When the draft Scottish Budget for 2025/26 was delivered by Shona Robison MSP, Scotland’s Finance Secretary to Holyrood on 4th December 2024 it contained a commitment for an ‘additional £4.5 million to deliver new specialist support across the country for Long Covid, ME, Chronic Fatigue, and other similar conditions.’
With such a sweeping statement, it was left to Ben Macpherson MSP to enquire how the funding proposal of £4.5m, covering a number of areas, would impact ME/CFS – especially in implementation of the ME/CFS NICE guideline (note – asked at a point when the guideline was not yet adopted by the Scottish Government as “the default clinical guidance on ME/CFS“).
Mr Macpherson’s query illicited a number of points from Jenni Minto MSP as Minister for Public Health and Women’s Health in December 2024 –
- “We want everyone living with ME/CFS in Scotland to be able to access the best possible care and support.”
- “We have commenced early work to determine how this funding should be allocated.”
- “While the Scottish Government sets the strategic policy for the NHS in Scotland, it is NHS Boards and healthcare professionals locally who have responsibility for both service delivery and ensuring people receive the right care for them, taking into account relevant guidance and the needs of patients.”
- “We have already taken a number of steps to demonstrate our support for the NICE guidelines. Most recently in November 2024 we published an analysis of data from all NHS boards about their arrangements for ME/CFS care and their awareness and implementation of the NICE guidelines.”
Indeed, the November 2024 Report did provide an update which made sober reading. As stated in its summary
Survey responses highlighted that provision for ME/CFS varies greatly across Scotland and ranges from generalist to specialist support by staff trained in ME/CFS. Only two NHS Boards have a specific specialist ME/CFS pathway for patients in their area and, at the time of this survey, only one of these pathways was active. Most NHS Boards agreed there are potential synergies between a specialist ME/CFS service and pathways for other long-term conditions.
What progress has been made in 2025?
The expectations of specialist care provision have risen since the Scottish Government withdrew the Scottish Good Practice Guide for ME/CFS in May 2025 and adopted the 2021 NICE guideline on ME/CFS plus the Delivery Plan on ME/CFS was published with provisions relating to care provision, education and attitudes to the disease.
However, even before the Delivery Plan was published Jackie Baillie MSP tabled a written question (S6W-37793) to Ms Minto –
To ask the Scottish Government whether it will provide an update on how the £4.5 million of funding for specialist support for long-term conditions announced in the Programme for Government 2025-26 will be allocated, broken down by (a) conditions it will cover, (b) services it will prioritise and (c) geographical focus.
The answer was less than inspiring and certainly not illuminating. It is to be wondered what has been done in the intervening months and why the reticence in indicating which conditions the funds are intended to cover. All this before a rigorous assessment of implementation of the NICE guideline is made never mind the newer (slight) aspirations of the Delivery Plan.
Work is ongoing to determine how the additional £4.5 million announced in the 2025-26 budget to deliver new specialist support will be allocated to NHS boards, what conditions it will cover and the services it will prioritise. It is expected that NHS boards will develop support based on their understanding of local population need and synergies with existing local service provision.
We want this money to have maximum impact and are working closely and carefully with boards across Scotland to allocate it as quickly and effectively as possible.
