Chamber and committees

Thank you. The convener is giving me the eye, so I think that I should make that my final question.

You said that cervical cancer screening uptake has reduced, but I am aware that there is self-sampling research going on now, and there is also research about urine testing for the human papillomavirus. Would that help? It is less invasive than traditional screening, so can we chivvy along that research so that we can also use either self-sampling or urine testing to screen people?

I have a quick question for Max Warner, as I am conscious that he has not said a lot.

Good morning to you all. I am interested in the good work that is being done on establishing rapid cancer diagnostic services. They were launched in Dumfries and Galloway, Ayrshire and Arran, Lanarkshire and the Borders in 2021, since when the uptake for bowel cancer screening seems to have become the highest ever in Scotland.

On 30 April 2022, there was a 67 per cent uptake in people returning their bowel screening kits, which is the highest in the programme’s history. Do we have enough data about breast screening, bowel screening and other screening uptake and how that leads to the requirement for intervention? I am looking at Katie Cuthbertson, because I got most of that information from the centre for sustainable delivery.

I must remind everybody that I am still a registered nurse, and I worked in the operating theatre and recovery room in NHS Dumfries and Galloway. I am looking at information that says that patients are sicker than they were pre-pandemic and that they have multiple comorbidities. How does making a patient ready for surgery affect waiting times and preparation? Is that a factor that we need to think about? I see Peter Hastie, Katie Cuthbertson and Professor Din nodding.

You have answered a lot of questions about cancer treatment waiting times, and we have said a little about pre-operative screening. I would like to pick up on what Sandesh Gulhane said about the perioperative environment, I have worked there, so I know that you need lab and X-ray support, recovery rooms and pre-operative support. That is why elective surgeries are not done at 10 o’clock at night. The capacity of the perioperative environment depends on the wider team. I know orthopaedic surgeons who would be really happy to just do arthroscopies and hips and knees all day, but the wider team is required for those.

Where should there be improvements? What could be done to improve cancer treatment approaches? We have addressed the diagnostic part, but then there is intervention. We might need more CT scanners, but we also need people to read the scans and diagnose patients from them. The situation is complex, but can you suggest anything that could be done differently? I will come first to Katie Cuthbertson and then to Professor Din.

I am interested in the improvement plan, which has been updated for 2023 to 2027. I would like to hear your thoughts about how that update is different to previous plans. Does it allow people to have more choice about and control of the plans for their care?

I want to ask about technological innovation and the use of artificial intelligence, which could help to reduce bed days, for instance. Last week Dr Tom Mackay, Catherine Kelly and Dr Mary Melville from NHS Borders gave a presentation to the lung health cross-party group, which I co-convene, about keeping chronic obstructive pulmonary disease and asthma patients out of hospital. They showed us that, among that small amount of patients, the implementation of artificial intelligence technology saved 236 bed days and removed the need for patients in remote and rural areas to have to make 50-mile or 100-mile round trips to get to hospital. I should say that patients in the NHS Dumfries and Galloway area have to travel similar distances.

What are your thoughts about the implementation of technology such as AI for out-of-hospital assessments, and can you tell us what other exciting technology is out there? We know that there are research studies about using such technology to examine X-rays to diagnose lung cancer, for instance. I would be interested to hear about something positive as we look at helping our NHS to address waiting times and so on.

The data in Public Health Scotland’s dashboard is really helpful. We can look at the data for all of Scotland or break it down by age group, choice of option or local authority. It shows that people up to the age of 18 have predominantly chosen option 1, which is direct payment, and that most people over 18 have chosen the option that involves help from the local authority or a combination. I found all that data interesting when I was analysing it.

I learned previously that people do not really equate self-directed support with what the local authority gives them. They say, “The local authority is doing this for me,” rather than, “This was my choice.” Should we in some way enhance people’s knowledge about what the self-directed support options 1, 2, 3 and 4 are so that people know that they are making a personal choice even if they have chosen the local authority option?

In each of your organisations, there are budgetary constraints. You have mentioned that already. Would any of you be happy to tell us about a good example of work that your organisation is doing to achieve the revised plan outcomes?