Chamber and committees

We are committed to delivering on the priority in the Women's Health Plan (WHP) to improve access for women to appropriate support, speedy diagnosis and best treatment for endometriosis.

We know that, for many women, diagnosis time for endometriosis is not acceptable. It is vital that we improve care and support throughout the whole diagnosis process.

To do this a number of actions have been taken including:

• The development of the Endometriosis Care Pathway for Scotland which aims to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms.
• A NHS Education for Scotland (NES) training package and framework focused on menstrual health for general practice and others working in Primary Care.
• A NHS NES ‘Masterclass’ on endometriosis for healthcare professionals.
• Improving the information available for women and girls on endometriosis and menstrual health through our work with NHS Inform, Young Scotland, the ALLIANCE and Endometriosis UK.

We are working closely with our stakeholders across Scotland to understand the effectiveness of these workstreams and their impact upon reducing diagnostic times for endometriosis.

The Scottish Government commissioned Healthcare Improvement Scotland to undertake a review to determine underlying causes of an increase in neonatal mortality in Scotland in 2021-22 and make recommendations for improvements in care.

The report, published in February 2024, found no evidence of systemic failures of maternity or neonatal care, unusual factors, or a cluster of any one factor that would account for the significant increase in neonatal deaths in 2021-22.

Following the publication, we are working with Healthcare Improvement Scotland and other partners on the recommendations of the review.

Mothers and Babies Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK), reports give us valuable insight into national and local rates of stillbirth and neonatal mortality. We expect all NHS Boards to carefully consider MBRRACE-UK reports, including their local reports, and undertake local reviews of services rated ‘red’ for stillbirth or neonatal death, and ensure that when deaths occur, any improvements are identified and acted on.

We will be writing to NHS Boards shortly to ensure that they have taken account of the MBRRACE-UK reports and to seek assurances in particular from Boards with higher-than-average rates that work is underway, or complete, to understand and learn from the possible factors which may have contributed to the reported increase.

The anticipated cut by the UK Government to the Scottish Government's capital budget of up to £1.3billion in real terms over the coming years has consequences. In December 2023, given the extremely challenging capital funding position, NHS Boards were instructed to pause any project development spend and instead direct capital budgets towards maintenance of the existing estate and essential equipment and digital replacement. Boards were notified that the Scottish Government does not anticipate starting construction of any new project over the next two years at least. Obviously should the UK Government change course on capital investment we have an opportunity to look at this again alongside the capital review ongoing across the Scottish Government.

There is therefore no change to the position on NHS Capital Projects as a result of the ongoing review of the Infrastructure Investment Plan.

We are committed to reducing waiting lists backed by an initial investment of £30 million has been allocated to Health Boards and will target reductions to the national backlogs that built up throughout the pandemic. This funding is being targeted at a series of national and local plans to reduce backlogs by maximising the use of local and national resources across Scotland. As part of this, we have allocated additional funding to Gynaecology services which we expect to l deliver around 3,500 New Outpatient Appointments.

NHS Scotland’s Centre for Sustainable Delivery (CfSD) is also playing a central role in working with Health Boards to ensure that they are able to continually identify new ways to increase capacity, and to respond to demand through service innovation and redesign.

CfSD programmes have developed strong clinically-led Specialty Delivery Groups (SDG), including one for Gynaecology, which promote multidisciplinary team working, and support local adoption of service improvement programmes. These groups are now well established and have supported several new and innovative pathway developments, many of which are now being successfully scaled up across Scotland, including Active Clinical Referral Triage (ACRT), Patient Initiated Review (PIR) and Enhanced Recovery after Surgery (ERAS).

This is all part of our programme to drive up productivity and tackle waiting lists, supported by the CfSD. Together, our actions will further enable NHS Scotland to maximise capacity, build greater resilience and deliver year-on-year reductions in the number of patients who have waited too long for treatment.

NHS Boards are responsible for implementing the National Code of Practice for GP premises.

The NHSScotland National Primary Care (GP) Premises Group has been set up to consider all matters relating to GP Premises including:

• Oversight of the implementation of the Code of Practice for GP Premises.
• Implementation of GP Sustainability Loans.
• Consideration and review of available guidance.
• Consideration of appropriate schedules of accommodation within Primary Care premises, and specifically that of General Practice occupied areas and how this may affect reimbursement.
• Provide a platform for the Scottish Government to present papers/proposals to the group.
• Provide a platform for the BMA to present papers to the group.
• Provide a platform for the NHS Boards to present papers to the group.
• Ensure the Rent Review Process is consistent and supports the intent of the GP contract where required.
• Standardise approaches, e.g. standardise leases across Scotland.

Health Boards are represented on a regional basis alongside the BMA, the Scottish Government and other stakeholders.

Transitionary funding, sometimes known as sustainability payments, were made to GP practices in 2021-22 and 2022-23 and reflected the status of the Primary Care Improvement Plans at that time. Since then we have continued to implement the plans and practices are now supported by over 4,900 multi-disciplinary team staff.

In 2024-25, we are investing over £190 million in the ongoing development of primary care multi-disciplinary teams.

As part of the 2018 GP Contract, the Scottish Government amended regulations for the delivery of CTAC Services. Boards are now responsible for providing a Community Treatment and Care service. These services are being designed locally, taking into account local population health needs, existing community services, and optimising benefit to practices and patients.

Our annual statistical publication provides a progress update on implementation of the 2018 GP contract.

The Scottish Government remains committed to improving the care and wellbeing of people through the best use of digital technologies. We work closely with NHS National Services Scotland (NSS), who manage the rollout of the new national GP IT System, ‘Vision’ supplied by Cegedim Healthcare Solutions. Our focus always is on patient safety and the resilience of such systems. The recent performance issue referred to was quickly identified as due to bandwidth capacity and was quickly resolved, since when there has been stable and consistent service for GP practices using Vision.

The additional £30 million for planned care, initially announced in April, will support health boards across the country deliver around 12,000 inpatient procedures, over 40,000 extra diagnostic procedures and around 12,000 new outpatient appointments.

Funding will target reductions to pandemic backlogs, including orthopaedics, ophthalmology, diagnostics for cancer referrals and patients waiting the longest time.

The funding will be allocated to health boards for the activity set out above based on delivery. We are working closely with health boards to monitor progress.