Chamber and committees

The information requested is not held centrally.

NHS Board Ayrshire and Arran received an initial formula capital allocation of £5.292 million from Scottish Government for investment in 2011-12. The board plans to supplement formula capital funded investment by drawing down banked funds and revenue funding part of the estate modernisation programmes.

NHS Ayrshire and Arran’s Board approved its Capital Investment Plan at a meeting on Wednesday 23 March 2011. Included in the capital programme for the year are the following projects:

Provision of new Dental facilities in East Ayrshire Community Hospital

Planning for improvements to Ayr Community Health and Dental Services at Ayr (Ailsa), Arrol Park and Biggart sites

Preparation for submission of a business case for the North Ayrshire Community Hospital project including improvements to Mental Health Services

Preparation for submission of a business case for changes to Front Door Acute Services at Ayr and Crosshouse Hospitals

Completion of Ayr (Ailsa) store

General estates modernisation.

I have overall Cabinet responsibility for the NHS in Scotland. Accountability for service delivery in the NHS including the procurement function rests with the Chief Executive and Accountable Officer for the NHS in Scotland.

NHS Ayrshire and Arran has not participated in any ministerial-level meetings to discuss the estate.

NHS Ayrshire and Arran has earmarked expenditure of £6 million for investment in primary and community care premises over the period 2011-12 to 2012-13.

NHS Greater Glasgow and Clyde has earmarked expenditure of £13 million for investment in multipurpose primary care facilities in 2011-12 and a further indicative £21 million expenditure is planned for 2012-13.

NHS Ayrshire and Arran currently have no plans to replace the Beith Health Centre but all property and accommodation issues are periodically reviewed in conformity with the board’s estate strategy.

The Scottish Government’s approach to tackling health inequalities was set out in Equally Well, the Report of the Ministerial Task Force on Health Inequalities, which was published in 2008. A key feature of Equally Well was the recognition that the only way to tackle health inequalities effectively was to address the underlying causes of poor health.

Poor health is one of the major outcomes associated with poverty and negative early years experiences. The implementation of Equally Well is, therefore, being taken forward alongside the Early Years Framework, the Government’s strategy for ensuring children have the best possible start in life, and the anti-poverty strategy, Achieving Our Potential.

Responsibility for the delivery of services and interventions lies with Community Planning Partnerships. Local authorities, NHS Boards and other local partners work through Community Planning Partnerships to co-ordinate approaches to identifying and solving local problems, improving services and sharing resources, in order to improve outcomes for local people. The Scottish Government has made clear that it expects action on the interlinked areas of health inequality, early years and poverty to be prioritised in Single Outcome Agreements. All Community Planning Partnerships in the west of Scotland have plans and services in place to tackle health inequalities.

This localised approach is supplemented by a number of national initiatives, supported by the Scottish Government, which contribute to tackling health inequalities in the west of Scotland. These include:

• Delivering the Keep Well programme which anticipates preventable ill-health by strengthening and enhancing primary care services in the most deprived areas of Scotland. Keep Well is especially prominent in the west of Scotland;

• Supporting the Equally Well test sites, which promote service redesign and collaboration between local public services, aimed ultimately at reducing inequalities in the health and wellbeing of people who use many of these services. There are four test sites in the west of Scotland – Glasgow City, Lanarkshire, Govanhill, and Clydebank;

• Funding the Healthier, Wealthier Children project which brings together support for vulnerable families, child poverty and financial inclusion with NHS and early years interventions across NHS Greater Glasgow and Clyde;

• Providing £435m to local authorities across Scotland between 2008-2011 through the Fairer Scotland Fund to progress outcomes linked to assisting people living in poverty, tackling high levels of multiple deprivation concentrated in communities, overcoming barriers to work and tackling health inequalities.

A vast range of initiatives aimed at tackling poverty and inequalities have been developed by the Scottish Government and its partners since 2007. There have been a significant number of targeted approaches undertaken in the West of Scotland across a range of issues that connect to social deprivation, underpinned by substantial investment.

For example:

• the Glasgow Centre for Population Health has been funded £1m every year since 2007 to deliver their programme of research and activity to address health inequalities and poverty in Glasgow and beyond;

• the Healthier, Wealthier Children project brings together support for vulnerable families, child poverty and financial inclusion with NHS and early years interventions across the NHS Greater Glasgow and Clyde area with funding of £1m over 15 months;

• Link Housing Association Older People’s Advice Service provides intense support to vulnerable older people covering benefits and pension advice, physical and mental health and wellbeing support and practical and home maintenance support in North Lanarkshire and Glasgow with funding of £1million over 3 years;

• we have provided £1.6m over two years to the Community Initiative to Reduce Violence, with a further £3.4m funding provided in services and in kind by partners to tackle the long-standing problem of gang violence in one of Glasgow’s hardest hit areas; and,

• a substantial funding package of £21.5m is in place for the Clyde Gateway Urban Regeneration programme in 2011-12 that will protect projects linked to achieving the Commonwealth Games legacy.

Scottish Government and COSLA social policy frameworks have set out clear expectations relating to tackling inequality. Responsibility for the delivery of services and interventions lies with community planning partnerships, funded through the Local Government Settlement. Local authorities and their community planning partners have been encouraged and supported to make best use of their collective mainstream resources to increase the pace of progress in tackling poverty and high levels of multiple deprivation in our communities. In addition, the Fairer Scotland Fund provided £435m to local authorities between 2008-2011 to progress outcomes linked to assisting people living in poverty, tackling high levels of multiple deprivation concentrated in communities, overcoming barriers to work and tackling health inequalities. Over 60% of this funding was allocated to local authorities in the West of Scotland.

A key way in which NHS Boards promote preventative healthcare is through their work on health improvement. NHS Ayrshire and Arran and NHS Greater Glasgow and Clyde, along with all other territorial Boards, are required to deliver a range of key health improvement services which are performance managed through HEAT targets. For 2011-12, the suite of health improvement HEAT targets includes targets for alcohol brief interventions, smoking cessation, child healthy weight interventions, suicide reduction, child fluoride varnishing and inequalities targeted health checks. These health improvement targets are supplemented by a target on access to drug and alcohol treatment services. The Scottish Government monitors Boards' performance against these national targets throughout the year and progress is published on Scotland Performs (http://www.scotland.gov.uk/About/scotPerforms).

NHS Ayrshire & Arran and NHS Greater Glasgow and Clyde also deliver a range of other health improvement services, in addition to those performance managed through the HEAT process. These include early years services, breastfeeding support services, healthy lifestyle programmes, weight management programmes and mental health support services.

NHS Ayrshire and Arran and NHS Greater Glasgow and Clyde contribute to the NHSScotland-wide health promoting health service approach to patient care where ‘every health care contact is considered a health improvement opportunity’. In 2008, the Scottish Government issued a Chief Executive Letter (CEL 14 (2008)) requiring NHS Boards to implement specific health promoting actions in relation to a range of topics - smoking, alcohol, breastfeeding, healthy eating and healthy working lives - to support health improvement in acute care settings. These actions continue to be implemented in all Board areas. Over time, the aim is for health improvement activity to become as much the mainstream business of the NHS as health care delivery.

More detailed information on the range of health improvement and preventative services offered by NHS Ayrshire and Arran and NHS Greater Glasgow and Clyde is available direct from the Boards.