Chamber and committees

The Scottish Government’s Infrastructure Delivery Pipeline published on 13 January 2026, sets out the projects and programmes it expects to fund over the next four financial years.

We are currently working with all health boards to develop an NHS whole system infrastructure plan for Scotland. This supports continued safe and effective use of existing facilities, through ongoing business continuity planning, as well as informing future investment priorities based on assessment of need across the whole of Scotland.

The first phase, Business Continuity Planning, is focussed on priority investment in the existing estate to support service continuity. Boards have completed risk-based assessments and received confirmation of items which can be progressed with additional funding from the Scottish Government. Future Business Continuity Plan submissions will be on a two-yearly full submission cycle, with interim years only requiring by-exception reporting of new essential maintenance or equipment replacement items not previously reported.

The second phase is focussed on the longer-term development of the estate to meet national, regional and local needs.

All Health Boards have been asked to undertake strategic needs assessments for three local investment priorities. In determining local investment priorities, Boards should also consider aspects of infrastructure resilience, capacity constraints and population-based service changes. Returns will be considered on a whole of Scotland basis. This approach aligns with the Scottish Government’s Health and Social Care Service Renewal Framework and Population Health Framework.

Further detail on NHS Whole System Infrastructure Planning is set out in Director of Health Finance.dot.

The Scottish Spending Review 2026 sets out the Scottish Government's indicative capital spending plans for the four years to 2029-30. This includes £4.1 billion health capital investment across major infrastructure projects, essential maintenance and replacing and upgrading vital medical equipment as part of the commitment to invest £10 billion over the next decade.

We are currently working with all health boards to develop an NHS whole system infrastructure plan (WSIP) for Scotland to support targeted investment based on need across all of the NHS estate. This supports continued safe and effective use of existing facilities, through ongoing business continuity planning, as well as informing future investment priorities based on assessment of need across the whole of Scotland.

The first phase, Business Continuity Planning, is focussed on priority investment in the existing estate and equipment to support service continuity. Boards have completed risk-based assessments and received confirmation of items which can be progressed with additional funding from the Scottish Government. Future Business Continuity Plan submissions will be on a two-yearly full submission cycle, with interim years only requiring ‘by-exception’ reporting of new essential maintenance or equipment replacement items not previously reported.

In addition to the above planning, Health Boards receive baseline Capital funding each year to be used at their discretion to address estate and equipment requirements. The Scottish Government also continues to fund the national rolling radiotherapy equipment and ambulance fleet replacement programmes.

This year’s Budget included £36 million for the walk-in pilot programme.

It is important to note that the situation relating to maintenance is dynamic; as NHS Boards address and eliminate items of maintenance, new items will emerge. It is therefore expected that there will be ongoing requirement for maintenance across the NHS estate.

While it is possible to compare year-on-year changes in backlog maintenance values, this does not represent a cash requirement. Elimination of backlog is achieved from a variety of measures – estate rationalisation and disposal of older properties, incorporating backlog work with redevelopment or lifecycle investment and targeting high risk areas, as we are already doing through NHS whole system infrastructure planning (WSIP).

This whole system approach to infrastructure investment supports continued safe operation of existing facilities. Boards have completed risk-based assessments and received confirmation of items which can be progressed with additional funding from the Scottish Government. Future Business Continuity Plan submissions will be on a two-yearly full submission cycle, with interim years only requiring ‘by-exception’ reporting of new essential maintenance or equipment replacement items not previously reported.

Further detail on NHS WSIP is set out in the answer to question S7W-00813 on 16 June 2026. 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 Scottish Government has commissioned Healthcare Improvement Scotland (HIS) to undertake an independent scalability assessment of our Rapid Cancer Diagnostic Service (RCDS) Pilots. This project will explore options to expand access to non-specific symptom pathways for cancer, such as RCDSs, in the most effective way to address population-level coverage.

This assessment will complete by Spring 2027. Scottish Government will review this assessment and work with HIS, the Centre for Sustainability (CSfD) and NHS Boards to consider effective RCDS expansion.

Whilst the March 2026 target was not met, sustained progress continues to be made and waiting lists continue to fall in Scotland, with new outpatient waits over a year decreasing for 11 consecutive months and inpatient and daycase waits reducing for 15 months in a row.

We are determined to continue to build on this substantial progress and the focus remains on maintaining this trajectory and building on progress to eliminate the longest waits as quickly as possible to ensure people receive the treatment they need.

The Scottish Government has commissioned the sub national structures to develop a clear and deliverable plan to eradicate all long weeks over 52 weeks as soon as possible, including the prioritisation of those who have been waiting over 78 and 104 weeks.

To ensure capital funding is targeted effectively, we are working with all health boards to develop a whole-system NHS infrastructure plan for Scotland, which will inform future investment priorities.

As part of this, we are taking forward a primary care infrastructure investment strategy, as set out in the Infrastructure Delivery Pipeline published on 13 January 2026. An initial tranche of 12 priority areas has been identified, based on health needs, population demographics and the condition of the existing estate, with work on three projects commencing immediately. This programme includes the development of a sustainable revenue funding model to support further investment in primary and community care infrastructure, including a network of local care and wellbeing centres across Scotland. To accelerate delivery, business case development and the revenue model will be progressed in parallel.

On current assumptions, construction is expected to begin from around 2031.

The Scottish Government’s Infrastructure Delivery Pipeline sets out the infrastructure projects and programmes the Scottish Government will fund over the next four financial years.

The Scottish Government is working with all Health Boards to develop a whole system infrastructure plan to identify investment priorities across NHS Scotland. Projects that had previously begun the business case process but were then paused, such as the remaining National Treatment Centres, will be considered as part of this work.

We have already invested an additional £100 million in 2026-27 to support delivery of commitments set out in the 25–26 Operational Improvement Plan, including action to reduce waiting times.

This funding is being allocated to Health Boards to support increased activity, including delivery of the commitment to undertake at least 50,000 operations and procedures within the first 100 days. Boards have flexibility to target this funding towards the specialties and services where waiting times are most challenged.

Information on the breakdown of these additional operations and procedures by specialty and location is not held centrally, as decisions on service delivery are made locally by Health Boards to reflect differing pressures and capacity across Scotland.