Chamber and committees

As recognised by Audit Scotland, spend on agency staff in NHSScotland is relatively small at just 2.6% of the overall staffing budget, and between 2015-16 and 2016-17 total spend on agency staff fell by 3%

In order to further reduce NHS Boards spend on agency staff we have established Regional NHS Staff Banks. Currently there are around 35,214 nurses and 2,889 doctors registered with Staff Banks across Scotland, and numbers continue to rise as recruitment is on-going. These Banks give Boards access to appropriately trained staff working on NHS contracts at NHS rates of pay.

We also have framework agency contracts in place for Nursing and Medical staff. We have recently reviewed the Medical Framework Contract which supplies up to 80% of Medical Locums at controlled rates of pay consistent with NHS rates. NHS Boards have been instructed to use only agencies on this contract. Boards have also implemented strengthened governance arrangements to ensure that all avenues are explored before agency staff are sourced.

The cost of building new houses is largely dependent on local factors such as land price, site conditions, infrastructure, building materials, size of the development etc.

The Scottish Government recognises there are some significant differences in the housing market of rural Scotland and in 2016 we launched the Rural and Islands Housing Funds with the aim to increase the long term availability of affordable residential housing in rural Scotland. Our Affordable Housing Supply Programme benchmark subsidy levels also take into account the additional cost of constructing homes in rural, remote and island areas.

The review of the planning system highlighted the importance of infrastructure to unlock opportunities for development and housing supply and we will introduce a Planning Bill to improve the system of development planning. Housing delivery is an on-going priority for this review, with a focus on supporting innovation in delivery, including self and custom build and alternative methods of construction.

We have also set up the Housing Infrastructure Fund in 2016 to unblock strategically important housing sites with all types and tenures of housing eligible for support.

Under Directive 2010/31/EU on the Energy Performance of Buildings, Energy Performance Certificates (EPCs) are required on the construction, sale or rental of most buildings, and also must be displayed in larger public buildings.

An EPC for a dwelling provides an Energy Efficiency Rating and an Environmental Impact Rating for the building. Calculation of the Energy Efficiency Rating takes the price of fuel into account as running costs are both important to householders and the most direct illustration of the benefit of improving energy efficiency.

The Scottish Government is committed to improving the energy efficiency of all types of buildings across Scotland as part of the long term Scotland’s Energy Efficiency Programme (SEEP). We will publish a route map on the future direction of the programme next year. We consulted earlier this year on the principles that would underpin SEEP, and on minimum energy efficiency standards in private rented housing which we proposed would be based on the EPC rating of the property. Responses to the consultations are currently being analysed and Ministers will consider feedback to the proposals, as part of the development of the route map.

The Scottish Government is committed to improving the energy efficiency of all types of buildings across Scotland as part of the long term Scotland’s Energy Efficiency Programme (SEEP) and, within the programme, will consult with homeowners on improving the energy efficiency of their properties.

This consultation will take account also of responses to consultation earlier this year on proposals for minimum energy efficiency standards in private rented housing. The proposals were informed by a working group which included representation from rural and urban landlords, in addition to environmental, fuel poverty, consumer and local authority interests as well as by extensive energy efficiency modelling work, covering 355 different house types that helped identify specific concerns in relation to improving rural properties. We are currently considering the responses to the consultation and will confirm the introduction of standards in the private rented sector in due course.

Delivering the highest quality of patient care is a key priority of the Scottish Government, but the provision of patient care and treatment is the responsibility of individual Health Boards.

The refreshed Healthcare Improvement Scotland (HIS) ‘Food, Fluid and Nutritional Care 2014 Standards’ sets out the importance of appropriate nutritional care assessment to identify patients who are, or may be at risk of becoming, nutritionally vulnerable. A nutritional care assessment should be undertaken within the first 24 hours of admission, which includes clearly and accurately recording a patient’s weight. If a risk of malnutrition is identified, the patient should be referred to the appropriate service.

Once the nutritional care assessment has been completed it will inform the care planning for that patient, and support clinical decisions on prescription of medicines and use of equipment.

NHS Boards’ compliance with these standards are scrutinised by HIS as part of its inspection of care for older people in acute hospital, and the reports from these inspections are publicly available.

5 October 2017, it is disappointing that services have fallen short of the high standards that patients have a right to expect. It is also concerning that leadership and governance issues were identified during the inspection and that they have impacted on patient care. I have spoken with the Chair of NHS Borders to make clear my concerns about the report's findings.

NHS Borders has sought the support of Healthcare Improvement Scotland for their work in improving patient care and to address issues highlighted in the inspection. Both organisations, along with Scottish Government officials including the Chief Nursing Officer, are working together to support the NHS Borders senior team in making the necessary improvements in care.

Scotland has some of the strongest rights for homeless people in the world, and the Scottish Government wants to ensure people are accessing those rights.

