Health Boards in Scotland have a duty to ensure that they have policies in place covering all forms of restrictive practice and that all staff receive appropriate training.

It is the expectation that episodes of restraint are recorded in clinical case records, that a critical incident review should take place locally if an injury occurs during the use of restraint and that any serious injury is reported to the Mental Welfare Commission for Scotland.

In 2019, I wrote to all Health Boards to confirm that they each had policies in place covering all forms of restrictive practice and that staff receive appropriate training.

We expect NHS Boards to adhere to current guidelines on the treatment of anaphylaxis from authorative professional sources such as the Resuscitation Council UK and National Institute for Health and Care Excellence (NICE).

NHS Inform is Scotland's national health information service that aims to provide people with accurate and relevant information to help them make informed decisions about their own health. This includes information about symptoms, diagnosis and treatment for anaphylaxis - https://www.nhsinform.scot/illnesses-and-conditions/immune-system/anaphylaxis .

Community pharmacists provide information, advice or assistance to people on the use of and any risks associated with medicines, and medical devices to prevent harm. This includes people who require an Adrenalin Auto Injector (AAIs) device.

Paediatric allergy services are organised through the Children’s and Young People’s Allergy Network Scotland (CYANS), which is a National Managed Clinical Network that focuses on improving health service provision for children and young people with allergies in Scotland.

NHS Inform provides information about the causes, treatment and prevention of anaphylaxis, including the possibility that someone suffering from anaphylaxis may go into cardiac arrest. We are committed to improving out-hospital cardiac arrest outcomes and, since 2015, over 508,000 people across Scotland have been equipped with cardiopulmonary resuscitation (CPR) skills. National public health campaigns have also been run to raise the overall awareness of using CPR skills.

In wider terms the Scottish Government is taking action to prevent anaphylaxis, for example in a move towards the introduction of full ingredient listing, with allergens emphasised, for foods sold on a Prepacked for Direct Sale basis, Food Standards Scotland is currently undertaking public consultation to inform the development of draft regulations, supporting technical guidance and a robust impact assessment for new Scottish regulations that are due to come into force in Autumn 2021.

Treatment for anaphylaxis may take place in primary care, in accident and emergency departments and in hospitals. Statistics provided by ISD shows the number of patients aged (a) under 16 years and (b) 16 years and over, who were discharged from hospital following treatment for anaphylaxis.

Table 1: Patients treated in hospital for a diagnosis of anaphylaxis in NHS Scotland; 2007 to 2018

Listed below are the six public inquiries constituted under the Inquiries Act 2005 since 2007. There have been a variety of other reviews and non-statutory inquiries for which costs are not held centrally.

The following table sets out NHS Scotland’s spend on both goods and services from other UK NHS bodies, as reported by NHS Boards in their annual accounts.

ISD publish waiting times for endoscopy as part of the Diagnostics Waiting Times publication. The data published gives the number of people who are still waiting at the end of each month, and does not provide the completed waiting times for this test. Performance against the 6 week standard is only available from quarter ending June 2009. These can be accessed at the following web site: https://www.isdscotland.org/Health-Topics/Waiting-Times/Diagnostics/

Information from a number of sources regarding the provision of workplace support across our health and social care services, is currently being considered on behalf of the Ministerial Short Life Working Group on Culture and Wellbeing, which I chair. The Group has a broad remit to examine and review existing provision, and will in due course publish a framework to support sustainable, longer-term cultural transformation.

One of the objectives of that framework will be to promote the implementation of practical strategies that ensure that all staff, regardless of their role or location have access to appropriate support services. An update to Parliament will be provided in the Spring, once the Short-Life Working Group has concluded its work.

Details of NHS expenditure on general practice and dental services are made available each year in the annual NHS publication “Scottish Health Service Costs”, also known as the Cost Book. The latest available Cost Book is for 2018-19 and the report can be accessed at the following location: https://www.isdscotland.org/Health-Topics/Finance/Publications/ .