The Ministerial Strategic Group for Health and Community Care (MSG) will be taking forward a review of progress of the Integration Authorities.

The MSG includes representation from the third and independent sectors as well as representation from Scottish Government, COSLA, NHS Boards, Local Authorities and Integration Authorities.

Following the announcement by the UK Government of the Soft Drinks Industry Levy, many drinks manufacturers completed programmes to reformulate sugary drinks to lower or zero sugar alternatives. I understand that much of this reformulation used sucralose or stevia, both sweeteners that can be safely consumed by people with phenylketonuria (PKU).

Scottish Government officials have had discussions with HM Treasury and HM Revenue and Customs about the Soft Drinks Industry Levy but the impact of those with PKU was not raised in those discussions.

The Scottish Government takes this condition seriously which is why at around 5 days old, babies are offered new-born blood spot screening to check if they have PKU or a number of other conditions. If PKU is confirmed, treatment will be given‎ straight away to reduce the risk of serious complications.

It is important that accurate labelling helps those with PKU make informed choices about their food and drink. I am advised by Food Standards Scotland that the only sweeteners that can break down to form phenylalanine are aspartame (E 951) or the salt of aspartame acesulfame (E 962). Under the food information legislation (Reg 1169/2011) any product containing these sweeteners are required to state on the label either:

• ‘contains aspartame (a source of phenylalanine)’ on the label if aspartame/ aspartame-acesulfame salt is designated in the list of ingredients only by their E number or,

• ‘contains a source of phenylalanine’ in cases where aspartame/aspartame-acesulfame salt is designated in the list of ingredients by their specific name.

The sweetener advantame (E 969) only produces very small amounts of phenylalanine and so does not need the phenylalanine labelling. This is as the European Food Safety Authority concluded “for a phenylketonuric child, the additional phenylalanine intake expected from ingestion of advantame-containing foods and beverages would represent a relatively small increment in the exposure to phenylalanine.

The Scottish Medicines Consortium (SMC) currently uses the following definitions:

- End of life medicine: a medicine used to treat a condition at a stage that usually leads to death within three years with currently available treatments.

 - Orphan medicines used for very rare conditions: a medicine with European Medicines Agency designated orphan status (conditions affecting fewer than 2,500 people in a population of 5 million) or a medicine to treat an equivalent size of population irrespective of whether it has orphan status.

 - Ultra-orphan medicine: medicines for extremely rare conditions may be known as ultra-orphan medicines. SMC uses this term for medicines used to treat conditions with a prevalence of 1 in 50,000 or less (or a maximum of 100 people in Scotland).

Clinical decisions on whether to prescribe any medicine are based on individual patient need and are a matter for the clinical judgment of the patient’s doctor in consultation with the patient, informed by advice and guidance about the medicine.

The Scottish Medicines Consortium takes a range of factors into consideration when deciding whether to accept a new medicine under review. This includes considering the clinical and health economic evidence provided by the submitting company as well as evidence submitted by patient groups to decide whether the medicine provides value for money.

Decisions made by the SMC are independent of Ministers and the Parliament.

I wrote to the Health and Sport Committee on 17 May to provide a further update on the Scottish Government’s progress in delivering the recommendations from the Review of Access to New Medicines.

I can confirm that the pharmaceutical company, BioMarin, has made a submission to the Scottish Medicines Consortium (SMC) for sapropterin (Kuvan®) for the treatment of phenylketonuria. The SMC will publish their advice in August.

Decisions made by the SMC are independent of Ministers and the Parliament.

The Scottish Government does not hold information on postgraduate applications to study at Scottish higher education institutions, nor on how many places were offered. The information may be available from the two institutions concerned.

The information requested is not held by the Scottish Government.

In January we announced a recommended 10.8%increase in student nursing and midwifery intakes for 2018-19 – the sixth successive, with an extra 364 places equating to over 3,700 entry places - this includes a recommended increase from 110 to 122 Learning Disability places – up by 10.9%.

Information for 2006 and earlier is not available as this was a transitional year in terms of how NHS staff were recorded due to the move from the Whitley system to Agenda for Change, the national NHS pay system which has introduced new pay bands and harmonised terms and conditions for the NHS workforce.

The number of learning disability nurses employed by each NHS Board is published by ISD Scotland and is available at the following links (Go to the “Band Grouping” tab for Bands 5-9 only):

Mar-15 to Dec-17

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2018-03-06/Nursing_and_Midwifery_SIP_D2017.xls

Sep-12 to Mar-15

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2016-12-06/Nursing_and_Midwifery_SIP_S2016.xls

Sep-07 to Sep-12

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2012-11-27/Nursing_and_Midwifery_SIP_S2012.xls

Attracting and retaining the right people, and raising the status of social care as a profession, is key to delivering quality care. That is why we have taken action to protect our social care services, including paying the real Living Wage to adult care workers, a move that has benefited up to 40,000 care workers.

And our living wage commitment will be extended to cover sleepover hours during 2018-19.

The work we have begun with our major stakeholders on all three Parts of the National Health and Social Care Workforce Plan is designed to ensure safe, sustainable and high quality services right across our NHS, social care and primary care services. The Part 2 recommendations, which were published in December 2017, cover the social care workforce and will directly address recruitment challenges, promote career pathways and improve workforce development in social care.

We have been working with the National Scottish Steering Group for Educational Psychologists (NSSGEP) on workforce planning to ensure a sustainable supply of educational psychologists to meet needs. On 25 May 2018 an agreement was reached between COSLA and the Scottish Government on a new partnership funding package to help with fees and living costs for trainee educational psychologists. This will deliver up to 30 new educational psychologists each year.

It is for individual local authorities to take decisions on the numbers of educational psychologists they need and employ. There are a number of reasons why educational authorities have unfilled positions, which can include when a recruitment process is on-going but not complete, where a recruitment process does not generate a suitable candidate, where the incumbent is on maternity leave, and where a local authority has not given approval to fill a vacancy.

The following table, taken from the school staff census, shows the number of educational psychologists (full time equivalent) employed by education authorities, broken down by local authority and year since 2010.