The great majority of abortions in Scotland are early medical abortions, where one or both medications are taken at home. These patients do not require bed spaces. Only a small minority of abortion patients require inpatient treatment, mostly as a day patient.

Whilst factors, including access to a bed, may sometimes cause a delay, Health Boards do their best to ensure patients can access abortion treatment as quickly as possible.

During the first trimester, all mainland NHS Boards within Scotland are able to offer surgical abortions, although access to surgical abortion is limited in some Health Board areas.

Currently no Health Board in Scotland is able to provide second trimester surgical abortions; if a patient is unable to access a medical abortion locally in the second trimester (over 20 weeks’ gestation), their Health Board will refer them to a service in England for treatment.

The COVID-19 pandemic has impacted on all NHS services to an extent, including abortion services.

The Scottish Government is committed to improving access to abortion services and the Women’s Health Plan includes a range of measures which aim to achieve this. Several abortion-related actions within the Women’s Health Plan have been progressed, including:

• making telemedicine consultations a permanent option for patients,
• continuing to allow women under 12 weeks’ gestation to take mifepristone and misoprostol at home where that is clinically appropriate and also now allowing women to take mifepristone at home at later gestations in certain circumstances,
• ensuring patients are offered the progestogen-only pill with their abortion medications, and
• working with stakeholders and Gillian Mackay MSP to introduce the Abortion Services (Safe Access Zones) (Scotland) Bill into the Scottish Parliament.

The Scottish Government commissioned NHS National Services Scotland (NSS) to develop a specification to deliver a national service for abortions between 20 to 24 weeks gestation within Scotland. NSS has been discussing its specification with NHS Boards and is also exploring other delivery options for the service. We anticipate that the long-term action within the Plan to review the provision of abortion services in Scotland will be considered as part of the forthcoming review of abortion law.

The Scottish Government is committed to its obligations under the Article 5.3 of the WHO Framework Convention on Tobacco Control.

In line with the WHO Guidelines for implementation, the Scottish Government Tobacco Control Team is undertaking a number of measures to support compliance. This includes, but is not limited to:

• Continuing to raise awareness of Article 5.3 across Scottish Government, Local Government and related bodies.
• Asking consultation respondents to make a declaration of any links to the Tobacco Industry within tobacco and vaping consultations, including the 2022 consultation on tightening rules on advertising and promotion of vaping products. and the recent 4-nations consultation on mandating quit information messages inside tobacco packs.
• Sharing UK Government guidance on engagement with the tobacco industry with internal and external stakeholders.

Further information on implementation of Article 5.3 will be included in our refreshed Tobacco Action Plan which will publish later in autumn.

The Social Care (Self-directed Support) (Scotland) Act 2013: statutory guidance states that if a supported person is dissatisfied with their care, their local authority should make the person aware that they can make use of the local authority's complaints procedure.

Supported people, their families and carers have the right to access a simple, timely and accessible formal complaints procedure if they feel they have been unfairly or unreasonably treated, or if they wish to challenge a decision that the local authority has made about their support. Local authority complaints processes therefore must be compliant with the 2013 Act.

Local government revenue funding is 2.6 per cent higher in real terms than it was in 2013-14 - as confirmed by the Accounts Commission. Local authorities also have a range of revenue raising powers that are not available to other public services, including newly devolved powers over empty property rates relief.

Scottish councils have been treated fairly throughout UK imposed austerity but we recognise the challenging environment they face and that is why we are committed to a New Deal with Local Government in order to ensure the sustainability of local services.

If a supported person chooses to use option one and receive a direct payment they may then also choose to employ a personal assistant. The Social Care (Self-Directed Support) (Scotland) Act 2013 Statutory Guidance states that, of the four SDS options, "Option 1 requires a level of responsibility that is greater than some of the other options. The local authority should make this point clear to the supported person. It should be transparent but it should also be supportive, explaining the additional support and information that can make the direct payment work for the supported person. The authority should ensure the supported person is offered independent advice and support where appropriate."

As part of their duty of care, the authority social worker should explain direct payment responsibilities to the supported person, relatives and relevant circles of support where applicable. They should also explain the additional support and information that the person can receive in order to manage their payment.

The Social Care (Self-directed Support) (Scotland) Act 2013 (2013 Act) Statutory Guidance states that:

“The Statutory Guidance accompanying the Public Bodies (Joint Working) (Scotland) Act 2014 sets out guidance for effective commissioning and procurement processes, including the putting in place of procurement plans providing specific detail to direct those responsible for contracting services.

In addition, best practice guidance on the procurement of care and support services provides further guidance on how procurement considerations can support SDS, where a public contract is the chosen form for funding social care provision.

The authority should seek to use the flexibility within the procurement regulatory regime to meet the legal duties of the 2013 Act. Local authorities should consider how best to develop a procurement strategy that ensure that the ability to ‘self-direct’ is not lost, and that the number of providers is not reduced unnecessarily.

Public reporting of the winter flu and COVID-19 vaccination programme launched on 21 September and can be accessed via PHS Vaccination Surveillance (shinyapps.io) .

The only publicly currently available data is the total number of vaccinations administered for both Covid-19 and flu. By the end of October, Public Health Scotland will begin publishing uptake data by eligible JCVI groups, including those at highest risk. It will also publish Health Board-level uptake data, alongside other information such as uptake by ethnicity and SIMD.

The additional data isn’t publicly available because it is management information that cannot be disclosed until the necessary data quality checks are complete to ensure that the data is robust. In the meantime, officials and health boards are using the management information to monitor uptake to ensure that it is what we are expecting.

Since the start of the pandemic we have worked collaboratively with Public Health Scotland and National Services Scotland to continuously update and improve our NHS Inform information , the online booking portal and access to the National Vaccination Helpline.

For the helpline we continuously monitor call wait times and when they rise above expected service level agreement wait times, we increase the numbers of call handlers to bring these down (to note this cannot be done immediately, as we need to bring in more staff which can take over 24 hours). The helpline also work closely with the scheduling team so that when a large number of invites go out to groups that typically use the helpline as opposed to the online portal, such as those of older age, we pre-emptively step up the number of call handlers to meet expected demand. We have automated messages explaining the current queue length and time, so that people can choose to call back at a quieter time. For those who cannot speak for long amounts of time, we have a mechanism whereby a nominated individual can speak on another person’s behalf.

We have continued to make the online portal as user friendly as possible. The latest development in 2023 was to make it easier for users to see the next available appointment is at their clinic of choice. We also include a person’s username in their appointment letter and this contains a QR code that will take them straight to the Winter vaccines | NHS inform landing page. NHS Inform contains helpful step-by-step videos on how to use the portal to book or change an appointment and we constantly monitor feedback from the public in regards to the portal to inform future changes and developments.