Chamber and committees

We are taking significant action to reduce waiting times, that is why I made an additional £50 million available to NHS Boards earlier this year.

I announced on 29 August the setting up of an expert group to reduce waiting times and improve the way elective care services are provided. The Elective Access Collaborative programme is bringing experts from the Scottish Government, NHSScotland and the Royal Colleges together in providing support to NHS Boards and will be crucial in bringing about sustained delivery of waiting times. This approach has seen us deliver improvements in unscheduled care. I will be making a further announcement on the early progress the collaborative has made in the coming weeks.

The Scottish Government agrees that a new GP contract is critical to delivering more care in the community. Scottish Government and the BMA have negotiated a new contract (published 13 November), details of the contract offer can be found at http://www.gov.scot/Topics/Health/Services/Primary-Care/GP-Contract

Unscheduled care is a key priority for Scottish Government and we want all hospitals across Scotland to sustainably achieve 95% of all patients attending A&E to been seen, treated and discharged or admitted with four hours. The latest weekly performance against the four hour A&E target for the w/e
29 October was 94.0%.

Since the launch of the six essential actions two years ago we have delivered significant improvements; Scotland is leading the way in the UK in terms of performance against the four hour A&E target, the number of patients waiting longer than four hours has reduced by 10% since 2012-13 compared to 180% increase in England.

Scotland’s performance in September was almost 8 percentage points better than England; more than 23 percentage points better that NI and almost 12 percentage points better than Wales (England 84.6%; Northern Ireland 69.4%, and Wales 80.6%); Scotland’s core site performance has been ahead of England for
31 consecutive months, to September 2017.

But we are not complacent. I recognise that more needs to be done to ensure a sustainable improvement in performance especially as we go in to the winter period. That is why I recently announced an additional £5 million to support winter resilience. This is over and above the £9 million, announced in May 2017, to support Unscheduled Care - total of £14 million for winter 2017, compared to £12 million the previous year.

The Scottish Government published Part 1 of the National Health and Social Care Workforce Plan on 28 June 2017. This makes specific recommendations in key areas to strengthen national, regional and local improvements to NHS workforce planning.

Parts 2 and 3 of the Plan, respectively covering workforce planning in Social Care and Primary Care, will bring this together iteratively to enable different systems to make the right links. A further integrated Plan will be published in 2018.

The national performance standard for cancer is 95 per cent of patients referred urgently with a suspicion of cancer are to begin treatment within 62 days of receipt of referral.

We know further work is needed to shorten waits for diagnostics and in September 2017 we formed a Ministerial Cancer Performance Delivery Group to drive forward service redesign and improvement, backed by £1 million investment on top of
£4.85 million already allocated to boards.

Among a series of actions the group will audit processes for managing patients with a suspected cancer, implement new scrutiny and monitoring processes for health boards struggling to meet the 62 day standard, and invest in the roll-out of new technology to assist with pressures on diagnostic services.

Integration Authorities' strategic commissioning plans set out how they intend to deliver care appropriate to people's needs in their localities, including any plans to shift provision of care from institutional to community settings. Strategic commissioning plans are accompanied by annual financial statements setting out spending intentions for the year to come. The main driver for hospital use is emergency admissions, of which many can be prevented by better services in the community. Using their budgets and through their strategic commissioning plans, Integration Authorities have control of the budgets across the unscheduled care pathway including commissioning responsibilities for three quarters of all emergency admissions, enabling them to redirect resources from acute to community-based provision, improving both the quality and sustainability of care.

The Health and Social Care Delivery Plan, published 19 December 2016, affirms that there will be a shift in the balance of care from hospital to community care settings, and to individual homes when that is the best thing to do. By 2021-22 more than half of frontline NHS spending will be in community health services.

As part of this shift, in every year of this Parliament there will be an increase in the share of the frontline NHS budget dedicated to mental health and to primary, community, and social care. This will be supported by an increase in health resource funding of £2 billion over the life of this Parliament.

The Scottish Government is committed to ensuring that NHSScotland delivers high quality services and improved outcomes for patients. The Modern Outpatient Programme and Scottish Access Collaborative will deliver sustainable improvements. We have adopted a collaborative approach for Unscheduled Care and Scotland’s A&E performance has been the best in the UK for the last 30 months.

All Boards were able to obtain the necessary financial information from the relevant integration authorities for inclusion in the final accounts. All Boards received an unqualified audit opinion for the 2016-17 annual accounts.

It is important to note that 2016-17 was the first full year that integration authorities were fully operational. Areas for improvement are being identified and addressed as part of the approach to be taken by relevant bodies for subsequent years.