Chamber and committees

The Centre for Sustainable Delivery is responsible for driving clinically-led service redesign and transformation in care across NHS Scotland. It consists of a number of national improvement programmes which are focussed on individual Scottish Government strategic priority areas.

The Programme Team workplans for 2024-25 are still in the process of being finalised and will be approved by Scottish Government.

A summary of the CfSD national programmes of work are as follows:

Modernising Patient Pathways (MPP) Programme: The MPP team deliver national improvements in planned care and support front line clinical teams to develop and implement sustainable improvements in service delivery. A key focus of the team is on developing national clinical pathways and supporting boards to increase the use of Active Clinical Referral Triage (ACRT) and Discharge Patient Initiated Review (PIR).

National Elective Coordination Unit (NECU): The NECU team supports improved access to care by providing a consistent approach to national demand and capacity assessment and allocation as well as providing waiting list validation to ensure lists are up to date.

Unscheduled Care Programme: The Unscheduled Care Programme delivers support and develops improvement tools to help Boards to manage urgent and unscheduled care capacity and capability, including Optimising Flow Navigation Centre (FNC) services, hospital-at-home models and developing pathways to support care home access to urgent care.

Cancer Improvement and Earlier Diagnosis Programme: The Cancer Improvement and Earlier Diagnosis team drives NHS Scotland’s cancer strategic priorities and plays a key role in delivering Scotland’s 10-year cancer strategy, including working with Boards to ensure the Framework for Effective Cancer Management (FECM) is embedded.

National Endoscopy Programme: The National Endoscopy Programme supports Boards to deliver the Endoscopy and Urology Diagnostic Recovery and Renewal Plan. This includes supporting the deployment of the new Endoscopy Reporting System and working with NHS Scotland Academy to promote and maximise training opportunities around non-medical endoscopy and cystoscopy.

Innovation Programme: The Innovation team manages the Accelerated National Innovation Adoption (ANIA) Pathway, which is designed to identify and support national adoption of high-impact innovations at pace.

National Green Theatres Programme: The Green Theatres Programme supports NHS Boards to meet the net zero commitments for NHS Scotland through reducing the carbon footprint of theatres and delivering more environmentally sustainable surgery.

Planned Care Programme: The Planned Care Programme is responsible for monitoring planned care performance across all NHS Scotland Boards. It also leads national improvement work around Trauma and Orthopaedics, Ophthalmology and Radiology.

Land and Assets is one of the three main areas of focus for the Anchors workstream of the Place and Wellbeing Programme. All NHS Boards submitted Anchor Strategic Plans in October 2023 setting out how they will maximise their footprint as owners of land and assets, for the benefit of their local population. NHS Boards have also submitted baseline metrics on their anchor activity, including the proportion of successful assets transfers to date relative to the number received.

We will use this feedback, working with NHS Scotland and the community sector, to understand what further support or guidance we can put in place at a national level to enable more community organisations to use, lease or take on NHS assets for the benefit of local communities.

Tackling health inequalities and improving population health remain clear, ongoing aims of the Scottish Government. Through the Place and Wellbeing Programme we are supporting local action to tackle health inequalities by: supporting health boards to operate as effective anchor institutions; supporting community and voluntary organisations; and ensuring they and public sector partners have the support and resources to take positive action locally.

Working alongside Public Health Scotland, the Scottish Government Anchors workstream within the Place and Wellbeing Programme is supporting NHS boards to act as effective anchor institutions and build greater prosperity in our local communities. All NHS Boards have now submitted Anchors Strategic Plans setting out how they are planning to maximise their footprint as employer, procurer and owner of land and assets, to channel greater wealth into local communities, which in turn will help contribute to reducing health inequalities.

Community and voluntary organisations play a key role is supporting the health and wellbeing of local communities. We are working with them to provide fairer funding processes and increase access to resources that can support them to work locally alongside the public sector to help reduce inequalities.

The Scottish Government is committed to unlocking the potential of scientific and technological innovation to transform lives, increase healthy life expectancy and reduce health inequalities across Scotland.

