3. To ask the Scottish Government how its cross-Government co-ordination of Covid recovery policies is addressing the needs of those affected by long Covid. (S6O-02065)

The Scottish Government is supporting a recovery that is focused on supporting individuals and communities who were most affected during the pandemic—including people with long Covid—and on reducing systemic inequalities across Scotland. The Scottish Government recognises the impact that long Covid can have on the health and wellbeing of those who are affected, and it is investing in scientific efforts to understand long Covid. We have made an initial £3 million available to NHS boards and their partners to deliver the best local models of care for assessment of and support for ongoing management or treatment of symptoms.

One of my Motherwell and Wishaw constituents, who had a horrendous Covid experience and is suffering from long Covid, is unable to get back to work as a pilot due to hearing loss. He has had one cochlear implant fitted following Covid complications, but that does not meet the requirements for his profession.

Current National Institute for Health and Care Excellence guidelines, which are followed by Health Improvement Scotland, stipulate that he must have another condition that impacts on cognitive ability for him to be eligible for a second bilateral implant. Those guidelines are from 2019—before the pandemic. As part of Covid recovery, is the Scottish Government committed to working across Parliament to review the guidelines that are in place so that people like my constituent, who have been made economically inactive due to long Covid, have their circumstances considered?

First, I am really sorry to hear about the impact that long Covid is having on Clare Adamson’s constituent. Healthcare Improvement Scotland is a national improvement organisation that supports the health and social care system to design and provide high-quality, sustainable and compassionate care for the people of Scotland.

The National Institute for Health and Care Excellence guidelines are developed by expert panels, taking into account relevant evidence. In Scotland, the Scottish intercollegiate guidelines network—SIGN—guidelines contain recommendations for effective practice based on current evidence. However, NHS boards in Scotland can choose to consider other guidelines, including NICE guidelines, where there is no SIGN guidance. At present, I am not aware of any plans to review that NICE guideline.

The Deputy Presiding Officer:

A number of colleagues want to ask supplementaries. The appeal to members to be brief in questions and answers stands.

In November, Humza Yousaf wrote to me and outlined how much long Covid support funding was being provided to each health board. Although I was happy to see a roll-out of long Covid rehabilitation pathways, there remains a lack of dedicated long Covid clinics in Scotland. Will the minister heed the call of health professionals such as NHS Grampian head of health intelligence, Jillian Evans, and provide dedicated long Covid clinics across Scotland?

Sandesh Gulhane is aware that it is the role of NHS boards to develop and deliver models of care that are most appropriate for the needs of their local populations. We are providing resource to boards, through our long Covid support fund, to enable them to do that. Initiatives that are being supported by the funding include key elements of care that are being offered by long Covid assessment clinics elsewhere in the United Kingdom, including a single point of access for assessment and co-ordinated support from services, including physiotherapy and occupational therapy.

Sandesh Gulhane will also be aware that the SIGN guidance, which was developed collegiately on a four-nations basis across the whole UK, says explicitly that a one-size-fits-all approach—such as long Covid clinics—is not appropriate for all areas.

As of May last year, NHS England had allocated £224 million to support assessment and treatment of long Covid, with £90 million of that being allocated in 2022-23. Applying the Barnett formula to those figures would produce funding of £21.7 million in Scotland, but the Scottish National Party Government has provided less than half of that amount, despite the number of people with long Covid having grown threefold.

Can the minister explain where the missing millions are?

Jackie Baillie will be aware that the long Covid support fund is a targeted additional resource for NHS boards to further enhance the assessment and support that they already provide for people with long Covid across a range of services.

In 2022-23, £18 billion was provided for the health portfolio, which is a record level of front-line health spending in Scotland. It is £323 per person, which is 10.6 per cent higher than the figure for England. We regularly engage with NHS boards regarding their capacity needs, and will continue to do so in order to inform allocation of the long Covid support fund.

According to media reports, a new study shows that one in 50 Scots has long Covid. On that basis, it could be estimated that around 460 people are living with long Covid in Shetland. What consideration will the Scottish Government give to providing specialist long Covid services in our rural and island areas?

One of the challenges that we have is in getting accurate data on long Covid prevalence, distribution and symptoms. We need that data to forecast and plan NHS services, but achievement of that objective is complex. Currently, we do not have the full picture.

The Scottish Government is happy to work closely with NHS Shetland and any other boards to help with providing information so that boards can plan adequately for their local needs. However, I emphasise—as I have in previous answers—that it is for local health boards to respond to need in their communities and to ensure that services can deliver for the people whom they serve.

In England and Wales, the NHS has set up long Covid clinics and the evidence so far demonstrates that that is definitely the right way to proceed to ensure that the individual comes first. Will the minister agree to look at that evidence and then come back to Parliament to state whether that is an approach that Scotland can follow?

In Scotland, we follow the clinical guideline that exists for long Covid, as was referenced in an earlier answer. It was developed rapidly and was published in December 2020 by SIGN, NICE and the Royal College of General Practitioners. That living guideline includes recommendations and guidance on clinical management of people who have long Covid, as well as recommendations for those who are planning services. I reiterate that that guideline notes that one model would not fit all areas. However, it is perfectly possible for local health boards to come forward with a long Covid clinic model, should they think that it fits their local needs. Development of such a model would be supported.