Tag: Health and wellbeing

Improving maternity services

New maternity standards to improve consistency and quality of care

Clear information about the standards women and their families can expect during their maternity care has been published by Healthcare Improvement Scotland. 

The standards set out that patients should receive safe and compassionate care throughout pregnancy, birth and the postnatal period, regardless of where they live or their individual circumstances, and that care should be responsive to each woman’s individual needs. 

The standards cover all aspects of maternity care, from antenatal appointments through to postnatal support, emergency care, mental health and wellbeing, and bereavement care. They apply across all settings, including hospitals, community services, midwifery units, and home births, and support NHS boards to actively work to reduce health inequalities and improve outcomes for women and their babies.

Once implemented, Healthcare Improvement Scotland will use the standards to drive this improvement, informing inspection and assurance activities across NHS boards.

Public Health and Women’s Health Minister Jenni Minto said: “The safety of women and babies is paramount.

“We commissioned Healthcare Improvement Scotland to develop the Maternity Care Standards, and I am grateful for their work to improve the quality and consistency of maternity care for women, babies, and families across Scotland. 

“Every woman deserves to feel safe, supported and listened to during pregnancy and beyond. These standards recognise that some women face additional barriers to getting the care they need and set out a clear commitment to making sure maternity services work equally well for everyone — whatever their background or circumstances.”

Melissa Dowdeswell, Director of Nursing and Integrated Care, Healthcare Improvement Scotland, said: “We are pleased to have published maternity care standards that set clear expectations for how maternity care should be delivered in Scotland. 

“The standards aim to promote consistency and improve the quality of maternity services across the country. They set out a blueprint for what good maternity care looks like and detail the levels of high-quality care and support that all women should expect to receive before, during and after birth. 

“During the development of the standards, we spoke to women from many different backgrounds, who shared their experiences of being pregnant and giving birth in Scotland. Their voices were central to the creation of the standards.

“We heard that women need to feel confident that a high-level of safe, effective and person-centred care will be consistently delivered in all maternity units across Scotland regardless of individual circumstances or needs.

“The development of these standards is a commitment to making sure this happens.”

“Completely unacceptable”

Issues faced by neurodivergent people must be urgently addressed, says Holyrood committee

Challenges faced by people with neurodivergence should be addressed “without delay” according to MSPs on Holyrood’s Equalities, Human Rights and Civil Justice Committee.

The Committee launched the inquiry after the delay to the Learning Disabilities, Autism and Neurodivergence Bill. Having held formal and informal sessions in light of this delay, the Committee agreed to focus on the challenges facing neurodivergent people in education, work and the criminal justice system

Throughout the inquiry the Committee heard about the importance of, and difficulty of getting, a diagnosis of a neurodivergent condition.

Dr Jim Crabb from the Royal College of Psychiatrists told the Committee that “[A] diagnosis can be incredibly powerful and validating; for some people, it can be life saving”, while Karbie Brook, from ARGH Scotland, told MSPs that prior to diagnosis: “I simply thought that I was a broken human, that I was no good at being human and that I did not really deserve to be here because what use was I anyway.”

The Committee also heard that, in some situations, delays to diagnosis had led to people taking their own lives and concludes that this situation is “completely unacceptable”.

In its report, the Committee warns that, with 43 percent of children in Scottish schools having an additional support need, action must be taken so that neurodivergence is not seen as a deficit.

The Committee says that it is essential for young people to receive a diagnosis early in life and calls for the Government to ensure that there is a long-term strategy and funding to ensure that Scotland has the workforce needed to be able to respond to the demand for diagnoses.

The report also explores the implementation gap between Scottish Government policies and the lived experience of witnesses. The Minister for Social Care and Mental Wellbeing told the Committee that the Government was now recalibrating systems due to an unforeseen increase in demand.

While the Committee welcomes this, it urges the Government to speak to people with lived experience to ensure services meet the needs of neurodivergent people.

