Chamber and committees

The Chief Medical Officer’s second annual report, Realising Realistic Medicine sets out the need to strengthen relationships between professionals and individuals, with the person at the centre of all decisions and the need to tackle unwarranted variation. The report can be accessed here: http://www.gov.scot/Publications/2017/02/3336/downloads#res-1

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

Different types of variation exist within the health and care system. Variation in health practices and outcomes exist, as well as variation in the volume of procedures carried out. There is a range of work, either planned or under way, that aims to strengthen person centred approaches and shared decision making to help tackle unwarranted variation. The Health & Social Care Delivery Plan which contains a series of priority actions that will begin to help embed Realistic Medicine across Scotland. They include:

• Refreshing our Health Literacy Plan, to support everyone in Scotland to have the confidence, knowledge, understanding and skills we need to live well with any health condition;

• Reviewing the consent process for patients in Scotland with the General Medical Council and Academy of Medical Royal Colleges and make recommendations for implementation. This is a key element in transforming the relationship between individuals and medical professionals;

• Commissioning a collaborative training programme for clinicians to help them to reduce unwarranted variation. This will support a workforce that can find more effective and valued ways of delivering medicine;

• Incorporating the principles of realistic medicine as a core component of lifelong learning in medical education and mainstream the principles of realistic medicine into medical professionals’ working lives at an early stage.

• Developing a Single National Formulary to further tackle health inequalities by reducing inappropriate variation in medicine use and cost and reduce the overall cost of medicine.

We will report progress towards achieving these actions through regular updates to the Delivery Plan Programme Board.

There is already some evidence of change in practice from individual clinicians, departments and NHS Boards as described in the CMO’s annual report Realising Realistic Medicine and we encourage boards to share and adopt good practice.

Within our Health and Social Care Delivery Plan we aim to reduce occupied bed days by 10 percent (around 400,000 bed days) by reducing avoidable admissions, delays and inappropriate long stay delays in hospital.

The Scottish Government has funded NHS National Services Scotland Information Services Division to provide data intelligence and support for Integration Authorities to allow them to continuously monitor, evaluate and report progress locally. Integration Authorities are also required to publically report on progress against nationally agreed integration indicators in their annual performance reports.

We will develop a medium term financial framework by February 2018 to support national, regional and local financial planning for the next 5 years.

I refer the member to the answer to question S5W-12312 on 20 November 2017. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.asp

Funding allocations for the Health and Sport portfolio and for NHS Boards for future financial years is a matter for the relevant spending review. The Scottish Government will publish its draft budget for 2018-19 on 14 December 2017.

The welfare of NHS staff is critically important, every health board is required to have policies in place and to comply with national policies on managing health at work, which includes activity to support staff wellbeing.

Scotland has led the UK in the development of nursing and midwifery workload and workforce planning tools. A Nation with Ambition – the Government’s Programme for Scotland 2017-18, published on 7 September 2017, published our commitment to introduce Safe Staffing legislation, enshrining our world leading workforce planning tools in law, commencing with the nursing and midwifery professions.

The Nursing 2030 Vision, launched by the Chief Nursing Officer earlier this year, sets a direction for nursing through to 2030. It recognises that when nurses are happy and valued, patient outcomes improve and services flourish. The Vision prioritises activity to support nurses’ health and wellbeing.

We will develop a medium term financial framework by February 2018 to support national, regional and local financial planning for the next 5 years.

The Scottish Government is encouraging Health Boards, Integration Authorities and other partners to take a more joined-up approach to improving services and patient outcomes. As part of this, three Regional Implementation Leads (North, East and West) are working together with local and national partners to plan and design better services for the populations in their areas. This will help to ensure that local, regional and national planning works together in practice and for the long term.

As part of the approach to finance and performance, NHS Boards prepare plans over a medium term timescale and submit this information to the Scottish Government as part of their Local Delivery Plans.

The Budget Process Review Group was established by the Finance and Constitution Committee and the Scottish Government to carry out a fundamental review of the Scottish Parliament’s budget process. The Group published its Final Report on 30 June 2017, which included comment on spending reviews and multi-year budgets.

The Cabinet Secretary for Finance and the Constitution has responded to this Report.

Boards are continuing to reduce their waiting times below the standard, in the last quarter 13 of the 14 Boards in Scotland recorded an average waiting time within the 18 week standard with 8 of these recording an average wait of 9 weeks or lower - half the target waiting time. At the same time the increase in demand for CAMH services clearly shows that in the past there were far too many children who were unseen, and whose need was unmet and as the capacity and provision of services have increased we have seen a sustained increase in the numbers accessing treatment each quarter and this should be welcomed.

We remain determined to improve performance and we will continue to work with Boards to make sure that happens right across Scotland and announced an additional £150 million for mental health services up until 2020, and as part of this funding £4.6 million has been awarded to Healthcare Improvement Scotland to establish a Mental Health Access Improvement Support Team to work in partnership with Boards to deliver sustained improvements in access to CAMHS and psychological therapies services for all ages and ensure services are designed and delivered in the most efficient way.