Chamber and committees

Within the policies we set, NHS Boards have responsibility for the design and delivery of services to meet the needs of their local populations and deliver safe, high-quality care. NHS Boards may commission local reviews of services to support them in the design and delivery of safe, sustainable services which best meet the needs of their local populations and geographies.

If Scottish Ministers have concerns about local services they would discuss these with the Board as they are responsible for local service delivery, following which Ministers may decide to commission an independent review. There are no set criteria for such decisions as it will depend on the circumstances of the issues under consideration and the most appropriate response.

Healthcare Improvement Scotland (HIS) undertakes independent inspections of obstetric maternity units in Scotland through its Maternity Inspection programme. The inspection programme launched in January 2025 and details of the inspection methodology are made publicly available on the HIS website, along with inspection reports and NHS Board improvement plans. Crucially, HIS maintains independence in its scrutiny activity, including in its inspection programme. HIS takes decisions around inspection activity using a risk-based, proportionate and data- and intelligence-led approach.

Links:

https://www.healthcareimprovementscotland.scot/inspections-reviews-and-regulation/safe-delivery-of-care-in-maternity-units-inspection-programme/

https://www.healthcareimprovementscotland.scot/inspections-reviews-and-regulation/inspections-of-nhs-hospitals-and-services/hospital-and-services-inspection-reports/

The supply of gas and electricity are reserved matters. The Scottish Government has no involvement in applications for electricity supply licences and is therefore unable to comment on this matter.

The commitment to recruit 1000 additional staff in Primary Care Mental Health remains paused.

We are still committed to the development of mental health and wellbeing workforce capacity in general practice through Action 15 of the Mental Health Strategy 2017-2027, and the Primary Care Improvement Fund (PCIF).

Action 15 at March 2022, had seen an additional 356 WTE mental health workers recruited to general practice and at March 2025, 179.7 WTE Mental Health workers were in post funded by PCIF.

The Scottish Government is taking bold and ambitious action to reform and renew our health and social care systems, with a clear focus on prevention as a cornerstone of our long-term visions where people live longer, are healthier and lead more fulfilling lives.

Through the Scotland's Population Health Framework - gov.scot and the Health and Social Care Service Renewal Framework - gov.scot, both published in June 2025, we have set out a strategic and joined-up approach to improving population health and reducing the burden of disease on the NHS. These frameworks work hand in hand to embed prevention across all levels of planning, delivery and accountability.

The PHF focuses on the primary prevention space, on what creates, sustains and protects good health across our society and communities in Scotland. The PHF is based on five key interconnected prevention drivers of health and wellbeing - prevention focused systems; social and economic factors; places and communities; enabling healthy living; and equitable access to health and care.

Working across these five areas is crucial because as much as 80% of what affects health happens outside the health and care system. The NHS is just one part of the whole system – local government, public agencies and a range of sectors and organisations all must have a laser focus on preventing ill health.

Increasing preventative care in the NHS is at the heart of the twinned SRF, which places prevention and early intervention at its core. We recognise that our current model of health and social care focuses most of its resources (workforce, finance, infrastructure) on caring for established sickness or care needs – and for this reason we have focused much of our renewal framework on how to change this.

The SRF sets out five key principles for renewal which provide an evidence-based and value-driven foundation from which to plan, make decisions, and deliver change. The first of these principles is the Prevention Principle – focusing on prevention and proactive early intervention across the continuum of care to realise long term wellbeing and reduce the burden of disease.

We are committed to improving health and wellbeing across Scotland by focusing on prevention at every stage – from helping people stay well, to detecting problems early, to supporting those living with long-term conditions. And this is why, the first change commitment in the SRF is Major Change 1- Prevention, which focuses on services that prevent disease, enable early detection and effectively manage chronic and long-term conditions.

We are determined to reduce avoidable cardiovascular deaths, by a fifth over 20 years by ensuring people receive timely and high-quality care. That is why by March 2026, we are investing just under £10 million in providing extra GP appointments to support 100,000 patients who may be at risk, due to obesity, smoking, or high blood sugar, blood pressure or cholesterol. This is part of our cardiovascular disease risk factors programme and has a particular focus on supporting people living in areas of deprivation. 95% of practices in Scotland have signed up to provide the service.

By finding risk factors sooner we can support individuals – for instance, if a person is overweight or obese and has developed type 2 diabetes, there is a range of options that their healthcare team can consider with the person. This includes the new national Type 2 Diabetes Remission programme, which is a national digital intensive weight management programme which will support 3,000 people recently diagnosed with type 2 diabetes. We have invested £4.5 million over three years into this programme, and we expect to help around 40% of people to achieve remission from the condition by the end of their first year in the programme, which will improve each person's health significantly.

This aligns closely to our new Long Term Conditions Framework, which we working to publish by the end of 2025. The Framework will improve the quality of care and support for people living with long term conditions. This includes helping people manage their conditions well, avoid complications and maintain their independence and quality of life.

Another example of work is how we can use pharmacogenetics in prevention. Pharmacogenetics is how a person’s genetics affect their response to certain drugs. We have invested £1.1 million to support testing of recent stroke patients to determine if they have a genetic variation that impairs the benefits of a drug commonly prescribed to reduce the risk of secondary stroke and which would mean an alternative drug should be considered for them. Around 60,000 stroke patients will be tested, with approximately 20,000 expected to be moved to more effective medication, with potential savings of £30 million in future health costs.