Karen Adam MSP, Convener of the Equalities, Human Rights and Civil Justice Committee said: “Some of the testimony that we heard during this inquiry was devastating and, as we say in our report, as a country we cannot carry on like this.

“Our inquiry has found that we must fundamentally change as a society. The Scottish Government must act urgently so that our public services understand distress, communication and difference properly, so that we can intervene early, reduce harm, and support better outcomes across education, health, employment and justice.

“I am also grateful to all those we heard from during our inquiry. We repeatedly heard about the barriers, stigma and discrimination faced by neurodivergent people, but having their views on the record shone a light on the scale of the problem.”

Public Health Scotland: Update on Meningitis

Public Health Scotland (PHS) is working closely with the UK Health Security Agency (UKHSA), other public health colleagues across the UK and NHS Boards in Scotland, to monitor the outbreak of meningitis in Kent.  

There are currently no cases known to be linked to this outbreak in Scotland and therefore no evidence of any increased risk here. 

Dr Jim McMenamin, Head of Health Protection Infection Services at PHS is encouraging everyone to be aware of signs and symptoms of meningitis: “Meningitis and meningococcal septicaemia can be very serious and life threatening if not treated quickly. 

“Signs and symptoms include a sudden high temperature, severe and worsening headache, a stiff neck, joint and muscle pain, vomiting and diarrhoea, a rash that doesn’t fade when a glass is rolled over it, confusion, drowsiness or unresponsiveness, a dislike of bright lights, and seizures (fits). These symptoms can appear in any order, but some may not appear. 

“If you or anyone you know develops symptoms, seek medical help immediately. Phone 999 for an ambulance or go to your nearest accident and emergency (A&E) department. Phone 111 or your GP practice for advice if you’re not sure if it’s anything serious or you think you may have been exposed to someone with meningitis.”

Vaccination against meningitis

The Joint Committee for Vaccination and Immunisation (JCVI) continues to review evidence on the most effective use of meningococcal vaccines within the UK routine schedule.

There are currently no plans to offer MenB vaccination outside the existing routine childhood schedule, other than for those identified by the Incident Response Team in Kent.

Two different types of meningococcal vaccines are available in Scotland and are part of routine immunisation programmes for children and young people.  

  • The Meningococcal B (MenB) vaccine was introduced in 2015 and is offered to infants and young children under 2 years old.
  • The Meningococcal ACWY (MenACWY) vaccine is offered to all young people in S3 as part of the school-based immunisation programme. This vaccine protects against disease caused by meningococcal groups A, C, W and Y.

Anyone who has missed the MenACWY vaccine offer can still receive this up to their 25th birthday. Visit www.nhsinform.scot/vaccinesforstudents to find out how to catch up.

Parents are encouraged to check if their children are up to date on their vaccinations. For information on how to check your own or your child’s vaccination history, please visit: www.nhsinform.scot/gettingvaccinations

More information on signs and symptoms of meningitis is available at 

www.nhsinform.scot/meningitis

Improving miscarriage care

Scotland leads the way with new patient charter

Scotland is set to become the first country in the UK to publish a miscarriage patient charter, giving women clear information about the care and support they can expect from the NHS.

The charter, commissioned by the Scottish Government and developed in partnership with baby loss charities Tommy’s, Held In Our Hearts and the Miscarriage Association, sets out the rights and entitlements women should receive during and following a miscarriage.

It builds on the Scottish Government’s Delivery Framework for Miscarriage Care, which is changing the way in which NHS Boards support women — ensuring they are supported after a first miscarriage, rather than after three.

Women across Scotland should be able to access private spaces in hospitals, progesterone treatment where clinically appropriate, and compassionate, culturally competent bereavement support with additional improved information available online and in printed patient leaflets in 18 languages including BSL and audio formats.

Public Health and Women’s Health Minister Jenni Minto said: “Miscarriage is devastating, and for too long women have not had the care and support they deserve.

