Chamber and committees

Information on agency nursing staff usage and costs is routinely published at

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2016-06-07/Bank_and_Agency_comp_M2016.xls

The latest published related to this question is reproduced in Table 1.

Table 1. Number (average whole time equivalent) and cost (£) of agency nursing and midwifery staff for financial period 1 April 2015 to 31 March 2016.

Sources: ISD Scotland (ISD(M)18)

In 2015-16 agency nursing represented just 0.4% of the total nursing and midwifery staffing in the NHS in Scotland (276.7 WTE out of total capacity of 66,143.9 WTE).

The Scottish Government and NHS National Services Scotland (NSS) have launched a nationally coordinated programme for the effective management of all temporary staffing (Managed Staffing Network Project). The aim establish Integrated Regional and National Staff Banks which allow NHS Boards to access a shared pool of NHS staff who are flexible, appropriately qualified and experienced and provide better value for money than alternative methods of filling the gaps.

 Notes:

1. Agency nursing and midwifery staff are employed by private organisations which respond to requests by NHSScotland.

2. To calculate the average WTE, 1 WTE is taken as a contribution of 37.5 hours per week x 52 = 1950 hours per year.

It is generally agreed that antidepressants are not classed as addictive medicines. They can, however, cause a discontinuation syndrome in someone taking them for a prolonged period of time if stopped abruptly. Prescribed medicines known to be addictive include benzodiazepines and some pain relieving medicines.

All NHS Boards monitor a range of prescribing indicators and against each they agree an appropriate action with practitioners. Drugs with the potential for addiction, such as benzodiazepines, are very commonly included in that process.

Decisions on the type of treatment to prescribe are for clinicians to make in discussion with their patients and to agree upon within the context of the patient’s long-term recovery.

All prescribing decisions should be in line with good clinical and prescribing practice, and clinicians are encouraged to review a patient’s medications regularly to ensure their continued clinical appropriateness, and to achieve the best possible health outcomes from the medicines they are prescribed.

In keeping with good clinical practice, clinicians should be providing on-going support and advice to patients who are prescribed medicines that are known to be addictive or with other long term effects. Where patients are concerned about the effects their medicines are having on their general wellbeing they should contact their GP as soon as possible and discuss alternative treatments that may be available.

The Bus Investment Fund (BIF) ran as a challenge fund for bus related projects from 2013 to 2016 for an initial period of three years after which it would be subject to review.

The Ring of Breadalbane explorer, as part of the grant conditions, provided statistics as to the project performance. The role of the BIF was not to support projects indefinitely, rather, it gave an opportunity for new or existing projects to access a level of financial support to enable them to improve their service and to collect data. It is hoped that once funding has ended projects will either be in a stronger position to continue commercially or have enough evidence collected to enable them to bid for funding from other avenues.

Operational decisions about measures to tackle drug-related crime are a matter for the Chief Constable, under the oversight of the Scottish Police Authority. The Scottish Government is committed to working with all its partners to reduce the damaging impacts of substance misuse. This includes the ‘Choices for Life’ schools based substance misuse education programme, delivered in partnership with Police Scotland and Young Scot.

ScotRail’s performance as a whole, has fallen below the expectations of passengers, and the demanding performance targets set by Scottish Ministers. The contractual targets are intentionally challenging, demanding a consistent improvement in punctuality and reliability over the life of the franchise, leading to 92.5% of trains being at their destination on time, as measured by the rail industry’s Public Performance Measure, by April 2019. ScotRail’s current performance here nationally is 89.6% over the last twelve months, against a target for the end of the second year of the franchise of 91.3 percent.

The mid-Scotland and Fife area falls into the ‘Suburban East’ franchise sector. In this sector, ScotRail’s current performance is sitting at a moving-annual-average of 89.5 percent, against a specific target for that sector for the end of the second year of the franchise, of 92.5 percent.

Under the terms of the Franchise Agreement, Transport Scotland (an agency of the Scottish Government) requested that ScotRail provide an Improvement Plan, which will outline their plans to address performance issues and achieve their contractual targets. This was received by Transport Scotland on 16^th September, and is now being reviewed, with the actions within the plan to be monitored.

The Improvement Plan has three points of focus: infrastructure, fleet and operations:

For the infrastructure, much is being done to improve signalling and cabling:

For the fleet, the emphasis is now much more on focussed maintenance initiatives, especially for the radiators on the Class 158 rolling stock, as these have been a particular source of concern;

For the operations, a specific focus on reviewing staff and passenger behaviours on the lines which are known to facing significant levels of delay.

Cancer waiting times data for quarter 2 (April - June) 2016 published by ISD on 27 September 2016 show 95.7% of cancer patients across Scotland received treatment within 31 days of a decision to treat with the median wait being only six days.

Challenges remain to the 62-day pathway with known capacity pressures for diagnostic scopes and radiological investigations. The Scottish Government continues to support improved performance across NHS Scotland and are actively engaging NHS Boards where there are challenges to sustained delivery against the 62-day standard. This is backed by additional funding of £5 million in 2016-17.

Breakdown of performance by NHS board can be found in the quarterly ISD statistical publications.

Under this Government, the number of GPs employed in Scotland has risen by 7.4 per cent to nearly 5,000 – the highest ever on record. Investment in GP services has gone up every year under this Government and we are committed to an increasing share of the NHS budget going to Primary Care in each year of this parliament.

We recognise recruitment into General Practice is an on-going challenge. We are supporting health boards to encourage GP recruitment and retention with a number of short and long term investments. We are investing £85 million over three years to develop Primary Care workforce and infrastructure. Additionally, in March we announced a further £20 million investment to ease workforce pressures over the next year.

We are testing community hub models in NHS Forth Valley and NHS Fife. By offering community hub fellowships in Fife and Forth Valley we have been able to attract young, recently qualified GPs to areas to which it has previously been difficult to recruit through the offer of portfolio careers and extended roles in the hubs.