clinical guidelines are recommendations to aid healthcare and other professionals in caring for people with specific conditions and are based on the best available evidence. NHS Board areas are encouraged to make best use of all relevant available guidelines.

The Programme for Government (PfG) 2019-20 commits the Scottish Government to ensuring that improvements are made to stroke pathways and services, including work to scope out and define what a progressive stroke unit looks like.

Work has been on-going during 2020 to progress this commitment, including several Scotland wide virtual meetings between the CMO Advisor and deputy CMO Advisor, and stroke physicians to gather views on the components of a progressive stroke service. The next meeting of the National Advisory Committee for Stroke, in March 2021, will consider the first draft a definition of a progressive Scottish stroke unit.

This description will refer to the best available evidence based on existing national and international guidelines. Comparisons with current practice and other western countries will reflect the best available evidence.

Once the definition of the progressive Scottish Stroke Unit has been defined, we will be able to compare it with current practice and also with international examples.

We place a great deal of importance on ensuring that stroke patients receive the care that they need in order to achieve their recovery potential. To ensure that this is the case, we fund the Scottish Stroke Care Audit (SSCA) as part of the Stroke Improvement Programme to regularly monitor the quality of care provided by the hospitals in all Health Boards by measuring performance against the Scottish Stroke Care Standards. These standards are regularly reviewed in line with current evidence, including UK wide guidelines such as NICE.

Health Boards and stroke services are supported by the Stroke Improvement Programme to improve performance against the Scottish Stroke Standards, and as a result, continuously improve their delivery of stroke care.

Initial assessments of the recently published results of the Scottish Health Survey 2019 have been undertaken.

These assessments note that, although the downward trend in smoking prevalence appears to continue, these particular results are likely to underestimate the true prevalence of smoking which during the previous survey stood at 17% of Scottish adults. This is due to the response rates in deprived areas being lower than usual, even when weighted, as a result of survey restrictions during the pandemic.

Further assessment and future studies will help determine the full impact of COVID-19 on smoking behaviour.

Quitting smoking is the best thing anyone can do to improve their health.

Quitting smoking is the best thing anyone can do to improve their health.

Although NHS free smoking cessation services were initially restricted as staff were redeployed in the early days of the pandemic, they were back on stream within a few weeks – operating between 9am and 5pm each day. Support, advice and prescriptions were available from pharmacies and GP practices throughout.

Both the Strategic Framework Business Fund and the £5 million Travel Agent Fund are tied to having a business premises, which reflects the higher overall costs facing premises-based businesses including rent and utilities.

While self-employed, homeworking travel agents are not eligible for these support schemes, they may be eligible for other forms of support, including the UK Government Self Employed Income Support Scheme (SEISS). In order to help those who are not able to access SEISS, the Scottish Government have recently relaunched the Newly Self-Employed Hardship Scheme, which makes grants of up to £4,000 available to qualifying self-employed people.

We have also recently increased our Local Authority Discretionary Fund from‎ £30 million to £120 million. Through this fund, councils can target additional support wherever they consider it most effective in the context of their local economy and business community. As such they have the option to provide direct support for self-employed or home working travel agents in their area if they consider it necessary.

Information on available support can be found on the Find Business Support website.

The Scottish Government also has issued a letter on 28 January, 2020 which provides a pathway for all the Allied Health Professional (AHPs) including the patient-facing physiotherapists to be prioritised during the first phase of the Covid-19 vaccination roll out programme.

The letter provides detail for Third and Independent sector frontline workers to use, to consider their eligibility for COVID-19 Vaccination, in line with JCVI prioritisation. Contact details are also provided for eligible frontline staff to use to make contact with their local health board for vaccine scheduling.

The letter was shared with the all relevant stakeholders such NHS, NSS, Health Boards, SG Chief Allied Health Officers, Allied Health Professional Secretariat, and the Royal College of Podiatry Chair for onward cascade.

You can also view the letter here: Cabinet Secretary for Commonwealth Games Sport Equalities and Pensioners Rights.dot (ccpscotland.org)

In November 2020, the UK Government extended the Self Employed Income Support Scheme (SEISS) for a further six months. The grant is available to self-employed individuals who were eligible for previous funding under the scheme, although they do not need to have claimed the previous grants. The Scottish Government has set aside funding of £15 million for a second iteration of the Newly Self-Employed Hardship Fund that we introduced in April 2020 in order to mitigate the financial challenges for those who are unable to access the SEISS. We are working to finalise the delivery mechanism and criteria for this fund and will publish more detail shortly.