Chamber and committees

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

I met with Lothian GPs last November to discuss how our significant national investment - £71.6 million this year - can directly support general practice across Lothian.

GPs are an integral and crucial part of our health service and our new GP contract, a historic joint agreement between the Scottish Government and the BMA, will help cut doctors’ overall workload, ensure GPs are able to spend more time with patients, and make general practice an even more attractive career prospect to younger doctors and in retaining our existing ones.

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.

The Scottish Government is presently consulting on a bold new diet and obesity strategy which proposes a package of measures to help people be more active and make healthier choices. This includes action to change the food environment and improve children’s diet by limiting the promotion of products high in fat, sugar and salt.

The Government is concerned by the growing evidence that obesity, and particularly child obesity, is increasingly linked to inequality. The strategy will therefore prioritise work with families in poverty and on low incomes to design services and approaches that meet their specific needs and are impactful. More widely we are taking action on addressing the underlying causes for health inequalities: ending poverty, fair wages, supporting families, and improving our physical and social environments. This is coupled with decisive action to address alcohol consumption, reduce smoking rates, encourage active living, healthy eating, and investment to improve mental health services.

The consultation on A Healthier Future - Action and Ambitions on Diet, Activity and Healthy Weight' runs until 31 January 2018.

On physical activity the Scottish Government has invested significantly to promote PE in primary and secondary schools and through the Active School Programme, amongst other initiatives, encourages children and teenagers across Scotland especially those in deprived areas to participate in sport.

The ‘National Food and Drink Policy; Becoming a Good Food Nation’ discussion document from published in 2014 highlighted the successes of Scotland’s first food and drink policy, ‘Recipe for Success’. It also set out the aspiration for Scotland to become a Good Food Nation in terms of what we produce and what we buy, sell and eat. The Scottish Food Commission has since been established to advocate the importance of food and drink to our health, environment, economy and quality of life. The Commission is currently preparing recommendations for the Good Food Nation Bill on which we will be consulting in due course.

Since the introduction of free school meals for all children in primaries 1 to 3 at all publicly funded schools in Scotland in January 2015, the Scottish Government has provided local authorities with funding of £203.1 million to deliver this commitment. We will be providing local authorities with a further £53.9 million in financial year 2018-19, however the allocations for the 2019-20 financial year are not yet known.

The Scottish Government allocated £2 million, £6.8 million, and £19 million in 2014-15, 2015.16 and 2017-18 respectively for additional Health Visitors. In 2016-17, funding for Health Visitors was included in the new Outcomes Framework (totalling over £160 million) issued to Health Boards. All of this funding supported the provision of an additional 500 health visitor posts. In addition, a further £4 million has been allocated to Health Boards over the same period in respect of Health Visiting training.

The above funding will allow us to meet the manifesto commitment by 2018, investing over £40 million by 2017-18.

The Nursing 2030 Vision sets a direction for nursing across Scotland through to 2030 in order to promote confident, competent and collaborative nursing for Scotland's future. To support nurses as we move towards 2030, the Vision emphasises the importance of promoting and providing clear and exciting career opportunities, supported by the right education and development; ensuring that practitioners are supported, enabled and listened to and that they have access to ongoing supervision appropriate to their roles; and putting in place measures to protect and promote nurses' health and wellbeing.

The Vision also emphasises the importance of ensuring that nursing is better understood by the public, enhancing their knowledge of how nursing can benefit them and increasing nursing's appeal as a career option. On 7 December 2017, the Chief Nursing Officer for Scotland published a report on Widening Participation in Nursing and Midwifery Education and Careers. The report recommends a range of measures to attract people into nursing, including a national campaign to recruit a more diverse workforce and tackle negative stereotypes.

A detailed action plan will be developed to set out measures to make the ideas in the Vision a reality over the short, medium and long terms, including to establish a more positive culture.

The Scottish Government is awaiting the Scottish General Practitioners Committee (SGPC) of the BMA's response to its poll of GPs on the new contract offer. Should the profession decide to accept the offer, the Scottish Government and SGPC will negotiate appropriate reporting mechanisms for the minimum income guarantee.

The new General Medical Services contract, if accepted by GPs, will introduce a more accurate workload formula, and the Scottish Government has committed £23 million to guarantee that no practice will lose income as a result of the new formula.

As part of the new contract arrangements, the Scottish Government will also invest £2 million in 2018-19 to support initiatives to attract and retain GPs in our rural and remote communities and ensure practices are sustainable, including:

• Continuing support for the ground-breaking Scottish Rural Medicine Collaborative.

• Expanding the £10,000 “golden hello” scheme to 160 rural and remote practices.

• An improved relocation package of £5000 per GP to encourage GPs to move to rural areas.

We will also continue the current bursary scheme to increase the attractiveness of GP specialty training posts. Over half of these bursaries will be attached to training posts in rural and remote areas.

In NHSScotland, the majority of temporary shifts are filled through the NHS Staff Bank. The Staff Bank provides NHS Boards with a pool of appropriately trained staff, working on NHS contracts at NHS rates of pay who can provide temporary cover for short term absences. We are working with NHS Boards to strengthen the Staff Bank network and have created Regional NHS Staff Banks that now allow NHS staff to work seamlessly across board boundaries, ensuring that NHS Boards have access to a greater pool of appropriately trained staff.

In order to continue to boost the numbers working in the NHS Staff Bank, recruitment is an on-going process. We have around 35,214 nurses and 2,900 doctors currently registered on these Banks.

The use of agency staff in Scotland remains low and represents only 2.6% of the overall staffing budget. Between 2015-16 and 2016-17 total spend on agency staff fell by 3%.

Workforce data on Health Visitors is published quarterly by ISD Scotland and is available from March 2015 onwards at the workforce statistics web site:- https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-12-05/Health_Visitors_S2017.xls.

Health Visitors were part of a recent review of community nurses data. Therefore, information on the Health Visitor workforce after March 2015 is not comparable with previous years.

We have engaged continuously with all Health Boards since the commitment to the delivery of the additional 500 Health Visitors in place by the end of December 2018 was made. The information provided to date suggests we are on track to meet this commitment.