Chamber and committees

Appraisal support

To support GP’s in preparing for appraisal the Scottish Government (SG) has funded a series of workshops delivered by NHS Education for Scotland (NES). They have been available across Scotland free of charge with reimbursement of backfill costs for their practice where required. The workshops have been well attended and well received. One of the main aims of the workshop is to reduce perceptions of appraisal as a burden to practitioners.

A wide demographic of participants have taken part, including newly qualified GPs and those with more experience. Each cohort of delegates and their learning needs will be very different, the facilitators are required to be flexible and responsive to this, adapting content and delivery style as required.

Another facility to support GPs is the GP Coaching Service . This scheme, launched in 2018, is also funded by SG and hosted by NES. It is aimed at GPs either experiencing difficulty with some of the challenges of GP practice in Scotland, at a crossroads in their career or thinking of leaving. It provides a wholly safe and confidential space that is tailored to the needs of the GP. The coaches are all professionally qualified and experienced in coaching individuals from all professions within the health service.

Service to supportdoctors physical and mental wellbeing

The General Medical Council (GMC) is undertaking a UK-wide review into the health and wellbeing of the medical profession. A Scottish unit has been setup within the wider UK work and is co-chaired by the GMC and Mr David Garbutt, Chair of NES. Along with the GMC and NES, stakeholders of this Scottish group include the SG, British Medical Association Scotland, the Academy of Medical Royal Colleges in Scotland, and many of the individual Royal Colleges in Scotland.

The aim of this group is to begin initiatives that seek to remedy the causes of ill health and poor wellbeing in doctors in Scotland with immediate effect. One of the work streams is to develop a proposal for a service in Scotland for unwell doctors akin to the successful Practitioner Health Programme and GP Health Service in England. The work on this proposal is currently being undertaken by stakeholders of the Scottish GMC Advisory Group and will be presented to the Scottish Government in the coming months.

As I stated in Parliament on 24 April 2019, the Scottish Government is currently working with the RCGP and others to consider how this proposal might best be taken forward.

The Scottish Government is increasing investment in primary care by £500 million over the lifetime of the Parliament. This will take spending on primary care to at least £1.28 billion and to 11% of the frontline NHS budget by 2021-22. As part of this commitment, £250 million will be in direct support of general practice.

Scotland’s Digital Health and Care Strategy, published last year, commits to putting in place the underpinning architectural and information governance building blocks for the effective flow of information across the whole care system. Work is already under way to tackle recognised issues such as interoperability, accessibility and reliability, including commencing work to deliver a new national digital platform. We have also developed, in consultation with Primary Care stakeholders such as the RCGP, a new £65 million GP IT systems contract (confirmed in February this year) that will deliver enhanced functionality and clinical and service benefits to GPs and patients from its first phase in mid-2020.

Schedule 1 of the Private Housing (Tenancies) (Scotland) Act 2016 (‘the Act’) sets out a list of Tenancies which cannot be private residential tenancies ( http://www.legislation.gov.uk/asp/2016/19/schedule/1/enacted ).

The Private Residential Tenancy replaces the Assured Tenancy system set out in the Housing (Scotland) Act 1988. Accommodation provided to students by a specified educational institution was exempt from the Assured and Short Assured Tenancy regime under the terms of the 1988 Act, and this is the same under the 2016 Act. Purpose built student accommodation (PBSA) is also exempt from the private residential tenancy because it does not form part of the mainstream PRS, as PBSA providers effectively act as private providers of ‘halls of residence’ accommodation. This enables PBSA providers to continue to fulfil their obligations under nomination agreements to accommodate students from Higher and Further Education Institutions.

The specific provisions set out in the 2016 Act relating to PBSA are to ensure that only a specific type of student let is exempt from the new tenancy. The Act sets out that student accommodation is exempt if the planning permission for that accommodation stipulates that it has to be used predominately for housing students; and the provider of the accommodation has at least 30 bedrooms in one building, or as part of a complex. Any other student let, which does not have the characteristics as set out in Schedule 1 of the 2016 Act, will not be exempt from the private residential tenancy regime.

The matter of who a landlord lets to would be an individual issue for them to consider, taking into account any other restrictions or agreements which they or the property may be subject to.

The intention behind setting a condition of a minimum number of bedrooms within Purpose Built Student Accommodation (PBSA), is to clearly distinguish PBSA accommodation from large flats let to students by landlords who are not PBSA providers. During the passage of the Private Housing (Tenancies) (Scotland) Bill through Parliament, a Stage Three amendment was brought forward which saw the minimum number of bedrooms within the definition of PBSA, increase from 15 to 30.

Research, at the time, found that the smallest PBSA building in Scotland housed
‎ 35 students and therefore a minimum of 30 bedrooms was found to be a reasonable limit in order to distinguish PBSA from normal Houses in Multiple Occupation (HMO) properties, that students often share. Landlords of students who live in properties in the mainstream private rented sector (including HMOs) do not have the same obligations as PBSA landlords to provide term time accommodation for Higher and Further Education Institutions. Students living in mainstream rented properties are not a homogenous group, and so Parliament confirmed the Scottish Government’s policy approach that they must be afforded the same level of security as other tenants living in the sector.

The Scottish Government currently have no plans to amend section 5(4)(b) of Schedule 1 of the Act.

Ocrevus (ocrelizumab) was accepted by the Scottish Medicines Consortium (SMC) in December 2018 for restricted use in adult patients with relapsing forms of multiple sclerosis where the patient has active disease.

The Scottish Government hopes to see a further submission from the manufacturer, Roche, to the SMC at the earliest opportunity for the primary progressive multiple sclerosis indication and we are aware that the SMC has been in regular contact with the manufacturer regarding their submission plans.

It should be noted that the decision to make a submission to the SMC is purely one for the manufacturer. SMC decisions are made independently of Ministers and the Scottish Parliament, which is important because it means that decisions on whether to accept newly licensed medicines are based on clinical and cost-effectiveness at a national population level for all Scotland.

The SG agrees that access to the medical profession, including GP, must be widened.

That is why we are taking forward a number of actions that will contribute towards a more secure and sustainable medical workforce which is more representative of the communities it serves.

We have invested £23 million in the medical education package. 50 additional ring fenced widening access places focused on SIMD 20 applicants were added in 2016. Two pre-medical entry programmes for those from less advantaged backgrounds commenced in 2017 with 40 places. Places have been increased to 50 for 2019 following the success of the first year of the programme.

There is emerging evidence that that widening access students are more likely to proceed directly to specialty training and more likely to become GPs.

I refer the member to the answer to question S5W-23664 on 13 June 2019. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx

The Scottish Government agrees with the College that there’s a need to enhance the quality, content and locations in which competency-based GP training is delivered, and work is already underway to deliver such improvements, within the existing GMC-approved 3 year training programme, with a particular focus on acquiring the relevant capabilities defined by the College and required by the GMC.

We are also supporting a number of pilots designed to enhance the competencies of GPs to assist them become more competent, confident practitioners with the skills to work within integrated care services. The emphasis is on GPs who have completed their training, thereby meeting the increasing demand for more flexible career options, complementing integrated service delivery models, and helping to support retention. The pilots will be evaluated and the results shared.

The Scottish Government also agrees with the need to increase the learning time medical undergraduates spend within GP practices, but this is dependent on a range of factors, and is an issue under active consideration by the increasing undergraduate education in primary care group Chaired by Dr John Gillies, and which is due to report shortly.