Chamber and committees

The Centre for Sustainable Delivery (CfSD) (and prior to this the Modernising Patient Pathways Programme within Scottish Government), have supported the rollout of the Digital Dermatology Appointment (DDA) system. This platform allows patients to interact with dermatologists by answering a series of questions and uploading images of their skin condition for the clinician to review. This system is used for both new and return patients. The system was offered for rollout to all Health Boards during COVID and to date is live in five Health Boards, with over 4000 patients having appointments this way.

In addition, the CfSD is actively promoting Active Clinical Referral Triage in Dermatology and encouraging the use of images to support this where this can be done safely. We are currently engaged in a piece of work to understand the use of images in referral pathways across all Scottish Health Boards and the output of this will support key work in 2022 to increase the use of images to support timely access to Dermatology care.

Our NHS workforce, across all specialties and care settings, have been remarkable throughout the pandemic. We are deeply grateful for their continued courage, commitment and professionalism.

This year we have made £12 million available to support the wellbeing of our workforce including across primary and social care services.

We are continuing to develop the National Wellbeing Hub, a 24/7 National Wellbeing Helpline, confidential mental health treatment through the Workforce Specialist Service and funding for additional local psychological support. We are also providing further support for practical measures to aid rest and recuperation alongside additional resources including Coaching for Wellbeing and grief and bereavement support.

The Centre for Sustainable Delivery (CfSD) is working with a number of Health Boards to implement the Digital Dermatology app, which allows patients to interact with a clinician at a time convenient to them, without having to attend hospital. This will support dermatology teams in conducting more virtual appointments.

The pharmacy profession and the provision of pharmaceutical services are highly regulated, overseen by the General Pharmaceutical Council (GPhC). The GPhC's role includes upholding health and safety standards for the pharmacy workforce, as well as for patients.

The Scottish Government regularly meets with Community Pharmacy Scotland, the representative body for pharmacy owners, to discuss a range of topics including workforce issues, including health and wellbeing. This year the Scottish Government has made £12m available to support the wellbeing of the pharmacist workforce. This includes £8m from the NHS Recovery Plan to provide ongoing wellbeing support for the workforce – alongside an extra £4m to provide further support to address winter pressures.

The funding supports the 24/7 National Wellbeing Helpline, our National Wellbeing Hub, Coaching for Wellbeing and the Workforce Specialist Service, alongside tailored psychological interventions for staff, providing individualised wellbeing support focusing on people’s physical and emotional needs.

The Chief Pharmaceutical Officer for Scotland in a joint letter (8 December 2021) with the leaders from the pharmacy sector, including the Royal Pharmaceutical Society (Scotland), has written to all pharmacy teams outlining the range of wellbeing support available to pharmacy teams and encouraging them to access these resources for support when needed.

Following a successful three year pilot, in 2013 the four nations agreed to a 10 year grant to support those affected by the thalidomide drug. Over the last nine years the Scottish Government has issued a total of £11.512 million to the Thalidomide Trust, for distribution to Scottish survivors. A further £1.636 Million is projected for the final year (2022-23), bringing total funding to £13.15 million.

The Scottish Government receives annual funding from the UK Government as part of the Barnett consequentials, however no funding is specifically ‘ring fenced’ for Thalidomide.

Breakdown of Funding:

The Centre for Sustainable Delivery (CfSD) is working collaboratively with the Dermatology AI Consortium championing Community Local Image Centres (CLICs) to improving the capture of images as part of the dermatology pathway. The idea is relatively new and the CLIC model is still in development. The consortium will be developing the operating model and evidence base to show their benefit. CfSD awaits the outcome of this with interest.

It should be noted that the Consortium is also considering other approaches to image acquisition to support dermatology referral – most notably increasing the ease and quality of image acquisition in Primary Care. It is unlikely that a one-size-fits all will suit the varied geography of NHS Boards and therefore CfSD is working to understand the current pathway arrangements in all Boards to support image acquisition prior to Secondary Care.

In Scotland, NHS Forth Valley is hosting a national project to support early diagnosis of skin cancer supported by digitalisation, the use of high-quality images, and machine learning. The project is called 25 by 25 - diagnosing cancer within 25 minutes by 2025. Industry, academics, and NHS are collaborating to rapidly innovate to create AI solutions in skin cancer.

This work is supported through the Scottish Health Industry Partnership and linked to the Health and Social Care and Wellbeing Programme. It takes the form of a number of challenges where partners innovate to find solutions to preparing images, creating AI learning environments, and real world Test Beds to try out new approaches in primary care with Consultant Dermatologist support.

The Scottish Government is not considering the possibility of allowing Health Boards to take over the running of community pharmacies that are struggling to remain open. Community pharmacies, along with other primary care contractors, are wholly independent private entities providing NHS services on behalf the Health Board. Any challenges faced by community pharmacy contractors in delivering existing pharmaceutical care services should be discussed with the Health Boards who will be able to consider actions to support service provision.

There is a range of projects being undertaken in Scotland to explore the use of AI in further high-demand medical areas, ranging from robotic surgery to the use of virtual reality in supporting mental wellbeing is currently being researched, evaluated, and implemented in Scotland.

The Industrial Centre for Artificial Intelligence Research in Digital Diagnostics (iCAIRD) website provides more information:

iCAIRD – Industrial Centre for Artificial Intelligence Research in Digital Diagnostics .

The Scottish Government has invested in the Detect Cancer Early programme in this area, has committed to investing in an AI Hub, and has prioritised the 25 by 25 programme for innovation investment in 2022.

This will enable AI innovation in the form of AI enabled triage, diagnostics, and treatment decision making support for Clinicians.

The Scottish Government has embraced artificial intelligence (AI) as a transformational technology for public good. We were the first UK country to establish an AI Strategy which set out our ambition for Scotland to become a global exemplar in the ethical and innovative deployment of AI.

As part of the Recovery Plans for the NHS, social care and the economy, the Government will support innovation in health care delivery and the adoption of AI solutions into use. Accelerating the adoption of new technologies that support improved access to healthcare, such as the use of artificial intelligence, will be integral to the recovery of NHS services, and there are a range of partner organisations that are central to this work, including the new national Centre for Sustainable Delivery.