Chamber and committees

The Scottish Government is resolute in its continuing commitment to the Act and its principles. A successful Implementation will only be achieved through the co-production of the relevant stakeholders. Their focus has naturally been on responding to the challenges presented by the pandemic.

As services remobilise we are re-engaging with stakeholders to ensure implementation takes account of the learning developed during the pandemic and recognises the new environment within which services will now operate.

Tables 1 and 2 present the number of patients covered by the Treatment Time Guarantee (TTG) waiting within an inpatient or day-case setting by NHS Board at 31 December 2021, and the number waiting over 1, 2 and 3 years for a hip or knee replacement procedure, respectively.

Table 1: Number of patients waiting for a hip replacement procedure 1,2 as an inpatient or day case at 31 st December 2021, broken down by NHS Board of treatment and length of wait.

Clinical guideline implementation is the responsibility of NHS Boards. The ultimate decision about a particular clinical procedure or treatment will always depend on each individual patient’s condition, circumstances and wishes, and the clinical judgement of the healthcare team.

Scottish Intercollegiate Guidelines Network (SIGN) guidelines have primacy in Scotland however NHS Boards and Integration Authorities may also choose to consider National Institute for Health and Care Excellence (NICE) guidelines in the planning and delivering services. Where there is not a current SIGN guideline in place Boards are expected to use other guidelines, such as NICE.

The decision to create, update and/or replace any SIGN guideline is not made by Scottish Government, it is made independently by the Evidence Directorate Work Programme Committee in Healthcare Improvement Scotland (HIS). Proposed guidelines under consideration can be found on the SIGN website: Our guidelines (sign.ac.uk) .

Table 1 presents the number of patients covered by the Treatment Time Guarantee (TTG) waiting for a hip or knee replacement procedure within an inpatient or day-case setting by NHS Board at 31 st December 2021.

Table 1: Number of patients waiting for a hip or knee replacement procedure 1,2 as an inpatient or day case at 31 st December 2021, by NHS Board.

The Scottish Government and COSLA published a National Workforce Strategy on 11 March 2022. This Strategy sets out a new framework to shape Scotland’s Health and Social Care workforce over the next decade; which places training, wellbeing, job satisfaction and the principles of Fair Work at its heart.

The Scottish Government has not engaged with this organisation specifically but a collaborative partnership approach has been taken to develop the Strategy. We have engaged with key partners across Health and Social Care, including NHS Boards, Local Authority representation, third and independent sector and staff-side representation through the National Workforce Planning Group and the Scottish Partnership Forum.

Moving forward with implementation of the strategy, we have committed to continuing to work jointly with partners across Health and Social Care.

The Strategy commits to publishing new workforce growth projections in the autumn, once we have had the opportunity to consider Health Board and Health and Social Care Partnerships' three year workforce plans. The staffing needs for services and professional specialties across NHS Scotland will be, in partnership with stakeholders, factored into the development of those projections.

A procurement process is underway for a web-based PROMS system to track the condition of long-waiting patients. Information and resources are being updated on NHS inform, and some joint work is ongoing with Versus Arthritis.

Earlier this year, the Scottish Government announced an extra £240,000 through the Chronic Pain Winter Support Fund to help 13 Scottish Government-funded projects across Health Boards, third-sector and other partners to enhance the support available for people with chronic pain. The money will go towards a range of services for people experiencing painful conditions, including those with knee pain, and also provide support to help people remain physically active.

There are currently no plans to add fluoride to the public water supply nationally. However, the Water (Fluoridation) Act 1985 continues to enable Health Boards, with the support of local communities, to ask Scottish Water to introduce water fluoridation. Where a Health Board with the support of its local communities wishes to ask Scottish Water to fluoridate the water supply, Scottish Government would be supportive of such a move.

Financing for retrofitting will be largely dependent on the ownership of the buildings.

There are a number of potential sources of financing including those referenced in our Infrastructure Investment Plan published in February 2021 and the latest Infrastructure Investment Plan Programme Pipeline Update from September 2021.

I have frequent discussions with Ministerial colleagues on a range of matters. We are committed to reforming council tax to make it fairer, working with the Scottish Green Party and COSLA to oversee the development of effective deliberative engagement on sources of local government funding. including Council Tax, that will culminate in a Citizens' Assembly.

The Scottish Government does not hold information on how many older people who are in relative or absolute poverty have raised concerns about not being able to afford both heating and food this winter. The sources of information below provides indicators of levels of poverty; and engagement with stakeholder organisations.

Poverty and food insecurity

One indicator of levels of poverty and food insecurity is the latest Family Resources Survey (FRS). The most recent information available for 2019/20 showed that food insecurity rates for Scotland reflected those of the UK as a whole, and that the rate of food insecurity was lower for people over 65. Both the FRS and the 2020 Scottish Health Survey (SHeS) indicated rates of between 1% and 3% for over 65s, compared to 8% overall.

According to the FRS, around a quarter of people in both relative and absolute poverty were experiencing low, or very low food security. The relative poverty rate after housing costs for pensioners was 14% in 2017-20, or 150,000 pensioners each year - consistently below that for working-age adults (19%).

Fuel poverty

Data from the Scottish Government’s national Warmer Homes Scotland (WHS) scheme provides an indicator for those at risk of fuel poverty. The scheme is designed to help those living in or at risk of fuel poverty through installing insulation and heating measures into individual properties. Eligibility for the scheme is based on “proxies”, including certain benefits such as Employment Support Allowance (ESA) and Personal Independence Payment (PIP), which are an indication of the likelihood of the household living in or being at risk of fuel poverty.

Referrals to WHS during the period 1 November 2021 and 28 February 2022 are as follows.