“That is changing. Scotland will become the first country in the UK to publish a miscarriage patient charter, meaning women know exactly how they will be supported by health services following their loss.

“This charter is a landmark moment — it tells women clearly what they should expect from their NHS, and it holds services to account for delivering it. Scotland is leading the way, and I am proud of the progress NHS Boards, and our charity partners have made together.”

Kath Abrahams, Chief Executive of Tommy’s, said: “The care and support offered to women after a miscarriage in the UK has for too long been inconsistent and inadequate.

“We welcome the commitment to change that for women in Scotland, and we’re delighted to have worked with the Scottish Government to create its charter for miscarriage care.

“We will continue to push for similar improvements across the UK and for the roll-out of Tommy’s Graded Model of Miscarriage Care, which promises women support and care from their first miscarriage rather than only after their third.”

 A Patient Charter for Miscarriage Care In Scotland

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Emergency Care crisis threatens UK’s ability to withstand next pandemic, RCEM warns

Efforts to ensure the UK healthcare system is resilient against future pandemics will be undermined if the capacity issues in emergency care systems that are already ‘struggling to cope year-round’ are not addressed, according to the Royal College of Emergency Medicine. 

The warning comes following the publication of the UK Covid Inquiry’s third report on the pandemic, titled the ‘Impact of Covid-19 pandemic on healthcare systems in the 4 nations of the UK (Module 3)’. 

The Chair of the inquiry, Baroness Heather Hallett, investigated the impact of Covid-19 on healthcare systems across the four nations, including government response, how society responded, capacity of health care systems, and the impact on patients and healthcare workers.  

Yesterday’s report concludes that healthcare systems “came close to collapse” and that ultimately, they “coped, but only just.” 

The inquiry has made 10 recommendations, including the need to increase capacity in urgent and emergency care and ensure hospitals have the ability to implement surge capacity.  

Dr Ian Higginson, President of the Royal College of Emergency Medicine said: “We welcome this thorough investigation by Baroness Heather Hallett and her team which has made a damning but honest assessment of how health systems around the UK coped with Covid-19. 

“For our members and their colleagues, this report will make for sobering reading – it reflects the reality they lived through during the pandemic. They showed up when they were needed, and in many cases worked beyond their limits. They remain exhausted and burnt out because of a system that continues to run red hot.  

“Covid-19 landed on an already fragile system. Our EDs were already experiencing overcrowding and long waits, which have only got worse since. 

It’s really frustrating that the obvious lessons around investing in emergency care haven’t been learned, and that it is necessary for a public enquiry into COVID to point out what everyone who works in emergency care already knew, still knows, and have been loudly saying.  

“Our EDs are struggling to cope year-round. There are doubts as to how well many would cope with a local major incident. How can they be regarded as prepared for the next pandemic or other potential crises?  

“Last year, 1,688,555 people waited 12 hours or more to be admitted, discharged, or transferred from a major ED in England. Compare that to 2019, when 487,729 people endured this wait.  

“We have patients receiving care on trolleys in corridors, on chairs in other non-clinical areas, waiting for an inpatient bed to become available for them to move into.  

“As the report recommended, there need to be plans for surge capacity in urgent and emergency care during a pandemic. This is true and we whole heartedly agree. But we need capacity all year round.  

“While we do have institutional knowledge of what a pandemic could bring, and the ability to isolate some patients with infectious illnesses due to infrastructural improvements, I haven’t seen anything to suggest that our emergency care systems are better prepared now than we were then.” 

“The failure to prepare, which is an ongoing theme of the enquiry modules, put front line workers at risk due to inadequate PPE and outdated facilities compared to other countries that have chosen to invest in their emergency care systems and their ability to manage infectious disease outbreaks. Our patients and colleagues paid the price of this failure. 

“This report is more evidence of the need to tackle systemic issues in urgent and emergency care. RCEM is pleased to have contributed to this important inquiry, and we will work with governments, across all four nations, to restore Emergency Departments to a state where they are fit for purpose and prepared for anything.” 

