Chamber and committees

Part 1 of the National Health and Social Care Workforce Plan published on 28 June 2017 made specific recommendations on strengthening available NHSScotland workforce data; The Plan commits to increasing training places for nurses and midwives by a further 1,600. That is 2,600 additional nursing and midwifery training places over this Parliament The Plan goes further and increases the number of medical training places by up to a further 100 over the lifetime of this Parliament.

On the need to respond more proactively to changing service and demographic demand, for example by using scenario planning; and on working with NHS Boards to reduce the overall use of agency staff through use of Regional and National Staff Banks.

These recommendations are being taken forward with NHS partners and stakeholders, with strategic oversight from the National Workforce Planning Group.

Integration Authorities' strategic commissioning plans set out how they intend to deliver care appropriate to people's needs in their localities, including any plans to shift provision of care from institutional to community settings. Strategic commissioning plans are accompanied by annual financial statements setting out spending intentions for the year to come. The main driver for hospital use is emergency admissions, of which many can be prevented by better services in the community. Using their budgets and through their strategic commissioning plans, Integration Authorities have control of the budgets across the unscheduled care pathway including commissioning responsibilities for three quarters of all emergency admissions, enabling them to redirect resources from acute to community-based provision, improving both the quality and sustainability of care.

Within our Health and Social Care Delivery Plan we aim to reduce occupied bed days by 10 percent (around 400,000 bed days) by reducing avoidable admissions, delays and inappropriate long stay delays in hospital.

The Scottish Government has funded NHS National Services Scotland Information Services Division to provide data intelligence and support for Integration Authorities to allow them to continuously monitor, evaluate and report progress locally. Integration Authorities are also required to publically report on progress against nationally agreed integration indicators in their annual performance reports.

Unscheduled care is a key priority for Scottish Government and we want all hospitals across Scotland to sustainably achieve 95% of all patients attending A&E to been seen, treated and discharged or admitted with four hours. The latest weekly performance against the four hour A&E target for the w/e
29 October was 94.0%.

Since the launch of the six essential actions two years ago we have delivered significant improvements; Scotland is leading the way in the UK in terms of performance against the four hour A&E target, the number of patients waiting longer than four hours has reduced by 10% since 2012-13 compared to 180% increase in England.

Scotland’s performance in September was almost 8 percentage points better than England; more than 23 percentage points better that NI and almost 12 percentage points better than Wales (England 84.6%; Northern Ireland 69.4%, and Wales 80.6%); Scotland’s core site performance has been ahead of England for
31 consecutive months, to September 2017.

But we are not complacent. I recognise that more needs to be done to ensure a sustainable improvement in performance especially as we go in to the winter period. That is why I recently announced an additional £5 million to support winter resilience. This is over and above the £9 million, announced in May 2017, to support Unscheduled Care - total of £14 million for winter 2017, compared to £12 million the previous year.

Funding allocations for the Health and Sport portfolio and for NHS Boards for future financial years is a matter for the relevant spending review. The Scottish Government will publish its draft budget for 2018-19 on 14 December 2017.

I refer the member to the answer to question S5W-12302 on 20 November 2017. 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.

We will develop a medium term financial framework by February 2018 to support national, regional and local financial planning for the next 5 years.

On 29 August, the creation of an expert group which will provide support to transform scheduled care and put services on a sustainable footing was announced. The Elective Access Collaborative Programme will bring together experts from the Scottish Government, NHS Scotland and the Presidents and Chairs of the Royal Colleges – to provide support to health boards in improving the way elective services are configured.

The work of this group is supported by additional investment of £50 million which is being made available to Boards to improve waiting times for all parts of the patient journey, and £5 million confirmed on 5 October 2017 to support winter planning and enhance resilience across the services, making sure patients are seen quickly, efficiently and without delay.

The Scottish Government is also investing £200 million in five new elective treatment centres and the expansion of the existing Golden Jubilee National Hospital.

The Scottish Government expects all Boards to take all reasonable steps to live within their means and make best use of the available resources as part of a balanced approach to performance. Within this context, the Scottish Government continues to follow the twin approach of investment and reform, and shifting the balance of care to community health services.