Chamber and committees

The new GP contract which has now been agreed between the Scottish Government and the Scottish General Practitioners' committee (SGPC) is a critical part of our plans to transform primary care services in Scotland. The proposals include reducing GP workload through the expansion of the primary care multidisciplinary team.

There will be significant new investment in expanded teams of health professionals in practices, widening patient choice and ensuring that GPs are able to focus on their expert medical generalist role. Additional health professionals will include pharmacy; nursing; Allied Health Professionals (physiotherapy, and paramedics and other urgent care practitioners); community mental health workers and non- clinical Support Workers (e.g. community Links workers).

Scottish Government is working closely with health boards through the Modern Outpatient Programme to transform services. This programme aims to reduce the demand for outpatient services and deliver care closer to patients’ homes. The Scottish Access Collaborative, which will be launched on 22 November, is based on a set of key principles and will help transform scheduled care and put services on a sustainable footing. This builds on extra investment of £50 million to cut waiting times this year.

The Scottish Government is committed to ensuring that national performance measures across health and social care lead to the best outcomes for people being cared for, whether in hospital or in the community. The Scottish Government, with support from COSLA, commissioned Sir Harry Burns to undertake an independent review of targets and indicators in health and social care to provide recommendations on how we can have a clearly understood measurement framework across the whole health and social care system. The report was published on 15 November and identifies some key principles and recommendations for using and developing targets and indicators going forward.

The Scottish Government will use these principles and recommendations to undertake a further stage of work, with the aim of ensuring a broader based assessment of the overall quality of care.

The Scottish Government has published a clinical care governance framework as part of the suite of statutory guidance for Integration Authorities. In 2018 we will be working with stakeholders who are delivering arrangements locally to learn from their experiences of implementing the framework to date and to provide updated guidance and support as necessary.

The Chief Medical Officer’s vision is that by 2025, all healthcare professionals will demonstrate Realistic Medicine principles and values through their professionalism.

Delivery of the CMO’s vision will not happen overnight. The desired change in culture will require strong collaborative clinical leadership across the health and care system and there are a series of priority actions set out in the Health & Social Care Delivery Plan that aim to strengthen relationships between professionals and individuals, with the person at the centre of all decisions, reduce waste and tackle unwarranted variation. All of which will help embed Realistic Medicine across Scotland. We will report progress towards achieving these actions through regular updates to the Delivery Plan Programme Board.

There is already evidence of some change in practice from individual clinicians, departments and NHS Boards that aim to reduce waste, reduce unwarranted variation and create a more personalised approach to care, as described in the Chief Medical Officer’s annual report Realising Realistic Medicine, and we encourage NHS Boards to share and adopt good practice.

There are two tools which although not specifically developed for Realistic Medicine, they are good examples of the type of approach that will assist clinicians to know whether they're practicing Realistic Medicine through patient feedback. A new measurement tool known as CollaboRATE has been developed and is intended for use to assess the quality of shared decision making in clinical encounters. A patient-reported measure of integration in care delivery is also being developed, known as IntegRATE. As Realistic Medicine becomes part of the way that we deliver care in Scotland, tools such as these will become very important in providing measures that will allow us to assess our ability to truly involve people in the decisions relating to their care. They will also help ensure that this is delivered in a joined up, integrated fashion between professionals, communicating and acting with clarity of role and mutual respect.

I refer the member to the answer to question S5W-12337 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.

I refer the member to the answer to question S5W-12300 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.

NHS Boards report to the Scottish Government throughout the financial year on financial performance. This includes a specific focus on progress in delivering planned savings.

The Scottish Government is encouraging Health Boards, Integration Authorities and other partners to take a more joined-up approach to improving services and patient outcomes. As part of this, three Regional Implementation Leads (North, East and West) are working together with local and national partners to plan and design better services for the populations in their areas. This will help to ensure that local, regional and national planning works together in practice and for the long term.

As part of the approach to finance and performance, NHS Boards prepare plans over a medium term timescale and submit this information to the Scottish Government as part of their Local Delivery Plans.

The Budget Process Review Group was established by the Finance and Constitution Committee and the Scottish Government to carry out a fundamental review of the Scottish Parliament’s budget process. The Group published its Final Report on 30 June 2017, which included comment on spending reviews and multi-year budgets.

The Cabinet Secretary for Finance and the Constitution has responded to this Report.