Chamber and committees

In August 2021 we published the NHS Recovery Plan, which set out actions and commitments that will support inpatient, daycase, and outpatient activity to address backlogs. This will be delivered through the implementation of sustainable improvements and new models of care. This includes the National Treatment Centre Programme, which will deliver capacity for ring-fenced elective activity. Four centres will open in the next year in NHS Fife, NHS Highland, NHS Forth Valley and NHS Golden Jubilee specialising in orthopaedics.

We recognise the impact long waiting times can have on a patient, from both a clinical and mental health perspective. At this stage in recovery from the pandemic, long waiting patients must now also be considered a priority. That is why earlier this month we updated the Clinical Prioritisation Framework to allow Health Boards the flexibility to treat the longest waiting patients in parallel with the most urgent. The expectation is that NHS Boards will follow the principles of this Framework to prioritise patients based on their particular clinical needs and those who have waited longest. This will allow NHS Board to ensure that the patients with the greatest needs are treated quickest.

The pandemic has been the biggest shock our NHS has ever faced. It has necessitated the imposition of Infection Prevention Control measures in order to contain its spread, particularly prior to the vaccination programme being fully rolled out.

These IPC measures, which have recently been deescalated, changed the way GPs see their patients. The Scottish Government wants to see greater availability of face-to-face appointments and is working with the BMA and RCGP to ensure this happens as quickly as possible. However, Covid has not gone away yet, therefore some precautions remain in place. We are clear that where clinically necessary face-to-face consultations will always be available to those who need them.

We must continue to move toward a position where choice is being offered routinely, and the Scottish Government welcomes the GMC’s proposed changes to the Good Medical Practice guidance placing a greater emphasis on shared decision-making between GPs and their patients.

Many GP practices did offer patients video or phone consultations as well as in-person face-to-face consultations before the pandemic changed the balance and we expect a number of patients will wish to continue afterwards with video or phone consultations rather than travel to their GP practice. Ultimately, what is most important is that appointments are agreed through shared decision making, balancing patient choice and clinical judgement.

We continue to explore new ways and approaches to support people to, for example, upload an image of their skin condition for review. This can support people to seek advice in a way that best supports their needs and requirements whilst also ensuring they still have access to a face-to-face appointment.

All GP practices are expected to follow the Infection Prevention and Control Manual for in-person visits as well as their local Health Board's guidance.

The pandemic has been the biggest shock our NHS has ever faced. It has necessitated the imposition of Infection Prevention Control measures in order to contain its spread, particularly prior to the vaccination programme being fully rolled out.

These IPC measures, which have recently been deescalated, changed the way GPs see their patients. The Scottish Government wants to see greater availability of face-to-face appointments and is working with the BMA and RCGP to ensure this happens as quickly as possible. However, Covid has not gone away yet, therefore some precautions remain in place. We are clear that where clinically necessary face-to-face consultations will always be available to those who need them.

We must continue to move toward a position where choice is being offered routinely, and the Scottish Government welcomes the GMC’s proposed changes to the Good Medical Practice guidance placing a greater emphasis on shared decision-making between GPs and their patients.

Many GP practices did offer patients video or phone consultations as well as in-person face-to-face consultations before the pandemic changed the balance and we expect a number of patients will wish to continue afterwards with video or phone consultations rather than travel to their GP practice. Ultimately, what is most important is that appointments are agreed through shared decision making, balancing patient choice and clinical judgement.

We continue to explore new ways and approaches to support people to, for example, upload an image of their skin condition for review. This can support people to seek advice in a way that best supports their needs and requirements whilst also ensuring they still have access to a face-to-face appointment.

All GP practices are expected to follow the Infection Prevention and Control Manual for in-person visits as well as their local Health Board's guidance.

NHS Boards understand and communicate with patients the importance of keeping as fit and healthy as possible while waiting for joint replacement surgery. To support patients waiting and recovering from surgery, Boards and partner organisations offer a range of support including pain management, mental health, physiotherapy, access to leisure services, weight management and financial support. Information and advice is also available through online platforms like NHS Inform.

We also work in close partnership with third-sector organisations who provide a wealth of knowledge and care though lived experience which many patients value. Charities such as Versus Arthritis also offer support to those awaiting treatment, including advice, information and practical help to manage the impact of musculoskeletal pain on people’s wellbeing. They also provide peer-led support such as walking groups and tai chi in local areas which enable people to improve their physical fitness and maintain their mental health and quality of life both before and after treatment.

We are working hard to abolish excessively long waits that have undoubtedly been exacerbated by the impacts of the global pandemic and we offer our sincere sympathies to all patients waiting for treatment.

Pausing of non-urgent activity during the pandemic has inevitably led to a build-up of numbers waiting for treatment, and the emergence of Omicron and the BA.2 sub-variant in late 2021 has undoubtedly added to existing significant pressure. We are working closely with NHS Boards to get those waiting for treatment the care they need as quickly as possible.

In order to support a sustainable reduction in the backlog of planned care procedures in Scotland, the Scottish Government published an NHS Recovery Plan in August 2021. Backed by over £1 billion of funding, this sets out our plans for health and social are over the next 5 years.

The NHS Recovery plan can be accessed here: NHS recovery plan - gov.scot (www.gov.scot)

I refer the member to the answer to question S6W-09008 on 15 June 2022. 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 Budget for 2022-23 sets out that during this financial year, the Scottish Government intends to lend £170m per annum in capital funding and to receive some £105m income per annum which is the interest on loans issued to Scottish Water. Across the 2021-27 period Ministers have committed to lend Scottish Water up to £1.03bn. Lending in future years will be agreed in future Budget Acts.

The quoted figure of -£97m is the resource budget for the Water Industry portfolio. This reflects some £105m income of interest payments by Scottish Water less amounts of spend on Hydro Nation and Private Water activities. The breakdown of spend is included within table 9.16 of the Budget.

Scottish Water is financed through revenue raised from customer charges and loans issued by the Scottish Government. The spending review has simply confirmed the intention to lend £170m per annum to Scottish Water and hence it has no impact on customers’ bills.

As required by the Water Industry (Scotland) Act 2002, Ministers made a Principles of Charging statement for the 2021-27 regulatory period. The statement included the increase to the maximum discount available under the water charges reduction scheme from 25% to 35%.

This information is provided in Scottish Water’s Annual Report and Accounts which is published on Scottish Water’s website and laid before Parliament each year. The accounting provision Scottish Water has made for household bad debt in each of previous 10 financial years is set out in the following table.

The average household bill in Scotland is calculated as revenue, net of applicable discounts and divided by the number of household properties in Scotland. The average household bill in England and Wales is published on the Discover Water information site at https://discoverwater.co.uk/annual-bill .