Chamber and committees

The Scottish Government remains committed to keeping the NHS true to its founding principles – publicly-owned, publicly-operated, and free at the point of need.

Health Boards might arrange treatment for some patients outwith NHSScotland for clinical reasons in exceptional circumstances. In all patient cases, the originating Health Board retains responsibility for the funding, consultation, diagnosis and treatment of their patients.

Guidance on establishing the responsible commissioner has been issued to NHS Boards from the Scottish Government to ensure services are always provided in the best interests of the patient: https://www.publications.scot.nhs.uk/files/cel2013-06.pdf .

Healthcare Improvement Scotland (HIS) is the national authority for the development of evidence-based advice, guidance and standards for health and care professionals. All Independent Healthcare Service providers, are required to register with HIS who regulate such services in Scotland. It is a matter for HIS to detail specific guidance available, however more information is set out on their website: https://www.healthcareimprovementscotland.scot/inspections-reviews-and-regulation/regulation-of-independent-healthcare/ .

NES published the Core Competency Framework for General Practice Administration Staff and Practice Managers in September 2023, which includes an accompanying learning needs analysis tools and training packages. The training packages include training resources specifically for GP receptionists.

In Scotland, youth work is recognised as being part of the wider professional sector known as Community Learning and Development (CLD).

Education Scotland offer professional learning which is open to all educators including CLD practitioners (Adult Learning, Community Development and Youth Work) across Scotland, such as the Educator Leadership Programme (ELP), Learning for Sustainability (LfS) & Building Racial Literacy (BRL).

The Education Scotland CLD team have also been working with YouthLink Scotland to support the development and implementation of joint work between teachers and youth workers, as part of a national SAC funded project https://www.youthlink.scot/education-skills/scottish-attainment-challenge/

Additionally, through Scottish Attainment Challenge and Pupil Equity Fund, at a local level, some local authorities are encouraging joint-training opportunities for teachers and CLD youth workers to facilitate greater understanding of the twin approaches to learning and skills development. These opportunities are based on the individual programme focus and are variable in duration, delivery style and formality.

In January 2022, the Scottish Government commissioned research to understand the outcome of primary care reforms for Scottish people. It commissioned a survey to assess public understanding, perceptions and experiences of primary care in the context of recent reforms and the COVID-19 pandemic. The report can be found here: https://www.gov.scot/publications/public-understanding-perceptions-primary-care-scotland-survey-analysis-report/pages/3/

To strengthen the evidence base on the national context for implementation of primary care multidisciplinary teams, including on patient experience and awareness, we have established a Phased Investment Programme. Through this programme, we will work with a small number of areas using an improvement science approach to demonstrate what a model multidisciplinary team can look like in practice and collect evidence on the impact of Multi-Disciplinary Team working which will then inform and support future long term investment.

Scottish Government is undertaking a range of actions to ensure healthy foods are available to and affordable for individuals living in areas of socioeconomic deprivation. This includes steps towards ending the need for food banks through our £1.8 million Cash-First Programme.

The programme will support eight public and third sector partnerships with four local authorities participating – Aberdeenshire Council, Fife Council, North Lanarkshire Council and West Dunbartonshire Council. This will strengthen urgent access to cash in a crisis and reduce the need for food parcels, meaning people can access the essentials they need whilst maintaining dignity.

Throughout 2023-24, we have also maintained funding levels for regional Community Food Networks so that they can continue to support people struggling to access healthier food options. The Networks help promote healthier diets in disadvantaged groups, whether that is due to lack of income, skills or cultural barriers. They provide a broad range of activities including: cooking classes, benefit checks, ‘grow-your-own’ food groups, cafés and food pantries.

Through funding the Healthy Living Programme, we are also helping convenience stores provide access to affordable healthier food options. More than two-thirds of the 2,300 strong Healthy Living Programme membership serves the most deprived areas of the country and ensures access to affordable, healthier food and drink in those communities.

The Scottish Government wants to ensure that every child can attain the highest level of health and wellbeing possible.

Between pre-birth and starting school, all children in Scotland are entitled to support from our universal Health Visiting service. In addition, 3- and 4-year-olds are entitled to 1,140 hours of funded early learning and childcare (ELC). We have also invested in targeted early years interventions such as the Family Nurse Partnership, ELC funding for eligible 2-year-olds and perinatal and infant mental health services. This work is underpinned by our Early Child Development Transformational Change Programme which focuses on prevention, better integration of policies, identifying policy and implementation gaps, and building collaboration across the whole system.

The health and wellbeing of school-aged children is also supported by Curriculum for Excellence (CfE). Health and Wellbeing is one of the eight curricular areas in CfE and is one of the three core areas that are the responsibility of all staff in a school. Furthermore, the Scottish Government has invested in the recruitment of School Nurses and School Counsellors, both of whom are able to prevent the escalation of health and wellbeing concerns.

Our work across all child health and wellbeing interventions continues to be guided by ‘Getting it right for every child’ (GIRFEC). GIRFEC is embedded across Scottish Government portfolios and helps to safeguard, support and promote the health and wellbeing of all children and young people.

The Scottish Government has established procedures for sharing information on communications campaigns and messaging at key points with territorial health boards. For example, this may involve presenting the results of creative or message testing or post-campaign evaluations. The learnings from these can be applied to the communications activity undertaken by territorial health boards.

A Transvaginal Mesh Implants Learning Package is available on Turas Learn for all primary care staff.

This was issued to all Primary Care Leads and NHS Board leads for Mesh by the Chief Medical Officer in October 2023 along with information and resources including the referral pathway for mesh patients available on the NHS Greater Glasgow and Clyde website, patient information on pelvic floor available on NHS Inform and the importance of sharing information with patients and obtaining fully informed consent using the use of BRAN during consent discussions: what are the benefits, risks, and alternatives, and what if I do nothing.

Topics within the learning package include:

• an introduction and background to pelvic floor disorders for women;

• a review of the background history to pelvic mesh in the UK;

• an overview of pelvic mesh complications; and case studies

The learning package remains the most comprehensive resource for primary care.

As part of their Continuous Professional Development (CPD), GPs are also required to access a wide range of professional development resources to support their continued professional development which includes online learning, information from colleges and interface working with primary and secondary care teams.

NHS Education for Scotland (NES) support the development and delivery of healthcare education and training for the NHS, health and social care sector and other public bodies. This includes the development of best practice guidelines as appropriate.

With regards to GP receptionists, NES published the Core Competency Framework for General Practice Administration Staff and Practice Managers in September 2023, which includes an accompanying learning needs analysis tools and training packages.

Advanced Nurse Practitioners are employed within a range of settings within Primary Care.

The 2023 General Practice Workforce Survey ( https://turasdata.nes.nhs.scot/data-and-reports/official-workforce-statistics/all-official-statistics-publications/general-practice-workforce-survey-2023/annual-report/?pageid=10709 ), reports that there are 553.7 whole-time equivalent (WTE) Advanced Nurse Practitioners (ANPs) employed by and working in General Practices.

Alongside this, the ‘Primary Care Improvement Plans - Implementation Progress Summary’ ( https://www.gov.scot/publications/primary-care-improvement-plans-summary-implementation-progress-march-2023/ ) reports that a total of 219.9 WTE ANPs employed by Health Boards within Urgent Care services.

The latest NHS Scotland Workforce data published by NES ( https://turasdata.nes.nhs.scot/data-and-reports/official-workforce-statistics/all-official-statistics-publications/05-march-2024-workforce/ ) shows that there are 4.8 WTE ANPs employed by the Scottish Ambulance Service, as well as 1.0 WTE ANP employed by NHS 24.