The Scottish Medicines Consortium (SMC) is a partner in a UK-wide multi-agency RAPID C-19 initiative, which is a collaborative partnership between the SMC and the National Institute for Health and Care Excellence (NICE). Building on this work, the SMC is exploring the potential for collaboration with NICE on a single technology assessment (STA) of tixagevimab–cilgavimab (Evusheld ® ) for the prevention of COVID-19.

The Scottish Government has had very constructive discussions with AstraZeneca on Evusheld ® for the preventative treatments for COVID-19. However, throughout the pandemic, a UK-wide approach to the procurement of therapeutics has been taken and has proven vital to allow the UK to have the buying power to secure significant numbers of therapeutics in a competitive global market. A UK-wide approach has also been taken on the development and implementation of clinical prescribing policies for COVID-19 therapeutics. This has ensured patients across the UK have had equal access to safe and effective medicines for COVID-19.

Despite the continued and unprecedented challenges presented by the COVID-19 pandemic, the Scottish Stroke Improvement Programme report, published on 28 June, highlights areas where a high level of care is provided for stroke patients, including improvements in the number of patients who receive brain imagining within 12 hours of arrival to hospital.

We recognise that there are areas within stroke care that have proven particularly challenging and we are committed to continued improvement. We expect health boards to identify aspects of their stroke services which do not meet the Scottish Standards and to work to improve standards of care locally.

We are not currently aware of any stroke unit closures.

The number of thrombectomy procedures carried out at each stroke centre in the last year are:

West of Scotland: 16

East of Scotland: 17

North of Scotland: 31

The Scottish Government does not hold information about individual patients transfers.

The Scottish Government recognises that delivery of the acute stroke care bundle is of crucial importance to the provision of high quality stroke care. Monitoring of performance against stroke bundle standards through the Scottish Stroke Care Audit allows the Scottish Government to identify where challenges are being faced in the delivery of high quality stroke care.

We continue to expect Health Boards to identify aspects of their stroke services which do not meet the Scottish Stroke Care Standards and to work to improve standards of care locally.

The Scottish Stroke Improvement Programme team works closely with services and NHS boards to use learning from the Scottish Stroke Care Audit to support improvement across the whole stroke pathway, including timely access to thrombolysis.

For example, planning work is ongoing within NHS Greater Glasgow and Clyde to develop a telemedicine stroke service. This aims to introduce remote specialist assessment of hyperacute stroke patients out-of-hours at Glasgow Royal Infirmary and 24/7 at Royal Alexandra Hospital to improve overall door-to-needle (DTN) times for thrombolysis.

The Stroke Improvement Plan has been in place since its introduction in 2014 and has provided the framework for the provision of stroke care in Scotland.

The Stroke Improvement Plan emphasises the importance of the delivery of the stroke bundle, to ensure that all appropriate patients receive timely access to key interventions. The latest Scottish Stroke Improvement Programme annual report (published in June 2022 and available at: https://www.publichealthscotland.scot/publications/scottish-stroke-improvement-programme/scottish-stroke-improvement-programme-2022-national-report/ ) contains data collected in 2021. This demonstrated improvements in the initiation of aspirin therapy within one day (92% in 2021 v. 89% in 2020) and stroke patients receiving brain imaging within 12 hours (89% in 2021 v. 86% in 2020). Stroke bundle performance data for 2022 will be available in the 2023 national report, due to be published in June 2023.

In line with the Stroke Improvement Plan’s priority relating to the need for a skilled and knowledgeable workforce, in 2022 the Scottish Government has continued to support Stroke and TIA Assessment Training (STAT+), a standardised programme of thrombectomy education for trained healthcare professionals. We have provided funding to enable Chest Heart and Stroke Scotland to continue to deliver these education sessions to NHS Boards across Scotland to ensure increased knowledge, skills and management of thrombectomy patients. The delivery of this education package will support the ongoing rollout of a national thrombectomy service.

Following the publication of the National Advisory Committee for Stroke’s Progressive Stroke Pathway, work is underway to develop a refreshed Stroke Improvement Plan by the end of 2022. This will outline how recommendations in the Progressive Stroke Pathway will be prioritized and implemented, as well as a continued emphasis on the importance of the Scottish Stroke Care Standards.

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.

All beavers that have been captured in Tayside and translocated to projects in Scotland, England and Wales are subject to disease screening and appropriate treatment as a licence condition prior to release. This screening ensures that beavers released under licence from NatureScot are not carrying Giardia prior to any translocations.