Chamber and committees

The information requested is provided in the following table. Please note that due to ongoing technical issues information from NHS Ayrshire and Arran and NHS Tayside are not included in the figures below.

NHS SCOTLAND: MEDIAN WAITING TIMES FOR URGENT AND ROUTINE FIRST OUTPATIENT APPOINTMENT IN RHEUMATOLOGY

Procurement commenced with the publication of a Contract Notice on 31 August 2017. Three companies are currently participating in the tender process for this project and the award of the contract is anticipated in December 2018. Construction works should commence immediately thereafter.

The Scottish Government has asked NHS boards to work collaboratively with each other and with partners to develop regional delivery plans. The plans will strengthen how services can best be planned and delivered, particularly at a regional level, and support the reform programme set out in the Health and Social Care Delivery Plan published in December 2016. The plans are in draft form and the Implementation Leads are engaging with stakeholders to refine their proposals over the rest of this year. Boards are now starting to develop clinical networks and new care pathways which will link hospitals and services across regions, including between rural and urban areas, to provide more effective and sustainable care for patients.

The Scottish Government recognises that health boards in remote and rural areas face particular recruitment and retention challenges.

There are a range of actions that are already being taken to support NHS Boards to recruit in remote and rural areas:

• We are providing £500,000 of funding for a new, shortened pilot course at the University of Highlands and Islands to enable 20 registered adult nurses to become fully qualified midwives in just 20 months, and then work in the region.
•  Funding has already been made available for 300 pre-registration nursing places through the University of the Highlands and Islands.
• Offering financial incentives for GPSTs (£20k bursaries to incentivise recruitment in ‘hard to fill’ locations); reconfiguring unpopular 4-year GP posts; improving the educational content and attractiveness of specialty posts and piloting new approaches such as the Broad Based Training Scheme.
•  The new Graduate Entry programme (ScotGEM) will introduce 55 undergraduate places from Autumn 2018 with a particular focus on general practice and rural medicine. ScotGEM includes a ‘return of service’ bursary of £4,000 per year. The optional grant, worth £16,000 over the 4 year course, will be payable to students who agree to work one year of service for each £4,000 claimed
•  NHS Education for Scotland has recently published its first education research and innovation report which outlines research undertaken to assess the extent to which factors, such as location, influence the career choices and preferences of doctors http://www.scotlanddeanery.nhs.scot/news/medical-directorate-education-research-and-innovation-annual-report-2018/
•  The Remote Rural Educational Alliance Learning Platform provides the opportunity for educational tools, and professional development amongst remote health workers.
• The creation of Rural Support teams in 2015 is a collaboration to provide service cover and inter professional support for remote working health professionals
• The ‘Being Here’ programme designed to recruit and retain healthcare professionals, particularly GPs, in remote and rural areas was delivered between 2014 and 2017.
• 11% increase in training places for mental health nurses from 465 to 516, and we fund the Open University to deliver a pre-registration programme for almost 80 nursing students including for mental health, particularly in remote and rural areas. We are also undertaking a marketing campaign to encourage recruitment into health and social care careers.

The Scottish Government is funding record numbers of undergraduate medical places and postgraduate training posts in Scotland, as well as providing the resources that NHS Education for Scotland(NES), Health Boards and GP practices require to deliver medical education and training in Scotland.

Rheumatic and musculoskeletal disease is a core part of the undergraduate teaching curriculum taught by each of the Scottish Medical Schools. In all the teaching programmes, the teaching and clinical experience of Rheumatic and musculoskeletal disease spirals throughout the curriculum; it is revisited across multiple years with the relevant underpinning science, clinical experience and multiple points of assessment.

Postgraduate medical training comprises 2 or 3 distinct phases of training; each phase has its own curriculum and learning outcomes. For those pursuing training towards being a General Practitioner the 2 phases are Foundation training (2 year programme) and GP Specialty Training (typically a 3 year programme). For those training to be physicians there are 3 phases – Foundation Training (2 year programme), Core Medical Training (2 year programme) and Higher Medical Training (typically 5 years’ duration and covering dual training combining a specialty with training in General Medicine); some physicians will train specifically in Rheumatology as one of the dual Higher Training specialties.

