Chamber and committees

The most recent estimate for whole time equivalent of GPs can be found in the General Practice Workforce Survey 2019 , published by Public Health Scotland in October 2021. This estimated that there were 3,613 GP whole time equivalents (WTE) in Scotland in 2019. This is an increase from an estimated 3,520 WTE in 2017, with 8 sessions per week equating to one WTE.

The latest data on GP WTE is scheduled to be published by Public Health Scotland, they have pre-announced publication of this analysis report for 29 November.

As advised in the letter I wrote to you on 26 October 2022, funding will be made available to health boards to boost workforce and recruit up to 750 nurses, midwives and allied health professionals. Early indication from Boards suggest the breakdown will be 634 nurses, 17 midwives and 99 allied health professionals. These numbers may vary as pipelines are developed and dependant on Boards service requirements. We will continue to work closely with Boards to monitor progress and provide support where required. Health boards are currently building their pipelines for international staff and will negotiate start dates with candidates and agencies.

In addition, 250 band 4 non-registrant posts have been identified and we are working with Boards to support the recruitment and training of staff into these posts, which are across acute, primary care and mental health settings.

NHS 24 has received £15.1 million to support improvements that lead to sustainable delivery across the Redesign of Urgent Care pathway and contribute to the wider ambition to reduce attendances at acute care.

This funding is largely committed to the recruitment of additional workforce to support the NHS 24 -111 service which includes increasing their call handler and clinical supervisor capacity which will support improvements in call answering times.

Funding will also be used to further develop public information through NHS Inform, develop public messaging about access to services and improve data sharing and digital support to optimise the continuity and co-ordination of care.

Table 1 presents the latest published number of patients covered by the Treatment Time Guarantee (TTG) that were waiting within an inpatient or day case setting in Scotland at 30 June 2022, and the number waiting over two years (104 weeks), 2 years and six months (130 weeks), and 3 years (156 weeks) for an Orthopaedics procedure.

Table 1 - Number of patients waiting for an inpatient or day case admission for Orthopaedics by length of wait in NHSScotland, at 30 June 2022

The Scottish Government recognised the unprecedented nature of the changes required in the Emergency Budget Review and also published analysis of the equality and fairness impacts of the most substantive in-year adjustments. Given the exceptional circumstances and time constraints under which the Review was undertaken, the summary evidence was necessarily presented at a high level and focused on the most substantial changes.

In the case of the £116m reduction in Covid-related spending, this covers a range of actions on vaccinations, test and protect, PPE and additional capacity to drive down additional costs. It is important to note that the spending reduction is a consequence of reduced prevalence and hospitalisation rates resulted in evidence-based easing of infection prevention and control measures.

However, the impact on inequalities continues to be a focus, and includes measures to ensure uptake rates and activity aimed at reducing vaccine inequalities are not negatively affected.

We will continue to develop equality evidence, as well as mitigations wherever possible for negative impacts, including building on the evidence on inequalities in relation to COVID vaccination, testing and surveillance, for example as set out in the equality impact assessment for the Coronavirus (COVID-19): Strategic Framework update (February 2022).

Health and Social care settings are expected to follow the National Infection Prevention and Control Manual when caring for individuals who have been diagnosed with or suspected of having COVID-19.

Guidance on infection control measures across health and social care settings is determined by, and kept under constant review in light of, new and emerging evidence. While reduced prevalence of the virus and hospitalisation rates has resulted in an easing of the previous infection and prevention control (IPC) measures, and a consequent reduction in costs, various mitigations remain in place.

These includeongoing symptomatic testing for staff working in face-to-face roles with patients and service users in health and social care settings and extended use of face masks and face coverings in hospitals, primary care and wider community healthcare. As well as ongoing support measures including the Social Care Staff Support Fund (supporting staff whilst they self-isolate), financial support arrangements relating to testing in care homes and staff vaccinations, and PPE Hubs remaining available in case of emergency PPE being required and for unpaid carers and personal assistants.

The Scottish Government continues to work closely with NHS Boards and Integration Authorities to manage Covid expenditure within the 2022-23 budget and is considering the on-going cost of measures as part of the 2023-24 budget process.

Reduced prevalence and hospitalisation rates has resulted in an easing of the previous infection and prevention control measures which has contributed, in turn, to a reduction in expenditure levels.

There are no plans to reduce COVID-19 testing in health and social care settings as a result of the Emergency Budget Review. In line with the Test and Protect transition plan, testing remains in place to support patient treatment and care, protect those in highest risk settings, monitor prevalence and the risk of new variants, and respond to outbreaks. Testing policy and protocols are kept under regular clinical review.

Similarly, PPE provision continues to be informed by infection prevention and control guidance. NHS NSS currently hold sufficient pandemic PPE stock to supply NHS Scotland well into 2023-24 based on current usage rates. Social Care PPE provision continues to be available in case of emergency PPE being required and for unpaid carers and personal assistants.

The Childsmile Programme is designed to help improve the oral health of children in Scotland and is delivered through a range of measures. The Childsmile Core Programme is available throughout Scotland and is introduced to families by their Health Visitor. Every child in Scotland is provided with a dental pack containing a toothbrush and toothpaste on at least six occasions by the age of five and can receive twice-yearly applications of fluoride varnish from the age of 2.

Childsmile School and Nursery ensures that all 3 and 4 year old children attending nursery are offered free, daily, supervised toothbrushing. Those children in the 20 per cent most deprived areas of Scotland are also able to receive an additional twice-yearly fluoride varnish applications by Childsmile dental teams in nurseries and schools until at least primary 4.

More information on the Childsmile programme can be found at: https://www.child-smile.org.uk/index.aspx .