The Royal College of Emergency Medicine provided evidence to the inquiry. 

A witness statement was submitted by former President, Dr Katherine Henderson MBE, who held the post between October 2019 and October 2022. 

Former RCEM President, Dr Katherine Henderson MBE said: “The Covid-19 pandemic was unprecedented.   

“For our members and their colleagues working in Emergency Medicine, it was a time few of us have faced before and our health care system was Nnot adequately prepared for a pandemic to hit, and to hit with such force.   

“Emergency care is a core service for the public that they should be able to trust can deliver the care they need. It must be adequately resourced to be able to respond.  

“In the pandemic staff lacked appropriate personnel protective equipment (PPE). And we struggled to isolate people who had COVID-19 to minimise the risk and prevent transmission of the virus. And there were concerns over ventilators and oxygen supplies. 

 “Emergency medicine staff are incredibly pragmatic and resilient, but the toll this has taken on the workforce cannot be understated. And the goodwill of those who are working in Emergency Departments can’t be the sole reason to prop up the system that isn’t working as it should. 

“The lessons contained in this report must bring about the urgent changes we need to futureproof our service – for both staff, and our patients.”

Supporting people with complex care needs

New plan to help people live in their own communities

Almost 400 people with learning disabilities and complex support needs will benefit from £20 million of funding to implement the Coming Home Action Plan, which sets out measures to ensure tailored support and housing close to home, family and friends.

This will fund bespoke support, home adaptations, equipment and technology to enable people to return to their communities rather than spending longer periods in hospital than necessary or living in supported accommodation far from home.

Minister for Social Care and Mental Wellbeing Tom Arthur said: “Every day spent unnecessarily in hospital is time away from someone’s community, family and friends. We cannot allow people to spend longer in hospital than they need to or to stay far from home just because they have more intensive support needs.

“We are beginning to see progress. The latest data shows that fewer people are delayed in hospital or placed in care settings far from home – but there is more to do. 

“I am pleased to see this £20 million funding bringing total investment in delivering the Coming Home agenda to £40 million since 2021. I thank Dr Anne MacDonald and partners for their commitment. Real change is delivered locally and this Action Plan, alongside additional investment, provides a strong framework for that.”

Cllr Paul Kelly, COSLA Spokesperson for Health and Social Care said: “We recognise the vital importance of ensuring that people with learning disabilities and complex needs spend no more time away from home than is absolutely necessary. COSLA remains fully committed to delivering the Coming Home Action Plan and to improving outcomes for the individuals and families we all serve.

“We have worked closely with the Scottish Government, Local Government, Integration Authorities, the NHS and Third Sector partners to develop the Action Plan and set out how we will jointly address these long standing issues. I am grateful for the significant commitment and time that all partners have invested in producing the Plan, which is published today. We now need to maintain that drive and collective focus as we move into delivery.

“Sustained, additional investment across the whole system will be crucial to ensuring that people with learning disabilities and complex needs can return home as quickly as possible.”

Dr Anne MacDonald, Chair of the Coming Home Short Life Working Group, said: “I’d like to thank colleagues across the sector for all their input to developing this Action Plan, which we hope will make a real difference to the lives of people with learning disabilities and complex support needs. 

“The Action Plan is focused on changes that will support people to live well in their local communities, to have choice and control about where they live, and to have their human rights upheld.”

Coming Home Action Plan

Easy Reader Summary

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Covid-19 Inquiry: NHS ‘coped – but only just’

Inquiry publishes third report and 10 recommendations, examining ‘The impact of Covid-19 on healthcare systems’

The Chair of the UK Covid-19 Inquiry, Baroness Heather Hallett, has today published her third report which concludes that the UK’s healthcare systems “came close to collapse”. Ultimately it “coped, but only just”.

Module 3, the third of the Inquiry’s 10 investigations, has examined the impact of Covid-19 on healthcare systems across the four nations. It investigated how governments and society responded to the pandemic, the capacity of healthcare systems to adapt and the impact on patients, their loved ones and healthcare workers.

