Chamber and committees

The Scottish Government considers the varying needs of all parts of our population when developing plans and strategies, including the needs of people living in rural and island areas. We recognise that our rural and island communities have specific, place-based needs when it comes to the effective delivery of public services, including healthcare.

That is why we have established an NHS Board-led working group which is considering ways to improve delivery of safe, quality and sustainable healthcare services across rural and island Scotland.

More broadly, work is underway to develop a systematic approach to mainstreaming rural policy, the Rural Assessment Toolkit, which will support identifying and addressing the needs of rural communities and economies in our work.

Under the Islands Act 2018, the Scottish Government has a duty to consider issues that affect island communities in the development and delivery of all policies, strategies and services. We are also working with island communities and local authorities to develop a new National Islands Plan to be published later this year.

These workstreams support our endeavours to meaningfully improve outcomes for our rural and island communities across portfolios.

We are committed to supporting Scotland’s workforce develop the skills needed for the clean heat transition. We have invested in a mobile training centre, launched in August 2023, for heat pump installation to ensure training is equally available across all locations. We also support clean heat installers through our Low Carbon Skills Grant which funds heat pump training in colleges across Scotland. It allows heating and plumbing apprentices to include heat pump training modules as part of their qualification at no additional cost to their employer. A number of colleges with likely rural catchments have delivered these modules.

The requested information on what percentage of healthcare staff currently working in rural areas are locum staff, broken down by NHS board is not centrally held.

The Scottish Government have a number of initiatives already in place to attract healthcare professionals to rural areas, including Aberdeenshire.

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 support Regional Transport Partnerships to develop their own plans around Transport to Health. An example of this will be continuing to support the work of the Health and Transport Action Plan led by NESTRANS and partners in Aberdeenshire.

Transport Scotland have included Transport to Health as one of seven thematic workstreams in their approach for delivery of the Accessible Travel Framework.

Throughout NHS Scotland, patients who require urgent or emergency surgery will always be given clinical priority as determined by the clinicians involved in their treatment and care.

In the event that a patient requires transport to an appropriate facility for treatment, there are several resources available including the Scottish Ambulance Service’s patient transport service for scheduled care, or emergency ambulance for life threatening incidents. Scotland’s rural communities are also supported by air assets from the Scottish Ambulance Service (helicopters in Inverness and Glasgow), Scottish Charity Air Ambulance (helicopters in Aberdeen and Perth) and HM Coastguard helicopters based at Prestwick, Inverness, Stornoway and Sumburgh in Shetland.

This year we invested £30m which is driving targeted action to address the longest delays. This will see around 24,000 New Outpatient Appointments and Inpatient/ Day-Case procedures as well as over 40,000 diagnostic procedures. The funding has included diagnostic services in NHS Grampian, NHS Shetland and NHS Orkney.

The Scottish Government does not share this view.

This morning, the First Minister will set out our plans for NHS Scotland renewal, delivered at pace and scale.

The NHS is the largest and most treasured public service we have. However, years of Westminster austerity and pandemic recovery have placed more pressure on our NHS than ever before and action is needed now to ensure it is supported to meet these demands. That is why we will take bold and ambitious steps to reform and renew our health service and deliver the change that people in Scotland need.

At the heart of this plan is action to reduce waiting times, making sure people get high quality care, more quickly. We will increase capacity across Scotland, adopting regional delivery models and enhancing how we use our National Treatment Centres. We will support people to travel for treatment, in line with their needs.

A key requirement of this approach is that we have a person-centred, cohesive healthcare system that is built around the patient journey, ensuring appropriate care is provided at home and in community, primary and secondary care settings.

We will set out more details in an operational improvement plan that will be published in March and will be a precursor to a Population Health Framework we will bring forward in Spring.

1. Improving access to treatment

We will reduce waiting times ensuring that by March 2026 no one is waiting longer than a year for their treatment as we recognise that for many, waits for treatments are far too long. We will deliver this by:

• Increasing capacity: Optimising National and Regional working we will deliver over 150,000 extra appointments and procedures in 2025/26. We will increase capacity through the National Treatment Centres across Scotland, which will see activity rise from just over 20,000 in 2024/25 to well over 30,000 in 2025/26. We will also use sites in Health Boards to protect planned care activity for specific specialities, including investment in Gartnaval and Inverclyde, Perth Royal Infirmary, Queen Margaret Hospital and Stracathro in NHS Tayside – these sites alone will deliver more than 2,500 additional orthopaedic appointments and procedures and 9,500 additional cataract procedures per year.
• Reducing the radiology backlog so that 95% of referrals are seen within six weeks by March 2026, through expanding to seven day services, recruitment, and utilising mobile scanning units.
• Rolling out a new Digital Dermatology Pathway in all general practitioners across Scotland by Spring 2025. Evidence suggests that this will allow around 50% of referrals to be able to be returned to the GP, with advice or re-assurance, without the patient having to wait for an appointment.
• Expanding the Rapid Cancer Diagnostic Services: The sixth service in Forth Valley opens in the Spring 2025 for those patients with non-specific symptoms of cancer, continuing to prioritise new patients. We will continue to work with Health Boards to further expand these service pathways to ensure population coverage.
• Reducing the pressure in our Hospitals: We will take action to free up capacity and reduce occupancy levels to get our acute hospitals working towards an optimal level for quality and patient flow of 85%. This will include reducing delayed discharges, increasing the number of short stays and reducing people staying in hospital over 14 days.
• Clear Child and Adolescent Mental Health Services (CAMHS) backlogs, and meet the 18-week target nationally by December 2025, ensuring children and their families get the support they need.

