Chamber and committees

We are working hard to abolish excessively long waits that have undoubtedly been exacerbated by the impacts of the global pandemic and we offer our sincere sympathies to all patients waiting for treatment.

Pausing of non-urgent activity during the pandemic has inevitably led to a build-up of numbers waiting for treatment, and the emergence of Omicron and the BA.2 sub-variant in late 2021 has undoubtedly added to existing significant pressure. We are working closely with NHS Boards to get those waiting for treatment the care they need as quickly as possible.

In order to support a sustainable reduction in the backlog of planned care procedures in Scotland, the Scottish Government published an NHS Recovery Plan in August 2021. Backed by over £1 billion of funding, this sets out our plans for health and social are over the next 5 years.

The NHS Recovery plan can be accessed here: NHS recovery plan - gov.scot (www.gov.scot)

We have invested £10 million in 21-22 to support cancer waiting times improvements. Latest data (Q4 2021) shows that the median wait for melanoma patients on the 62 day pathway (from urgent suspicion of cancer referral to treatment) is 27 days and 0 days for those on a 31 day pathway (from decision to treat, to first treatment).

We are also investing in our £44 million Detect Cancer Early Programme. The Detect Cancer Early website (getcheckedearly.org) features an interactive ‘symptom checker’ tool to raise awareness of the common signs and symptoms of cancer, including skin cancers to improve the likelihood of better outcomes for melanoma patients. To further improve diagnosis, Scotland’s first three Early Cancer Diagnostic Centres (ECDC) have been established. The Centres provide primary care with access to a new, person-centred fast-track diagnostic pathway for patients with non-specific symptoms (including weight loss, nausea, and fatigue) that are suspicious of cancer.

As part of our NHS Recovery Plan we are investing over £400m to create a network of 10 National Treatment Centres across Scotland, increasing capacity for over 40,000 additional planned elective procedures and diagnostic care across 12 specialities, including cancer treatments.

More specifically, the Centre for Sustainable Delivery manages a Dermatology work-stream, to improve patient pathways, experience and outcomes within the specialty. As part of this work they have committed to ongoing work in relation to Dermatology Nursing Education and working with the British Association of Dermatologists to ensure sustainability and to increase the range of pathways where primary care have access to high quality referral information from a single source.

Work is underway to develop a new cancer strategy for NHS Scotland. Ensuring cancer patients, including those affected by melanoma, have access to equitable, timely treatment will remain a priority.

The Scottish Government does not collect the detailed breakdowns of debts owed to Public Bodies. The information that is collected by Scottish Government will not necessarily distinguish between debts owed by individuals and debts owed by companies and other organisations.

Every Public Body produces and publishes an Annual Report and Accounts, and within this publication will report on amounts owed to them. The information within these accounts on debts owed to the Public Body may be at a relatively high level and may not distinguish between the different types of debt owed to them.

These annual accounts will normally be available online on the website of the individual entity. In the earlier period covered by the request – i.e. starting from 1999 – it may be necessary to approach the Public Bodies directly.

In August 2021 we published the NHS Recovery Plan, which set out actions and commitments that will support inpatient, daycase, and outpatient activity to address backlogs. This will be delivered through the implementation of sustainable improvements and new models of care. This includes the National Treatment Centre Programme, which will deliver capacity for ring-fenced elective activity. Four centres will open in the next year in NHS Fife, NHS Highland, NHS Forth Valley and NHS Golden Jubilee specialising in orthopaedics.

We recognise the impact long waiting times can have on a patient, from both a clinical and mental health perspective. At this stage in recovery from the pandemic, long waiting patients must now also be considered a priority. That is why earlier this month we updated the Clinical Prioritisation Framework to allow Health Boards the flexibility to treat the longest waiting patients in parallel with the most urgent. The expectation is that NHS Boards will follow the principles of this Framework to prioritise patients based on their particular clinical needs and those who have waited longest. This will allow NHS Board to ensure that the patients with the greatest needs are treated quickest.

