Chamber and committees

We recognise that too many people are waiting too long for an appointment and treatment. This is why I published the Waiting Times Improvement Plan on 23 October 2018. This Plan is backed by £850 million and sets out the actions needed to ensure future delivery of waiting times standards and guarantees for all patients across Scotland by Spring 2021.

To support NHS Grampian to make improvements, we have provided them with more than £11 million of additional funding in this financial year. This will support them to recruit additional staff, run evening and weekend clinics and theatre sessions, all of which will support the reduction of waiting times.

In addition, we are investing £200 million in a network of new elective and diagnostic treatment centres to provide additional capacity and increase patient access to services. One of these centres will be located at Aberdeen Royal Infirmary and we are working closely with NHS Grampian to ensure this facility provides the best outcomes for patients.

The Scottish Government currently funds a GP mentoring Scheme in NHS Highland to support First 5 GPs in the Highland and Islands. Ten GP mentors were trained in late 2018- early 2019 and each provide 8 hours of support per month. The scheme can be accessed by all GPs in the region who are seeking mentorship support.

This was designed as a pilot scheme and an evaluation of its success with a view to expanding it to other parts of Scotland is being carried out.

A further course is underway this year to train a further 10 mentors from both primary and secondary care.

The Scottish Government continues to pass on all health resource consequentials from UK related health spending to support the measures set out in the Health and Social Care Medium Term Financial Framework.

Recent decisions taken by the UK Government have resulted in an annual shortfall of over £90 million for Scotland’s health services. Despite commitments to fund the change to employer pension contributions, the UK Government has only provided £280 million of the necessary funding in 2019-20 for their decision. This has left a shortfall of £48.4 million this year, which the Scottish Government has now met in full. This comes on top of the UK Government reducing health funding in Scotland by £42 million with effect from next year, compared with its previously claimed level of consequentials.

The Scottish Government will continue to prioritise and protect frontline services, and Scottish Ministers call for previous funding commitments from the UK Government to be delivered in full.

Barnett consequentials are as follows:

2017-18: £411 million

2018-19: £476 million

2019-20: £1,021 million (including £280 million for employer pensions costs).

The Public Bodies (Joint Working) (Scotland) 2014 Act requires Integration Authorities, which are responsible for planning and commissioning local health and social care services for all adults, including older people, as a minimum. To support this work, Integration Authorities are required to publish a Strategic Commissioning Plan, which identifies strategic priorities and strategic direction, and to publish annual performance reports on progress towards achieving the nine National Health and Wellbeing Outcomes. There are nine outcomes which are high-level statements of what health and social care partners are attempting to achieve through integration for their local population including older people through improving the quality and sustainability of services and supports across health and social care. Within their annual performance reports, Integration Authorities set out an assessment of performance across a core suite of national and local integration indicators and review how well they have met the objectives set out in their Strategic Commissioning Plans.

The Ministerial Strategic Group for Health and Community Care, co-chaired by myself and the COSLA Health and Social Care Spokesperson, provides political leadership for integration and oversees progress.

The Group is also overseeing the Reform of Adult Social Care Support Programme which is being jointly led by Scottish Government and COSLA in partnership with people who use social care support, carers, and the social services sector. This programme was launched jointly by the Cabinet Secretary and COSLA’s Health and Social Care Spokesperson in June 2019 and aims to support Integration Authorities, the wider sector, and communities in supporting local reform of adult social care support in context of integration. It will advise Scottish Ministers if national changes or interventions are required. The reform programme will focus on the following workstreams: the purpose and value of social care support and self-directed approaches; consistent experience and expectations; models of care and support; workforce conditions and skills; investment in care and support; commissioning and procurement and communities, care and support.

Since the launch of the Waiting Times Improvement Plan additional funding has been made available to all territorial Health Boards and the Golden Jubilee in 2018-19 and 2019-20. The following tables sets out the additional funding allocated to each Health Board to support activities aimed at improving waiting times across a range of services. The details for 2019-20 also include funding specifically aimed at improving cancer and diagnostics waiting times.

Table 1

The Waiting Times Improvement Plan, which I launched in October 2018, set out a range of actions aimed at ensuring the delivery of waiting times standards and guarantees for all patients across Scotland by Spring 2021. Implementation of the Plan will increase capacity, clinical effectiveness and efficiency across Health Boards, and will help reduce waiting times and implement new models of care that will increase patients access to services and consequently reduce the number operations and procedures cancelled for non-clinical reasons.

Specific actions outlined in the Plan to change the way we deliver healthcare include: redesigning speciality-specific pathways, for example: the roll out of Rapid Access Neurology Clinics and one-stop cancer diagnostic clinics; rolling out an ‘opt-in’ process for patient appointments to reduce the need for follow-up appointments when everything is fine and improving booking systems to minimise unnecessary delays; and increasing the use of the Attend Anywhere Video Consultation platform to save patients unnecessary travel time and increase the time clinicians are able to spend with patients who need face-to-face consultation. We are also investing £200 million in development of a network new elective and diagnostic treatment centres to provide additional capacity and increase patient access to services.

All of these activities and more, will ensure that patients can more easily be seen and treated at a time and place that is more appropriate to their needs and will ensure that there are fewer cancellations for non-clinical reasons.

(a) The DG Health and Social Care has issued sign-off letters relating to the 2019-20 Annual Operational Plans (AOPs) received from all territorial and national NHS Health Boards, apart from NHS Health Scotland. The sign-off letters confirm that the Scottish Government considers the Plans to form a satisfactory basis on which to hold the Board to account for their contribution over the year to delivering Ministerial priorities in relation to Health and Social Care. Each of the letters is tailored to the individual circumstances of the Board, highlighting any areas where the Board is required to continue to work with officials to refine the detail of their plans or where sign-off is contingent upon achievement of a specific outcome.

Copies of all the sign off letters will be made available on the Scottish Government website before the end of December 2019.

NHS Health Scotland did not produce an Annual Operational Plan for 2019/20 as it has been preparing to become part of Public Health Scotland during this period. The Board has, however, produced and published a final Delivery Plan to cover this period.

(b) All of the AOPs have either been published on the Boards’ websites or have been discussed as part of Board meetings held in public and are available on their websites as part of the papers for these meetings.

Discussions on additional funding for 2020-21 will be taken in line with consideration of Boards’ Annual Operational Plans for 2020-21 once these have been received. Final Plans are due to be submitted to the Scottish Government by the end of February 2020.

All territorial health boards have now signed up to using the Attend Anywhere Video Consultation service. Work is underway to scale up the use of this service now across Scotland and to embed this into routine practice. The greatest uptake has so far been seen across the North of Scotland in acute services.

This service has been fully funded by the Scottish Government's Technology Enabled Care (TEC) Programme at a technology cost of £650,000 from 2017 to 2020.

Scotland's Economic Strategy, launched in 2015, identifies those sectors where Scotland has a distinct comparative advantage. The latest available statistics on the Growth Sectors are available at https://www2.gov.scot/Topics/Statistics/Browse/Business/Publications/GrowthSectors

Scotland’s Economic Strategy sets out the need to pursue a more balanced form of economic growth, through greater inclusion and increasing the contribution from investment, innovation and net trade, rather than consumption, in order to achieve growth that is sustainable in the long-term.