Chamber and committees

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.

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.

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.

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-12300 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.aspx.

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).

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. 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 include 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

Midlothian health and Social Care partnership have recently completed a significant piece of work to review and redraw the Practice boundaries to better reflect existing (and potential) list size capacity and planned house building within Midlothian. These changes were developed and agreed by all Practices.

In 2016-17, there were 978 incidents of domestic abuse recorded by the police in the Scottish Borders. This represents an increase of 47% from 665 incidents recorded in 2008-09. The rate of incidents recorded per 10,000 population in the Scottish Borders has increased from 59 in 2008-09 to 85 in 2016-17. However, this rate has been consistently below that of the Scottish average which in 2016-17 was 109 per 10,000 population.

The Scottish Government is investing almost £30 million (2017-20) from the Equalities portfolio to support a range of projects and initiatives – including support for a range of front line specialist services working with women and children who have experienced domestic abuse. Separately, we committed an additional dedicated £20 million over 2015-18 from Justice budgets to be invested in a range of measures to tackle all forms of violence against women and girls.

We are also implementing Equally Safe, Scotland’s strategy to tackle all forms of violence against women and girls. This aims to prevent violence from occurring in the first place, build the capability and capacity of mainstream and specialist services to support survivors and those at risk, and strengthen the Justice response to victims and perpetrators. A Delivery Plan for Equally Safe will be published by end 2017.

We are also improving the justice system response to domestic abuse. The Domestic Abuse (Scotland) Bill, which is currently before Parliament, will create a new offence criminalising a course of abusive behaviour towards a partner or ex-partner. The offence will help law enforcement agencies in dealing with domestic abuse with a law that reflects a modern understanding of domestic abuse and will cover all the types of behaviour that can constitute domestic abuse; crucially this includes psychological harm. This new offence will help our justice partners such as Police Scotland and the Crown Office to more effectively deal with domestic abusers.

The Scottish Government is aware of the pressures facing general practice and are fully committed to supporting a model of sustainable general practice.

Today the Scottish Government has published the new GMS 2018 contract offer. It aims to re-invigorate general practice and to re-energise the core values associated with it. It aims to create a dynamic and positive career for doctors and ensure that patients continue to have accessible, high quality general medical services.

The Scottish GMS 2018 contract offer can be accessed here - http://www.gov.scot/Publications/2017/11/1343

We will invest £100m in 2018-19 to support the new contract. This investment is delivered as part of our commitment to increase funding in direct support of general practice by £250m by the end of this parliament.

The Scottish Primary Care Information Resource (SPIRE) will go live in April 2018 and will make a major contribution to the analysis of local health and social care systems and will significantly improve GP practices’, Integration Authorities and NHS Boards’ understandings of their local populations’ needs.

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 Scottish Government recognises the need to offer Boards as much flexibility between years as possible, and this is already reflected in the Scottish Government’s approach. Brokerage arrangements and banking of funds to be drawn down in future years are examples of mechanisms from which Boards benefit.

The Scottish Government will consider how to improve on the mechanisms already used to provide financial flexibility for NHS Boards. This will require to be within the wider constraints in which the Scottish Government operates and the regulations set by HM Treasury.