We have committed to renewing and redoubling our efforts to prevent and reduce homelessness by establishing a new short term Homelessness and Rough Sleeping Action Group. This Group has one of its objectives of transforming temporary accommodation so will look at this in the round.

In addition, we have created an Ending Homelessness Together fund of £50 million over a five-year period and will invest an additional £20 million in alcohol and drug services.

As well as the new short term Action Group, we will continue to work with local authorities through the Housing Options Hubs and the Homelessness Prevention and Strategy Group (HPSG) in the longer term.

The allocation and management of temporary accommodation is a matter for local authorities. The Scottish Government wants time in temporary accommodation to be as short as possible and we are increasing housing supply to help with this which will help families with children and young people. We have also introduced a cap of
7 days for families with children and pregnant women living in unsuitable accommodation down from 14 days

Transport Scotland meets regularly with ScotRail and Network Rail on proposed engineering works to ensure disruption to customers is kept to a minimum.

Planned renewals, maintenance and project works are all a vital part of improving and sustaining the rail network for the benefit of customers and our economy.

Recent engineering works in the Millerhill area required the closure of a junction which leads to the Borders route for safety reasons, unfortunately there were no alternatives to avoid the situation.

There are more planned Sunday engineering works in October 2018, associated with maintenance and improvements in the Edinburgh area which will necessarily impact the Borders service. Discussions will take place with ScotRail and Network Rail to ensure needs of passengers on the Borders route are fully considered.

There has been no requirement to disrupt customers on the new Borders route by undertaking engineering work on the route itself.

The report of the Significant Case Review carried out following the tragic death of Madison Horn in 2014 was published in 2016. The SCR following Madison's death made six national recommendations. These recommendations were:

1) The Scottish Government should consider amending Section 245D (4) of the Criminal Procedure (Scotland) Act 1995, in relation to Restriction of Liberty Orders, and review guidance on community orders to enable effective information sharing;

2) Home Assessment Reports should be written reports;

3) The Scottish Government should consider publicising on an annual basis, themed recommendations from SCRs across Scotland and the UK;

4) The Scottish Government should consider introducing Multi Agency Risk Assessment Conference as a statutory provision, and Police Scotland and partner agencies should consider the development of a shared electronic system linking Multi Agency Risk Assessment Conference (MARAC) and Multi Agency Tasking and Coordinating (MATAC);

5) The Scottish Government is asked to review the Child Protection Guidance 2014 and the National Risk Framework 2012; and,

6) The Scottish Government is asked to look into how retained information by the contracted electronic monitoring company can be used more effectively in combining antecedent with current data.

In line with these recommendations, the Scottish Government is working with partners to take forward the following action:

1) Scottish Ministers are exploring amending relevant legislation in relation to the recommendation of the serious case review. It is intended these amendments will be taken forward as part of wider legislative changes recommend by the Electronic Monitoring Working Group. In addition to amending legislation, Justice Officials have worked with the Scottish Courts and Tribunals Service to implement some interim measures, not requiring primary legislation, to improve information sharing practices. The Scottish Government will also review parts of the Restriction of Liberty and Community Payback Order guidance in the context of future legislation.

2) The most recent Scottish Government guidance already makes clear that every Home Assessment Report must be a written report. The Scottish Government is working with partners to ensure that this guidance is implemented and the relevant legislation is currently being reviewed to assess whether it can be strengthened.

3) All Significant Case Reviews relating to children have, since 2015, been shared with the Care Inspectorate. It carries out an analysis of the findings of the reviews and publishes national learning from those Case Reviews every three years in order to reflect a national picture. The next report publication is expected later this year.

4) As part of Equally Safe, the Scottish Government’s strategy to prevent and eradicate violence against women and girls, we are working with partners to improve the capability, capacity and consistency of Multi Agency Risk Assessment Conferences (MARAC) and we are taking forward discussions with stakeholders on what is required to ensure that MARACs operate as effectively as possible, including considering if they should be placed on a statutory footing, how to ensure consistent national application of standards and how to improve data sharing between agencies.

Police Scotland are working towards developing a performance framework which will enable measurement of the outcomes of the Multi Agency Tasking and Coordinating (MATAC) process and a consistent approach towards MATACs across Scotland.

5) The Scottish Government updated the National Guidance for Child Protection in Scotland in 2014 to ensure that professionals working with children can identify and act on any concerns to ensure the safety and wellbeing of the child concerned. The Child Protection Improvement Programme will drive another revision of the National Guidance to reflect changes in legislation in relation to domestic abuse and the minimum age of criminal responsibility, and to capture specific recommendations from individual SCRs.

6) The Scottish Government is currently considering data management in the context of the proposed electronic monitoring provisions in the Management of Offenders Bill and are working with partners to consider where improvements on date sharing can be made.
We continue to have contact with Fife Council to be assured that progress continues to be made with the implementation of local recommendations from this significant case review. Our focus therefore is fully on ensuring that where improvements need to be made to national and local practice, as part of the learning from the Significant Case Review, these are being taken forward.