Today’s new report, ‘The impact of the Covid-19 pandemic on healthcare systems of the United Kingdom’ (Module 3), finds that the UK entered the pandemic ill-prepared. Healthcare systems were already overstretched and in a precarious state. This fragility had profound consequences once the crisis hit, especially when the numbers of people seeking treatment for Covid-19 started to increase dramatically.

Healthcare systems were overwhelmed and came close to collapse. Despite the best efforts of healthcare workers, many Covid patients did not receive the care they would otherwise receive and non Covid patients had their diagnoses and treatment delayed. For some this meant their condition became inoperable. Healthcare workers put their lives at risk and the pandemic had a significant and long-lasting impact on their mental health and wellbeing. 

In hospitals, visiting restrictions meant some vulnerable patients were left without vital support. Some people died alone. This continues to have a devastating impact on the bereaved.

Baroness Hallett calls for the prompt and thorough implementation of 10 key recommendations. These are necessary to prevent healthcare systems being overwhelmed in the next pandemic.

“This third UK Covid-19 Inquiry report concerns the impact of the pandemic on the UK’s healthcare systems. I can summarise that impact as: we coped, but only just.

“The healthcare systems came close to collapse. Healthcare workers carried the burden of caring for the sick in unprecedented numbers. It came at a huge cost to them, their families, their patients and the loved ones of patients. Collapse was only narrowly avoided thanks to the extraordinary efforts of all those working in healthcare across the UK.

“Despite those efforts, some patients did not get the level of care they would usually receive. The enormous strain placed upon the healthcare systems was unprecedented. Those working within it were obliged to work under intolerable pressure for months on end.

“We cannot know when, but there will be another pandemic. My recommendations, taken as a whole, should mean that the UK is better prepared for that pandemic. In doing so, we shall avoid some of the terrible human cost of Covid-19.

“I urge governments across the UK to work individually and collectively to implement these recommendations, in full and in a timely manner.”

A four-page brief summary of the report can be found on the Inquiry’s website and is available in a variety of languages and accessible formats.

In total, 95 witnesses gave oral evidence during Module 3 public hearings held in London in autumn 2024. The Inquiry heard from healthcare professionals, policy-makers, relevant experts, groups representing those most at risk from contracting Covid-19 and those who developed Long Covid as a result of catching the virus.

The Inquiry also heard from serving and former senior politicians, leading scientists, key medical professionals and civil servants.

Some of Baroness Hallett’s  conclusions are as follows:

  • While health ministers maintained that the UK never reached a state of overwhelm, “there was clearly overwhelm”. Lower levels of care were provided to patients and patients did not always get the care they needed, notwithstanding the efforts of healthcare workers.
  • The pressure was, at times, intolerable and this continued for wave after wave of the virus. Healthcare systems entered the pandemic with low numbers of hospital beds, high bed occupancy, high numbers of staff vacancies and of sickness absences, meaning systems were in a precarious position from the outset.
  • Initial infection prevention and control guidance was flawed because it assumed that Covid-19 was spread by contact transmission and failed to consider the extent to which the virus was also spread by aerosol transmission.
  • Supplies of Personal Protective Equipment (PPE) were particularly constrained at the start of the pandemic, causing healthcare workers sometimes to work in inadequate and unsuitable PPE and put themselves and their families at risk to care for patients.
  • 111 services were not able to cope with the level of demand. Call demand for advice and information about Covid-19 increased dramatically, particularly in the early stages of the pandemic.
  • Waiting times for emergency ambulances grew. Waiting times for even the most life-threatening calls grew, with some ambulance services resorting to military aid to ensure there was not a significant risk to life.
  • Visiting restrictions meant that many patients died without the comfort of being surrounded by their loved ones, while vulnerable patients such as those with dementia or a learning disability and children in mental health inpatient units, as well as women accessing maternity services  were left without vital support.
  • The public messaging “Stay Home, Protect the NHS, Save Lives” may have, inadvertently, sent the message that healthcare was closed, contributing to a decline in attendances even for life-threatening emergencies such as heart attacks.
  • The mental health of healthcare staff was severely impacted, with many exhibiting signs of post-traumatic stress disorder, while burn-out was common.

