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The Scottish Government recognises the importance of a consistent approach being taken forward in the community to support people with the management of their condition across Scotland, which includes accessing the right support and services. Throughout our response to the COVID-19 pandemic, where an urgent or essential clinical need has existed, access to Allied Health Professionals has been available.

Work is underway through the National Advisory Board for Rehabilitation to implement the Framework for Supporting People through Recovery and Rehabilitation during and after the COVID-19 Pandemic . The Framework is aligned to the Re-mobilise, Recover, Re-design: the framework for NHS Scotland, and puts in place clear principles, priorities and objectives to support planning to meet increasing demand and to provide high quality person-centred rehabilitation in different settings.

Fair Start Scotland’s key priority is to ensure participants receive a quality service in their journey to finding and sustaining employment, through tailored support that meets their needs and takes into account their personal circumstances.

Eligibility for Fair Start Scotland (FSS) is open to people with a range of barriers, however it is aimed that those for whom work is a realistic prospect within 12-18 months. Participants develop an action plan which sets out their goals and the pace at which they want to achieve them.

For participants with more significant barriers, up to 18 months pre-employment support is available. During this time Providers can commission any specialist support required to help participants move towards becoming work-ready, including work experience and placements to help build up to working longer hours where that meets the participant's longer-term goals.

As part of Fair Start Scotland contracts, Service Providers are paid when job outcomes reach 13, 26 & 52 weeks. These milestones are used to drive good job quality and increase income for participants, in line with Scottish Government Fair Work principles. Providers are only paid for outcomes where participants are working more than 16 hours per week as this more likely to provide a secure income however, there is no expectation that participants will work to this level if it’s not what they want to do.

Through the in-work support offered as part of the service, Providers continue to work with participants for a further 12 months after entering employment to further develop their skills, increase their confidence and ensure the job continues to fit their needs.

As part of continuous improvement activities over the coming year, the Scottish Government and Service Providers will continue to promote Fair Start Scotland, reviewing their marketing strategies to adapt to local labour market needs and potential changes in demand as a result of the COVID-19 pandemic.

In response to the COVID-19 pandemic, Service Providers have enhanced digital promotion of the service through an increased social media presence, which has had some success in increasing the volume of referrals from third party organisations during the lockdown period.

We are working with Service Providers to generate local action plans to identify new ways to extend awareness of and reach to some of the more under-represented groups on the service.

We will also continue to work with Service Providers and partners, including the Department for Work and Pensions to promote and improve the service to ensure that those who are eligible would benefit from Fair Start Scotland support, are able to do so.

Fair Start Scotland aims to support those further from the labour market towards employment, and provides 12 – 18 months of pre-employment support. As participants join each month, not enough time will have passed to present a complete picture of employment outcomes for many of them. Time must then also be taken into account to allow participants to reach 3, 6 and 12 months employment. Each quarterly release of statistics presents a developing picture of employment outcomes for year two of the service, which will increase as more participants move through the service into work, and sustain that work over time.

The most recent statistics published on 25 November 2020 show that, of the 27,076 people who started on Fair Start Scotland, 8,329 participants (33%) went on to start work.

The statistics also show that the majority of participants who started a job went on to sustain them for at least 6-12 months:

- 71% of people starting work went on to sustain employment for 3 months;

- 78% of those who sustained employment for 3 months reached at least 6 months; and

- 77% of those who sustained employment for 6 months went on to reach at least 12 months.

Fair Start Scotland is an entirely voluntary service where people are not driven to take part by the fear of benefit sanctions. Participants retain the right to leave at any time as they can face a range of challenges and barriers, due to changes in their circumstances, health or for personal reasons. We know from previous research on the transitional employment services (Work First and Work Able Scotland) that participants often leave as a result of a temporary deterioration in their physical or mental health.

As part of our continuous improvement activities over the coming year, we will continue to explore ways to reduce the volume of participants leaving the service early, including improvements to specialist support for those who need it and the introduction of a “right to re-referral” for participants who left early or completed their support without moving into work. Our next FSS evaluation report, due to be published in Autumn 2021 will also include an in depth focus on early leavers and we will ensure that any learning from the results is promptly put into practice throughout the contract extension period.

In line with the values of dignity and respect inherent to Fair Start Scotland, participants continue to be positive about their experience of the service. Of those surveyed for the Year 2 evaluation report:

- 91% of people who have used the service feel they were treated with dignity and respect;

- 80% of people felt the service took account of their individual needs and circumstances; and

- 81% of people felt the service offered support to improve their general quality of life and wellbeing.

The figure of 27% quoted only represents the first quarter of Year 3, from April to June 2020.

In the most recent quarter (July – September 2020) there was a large increase in the proportion of unknown equalities monitoring data gathered by FSS Service Providers, therefore it is not possible to report on the change in the proportion of disabled people during this time.

We recognise the impacts of the COVID-19 pandemic on Fair Start Scotland where people with health concerns or disabilities have become less inclined to engage with services during this time. This has also had an impact on collection of the equalities monitoring data.

While there has been a drop in the overall percentage of people with disabilities joining the service, the proportion (27%) remains broadly in line with the Scottish unemployed population as a whole, 30% of whom report having a disability. ( Source: ONS, Annual Population Survey, Jan-Dec 2019).

As part of our continuous improvement activities with FSS Service Providers over the coming year, we aim to extend the reach of the service to disabled people, ethnic minorities and other groups as suggested by our evaluation feedback and performance data.

The Scottish Government remains committed to at least halving the disability employment gap in Scotland by 2038, and statistics show that there has been a steady growth in employment rates for disable people in between 2014 and 2019 from 41.5% to 49% (Source: ONS, Annual Population Survey, Jan-Dec data).

General practice has continued to provide services to patients throughout the pandemic, albeit with unavoidable restrictions to accommodate necessary infection prevention and control.

Patients with complex needs continue to receive the support of GP practices which are working hard to prioritise those at high clinical risk both through remote consultations and, where appropriate, face to face appointments including where patients have difficulties with remote access.

Where MSPs have specific concerns on behalf of their constituents on the availability of services from an independent contractor to the NHS, the relevant NHS Board should be able to assist in the first instance.

The Scottish Government is consulting on the future arrangements for early medical abortion at home to allow abortion providers and other health professionals, the general public and in particular women who have experience of abortion services the opportunity to comment and submit evidence. Scottish Government officials have asked NHS Boards to make women receiving abortion treatment aware of the consultation where appropriate so that they can respond to it if they wish.

Data on this can be found on the Public Health Scotland website at https://scotland.shinyapps.io/phs-covid-wider-impact/ .

This information would be held by NHS Boards.