2. Shifting the balance of care

We will take clear action to ensure people receive the right care in the right place recognising that acute hospitals is not always best for patients or their family. This will include making it easier to see a first point of contact with the NHS (for example a general practice team, dentist, optometrist or community pharmacist).

• Hospital at home: we will expand the combined number of Hospital at Home and virtual beds to at least 2,000 by December 2026 or sooner if possible. This will include expanding the type and coverage of treatment people can expect to allow more people to receive care and treatment at home rather than in hospital.
• Frailty: we will deliver direct access to specialist Frailty teams in every Emergency Department by summer 2025. This will enable people who experience frailty to be referred directly by GPs and the Scottish Ambulance Service to specialist frailty services as an alternative to admission or attending A&E .
• Access to GPs and other primary and community care clinicians: we will increase the capacity in general practice and develop a new quality framework this year to make GP services more consistent across Scotland, so everyone can rely on getting the care they need, no matter where they live. We want to make it easier to get an appointment with a GP, reduce the 8am rush for appointments, and enable people to see and build a relationship with the same clinician when it matters.
• Eyecare: we will deliver a new acute anterior eye condition service during 2025, which, together with the impact of the Community Glaucoma Service, when fully rolled out will free up a combined 40,000 hospital appointments per year.
• Pharmacy: expanding the NHS Scotland Pharmacy First Service so that community pharmacies can treat a greater number of clinical conditions, such as sinusitis and sore throats, and prevent the need for a GP visit.
• Dentistry: we will further strengthen primary care dental services through targeted investment in the workforce to improve capacity and patient access in the short to medium-term, including a 7% increase in student numbers from September 2025. We will also review existing incentives for rural practices, supporting workforce sustainability across Scotland.

3. Improving access to health and social care services through digital and technological innovation

People rightly expect to have a more modern and easier experience when interacting with their health and care services, so we will deliver a stronger digital first approach to the delivery of all our health and social care services. This will include:

• A new online app for health and social care: we will bring forward delivery and begin to roll this out from December 2025, starting in Lanarkshire, so people can securely access and manage their hospital appointments online, receive communications, find local services and access and update their personal information.
• Build on digital platforms to increase operating theatre capacity: By June 2025, we will roll out a theatre scheduling tool that has been shown to increase productivity in operating theatres by 20% making it easier for people to get their treatment quicker.
• Adopt new innovations: Before the end of 2025-26, we will start using genetic testing to deliver improved clinical outcomes and target medications, for recent stroke patients and newborn babies with bacterial infections. We will also support 3,000 people newly diagnosed with type 2 diabetes over the next three years with a new national digital intensive weight management programme to put their type 2 diabetes into remission.

4. Prevention – ensuring we work with people to prevent illness and more proactively meet their needs.

Scotland has a long and proud history of progressive public health action. From the first UK nation to ban smoking in public places almost twenty years ago to the first country in the world to uprate a Minimum Unit Price for alcohol five months ago. Although treating ill health across the population is essential, we want to do more to detect and prevent ill health before it happens - improving health for people and reducing demand on our health and care services. We will therefore build on this progress to:

• Publish a new Population Health Framework by Spring 2025 : a long term approach to primary prevention that we are developing with our NHS, Local Government, community and voluntary sectors and business.
• Publish our medium term approach to health and social care reform before summer Parliament recess: This will build on the vision set out by the Cabinet Secretary in June and the actions outlined here and demonstrating how we plan our services for our whole population over the period 2025-2030.
• Proactive prevention: we will immediately invest in general practice and community-based teams to enable more proactive outreach in areas of greatest need and work with people who have a high risk of Cardio Vascular Disease (CVD) or frailty, to reduce their risk. Alongside this enhanced service commencing in April 2025, our wider CVD Risk Factors programme will support people to reduce key risk factors including high blood pressure, high cholesterol, high blood sugar, obesity and smoking.

We have already invested £30 million to reduce waiting lists that built up throughout the pandemic. This funding is being targeted at a series of national and local plans to reduce backlogs by maximising the use of local and national resources across Scotland. As part of this, we have allocated additional funding to Gynaecology services which we expect to deliver around 3,500 new outpatient appointments.

The Budget we set out on 4 December 2024 will throw the weight of the government behind performance improvements with almost £200 million to reduce waiting lists and help support reduction of delayed discharge. By March 2026, we expect no one to be waiting longer than 12 months for a new outpatient, inpatient treatment or day case treatment.

With regards to the average wait times across all boards compared with waiting times in rural areas such as Aberdeenshire, this information requested is not held centrally by the Scottish Government the member may wish to contact NHS Grampian directly for information.