Chamber and committees

The GP Recruitment and Retention programme has successfully delivered more GPs and builds on a wide range of initiatives that encourage GPs to enter and remain in the profession - for example, the ground-breaking Scottish rural medicine collaborative involving 10 rural NHS boards, continued support for doctors returning to GP practice and developing a new national recruitment website.

The new GP contract, if accepted, will ensure GPs can spend more time with patients and less time on bureaucracy. If accepted, it will help cut doctors’ workload and make general practice an even more attractive career choice for young doctors.

The priority will be on the wider development of the multi-disciplinary team to free up GP's workload. This will be done over a 3 year transitional period from 2018-21.

We have recently announced the commitment to increasing the number of GPs by at least 800 over ten years to ensure a sustainable service that meets increasing demand on our services. Our strategy to recruit and retain our existing GPs will be set out in part 3 of the national health and social care workforce plan to be published early next year.

Our balanced approach to performance is reflected in the Sustainability and Value Programme which supports NHS Boards to deliver their efficiency savings and oversees four workstreams across NHS Scotland: workforce, clinical transformation; effective prescribing and shared services. Work included in the programme may flow from a number of sources and can be drawn from any evidence but must meet a number of set criteria:

• Outcomes are better;

• Staff gain from the initiative by, for example, improved utilisation of skills and competencies;

• It is proven to be more cost-effective at a local, regional or national level.

One example of a saving successfully delivered by NHS Boards under the Sustainability and Value Programme is the £8.4 million achieved in 2016-17 by switching to ‘once for Scotland’ procurement and prescribing for biologics.

As announced in the Draft Budget on 14 December, the Health and Sport resource budget will increase by over £400 million to £13.1 billion in 2018-19. We have prioritised investment in frontline services, and total additional funding for our frontline NHS Boards will amount to £354 million. These increases have only been made possible, without impacting on other public services, through the progressive tax policies set out in the Draft Budget.

Our estimate is that Conservative tax policies would have resulted in a reduction in the Scottish Government’s resource budget of £501 million in 2018-19.

The most recent Scottish Social Services Workforce Data, published in September 2017, shows there were 38,940 people employed in the Day care of children sector (including child minders) on 31 December 2016. In 2015, the total number was 39,030. The First Minister recently announced that our workforce modelling indicates up to 11,000 additional employees will be required to meet the needs of the expansion. Those additional employees will be in place by 2020.

The Scottish Government is currently working with local authorities to deliver our commitment to provide an additional graduate in nurseries in Scotland’s most deprived areas by August 2018. The additional staff will start to enter settings from April 2018 and, as part of the additional £52.2 million revenue funding that local authorities will receive to support the expansion of early learning and childcare in 2018-19, we are providing funding for these posts.

In 2017-18 we invested £1.5 million to fund additional places for teacher training and the BA Childhood Practice award to support delivery of this commitment.

We have treated local government very fairly despite the cuts to the Scottish Budget from the UK Government. The overall increase in spending power to support local authority services this year amounts to £383 million or 3.7 per cent compared to 2016-17.

The 2018-19 local government finance settlement foresees an increase both in revenue and capital (11 per cent) investment as part of a wider package of measures. Together with the additional power to increase Council Tax by up to 3 per cent (worth around £77 million), this will generate an increase of 1.6 per cent in the overall resources to support services next year.

Decisions on the use of reserves are rightly the responsibility of individual local authorities to take where it is prudent and sustainable to do so.

Behaviour in Scottish Schools Research 2016 shows that the vast majority of pupils in our schools are well behaved. With regard to mobile phones, we urge schools and local authorities to think carefully about how they can be used to enhance the learning experience, whilst also educating learners about appropriate use.

The Scottish Government will discuss the findings from the research with key stakeholders, including the Scottish Advisory Group on Relationships and Behaviour in Schools, and present an agreed plan of action to ensure that continued improvements in behaviour can be realised.

The Family Nurse Partnership will be rolled out to all mainland boards by the end of 2018. This expected cost will be around £16m per year. An additional 30 family nurses are expected to be recruited between now and the end of 2018.

Sir Harry Burns’ independent review of targets and indicators was published on 15 November. Sir Harry identifies some key principles and recommendations for developing and using targets and indicators going forward. He suggests that targets and indicators have an important place in our health and care system but only as part of an overall approach to improvement and learning. He recommends that there should be a greater focus on the use of improvement approaches, and an avoidance of a narrow view of performance based on handful of measures. Underpinning any work is a recommendation from Sir Harry that we do more to understand the quality of health and social care from the perspective of people using services. The Scottish Government will use these principles and recommendations to undertake a further stage of work, with the aim of ensuring a broader based assessment of the overall quality of care. As part of this we will look to develop better ways of understanding people’s experiences of care whether in hospital or in the community. This work will sit alongside a range of existing and new activity to improve data quality and availability in health and social care.

The national living wage is the statutory minimum wage that workers aged over 25 must be paid and is set by the UK Government.

The real Living Wage is a higher, and independently-calculated, wage rate which is intended to reflect the cost of living. It is set by the Living Wage Foundation.

The Scottish Government wants to see all care workers delivering the funded early learning and childcare entitlement, across all sectors, paid at least the real Living Wage by 2020.

To enable this we are committed to providing sufficient funding to allow local authorities to agree rates with funded early learning and childcare providers in the private and third sectors that enables them to pay the Living Wage to care workers providing the funded entitlement. Our initial estimates indicate that this funding will be around £50 million per annum, and these estimates are currently being considered in detail by the ELC Finance Working Group as part of our joint work with local government to reach agreement on a package of multi-year funding to support the expansion. This estimate is based on analysis from the Financial Review of Early Learning and Childcare, published in September 2016, a part of which captured information on the costs of delivery from around 220 ELC providers in the private and third sectors.

We have funded 14 trials across Scotland to test out different ways in which the expansion of early learning and childcare entitlement to 1140 hours can be delivered. 12 of the trials are still operational and learning is continuing to be gathered through an evaluation process. The service offered by the 2 trials that concluded in the summer, in Edinburgh and the Scottish Borders, have continued to be offered to families as part of the early phasing of 1140 hours entitlement within those areas.

A final report on learning from the trials will be prepared by Summer 2018. Early lessons were disseminated in the Interim Learning Report circulated to all authorities in October