Chamber and committees

The Scottish Government supports NHS Health Boards in their efforts to ensure that they have the right staff in place to meet the healthcare needs of the local population.

Staffing levels within NHS Grampian have increased by 7.1 % under this Government, rising from 11,203.3 WTE as at Sept 2006 to 11,994.6 WTE as at Sept 2017. While there has been a slight decrease in NHS Grampian workforce, down 0.4%, in the last year, we are confident the steps we are taking to improve workforce planning arrangements will directly benefit NHS Grampian, its workforce and patients.

We are committed to pursuing a twin-approach of investment and reform. We have increased NHS Grampian’s resource budget by over £315 million (since 2006-2007), which has supported the recruitment of over 800 staff, including clinical and nursing staff.

Nevertheless, we recognise that Health Boards in the North and North East of Scotland face recruitment and retention challenges. Through workforce planning activity we support remote and rural recruitment in a number of ways and would encourage Boards to make full use of all tools available, including the Shortage Occupation Lists, as appropriate.

The NRAC formula reflects the most objective measure of funding equity we have developed. The formula is kept under continuous review by experts to ensure it remains a robust and equitable method of allocating health service funding.

NHS Grampian was 3.7% behind its target funding allocation when the NRAC formula was introduced in 2009-10. The Scottish Government has invested significantly in supporting the Boards that are behind parity and, since 2015-16, NHS Grampian has received additional funding of £47 million for the specific purpose of accelerating NRAC parity, and will receive a further £5 million in 2018-19 to support a further move towards parity.

As with all NHS Boards, we are continuing to work with NHS Grampian to ensure public money is being used effectively to deliver better services, better care and better value. NHS Grampian has received a £4.9 million share of the £50 million made available in May 2017 to improve waiting times performance for all parts of the patient journey. This is supported by the Access Collaborative which brings together clinicians, staff and patients to help reduce planned waiting times by improving communications between community and hospital staff to identify the right treatments, and streamline patient care.

Grampian will also receive a share of the £8.4 million announced on 11 December. This additional investment will enhance resilience ahead of the busy Christmas and New Year period.

We expect all Health Boards, including NHS Grampian, to meet and maintain national performance targets and standards from the resources provided.

The Scottish Fiscal Commission is responsible for producing independent economic and fiscal forecasts to inform the Scottish Budget. The Scottish Government has set out its plans for supporting the economy and enabling inclusive growth in the Draft Budget 2018-19. Spending on the economy will increase by £270 million next year, and investment in City Region Deals will double. The government is supporting public sector pay by lifting the 1% public sector pay cap, and the reforms to income tax mean that the majority of tax payers will be paying slightly less tax next year.

In 2018-19 NHS Grampian will receive a baseline funding uplift of £18.5 million, and a share of the £175 million increase in funding for reform, which includes a £17m increase for Mental Health and CAMHS services. NHS Grampian is also benefiting from a share of the £150 million investment in mental services which we are making over a five year period.

We expect all Health Boards, including NHS Grampian, to meet and maintain national performance targets and standards from the resources provided. The Scottish Government remain determined to hit our target of 90% of people seen within 18 weeks from referral to treatment for Psychological Therapies. We will continue to work with Boards to make sure that happens right across Scotland.

The Scottish Fiscal Commission is responsible for producing independent economic and fiscal forecasts to inform the Scottish Budget.

The SFC’s forecasts are informed by judgements on overall macroeconomic conditions across the Scottish and UK economy. The SFC’s recently published forecast highlights Brexit as one of the downside risks facing the Scottish economy across the forecast period alongside generally tightening fiscal policy from the UK Government, and the contractionary direction of monetary policy.

Latest published figures for psychological therapies waiting times across Scotland indicate that the average waiting time was 7 weeks compared with 13 weeks in NHS Grampian. While the average wait in NHS Grampian is higher than the national average this is still within the 18 waiting times standard. Where patients are waiting longer these are typically complex cases requiring multi-agency interventions. We want to reach a position where people receive the appropriate support and treatment according to their clinical need and in line with clinical good practice.

