Chamber and committees

Unlike local authorities and integration authorities, NHS Boards do not publish draft accounts.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.

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.

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.

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 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.

For nearly 70 years, our health and social care service have continually evolved with our society – and they must continue to do so. The Health and Social Care Delivery Plan with the oversight of the National Programme Board presents the actions that health and care services will take to further improve the care and health of our population. A programme of local, regional and national communications and engagement on the Delivery Plan is underway with staff, partners and the public, creating a culture for improved and sustainable health and care services.

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.