Chamber and committees

The pandemic has been the biggest shock our NHS has ever faced. It has necessitated the imposition of Infection Prevention Control measures in order to contain its spread, particularly prior to the vaccination programme being fully rolled out.

These IPC measures, which have recently been deescalated, changed the way GPs see their patients. The Scottish Government wants to see greater availability of face-to-face appointments and is working with the BMA and RCGP to ensure this happens as quickly as possible. However, Covid has not gone away yet, therefore some precautions remain in place. We are clear that where clinically necessary face-to-face consultations will always be available to those who need them.

We must continue to move toward a position where choice is being offered routinely, and the Scottish Government welcomes the GMC’s proposed changes to the Good Medical Practice guidance placing a greater emphasis on shared decision-making between GPs and their patients.

Many GP practices did offer patients video or phone consultations as well as in-person face-to-face consultations before the pandemic changed the balance and we expect a number of patients will wish to continue afterwards with video or phone consultations rather than travel to their GP practice. Ultimately, what is most important is that appointments are agreed through shared decision making, balancing patient choice and clinical judgement.

We continue to explore new ways and approaches to support people to, for example, upload an image of their skin condition for review. This can support people to seek advice in a way that best supports their needs and requirements whilst also ensuring they still have access to a face-to-face appointment.

All GP practices are expected to follow the Infection Prevention and Control Manual for in-person visits as well as their local Health Board's guidance.

In August 2021 we published the NHS Recovery Plan, which set out actions and commitments that will support inpatient, daycase, and outpatient activity to address backlogs. This will be delivered through the implementation of sustainable improvements and new models of care. This includes the National Treatment Centre Programme, which will deliver capacity for ring-fenced elective activity. Four centres will open in the next year in NHS Fife, NHS Highland, NHS Forth Valley and NHS Golden Jubilee specialising in orthopaedics.

We recognise the impact long waiting times can have on a patient, from both a clinical and mental health perspective. At this stage in recovery from the pandemic, long waiting patients must now also be considered a priority. That is why earlier this month we updated the Clinical Prioritisation Framework to allow Health Boards the flexibility to treat the longest waiting patients in parallel with the most urgent. The expectation is that NHS Boards will follow the principles of this Framework to prioritise patients based on their particular clinical needs and those who have waited longest. This will allow NHS Board to ensure that the patients with the greatest needs are treated quickest.

NHS Boards understand and communicate with patients the importance of keeping as fit and healthy as possible while waiting for joint replacement surgery. To support patients waiting and recovering from surgery, Boards and partner organisations offer a range of support including pain management, mental health, physiotherapy, access to leisure services, weight management and financial support. Information and advice is also available through online platforms like NHS Inform.

We also work in close partnership with third-sector organisations who provide a wealth of knowledge and care though lived experience which many patients value. Charities such as Versus Arthritis also offer support to those awaiting treatment, including advice, information and practical help to manage the impact of musculoskeletal pain on people’s wellbeing. They also provide peer-led support such as walking groups and tai chi in local areas which enable people to improve their physical fitness and maintain their mental health and quality of life both before and after treatment.

We are working hard to abolish excessively long waits that have undoubtedly been exacerbated by the impacts of the global pandemic and we offer our sincere sympathies to all patients waiting for treatment.

Pausing of non-urgent activity during the pandemic has inevitably led to a build-up of numbers waiting for treatment, and the emergence of Omicron and the BA.2 sub-variant in late 2021 has undoubtedly added to existing significant pressure. We are working closely with NHS Boards to get those waiting for treatment the care they need as quickly as possible.

In order to support a sustainable reduction in the backlog of planned care procedures in Scotland, the Scottish Government published an NHS Recovery Plan in August 2021. Backed by over £1 billion of funding, this sets out our plans for health and social are over the next 5 years.

The NHS Recovery plan can be accessed here: NHS recovery plan - gov.scot (www.gov.scot)

The exact number of unpaid carers living in Scotland is not known. Therefore, the number of unpaid carers in Scotland is estimated from national survey data. The preferred survey used to estimate the number of unpaid carers is the Scottish Health Survey , as it samples both adults and children and allows for detailed breakdowns.

The latest estimates from the 2020 Scottish Health Survey telephone survey , which ran with a reduced number of questions due to the Covid-19 pandemic, suggest that there were around 839,000 (between 738,000 and 939,000) adult unpaid carers (aged 18+) living in Scotland in 2020.

This report cannot be compared to previous years due to differences in methodology from the main Scottish Health Survey series.

Data from the 2021 Scottish Health Survey will be published in Autumn 2022.

Responsibility for the delivery of social care, including the setting and collecting of charges related to social care and support, lies at a local level.

The Scottish Government collects and publishes national data through the Local Financial Returns (LFRs). These are a series of detailed returns that collect final, audited financial data for local authorities in Scotland. The data is published as part of the annual Scottish Local Government Finance Statistics (SLGFS) publication.

The figures provided in the following table relate to all income received relating to customer and client receipts in relation to Social Work services, including Children & Families and Adult Social Care, for the last five years for which data is available.

During the pandemic, the private sector was utilised to provide additional capacity to treat urgent and cancer patients, and this proved to be of great assistance. We remain open to the option of utilising the private sector again to support orthopaedics and other specialties with excessively long waiting lists. However, at present - and for the foreseeable future - the private sector has very limited capacity due to a backlog in their own private patients. There is therefore very limited capacity available for the treatment of NHS patients in these facilities.

I refer the member to the answer to question S6W-06836 on 8 March 2022. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

The Final Determination explained that the Commission would expect that its charge caps would allow Scottish Water’s annual revenue in the final year of the current regulatory control period to be no less than £1,392m. This level of revenue was based on assuming an average charge cap of 1.5% a year above inflation over the regulatory control period 2021-27. Based on the level of charges to date, and using the same assumptions made in the Final Determination, charges would need to rise by 1.8% above the rate of consumer price index inflation in order to achieve this same level of revenue.

This information is provided in Scottish Water’s Annual Report and Accounts which is published on Scottish Water’s website and laid before Parliament each year. The accounting provision Scottish Water has made for household bad debt in each of previous 10 financial years is set out in the following table.