Similarly, a programme to provide a genetic test for newborn babies will also receive £800,000 funding to determine if they have a genetic variation which puts them at risk of permanent hearing loss if they are treated with a common emergency antibiotic. 10,000 newborns will be tested, with those at risk of adverse reactions moved to safer antibiotics, helping prevent profound hearing loss and saving an estimated £8 million in health and education costs over their childhood.

Prevention work is also vital for mental health and wellbeing. We are already implementing the Mental Health and Wellbeing Strategy and updating our delivery plan, recognising how inequalities can affect mental health and understanding the connection between mental and physical health needs. Our approach includes prevention, early support, and ongoing care for those living with mental health conditions.

We continue to invest in community-based prevention and wellbeing initiatives. The Communities Mental Health and Wellbeing Fund for adults has provided £81 million over five years, supporting thousands of local projects focused on prevention and early intervention, with a further £15 million committed in 2026-27. We have also invested over £65 million since 2020 in community mental health support for children, young people and families, which reached almost 80,000 people in 2024-25, and will continue with the baselining of this £15 million per annum funding into local authority budgets from 2025-26. In addition, we have ensured access to counselling services in secondary schools across Scotland, and we continue to support local authorities with £16m a year.

We are committed to a whole-system approach to prevention, ensuring that NHS Scotland is not only equipped to treat illness but is actively working to prevent it, reduce inequalities and improve health outcomes for all. The examples I have given today demonstrate only some of our renewal efforts, and we will all have to lead and drive this shift to focus more on prevention within the NHS to make the impact we need.

The Scottish Government regularly meet with the Coalition of Care and Support Providers in Scotland (CCPS) and the Health and Social Care Alliance Scotland (The ALLIANCE) at both official and ministerial level. Both organisations are key stakeholders who have been heavily involved in the work on the National Care Service, social care workforce and our reform and renewal programme through their membership of the Key Stakeholder Steering Group (KSSG) as well as through other regular policy engagement.

The First Minister met with the CCPS and others at a round table event on 20 May 2025 and with the ALLIANCE, the CCPS and others at an event on 16 June 2025.

While the Scottish Government has overall responsibility for health and social care support policy in Scotland, it is for local authorities and health boards to work with the Health and Social Care Partnerships (HSCPs) to set budgets and ensure that social care support services are in place to provide people with the appropriate support.

Social Care spend therefore occurs at a local government level and details can be found in the Local Finance Returns: https://www.gov.scot/collections/local-government-finance-statistics/#scottishlocalgovernmentfinancialstatistics

However, each year, the Scottish Government does provide additional investment into Social Care.

Details of the Scottish Budget for each year can be found here: https://www.gov.scot/budget/

The Scottish Government is committed to developing a sustainable health and social care system that ensures people get the right care, at the right time, in the right place. In support of this, the Budget provides almost £2.2 billion investment for social care and integration – delivering on our Programme for Government commitment to increase social care spending by 25% over this Parliament, two years ahead of our original target. This includes an additional £125 million to support delivery of the pay uplift to a minimum of £12.60 per hour for adult social care workers in 2025-26.

Despite this substantial funding increase, we are aware that significant challenge for social care service provision remains. We are therefore working with partners on a programme of work to understand the current financial viability picture in the social care sector. This has included engaging with local leaders through the Collaborative Response and Assurance Group, as well as Ministerial roundtables with partners.

The Scottish Government regularly meet with the Coalition of Care and Support Providers in Scotland (CCPS) and the Health and Social Care Alliance Scotland (The ALLIANCE) at both official and ministerial level. Both organisations are key stakeholders who have been heavily involved in the work on the National Care Service, social care workforce and our reform and renewal programme through their membership of the Key Stakeholder Steering Group (KSSG) as well as through other regular policy engagement.

The most recent ministerial meeting with the CCPS was with the Minister for Public Finance, Mr Ivan McKee, who met with Rachel Cackett, CCPS CEO, on 25 August 2025.

I chaired the most recent meeting of the KSSG on 8 July 2025, which was attended by Sara Redmond, Chief Officer at the ALLIANCE.

The Scottish Government recognises that access to social care services can vary significantly depending on where people live.

Through the Care Reform (Scotland) Act and the work of the NCS Advisory Board, we are taking decisive steps to end the postcode lottery and deliver care based on need, not geography.

The Care Reform (Scotland) Act introduces wide-ranging reforms that enshrine rights in law. Key measures include:

• Anne’s Law which recognises family and friends of care home residents as essential contributors to their care—not merely as visitors, but as integral members of the care team
• Introducing a statutory right to breaks for unpaid carers
• Expanding access to independent advocacy
• Improving information sharing across care settings
• Establishing a National Chief Social Work Advisor and National Social Work Agency
• Reforming procurement routes for the third sector

The interim NCS Advisory Board brings together people with lived experience of care, frontline workers, service providers, and representatives from local government and the NHS. Their role is to advise on how we build a fairer, more responsive system that puts human rights and equity at its core.

The Board will work alongside established national programmes to drive improvement and ensure that services are consistent, fair, and high-quality, regardless of where people live in Scotland.