Chamber and committees

The estimated cost for operation of the Northern Isles Ferry Service by NorthLink Ferries over the three month period from 1 November 2019 to 31 January 2020 is £14.6 million. Had the contract started, funding for the same period would have been made available, therefore this is not an unfunded pressure.

It should be stated that the annual grant for the contract extension period includes the subsidy to support the services. This includes fuel and port dues as well as all other necessary maintenance and operational costs for all vessels.

I published a Waiting Times Improvement Plan on 23 October 2018 which directs more than £850 million of investment to substantially and sustainably improve waiting times in the face of rising demand for services. This investment will see phased and sustained improvement over the next period to spring 2021 with the aim that no patient will wait more than the waiting standards and guarantee. As part of the waiting times Improvement Plan we are making available more than £102 million to Health Boards in 2019/20, to increase capacity in the system, for example, more staffing, evening and weekend clinics and additional theatre sessions to ensure progress towards delivering the waiting times improvement plan.

Scotland has already made significant strides to increase capacity within our hospital eye service (HES). For example:

• improvements in community eyecare mean that Scotland has 50% fewer new patients in ophthalmology than in England. This is due to more patients being managed in community optometry and better referrals into the HES.
• 40,000 post-cataract surgery reviews are now safely discharged into the community each year.
• upskilling nurses to undertake procedures previously carried out by ophthalmologists has transformed this service within secondary care, and is preserving sight for patients with wet age-related macular degeneration. Currently 60,000 such injections are carried out in Scotland each year.

The Scottish Government’s National Eyecare Workstream is supporting Health Boards to implement new ways of working in order to deliver services more efficiently and on a sustainable basis and we are now able to preserve the sight of patients who would previously have gone blind. With ground-breaking research into gene-therapy, stem cell treatments, new drugs and surgical advances, these successes will continue.

The findings of a survey to collate information about the workforce at specialist pain clinics in Scotland has been published by the National Advisory Committee for Chronic Pain (as an annex to meeting minutes) and can be found on the Scottish Government webpage [ https://www.gov.scot/publications/national-advisory-committee-for-chronic-pain-minutes-june-2019/ ]. This is in line with my response to previous answers to PQs (S5W-19321 on 6 November 2018 and S5W-21802 on 6 March 2019). 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/parliamentarybusiness/28877.aspx.

NHS Highland is committed to reducing waiting times for patients across NHS Highland. Transformational work is taking place to establish and develop local clinics to reduce travel time for patients where possible and where the pathway supports this to ensure that geography does not compromise patient care and waiting times.

The Scottish Government has committed funding to provide an Elective Care Centre, which will be a purpose built facility to deliver a full Ophthalmology Service that will attract new staff who can continue to support the development of the remote and rural elements of the service. The centre is part of the Scottish Government’s commitment to create a new network of elective and diagnostic treatment centres to ensure that we have high-quality provision of elective care services that meet the needs of an ageing population.

As part of the Scottish Governments Waiting times Improvement Plan we are making available more than £102 million to Health Boards in 2019-20, to increase capacity in the system, for example, more staffing, evening and weekend clinics and additional theatre sessions to ensure progress towards delivering the waiting times improvement plan of which more than £7 million has been made available to NHS Highland.

During 2019-20 we have provided an additional £119,597,022 across all territorial Health Boards and the Golden Jubilee National Hospital through the Waiting Times Improvement Plan. This funding will support Health Boards to improve waiting times across a range of services including cancer and diagnostics. The following tables shows the additional funding that has been made available to each Health Board.

Table 1

Transport Scotland provides policy advice and support to Ministers on all aspects of the provision and funding of lifeline ferry services. The cost of specific aspects of the advice and support provided by Transport Scotland, such as the administration of Pentland Ferries' complaints, is not routinely recorded.

The process of responding to State Aid complaints lodged by Pentland Ferries with the European Commission has involved a broad range of activities, including extensive consideration of previous policy and analytical material, officials meeting with the European Commission in Brussels, internal meetings and communications by phone and correspondence. All of this has required us to work with colleagues from Scottish Government Legal Directorate, the State Aid Unit, Analytical Services and Finance. While travel and subsistence costs can be identified, not all of our partners record separately how much time and resource they have allocated to individual tasks and it is therefore not possible to accurately calculate the cost of dealing with Pentland Ferries’ complaints in the way that has been requested.

As indicated in the National Health and Social Care Workforce Plan Part 3 the Government commissioned a District Nursing Short Life Working Group to advise on developing and sustaining the District Nursing Service. The Government is now considering a number Short Life Working Group's work recommendations including increasing the District Nurse workforce over the next five years. As we draw together the Integrated National Health and Social Care Workforce Plan, any planning assumptions made will be regularly revisited over time as the primary care workforce is considered in its entirety.

We have allocated £146,295,385 in 2018-19 and 2019-20 to territorial Health Boards and the Golden Jubilee National Hospital – from the £850 million Waiting Times Improvement Plan. The following table shows the breakdown by year:

Information regarding average waiting time for chronic pain treatment in each NHS board is not held centrally by ISD. ISD publishes quarterly median wait times (weeks) for the total number of patients seen at a pain clinic-service, and a pain psychology clinic for a first appointment. This data collected is an aggregate count provided each quarter, therefore, cannot be recalculated to provide an annual figure.

Table 1 show the quarterly median wait times (in weeks) for pain clinics-service and pain psychology clinics.

Table 1 – Median wait time for patients seen at a pain clinic-service 1 and pain psychology clinic for a first appointment (completed waits) QE March 2017 - June 2019 for NHSScotland

We’ve already published workforce plans covering the NHS, Primary Care and Social Care. Our integrated national health and social care workforce plan will be the first of its kind in the UK when it is published later this year.