New research from Public Health Scotland (PHS), conducted in collaboration with Sciensano* and recently published in Public Health, the journal of the Royal Society of Public Health, projects a surge in the number of adult cases of excess weight in Scotland by 2040.
The findings highlight the scale of the challenge for both population health and future care services.
Current estimates from the Scottish Health Survey show that around two-thirds of Scottish adults are overweight, and one-third are living with obesity. These figures are disproportionately higher than other UK nations and among the highest compared to other European Union countries.
This new research analysed data from the Scottish Health Survey and found that, without urgent and sustained intervention, the number of adults who are overweight or living with obesity is set to rise significantly.
Dr Grant Wyper, Principal Epidemiologist, PHS, said:“Our findings highlight the stark challenge ahead. We estimate 3.3 million cases of adult excess weight by 2040, with more pronounced increases for obesity. Between 2025 and 2040, we estimate an additional 118,000 female and 36,000 male cases of obesity.
“Furthermore, recent increases in excess weight among adults aged 65 and above are projected to intensify towards 2040, signalling growing and more complex pressures on Scotland’s health and social care systems in the coming decades.
“These findings should be seen as a clear warning, but the projections are not inevitable. Delivering on the Population Health Framework priority to improve healthy weight is vital.
“Excess weight is linked to a wide range of health conditions, including premature death, meaning that our findings point to the risk of future adverse impacts on population health and unsustainable pressure on healthcare services.”
Claire Hislop RNutr (Public Health), Organisational Lead – Food & Physical Activity, PHS, added:“The time for incremental change is over. The evidence shows we must accelerate progress on bold, preventative measures that reshape the food environment and ensure healthier options are accessible, affordable and widely available.
“At the same time, we must strengthen comprehensive weight management and support services to improve the health and wellbeing of the people of Scotland. This approach aligns with the ambitions of the Population Health Framework.
“The framework priority for improving healthy weight needs a whole system package of prevention and treatment measures to improve levels of healthy weight, alongside ongoing policy developments to create conditions for better health and reduced inequalities.”
SCATHING REPORT HIGHLIGHTS HOMES INSULATION SCANDAL
98% of homes with external wall insulation installed under the UK government’s ECO scheme require work to correct major issues that will cause problems such as damp and mould.
DESNZ’s consumer protection system, which was set up in 2021, did not alert it to significant issues with the quality of installations until late 2024.
The NAO recommends that DESNZ sets out how and when affected households can have faulty installations repaired, and reforms the consumer protection system.
A new National Audit Office (NAO) report sets out the reasons for failures in the government’s energy efficiency scheme for homes, including poor-quality installations, weak government oversight and inadequate audit and monitoring, which the Department for Energy Security and Net Zero (DESNZ) believes have led to tens of thousands of households needing repair work to correct major issues that will cause problems such as damp and mould.
The government’s Energy Company Obligation (ECO) scheme aims to tackle fuel poverty and reduce carbon emissions in Great Britain by requiring energy companies to fund the installation of energy efficiency measures, such as insulation, in homes.
But poor installation work has resulted in an estimated 22,000 to 23,000 homes with external wall insulation fitted under the scheme (98% of the total) and 9,000 to 13,000 homes with internal insulation (29% of the total) having major issues that need fixing. A small percentage of these installations also pose immediate health and safety risks.
Possible explanations why so many installations have been carried out to such a poor standard include an under-skilled workforce, with work being subcontracted to individuals and firms who are not competent or certified; uncertainty over which standards apply to which jobs; and businesses ‘cutting corners’ when undertaking design and installation work.
DESNZ implemented a new consumer protection system for the scheme in 2021, which included appointing TrustMark as its government-endorsed quality scheme.
But this system failed to alert DESNZ to significant issues with the quality of installations until October 2024, by which time the media had already reported on individual cases of bad mould in homes.
Reasons for the ECO scheme’s shortcomings include:
weak government oversight resulting in widespread issues with the ECO scheme not being identified sooner;
an overly complex consumer protection system that ultimately failed due to unclear and fragmented roles, responsibilities and accountabilities among DESNZ, Ofgem and private sector certification bodies and scheme providers;5
TrustMark’s funding arrangements limiting its ability to have analytical systems fully up and running until the latter half of 2024; and
insufficient audit and monitoring, in part due to weaknesses that allowed installers to ‘game’ the system.6
In addition to these issues, in November 2024 Ofgem estimated that businesses had falsified claims for ECO installations in between 5,600 and 16,500 homes, potentially claiming between £56 million and £165 million from the energy suppliers operating under the scheme.7
DESNZ and Ofgem took action once TrustMark made them aware of the extent of the problems. This included asking certification bodies and scheme providers to suspend the worst performing installers; communicating the issues to potentially affected households and to the wider public; and implementing immediate changes to theconsumer protection system.
DESNZ also plans to apply the lessons learned from this experience to the design of its future schemes and its forthcoming Warm Homes Plan.
To improve the consumer protection system, and to boost householders’ confidence in government-backed schemes, the NAO recommends that DESNZ:
takes clear responsibility for schemes such as ECO, even when they are funded through consumers’ electricity bills;
clarifies its approach to repairing faulty ECO scheme installations alongside its Warm Homes Plan;
reforms the consumer protection system for retrofit schemes; and
reports annually on a statistically robust estimate of the level of fraud and non-compliance in each of its retrofit schemes.
Gareth Davies, head of the NAO, said: “ECO and other such schemes are important to help reduce fuel poverty and meet the government’s ambitions for energy efficiency.
“But clear failures in the design and set-up of ECO and in the consumer protection system have led to poor-quality installations, as well as suspected fraud.
“DESNZ must now ensure that businesses meet their obligations to repair all affected homes as quickly as possible. It must also reform the system so that this cannot happen again.”
Sir Geoffrey Clifton-Brown MP, Chair of Westminster’s Committee of Public Accounts. said: “The failures of the two current Energy Company Obligation (ECO) schemes are stark, with nearly all external and nearly a third of internal wall insulation fitted under the schemes requiring remediation.
“The potential impact of major issues to the health and safety of affected households must not be understated.
“Despite allegations of fraud, lack of sufficient quality data means that overall levels of fraud in ECO remain unknown.
“DESNZ and Ofgem have been quick to act after becoming aware of widespread problems, but their efforts remain hampered by weak government oversight and an overly complex consumer protection system.
“It is imperative that households receive clarity on how they can fix their homes and a system is put in place whereby these failings do not reoccur.”
A network of walk-in GP clinics will open as part of work to improve access to primary care.
The clinics, which would be staffed by GPs, nurses and support staff, will be open seven days a week, 12:00-20:00, in addition to existing primary care services. They will provide a range of same-day assessments, diagnostics and treatment.
Fifteen clinics in sites across Scotland will proceed initially to test the benefits for patients.
Health Secretary Neil Gray said: “Improving access to primary care and shifting more care into the community is central for this Government.
“As part of this, we are taking forward new and innovative ways to improve access to primary care, including the benefits of local walk-in GP clinics.
“These will be in addition to core GP services and will offer additional flexibility for patients. These will be designed in collaboration with NHS Boards, GPs and other partners to ensure they strengthen existing services.”
The announcement was made by First Minister John Swinney at the SNP’s annual conference in Aberdeen yesterday.