Foundation training is designed to be generic and to achieve competence to meet curricular outcomes across 20 professional capabilities for all entering postgraduate medical training in Scotland and the UK; examples of these capabilities are the ability to recognise, assess and manage patients with long-term conditions, how to take a history and examine a patient and formulate a differential diagnosis. The expectation is that the generic capabilities apply across disease areas including rheumatological and musculoskeletal conditions. Foundation trainees are placed in GP practices in Foundation Year 2.

General Practice Specialty Training (GPST) is based on the Royal College of Practitioners (RCGP) curriculum which is approved by the GMC. Rheumatology awareness training is covered in the Curriculum Statement 3.20 Care of People with Musculoskeletal Problems. NES also supports Continuous Professional Development (CPD) activities for all GPs through a variety of means. Specific educational support of GPs to improve their awareness of rheumatology includes (a) Practice Based Small Group Learning (PBSGL) modules and (b) Taught courses on arthritis (along with Arthritis Care Scotland), joint injections and musculoskeletal medicine.

Core Medical Training ensures trainees gain competence in describing and eliciting the examination features of musculoskeletal disease, recognise when specialist rheumatology opinion is indicated, outline the indications, contraindications and side effects of major immunosuppressive drugs including corticosteroids, recognise the need for long-term review in many cases of rheumatological disease and their treatments, recognise the importance of a multidisciplinary approach and use national and local guidelines appropriately.

The GMC-approved Higher Medical Training curriculum develops competences around recognition, assessment, diagnosis and management including therapeutics and multidisciplinary team working around themes such as ‘back pain’, joint pain’ and musculoskeletal diseases with requirements specifically in relation to a list of conditions.

I refer the member to the answer to question S5W-18145 on ‎28 August 2018. 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 proposed abolishing the requirement for corroboration in criminal cases during the passage of the Criminal Justice (Scotland) Act 2016. At that time however there was no legal or parliamentary consensus for the abolition. The Scottish Government therefore asked Lord Bonomy to carry out an independent review to consider what additional safeguards may be required if the corroboration rule was removed. The Review recommended a wide range of substantive and constructive criminal justice reforms.

One of the key recommendations of Lord Bonomy’s Review was that research into jury reasoning and decision making should be undertaken so that any changes to our jury system is informed by evidence that could point to safeguards if the rule is abolished.

The Scottish Government took forward this recommendation and this research is now underway. It is expected to complete in Autumn 2019. Any future consideration of corroboration reform needs to await the findings of this important research and be considered in the wider context of that and the other recommendations of Lord Bonomy’s group.

The Scottish Government funds Paths for All to deliver against national physical activity priorities, including walking for health. Paths for All, Age Scotland, Scottish FA, SPFL Trust and SAMH initially developed walking football in Scotland to establish the Scottish Walking Football Network. This led to the creation of Walking Football Scotland which my predecessor helped launch on 6 December 2017.

The Scottish FA is also supportive of Walking Football Scotland, with much of the local delivery already coordinated by the community clubs and partners the Scottish FA invests in.

I look forward to working with Walking Football Scotland as the sport grows across Scotland. The new organisation already has more than 45 member organisations which run more than 70 sessions every week. As well as physical and mental health, the additional social benefits that come from playing walking football make this an excellent and inclusive game.

The second Strategic Transport Projects Review (STPR2) will be an examination of the strategic transport infrastructure interventions required to support the delivery of the Scotland’s Economic Strategy and deliver a transport network which is fit for the 21st century, in the context of priorities to be set out in the new National Transport Strategy. It will provide a clear alignment with Scotland’s national plans, policies and strategies, including the National Planning Framework (NPF4) and the Climate Change Plan and will inform the next Infrastructure Investment Plan.

Initial work on STPR2 is underway. Transport Scotland will continue engagement with regional partners and groupings, including the Ayrshire councils, over the coming months which will provide an opportunity for partners to be involved and influence the review.

I refer the member to the answer to question S5O-02228 on 14 June 2018. The answer to the oral parliamentary question is available on the Parliament's website, the Official Report can be found at http://www.parliament.scot/parliamentarybusiness/report.aspx?r=11601&i=105147