Most Health Boards across NHS Scotland offer fast-track clinics for patients with an urgent suspicion of skin cancer, including malignant melanoma. We are supportive of coordinating tests where possible to support faster diagnosis and improve patient experience, which is why we are developing national optimal cancer diagnostic pathways.

£10 million was released in 21-22 to support the recovery and redesign of cancer pathways, including to support one-stop clinics, with similar levels of investment expected this year.

Meanwhile, we continue to support the Dermatology Consortium that are exploring solutions for the rapid diagnosis of skin cancer in NHS Scotland.

The pandemic has been the biggest shock our NHS has ever faced. It has necessitated the imposition of Infection Prevention Control measures in order to contain its spread, particularly prior to the vaccination programme being fully rolled out.

These IPC measures, which have recently been deescalated, changed the way GPs see their patients. The Scottish Government wants to see greater availability of face-to-face appointments and is working with the BMA and RCGP to ensure this happens as quickly as possible. However, Covid has not gone away yet, therefore some precautions remain in place. We are clear that where clinically necessary face-to-face consultations will always be available to those who need them.

We must continue to move toward a position where choice is being offered routinely, and the Scottish Government welcomes the GMC’s proposed changes to the Good Medical Practice guidance placing a greater emphasis on shared decision-making between GPs and their patients.

Many GP practices did offer patients video or phone consultations as well as in-person face-to-face consultations before the pandemic changed the balance and we expect a number of patients will wish to continue afterwards with video or phone consultations rather than travel to their GP practice. Ultimately, what is most important is that appointments are agreed through shared decision making, balancing patient choice and clinical judgement.

We continue to explore new ways and approaches to support people to, for example, upload an image of their skin condition for review. This can support people to seek advice in a way that best supports their needs and requirements whilst also ensuring they still have access to a face-to-face appointment.

All GP practices are expected to follow the Infection Prevention and Control Manual for in-person visits as well as their local Health Board's guidance.

Ensuring sufficient community pharmacy provision is the responsibility of NHS Health Boards in their local areas. Arrangements are set out in the NHS (Pharmaceutical Services) (Scotland) Regulations 2009 and decisions regarding pharmacy provision are made through a Board’s Pharmacy Practices Committee (PPC). The process is independent of Scottish Ministers and Government.

We are working hard to abolish excessively long waits that have undoubtedly been exacerbated by the impacts of the global pandemic and we offer our sincere sympathies to all patients waiting for treatment.

Pausing of non-urgent activity during the pandemic has inevitably led to a build-up of numbers waiting for treatment, and the emergence of Omicron and the BA.2 sub-variant in late 2021 has undoubtedly added to existing significant pressure. We are working closely with NHS Boards to get those waiting for treatment the care they need as quickly as possible.

In order to support a sustainable reduction in the backlog of planned care procedures in Scotland, the Scottish Government published an NHS Recovery Plan in August 2021. Backed by over £1 billion of funding, this sets out our plans for health and social are over the next 5 years.

The NHS Recovery plan can be accessed here: NHS recovery plan - gov.scot (www.gov.scot)

Public Health Scotland (PHS) uses the national waiting times warehouse to collect electronic patient records covering the waits that patients experience waiting for treatment as an inpatient or day case under the Treatment Time Guarantee. This data source can be used routinely to identify the specialty of treatment. However this information does not provide the level of detail requested.

More detailed information on the procedure(s) that is planned or undertaken for a patient will be held locally by NHS Boards.

Statistics relating to the waits patients experience for inpatient or day case treatment at specialty level are published up to 31 March 2022 and can be found using the link below:

https://publichealthscotland.scot/media/13252/ipdc_may22.xlsx

In accordance with waiting times guidance, cancellations resulting from hospital operational circumstances should not result in any detriment to the patient. The Scottish Government expects that NHS Boards will offer a rescheduled appointment as soon as possible to any patient within NHS Scotland who has had their operation cancelled.