The Chair considers that all Module 3 recommendations should be implemented in full and in a timely manner.

The Inquiry will monitor the implementation of the recommendations during its lifetime. In summary, the Inquiry recommends:

  • increasing capacity in urgent and emergency care and ensuring that hospitals have the ability to implement surge capacity;
  • strengthening the body responsible for infection prevention and control guidance, broadening its membership to enhance its decision-making and improving the guidance itself;
  • improving data collection, enabling individuals at highest risk of harm from infection to be more easily identified and recording deaths of healthcare workers more accurately;
  • promoting a standardised process and documentation for advance care planning, recording patients’ preferences for future care and treatment;
  • increasing support for healthcare workers, improving retention and increasing resilience; and
  • publishing guidance to assist decision-makers, providing clear criteria for clinical decisions if critical care resources become completely exhausted.

A full list of the Inquiry’s recommendations can be found in the full report. 

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The Inquiry has published recommendations for Module 1 and Module 2. Baroness Hallett welcomes the action taken by the four governments of the UK to date and trusts that all remaining recommendations will be implemented promptly and in full. Progress on the implementation of recommendations can be tracked on the Monitoring of Inquiry Recommendations page on the Inquiry’s website. The Inquiry expects to receive the next progress update in May 2026.

Module 3 was the first to publish a record of the Inquiry’s listening exercise, Every Story Matters, which brought together the contributions of more than 32,000 people. The Healthcare Record sets out the personal impact of the pandemic in stark and often distressing terms.

The Inquiry’s next report – focusing on the development of Covid-19 vaccines and the implementation of the vaccine rollout programme (Module 4) will be published next month, 16th April 2026. A further four reports will follow covering Modules 5 to 9, with the final report, Module 10, scheduled to be published no later than Summer 2027.

Read the full Module 3 report, the In Brief summary  and other accessible formats on our website.

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Making non-surgical procedures safer

New legislation passed

The Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Bill, which regulates higher-risk cosmetic procedures such as Botox and fillers, has been passed by the Scottish Parliament.

The Bill requires procedures to be performed by, or alongside, certain healthcare professionals in a registered setting, bringing consistent regulation to the industry. The Bill also ensures non-surgical cosmetic procedures cannot be performed on under 18s.

Healthcare Improvement Scotland will be able to inspect premises where there are reasonable grounds to believe an offence is being committed.

The Scottish Government will support businesses to adapt to the new requirements. Businesses will have at least until September 2027 to make necessary changes.

Public Health Minister Jenni Minto said: “Non-surgical cosmetic procedures are increasingly popular, and when not carried out safely they can cause serious and lasting harm.

“This legislation is designed to ensure that higher-risk procedures take place in appropriate settings with a healthcare professional present, and that under-18s are properly protected. These are meaningful, proportionate changes that put public safety first.

“I also recognise the importance of ensuring businesses are supported to adapt to new requirements and we have listened closely to the sector. The offences in the Bill cannot come into force before September 2027 giving an extended period of time for businesses to respond to these changes. The Bill is designed to be responsive to changes in the industry, and the procedures will be kept under review to ensure the list remains effective and proportionate.

“I am incredibly grateful to everyone who campaigned so passionately on this issue – their determination has helped shape stronger legislation.

“I am also grateful to colleagues across the Parliament who worked together constructively to pass this Bill.”

NHS Lothian launches Neurodiversity website

Neurodiversity recognises that there’s no single ‘right’ way for a brain to think, learn or experience the world.

Explore support, services and practical guidance available across Lothian and the wider community on our newly launched website:

https://services.nhslothian.scot/neurodiversity/