Chamber and committees

Statistics published by Information and Statistics Division (ISD) Scotland on 21 February 2017 show that the mortality rate for heart disease had fallen 37.6% per cent between 2006 and 2015. ISD statistics for cancer mortality, published on 31 October 2017 also show a fall in mortality rates of 11% between 2006 and 2015. Whilst we know that Scotland is behind other UK countries, it encouraging to see that mortality rates for heart disease and cancer have decreased over the last decade.

We know more needs to be done to tackle the risk factors associated with heart disease and cancer. Healthier eating, being more active, stopping smoking and drinking sensibly can all play their part in reducing the risk of heart disease and cancer, and we are taking firm action in all these areas to support people across Scotland to live healthier lives. This includes our Heart disease plan published in 2014, our £100 million Cancer Strategy published in 2016 and our upcoming Obesity Strategy, which is currently out for consultation.

These plans emphasise the Scottish Government’s commitment to tacking heart disease and cancer and outline key ambitions and actions to improve the detection, diagnosis, treatment and aftercare of heart disease and cancer for all people in Scotland.

Unlike local authorities and integration authorities, NHS Boards do not publish draft accounts. NHS Boards publish their annual accounts once the accounts have been audited and laid before the Scottish Parliament.

All NHS Boards received an unqualified audit opinion for their 2016-17 accounts.

The Chief Medical Officer’s reports, Realistic Medicine and Realising Realistic Medicine, seek to put the person receiving healthcare at the centre of decision-making and create a personalised approach to their care. Realistic medicine aims to reduce harm, waste and unwarranted variation, all while managing risks and innovating to improve.

One of the actions arising from the Health and Social Care Delivery Plan in support of this is to review the consent process for patients in Scotland with the General Medical Council and Academy of Medical Royal Colleges and make recommendations for implementation from 2018 onwards. This is a key element in supporting shared decision making and transforming the relationship between individuals and medical professionals.

In addition, our world-leading action plans on health literacy are working to build the skills, confidence, knowledge and understanding that people need to cope with the complex demands of the health and care system. This is vital to supporting people’s greater involvement in decisions about their care and treatment.

The Scottish Government’s position on patient safety is very clear – it is, and will remain, of paramount importance. The Healthcare Quality Strategy for NHSScotland has three quality ambitions to provide safe, effective, person-centred care.

The Scottish Patient Safety Programme (SPSP), has been key to the delivery of these ambitions since its launch in 2008. It has brought about a number of improvements in care and safety. The Acute Adult Programme includes the Deteriorating Patient workstream (including infections, sepsis, bedsores and falls) and continues to work with Health Boards to test and implement processes that will further improve reliable and safe care delivery across a range of clinical areas.

The new GP contract which has now been agreed between the Scottish Government and the Scottish General Practitioners' committee (SGPC) is a critical part of our plans to transform primary care services in Scotland. The proposals include reducing GP workload through the expansion of the primary care multidisciplinary team.

There will be significant new investment in expanded teams of health professionals in practices, widening patient choice and ensuring that GPs are able to focus on their expert medical generalist role. Additional health professionals will include pharmacy; nursing; Allied Health Professionals (physiotherapy, and paramedics and other urgent care practitioners); community mental health workers and non- clinical Support Workers (e.g. community Links workers).

As part of the existing approach to planning and identifying savings, NHS Boards focus on delivering recurring savings.

To ensure that public resources are used as effectively as possible and to help meet increasing demand and deliver reform, the Scottish Government has established a Sustainability and Value Programme to maximise the benefit from efficiency and productivity savings.

This Programme supports NHS Boards in identifying recurring savings which are then retained for local reinvestment. Savings plans are continually developed throughout the year, to deliver better services, better care and better value.

The Scottish Government Equality Evidence Strategy, published on 18 July 2017, identifies evidence gaps across policy areas for all protected characteristics and sets out its general approach to filling these.

Over the four year period of the strategy, the Scottish Government will carry out further engagement with stakeholders to prioritise these gaps and define projects aimed at improving the equality evidence base.

Equality Evidence Strategy: http://www.gov.scot/Publications/2017/07/9574/1

NHS Scotland’s Information Services Division (ISD) has recently published its Equality Evidence Finder, which summarises information about the availability and use of equality data from key national administrative health datasets. A companion report, Measuring use of health services by equality group, sets out a number of steps that ISD aims to take forward in order to build upon the work presented in the report and through the Equality Evidence Finder.

ISD Equality Evidence Finder: http://www.isdscotland.org/Health-Topics/Equality-and-Diversity/Equality-Evidence-Finder/

Measuring use of health services by equality group: https://www.isdscotland.org/Health-Topics/Equality-and-Diversity/Publications/2017-06-27/2017-06-27-Measuring-Use-of-Health-Services-by-Equality-Group-Report.pdf

Since 2012, the Scottish Government has included a core set of questions in each of the three major household surveys it conducts. This has been done specifically to allow responses to be combined across the surveys. This large sample enables the analysis of key health indicators with reference to sexual orientation, religious belief, and disability (as measured through the presence of long-term conditions and limiting long-term conditions). This data was used earlier this year to inform a report on sexual orientation in Scotland.

Scottish Survey Core Questions: www.gov.scot/SSCQ

Sexual Orientation in Scotland 2017: A Summary of the Evidence Base: http://www.gov.scot/Publications/2017/01/4911/0

The Chief Medical Officer’s vision is that by 2025, all healthcare professionals will demonstrate realistic medicine principles and values through their professionalism.

The posters that have been developed and displayed by NHS Borders support one of the key principles of Realistic Medicine, which is to strengthen the relationships between healthcare professionals by encouraging people to ask their healthcare professionals questions that will support shared decision-making and giving people informed choices about their treatment and care.

The NHS Borders poster initiative is highlighted in the Chief Medical Officer’s annual report, Realising Realistic Medicine and NHS Dumfries and Galloway, NHS Lanarkshire and NHS Forth Valley are now piloting similar posters. We would encourage all NHS Boards to consider adopting this person centred approach.

The Scottish Government supports improvement of foot care service delivery through nationally produced tools and resources including the Traffic Light tool and CPR for feet.

We understand that, NHS Valley are at present piloting a fast track referral/triage system to improve service delivery in a standardised manner and reduce variation in practice within their Board. The results will be discussed with our Scottish Diabetes Foot Action Group so that best practice can be shared nationally.

The new GP contract which has now been agreed between the Scottish Government and the Scottish General Practitioners' committee (SGPC) is a critical part of our plans to transform primary care services in Scotland. The new contract aims to reinvigorate general practice and turn it into a positive career choice for existing and future GPs. GPs will have the opportunity to vote on the new contract at a special SLMC Conference in December.

The proposals include reducing GP workload through the expansion of the primary care multidisciplinary team and allowing GPs to focus on their role as expert medical generalists. This will give GPs a more fulfilling role, with more time to see and treat the patients that need them most.

There will be new investment in expanded teams of health professionals in practices, which may includes pharmacists, nurses, physiotherapists, paramedics, community mental health workers and non-clinical support workers for example community links workers.

More detail on the primary care workforce will be provided in the National Health and Social Care Workforce Plan: Part 3 Primary Care in 2018.

The new GP contract can be accessed here - http://www.gov.scot/Publications/2017/11/1343