Chamber and committees

Challenges in delivering healthcare vary across Scotland due to population needs, as a result there is not a one-size fits all solution.

Work is already underway to progress reforms to ensure long-term sustainability, reduce health inequalities, deliver services closer to home, further harness the benefits of digital technology, and improve population health outcomes in Scotland.

To support sustainability of acute health services within remote, rural and island communities, we have convened an NHS Board-led working group which is working to develop a framework for delivery of health services in rural and island areas and considering how best to deliver the right care in the right place.

This group will determine a framework for the delivery of sustainable care for our rural and island communities, supporting effective local decision making while allowing service design and delivery to be adapted to place-specific needs and circumstances.

The Scottish Government published our Cancer Strategy for Scotland 2023-2033 along with an initial three year Cancer Action Plan for Scotland 2023 – 2026 in June 2023. Over a 10-year period, our strategic aim is to improve cancer survival and provide excellent, equitably accessible care.

The strategy and plan have a focus on reducing inequities in access to cancer care and cancer outcomes. This means treatment and care will be equally good wherever anyone lives and whoever they are. Actions to tackle inequalities are incorporated into other ambitions in the action plan.

The Scottish Government is looking to improve our understanding of the experience of people with cancer living in rural and island communities. Examples include an independent evaluation of their access to cancer care services, and a research programme on rural healthcare funded by the Chief Scientist Office.

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.

Our vision is for ‘a Scotland where people live longer, healthy and fulfilling lives.’ is supported by four key areas of work: improving population health, a focus on prevention and early intervention, providing quality services, and maximising access, all underpinned by a person-centred approach.

The majority of health boards across Scotland have all, or some of their constituent population in a rural area. Health Boards and Health and Social Care Partnerships take account of the diverse needs of their populations and plan their service provision according to that need.

Officials engage with Health Boards and HSCPs on a regular basis to review health outcomes.

I refer the member to the answer to the question S6W-33527 on 27 January 2025. All answers to written Parliamentary Questions are available on the Parliament’s website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

The Scottish Government does not hold information on how many GP practices in rural areas have closed in each of the last five years. NHS Boards are responsible for managing their contracts with GP practices and determining, with Health & Social Care Partnerships, whether to replace any practices that have closed.

Policy development was taken forward to determine which courses were available. It was concluded that, due to a number of factors, that it would not be taken further, not least due to the inhibitions of the current devolution settlement.

The Scottish Government’s role is to set the strategic policy for the NHS in Scotland, NHS Boards are responsible for service delivery. All Health Boards should consider patient transport needs when they plan and deliver services.

On 30 October, the Scottish Government published the Transport to Health delivery plan which sets out commitments against transport and healthcare across the work of Health and Social Care and Transport Scotland. The plan was informed by the 2019 Transport to health and social care report prepared by the Mobility and Access Committee for Scotland (MACS) on behalf of Ministers.

As set out in the plan, we will continue to use the NHS annual delivery plans to re-emphasise the need for Health Boards to consider patient access as part of the care pathway and reflecting the opportunity that is emerging for reducing the number of patient journeys through alternative options.

I refer the member to the answer to the question S6W-33695 on 27 January 2025.

In addition, the Scottish Government has not received correspondence with regards access to community optometry services for children living in rural and remote areas.

All answers to written Parliamentary Questions are available on the Parliament’s website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

The National Health Service (General Ophthalmic Services) (Scotland) Regulations 2006, as amended, do not require community optometry practices to be accessible for disabled people. However, the majority of practices are accessible. Where they are not, the Scottish Government provides an additional fee to practices for the provision of domiciliary care to eligible patients.

NHS Board’s baseline revenue allocations are set out annually in the Scottish Budget, as published on the Scottish Government’s website. In addition, resource and capital spending limits are reported in Board’s annual accounts, which are published on their websites.

The Scottish Government allocates funding to territorial NHS Boards based on the NRAC formula. The NRAC formula takes into account factors in addition to population levels, including excess costs of delivering healthcare in remote and rural areas.

Since 2006-07, baseline funding for health and social care has increased by 120% in cash terms and 37% in real terms.

Since 2012-13, over £3.5 billion of additional funding has been committed to those NHS Boards below their NRAC parity levels, ensuring all Boards remain within 0.6% of parity.

More information on the NRAC formula is available at: Resource Allocation Formula in Scotland - Finance - Data & intelligence from PHS (isdscotland.org)