The £7 billion figure referred to in the question would appear to have been calculated using turnover data from the Scottish Government Business in Scotland 2017 publication. The primary purpose of this publication is to provide information about the number of enterprises operating in Scotland as at March each year. The Inter-Departmental Business Register (IDBR) is the main data source for the publication. The IDBR is a database of all businesses registered for VAT and/or PAYE, maintained by the Office for National Statistics.

The latest Businesses in Scotland 2017 publication is based on a snapshot of the IDBR as at March 2017. However, there are significant time lags associated with the IDBR employment and turnover data. On the IDBR, turnover for the majority of registered enterprises is based on VAT returns for a 12 month period. For 2017, these tend to relate to a 12 month period ending in December 2015, or January/February 2016, depending on the reporting pattern of the business. More information on this is available at: http://www.gov.scot/Topics/Statistics/Browse/Business/Corporate/Methodology

The latest Oil and Gas Production Statistics include the period 2016-17, which saw a year-on-year increase in the approximate sales value of oil and gas by 15.2%. This increase reversed four years of approximate sales value declines and was largely due to the increase in the wholesale price of oil across this period, complimented by small increases in production. This figure is more up to date than the turnover information provided in the Businesses in Scotland 2017 publication for the reasons listed above. More information on the Oil and Gas Production Statistics 2016-17 is available at: http://www.gov.scot/Topics/Statistics/Browse/Economy/oilgas1617

The psychological therapies waiting times standard was introduced in 2014 as an improvement target and we have seen significant progress since then with much more robust and transparent data. The continued and substantial increase in demand for services clearly shows that in the past there were far too many people who were unseen, and whose need was unmet. As the capacity and provision of services have increased we are have seen more people accessing treatment each quarter and this should be welcomed.

In order to meet the target, Boards will need to have in place services that meet the full range of people’s needs, including lower-intensity interventions that can prevent people needing to access higher intensity treatments such as psychological therapies. It will also require all areas of mental health services to be working effectively together. We remain determined that we will hit our 90 per cent target and we will continue to work with Boards to make sure that happens right across Scotland.

The National Records of Scotland project that based on current trends, the population of Scotland will rise to 5.7 million by 2039, and that the population will age significantly, with the number of people aged 65 and over increasing by 53% between 2014 and 2039. The number of people of pensionable age per 1000 people of working age is projected to increase from 311 in 2015 to 397 in 2039. This will present a number of challenges in terms of both the structure of the economy, and the way we innovate to deliver public services to meet these demands.

The Scottish Government ‘s Economic Strategy (2015) sets out our approach to ensuring that our labour market, our public services and welfare system are resilient and successful both now and in the future. In turn, Scotland’s Labour Market Strategy (2016) builds on the Economic Strategy and highlights the link between employment and improving outcomes across a number of dimensions of Scotland’s social and economic performance. Taking account of changing demographics and ensuring our labour market is able to respond to new demand on both public services and welfare is a key part of this co-ordinated response.

The Scottish Government remain determined to hit the target of 90% of people seen within 18 weeks from referral to treatment for Psychological Therapies. We will continue to work with Boards, including NHS Grampian, to make sure that happens right across Scotland.

As part of the £54.1m package of support announced by the First Minister in January 2016, £24.6 million has been awarded to NHS Education Scotland (NES) to improve workforce supply and train existing staff to deliver services for children and young people, as well as psychological therapies for all ages.

Following a series of commissioning visits, in June 2016 NES wrote to all Boards setting out an individual, tailored offer of funding and workforce development. A significant proportion of the funding from NES is for service posts, intended to support service delivery by providing training, coaching and supervision in evidence-based interventions. This package of funding also includes £24.7m to be provided to NHS Boards to improve their capacity to see more people more quickly, which could include additional staff, with NHS Grampian receiving an allocation totalling £427,219 in the first year.

In addition funding will reach £35 million by 2022 for 800 additional mental health workers in key settings such as GP surgeries, ensuring local provision and support is at the heart of our plans.