Chamber and committees

PHS collate data on Direct Cancer Referrals. This includes self, GP or NHS24 referral to A&E or other, where the signs and symptoms are consistent with the cancer diagnosed as per the Scottish Referral Guidelines. Data on these patients are only available from PHS from 2010 onwards as outlined in the following table.

Table 1: Number of direct cancer referrals 1,2,3 on the 31 day pathway since data-set began

We held a public consultation for the new cancer strategy from 12th April – 7th June. Anyone who wished to submit a response was welcome to through Citizens Space, this includes members of the public, professionals working with cancer services, and organisations. The results of the consultation will be published shortly and will feed into the development of the next cancer strategy.

Early insights from the initial consultation report show that organisations in the cancer sector welcome a long-term strategy with broad overarching aims to help achieve structural changes in the delivery of cancer care.

Place directors are not appointed - these roles are voluntary positions taken on by civil servants at deputy director and director level, alongside their day-to-day responsibilities. A list of current place directors and their local authority and Community Planning Partnership areas can be found on the Scottish Government website, under Community Planning [ Community planning - Improving public services - gov.scot (www.gov.scot) ].

The requested information on how many nurses have (a) joined and (b) left the NHS in Fife each year since 2007 is not centrally available.

Information on how many Nursing & Midwifery staff have (a) joined and (b) left the NHS since 2012 can be found in the following link: NHSScotland workforce | Turas Data Intelligence .

Public Health Scotland (PHS) receives monthly data from most NHS Boards on the number of patients covered by the 18 weeks Referral to Treatment (RTT) standard seen within each specialty, including audiology. Due to the aggregate nature of this data collection, the requested detail on average length of wait and age are not available.

However, Table 1 shows the total number of patients seen and the number that waited over 18 weeks to be seen for audiology services across NHS Scotland, from January 2014 to December 2021 – the latest complete calendar year. This includes all patients reported as seen on the 18-week RTT pathway for audiology. Please note, almost all patients on this pathway are not admitted for treatment and their journey ends after seeing an audiologist in an outpatient setting.

Due to the complexities of 18 week RTT local data collection and reporting, the length of wait cannot be accurately measured by the Board of treatment for all patients. The impact of which for audiology is reflected in the number of unknown waits reported in the following table.

Table 1: Total patients seen and number of patients that waited over 18 weeks, January 2014 – December 2021, NHS Scotland, Audiology.

The Scottish Government is committed to ensuring that NHS Scotland has a skilled and sustainable workforce, we work in partnership with NHS Boards who are responsible for taking decisions about the configuration of midwifery services, commensurate with their local population needs.

We have taken a range of measures to support midwifery workforce supply, having grown the number of funded places on undergraduate midwifery programmes in Scotland by 20% over the last decade, to 301 funded places in 2022. Additionally, we offer a comprehensive and competitive package of student support, which is the best in the UK. In January 2022, we welcomed students from across Scotland on to a new, shortened midwifery training pathway at Edinburgh Napier University. These students will qualify as midwives in 20 months whilst continuing to work in their home regions, including in Scotland's remote and rural health boards.

In addition to our investment in education and training, we are providing direct recruitment support to all health boards across Scotland, through coordinated national marketing activity and support for ongoing international recruitment, including £8m to support the recruitment of up to 750 nurses, midwives and AHPs announced on 04 October 2022. We continue to look for opportunities to increase levels of recruitment and retention of healthcare staff in rural areas and have committed to undertaking further activity on remote and rural recruitment and retention, under the auspices of the National Health and Social Care Workforce Strategy.

In Scotland, the Scottish Medicines Consortium (SMC) appraises the clinical and cost-effectiveness of newly-licensed medicines. Following a full submission for zanubrutinib (Brukinsa ® ) as monotherapy for the treatment of adult patients with Waldenström’s macroglobulinaemia (WM) who have received at least one prior therapy, or in first line treatment for patients unsuitable for chemo-immunotherapy, the SMC issued ‘not recommended’ advice for routine use of this medicine in NHS Scotland on 12 September 2022. The advice detailed that a comparable drug is currently available for this indication, and the company did not present a sufficiently robust economic analysis to gain acceptance by the SMC.

However, the SMC has received a fast track resubmission which was reviewed at the SMC’s Committee meeting on 4 October 2022, and its advice will be published on 7 November 2022. In the meantime, you can access a summary of the current status of this resubmission on the SMC’s website here .

There are alternative routes of access available for a medicine that is not recommended by the SMC. A doctor can request access to licensed medicines for a patient on an individual ‘case-by-case’ basis through the Peer Approved Clinical System (PACS) Tier Two process, where a doctor considers there would be a clinical benefit for a patient.

The decision on whether to prescribe a medicine for a patient, and which medicine to prescribe, is entirely one for the clinician in charge of a patient’s care to make, having taken into account the patient’s clinical condition and the safety of the patient.

The A75 and A77 routes were considered as part of the UK Government’s Union Connectivity Review (UCR), with potential funding following on from the recommendations.

In March 2022, Transport Scotland (TS) officials had an initial discussions with their UK counterparts in from the Department for Transport (DfT). The subject of possible UCR related funding opportunities, which was first identified in March 2021, was raised by DfT officials and TS officials followed-up with a number of specific clarification questions. Answers to these were received in May, and a follow-on meeting occurred on 16 June.

A subsequent discussion is scheduled for 31 October which will cover UCR recommendations and associated proposed funding for the A75. Potential development work for the A77 was not identified for funding by the UCR process, so will not be on the agenda for discussion, as, along with all other transport recommendations identified by STPR2, it remains a devolved matter.

As set out in our public consultation we are considering how to address health inequalities and promote equitable access to cancer services. We have outlined ‘reducing inequalities’ as one of our main aims in the consultation. With over 250 responses received we have now commissioned independent analysis of the responses and anticipate the results to be published shortly. The results will inform the cancer strategy.

In addition, we held a series of workshops with patients and key stakeholders in September 2022 to help us gain further insight into the consultation responses and hear directly about peoples’ experiences of cancer and inform the development of the cancer strategy.

The final Union Connectivity Review (UCR) Report was published in November 2021.

In March 2022, Transport Scotland officials had discussions with their UK Government counterparts at the Department for Transport (DfT) at which the findings of the UCR were discussed. Transport Scotland also provided an update on the second Strategic Transport Projects Review (STPR2) which had been published in January 2022, in particular Recommendation 40, which relates to the A75 and A77.

Discussions have continued on the subject of possible related funding opportunities for development work on the A75 and the next scheduled meeting between officials is on 31 October.