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Secondary breast cancer – breast cancer that has spread to other parts of the body – is recorded on the Scottish Cancer Registry if it has occurred when the diagnosis is first made. The Scottish Cancer Registry uses a variety of sources of information to confirm stage at diagnosis and the quality of this work is assessed through audit and external quality assurance.

Public Health Scotland is part of an ongoing JRC-ENCR (Joint Research Centre – European Network of Cancer Registries) short life working group to improve and standardise collection of information on cancer recurrence. The aim of this work is to improve collection of secondary cancers that occur some time after the initial diagnosis. This will add to the information about secondary breast cancer at the time of diagnosis.

Several new and better sources of data on secondary cancers are being integrated into the national cancer intelligence platform at Public Health Scotland (PHS). For example, Systemic Anti-Cancer Therapy data for the whole of Scotland are now collated at PHS and these include information on whether treatments for breast cancer are for primary or secondary disease.

The National Cancer Quality Steering group have overseen the development of a newly proposed QPI on 'Recurrence Following Breast Cancer Treatment' in 2022.

I refer the member to the answer to question S6W-13150 on 17 January 2023. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

As pharmacies, medicines homecare providers must demonstrate that they can meet the standards for registered pharmacies set by the General Pharmaceutical Council (GPhC). The standards are designed to create and maintain the right environment for the safe and effective practice of pharmacy and to improve the quality and safety of services provided to patients and the public. The GPhC inspect registered pharmacies to seek assurances that the standards are being met. Depending on the range of services provided, medicines homecare providers may also be registered with additional regulators such as the Care Inspectorate and the Medicines and Healthcare products Regulatory Agency.

To ensure compliance with regulatory standards, providers must have governance arrangements in place to safeguard the health, safety and wellbeing of patients and the public. This will include effective systems for risk management and the management of complaints and incident including root cause analysis of issues arising and implementing corrective and preventative actions.

Health Boards have contractual arrangements in place with Homecare Providers via either Service Level Agreements or Framework Agreements. These agreements detail responsibilities for service provision and define service requirements including governance and reporting.

Before arrangements are made to set-up a new service, Health Boards undertake risk assessments to assess the risks associated with supplying a particular medicine through a home delivery service. In addition, before a patient is on-boarded on to a service, checks are undertaken to help ensure that homecare is suitable for an individual patient.

The breakdown of the 356.1 whole time equivalent posts recruited within GP practices by NHS Health Board is as follows;

The breakdown of the 958.9 whole time equivalent (WTE) posts by NHS Health Board is as follows;

The Scottish Government will continue to support sustainable change and improvements in Tayside, to ensure the safe and effective delivery of mental health services.

To ensure that Tayside Mental Health Services have the resources needed to deliver on the recommendations contained in the Oversight Group’s Final Report, the Scottish Government will provide access to advice from Professional Advisors and Senior Officials in the Mental Health Directorate as partners in Tayside develop a detailed improvement plan. The plan will contain clear milestones and deliverables which progress key areas for action.

More widely, the Scottish Government has increased financial resources across Scotland, with NHS Mental Health expenditure rising from £1.1bn in 2019-20 to £1.25bn in 2020-21: an increase of £172m.

The Scottish Government will invest in Changing Places Toilets over this parliamentary term, in order to increase the number of these facilities across the country and to support mobile Changing Places Toilets to allow people easier access to events and outdoor venues.

This investment will be delivered in phases over the course of this parliamentary term. The Scottish Government is progressing the first phase of work to design an investment programme that ensures that the Changing Places Toilets which are built are fit for purpose. We have recently published our Changing Places Toilets: Planning Guide and an accompanying easy read for people who are planning to develop Changing Places Toilets now.

Further details will be available soon.

I refer the member to my answer to question S6W-13660 on 19 January 2023. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

The Scottish Government is aware of the Welsh publication. Similarly, we are keen to reduce, and where possible eliminate, the use of restraint in respect of children across all settings.

We are working with partners to explore definitions of restraint, along with the availability of data, guidance, training and support. We are keen that any work taken forward should focus on practice improvement and learning and development of how we support practitioners so that they are better equipped and informed.

Energy policy, including the rollout of smart meters programme, is a matter reserved to the UK Government.

Smart meters have an important role to play in helping the Scottish Government achieve our aim of increasing energy efficiency across Scotland as well as helping consumers manage their spend on energy. At the recent energy summit chaired by the First Minister, we committed to working with partners to increase the number of households with smart meters in Scotland, with a focus on rural areas, by highlighting the benefits they can deliver in terms of both energy bills and energy efficiency. As part of this work, we will continue to call upon BEIS and Ofgem to take the necessary action to ensure all households eligible for a smart meter have the opportunity to install one in their home.

In the meantime, we will continue to work with our consumer advice and advocacy partners to ensure they are equipped with the necessary knowledge and information to support consumers seeking help on managing or accessing a smart meter.

I would also urge consumers who are struggling with their energy bills to contact Energy Advice Scotland on 0808 196 8660 or at energyadvice.scot.