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Public Health Scotland (PHS) is unable to provide information on how many patients have died while on an NHS Scotland waiting list in each year as far back as 1999. However, the national waiting times datamart captures quality-assured data on the reasons for a patient being removed from a waiting list, including when a patient has died, from 1st April 2013 onwards.

Table 1 contains the following trend information for the period 1 st April 2013 to 31 March 2022, presented by financial year:

? The number of patients waiting to be seen at a new outpatient appointment or waiting to be admitted for treatment as an inpatient or day case, expressed as an average based on the number waiting at the end of quarters in each financial year.

? The number of removals from waiting lists for the reason ‘died’.

? A simple mortality rate is also included to account for variation in waiting list sizes. This is presented as the number of deaths per year per 1000 patients waiting at quarter-end, averaged over the quarters provided for each year.

Table 1: Average waiting list size and total number of patients removed from lists for the reason ‘died’ whilst waiting for a new outpatient appointment or treatment as an inpatient or day case, NHSScotland, April 2013 to March 2022

There is currently specialist perinatal mental health provision in every mainland Health Board. We are working intensively with Boards to build their provision to the levels outlined in Delivering Effective Services . As of May 2022, there were 12 Health Boards with specialist community perinatal mental health teams, eight of which were fully established. These are: Borders, Dumfries and Galloway, Fife, Forth Valley, Greater Glasgow and Clyde, Lanarkshire, Lothian and Tayside.

We are working closely with other Boards to ensure that services will be fully established by March 2023. This includes island Boards where regional working as well as Board level provision is a key priority area.

Developing specialist Community Perinatal Mental Health teams across every Health Board has been a priority since the start of the Perinatal and Infant Mental Health Programme Board. Since 2019 we have invested over £5.5 million to establish specialist community perinatal mental health teams in every area of Scotland. This is in addition to investment in other specialist services such as infant mental health services and maternal and neonatal psychological interventions (MNPI).

To support Health Board areas to use this funding to develop local services, the Perinatal Mental Health Managed Clinical Network Scotland have developed a number of supporting resources. These include service development guides, care pathways and role descriptors.

We have also recruited a Perinatal and Infant Mental Health Service Development Advisor to work closely with Boards to support them in their implementation of specialist services.

Finalising the establishment of specialist perinatal mental health provision across all Health Boards in Scotland is a priority for the final year of the Programme Board. Every NHS Board area has an Executive Lead driving forward the programme of work and both strategic and implementation groups are also in place.

Since it was established in April 2020, there have been 88 successful claims to the Mother and Baby Unit (MBU) Family Fund. NHS Greater Glasgow and Clyde and NHS Lothian do not hold comprehensive information about a claimant’s home Board. Since April 2020:

? 32 families made a claim to NHS Greater Glasgow and Clyde MBU, with an average amount claimed of £303.

? 56 families made a claim to the NHS Lothian MBU, with an average claim of £250.

The Scottish Government recognises that seal predation is one of a number of pressures affecting wild Atlantic salmon in rivers, which is why it commissioned work in partnership with Crown Estate Scotland to review measures that have been adopted globally and which could assist in developing non-lethal strategies to address seal predation on salmon in Scottish rivers.

The report ( Review of non-lethal seal control options to limit seal predation on salmonids in rivers and at finfish farms | Marine Scotland Data Publications ) which was published in March 2021 recognises that there is no single effective solution to address the problem given the nature of rivers and predation, but that there are a range of measures that have been shown to have some success or have the potential to reduce predation. The Scottish Government therefore continues to work with the sector, stakeholders and the scientific community to explore practical ways to address interactions between salmon and seals in rivers, building on the recommendation of the report.

Furthermore, the Sea Mammal Research Unit, at the University of St Andrews has provided significant advice and support to the River Dee in recent years in relation to quantifying seal presence in the river and exploring possible solutions for minimising interactions.