The Accelerated National Innovation Adoption (ANIA) pathway has been established to provide a national approach to the identification and adoption of research proven scientific and technological innovations. The ANIA pathway is led by the Centre for Sustainable Delivery, hosted by NHS Golden Jubilee. It is a collaborative venture that also draws on the expertise of NHS National Services Scotland, Healthcare Improvement Scotland, Public Health Scotland and NHS Education for Scotland.

The ANIA pathway is governed by an Innovation Design Authority (IDA). This brings together senior Scottish Government and NHS leadership to support improved partnership working, provide system leadership and take joint decisions on the progression of innovations through ANIA stage gates.

Following recommendations from the IDA, the Scottish Government has:

• Invested £1.8 million in a national digital dermatology programme to prioritise the most urgent referrals, quickly offer advice for those who do not require a face-to-face appointment, prevent unnecessary anguish and reduce late-stage skin cancer diagnosis.
• Invested £350,000 in a new national team based within NHS Golden Jubilee to accelerate the distribution of Closed Loop Systems for people living with Type 1 Diabetes, increasing effective glycaemic control, and reducing the likelihood of complications, which at their most serious can include blindness, renal failure, and amputations.

There are a range of further innovations currently being evaluated within the ANIA pathway. Scottish Ministers will consider investment in these programmes following any recommendation by the IDA.

I can confirm that NHS Boards have received financial and policy support to implement the Health and Care (Staffing) (Scotland) Act 2019. This support has been ongoing since the Bill was enacted. Each NHS Board has been provided with funding for Workforce Leads (proportionate to the size of the Board) to support preparations for the commencement of the Act. This funding has been extended for an additional year to cover the financial year 2024-2025.

In addition to this, the Scottish Government has produced statutory guidance, in collaboration with Health Boards and other key stakeholders, which has offered clarity and better understanding of each duty within the Act. The Scottish Government has engaged extensively with Health Boards over the past two years through in-person and online events and quarterly reporting.

Healthcare Improvement Scotland has been commissioned by the Scottish Government to support NHS Boards, and its Healthcare Staffing Programme has provided support, including an advisor who works closely with each Board and hosting a network of meetings where Board representatives can come together and share learning.

NHS Lanarkshire is responsible for the delivery of primary care services in Lanarkshire.

The headcount of GPs in Scotland is now sitting consistently at over 5,000, with an increase of 271 additional GPs since 2017 towards our 800 target. Training new GPs is key to our approach, and this takes time. We have expanded GP Specialty Training, adding 35 places this academic year and a further 35 places next year. As a result there are currently just over 1,200 trainee GPs in Scotland.

GP training programmes in Scotland have been filling at a very high level since 2019, with 99% posts filled in 2022 and 100% filled in 2023. 2023 is the first year in which GPST has filled at 100% in Scotland, with all 343 posts having filled.

We also invest over £1m per annum in a range of recruitment and retention initiatives so that becoming a GP remains an attractive career choice.

Decisions on clinical pathways are not for the Scottish Government. These decisions are for clinicians, based on the best evidence available, through the appropriate clinical governance structures.

On 18 April, in a joint statement, NHS Greater Glasgow and Clyde and NHS Lothian confirmed that both Boards have paused any new prescription of puberty-supressing hormones and cross-sex hormones for young people as a treatment option for gender dysphoria.

The small number of patients directly impacted by this change, and their families, were notified in advance of this statement. It is right that they were the first to hear about it, sensitively and from the services caring for them, before a public statement was made.

In the context of specialist provision of gender identity healthcare to children and young people, since publication of its Strategic Action Framework for Gender Identity Service improvement in December 2021, the Scottish Government has maintained an extensive dialogue with NHS Health Boards in Scotland on how to collectively work to improve healthcare provision in this sphere.

On 18 April, in a joint statement, NHS Greater Glasgow and Clyde and NHS Lothian confirmed that both Boards have paused any new prescription of puberty-supressing hormones and cross-sex hormones for young people as a treatment option for gender dysphoria.

The small number of patients directly impacted by this change, and their families, were notified in advance of this statement. It is right that they were the first to hear about it, sensitively and from the services caring for them, before a public statement was made.

Parliamentary business is a matter for the Scottish Parliament’s Parliamentary Bureau and the Parliament itself.

The information that has been requested is not held centrally by the Scottish Government.