The Bus Priority Rapid Deployment Fund (BPRDF) ran from July 2020 until June 2021 and was designed to support local authorities – working closely with bus operators - to respond to congestion with interventions such as temporary bus lanes or gates. 41 bus priority projects were implemented across Scotland.

Though the Fund was for short-term measures, it provided an opportunity for local authorities to test interventions as they developed plans for longer-term investment in bus priority, to lock in benefits for bus passengers, the bus industry and the environment. Learning and evidence from BPRDF informed local authority applications to the Bus Partnership Fund, which opened in July 2021 for bids to develop and deliver permanent bus priority infrastructure on local roads.

Section 40 of the Nationality and Borders Act 2022 amends section 24 of the Immigration Act 1971 to include a new offence of arriving in the United Kingdom without a valid entry clearance. The new offence comes in force on
‎ 28 June 2022.

There are no plans to introduce Lord Advocate’s guidelines in relation to the new offence.

Where the circumstances of alleged offending are reported to the Procurator Fiscal, prosecutors will decide on appropriate prosecutorial action, if any, on the basis of both the principles in the published Scottish Prosecution Code and, where relevant, the published Lord Advocate’s instructions for non-prosecution of victims of human trafficking.

Since the start of the Perinatal and Infant Mental Health Programme Board we have invested over £18m in improvements to services and support for parents, infants and families across Scotland. This includes £5.5m for development of specialist Community Perinatal Mental Health services.

Funding levels for each Board have been primarily based on the gaps identified in Delivering Effective Services Report – Perinatal Mental Health Network Scotland and further shaped through discussions with each Board to ensure funding meets local need. As the we progress the programme of work, allocations are transitioning to an NRAC share which is the Scottish Resource Allocation formula used to distribute funding to NHS Boards.

Initial development funding was provided to two Health Boards in the North of Scotland in 2019-20. Funding was then rolled out to all mainland Boards in 2020/21 and all Boards received an allocation in 2021-22.

Following conclusion of the current Programme Board in March 2023, £8m per annum has been earmarked as recurring funding to Health Boards to support the sustainability of perinatal and infant mental health services across Scotland. This includes £5m specifically for specialist Community Perinatal Mental Health services.

Please see the following tables for a breakdown of funding allocated per Board for specialist Community Perinatal Mental Health services for the last 3 financial years.

The information requested relating to non-Mother and Baby Unit adult mental health inpatient admissions during the pregnancy or the postnatal period is not held centrally. However, the Scottish Government Perinatal and Infant Mental Health Programme Board is looking at this question as part of the work following the Mother and Baby Unit (MBU) Inpatient Provision Consultation which closed on 31 May 2022.

A national Perinatal Mental Health Dataset for specialist Community Perinatal Mental Health services (as well as Mother and Baby Units and Maternity/Neonatal Psychological Interventions services) has recently been launched by the Perinatal Mental Health Managed Clinical Network. It is currently being rolled out across Health Boards. The dataset builds upon a previous Clinical Audit System which reported on a limited number of clinical indicators for Mother and Baby Units. The Perinatal Mental Health Dataset will include a range of indicators of clinical activity, recorded by local specialist teams. It will be used to support local service development and quality improvement. The dataset will act as a tool to support Health Boards with local improvement in service planning and delivery, enabling them to understand and respond to local need.

The Transition & Recovery Plan, published in October 2020 and backed by an additional £120m of funding, is transforming services, with a renewed focus on prevention and early intervention. A key commitment in the Transition and Recovery plan is to support the collaborative development, implementation and assessment of quality standards for mental health services. To help ensure that services deliver and measure Psychological Therapies in a more standardised way across Scotland, a new national standard for Psychological Services and Therapies is currently under development with a publication date of Summer 2022.

As part of our investment in Mental Health and Wellbeing in Primary Care Services we will ensure that local planning groups, and in particular local primary care mental health services, are fully aware of the resources and services available for perinatal mental health and are supplied with clear guidance on how to support women and families in accessing these services. This will include support to access wider mental health support hubs, groups and helplines.