Chamber and committees

In Scotland, NHS Forth Valley is hosting a national project to support early diagnosis of skin cancer supported by digitalisation, the use of high-quality images, and machine learning. The project is called 25 by 25 - diagnosing cancer within 25 minutes by 2025. Industry, academics, and NHS are collaborating to rapidly innovate to create AI solutions in skin cancer.

This work is supported through the Scottish Health Industry Partnership and linked to the Health and Social Care and Wellbeing Programme. It takes the form of a number of challenges where partners innovate to find solutions to preparing images, creating AI learning environments, and real world Test Beds to try out new approaches in primary care with Consultant Dermatologist support.

The Scottish Government has invested in the Detect Cancer Early programme in this area, has committed to investing in an AI Hub, and has prioritised the 25 by 25 programme for innovation investment in 2022.

This will enable AI innovation in the form of AI enabled triage, diagnostics, and treatment decision making support for Clinicians.

NHS Scotland’s staffing levels are at a record high, following nine years of consecutive growth. This includes record numbers of staff within the nursing and midwifery job family.

Creating new vacancies is an essential part of workforce expansion and are to be expected as we work to rapidly grow our nursing and midwifery workforce. The nursing and midwifery establishment has increased by 7.6% in the last year, or by 4,924.6 whole time equivalent posts. 77% of the nursing and midwifery vacancies reported at September 2021 have been recorded in the last three months, reflecting the extensive range of new posts being created.

We have announced a record £300 million of investment to support Health Boards and their staff over the coming months, as well as over £1 billion of funding through the NHS Recovery Plan. Through these investments, £4.5m of funding is being made available to Health Boards to attract registered nurses from outside Scotland. This is supplemented by an additional £1m to enhance Boards’ capacity for international recruitment, and £1m of recurring funding to fund International Recruitment Lead posts in Boards. We are also investing £11 million over the next 5 years in new recruitment activity and through the recent launch of the National Centre for Workforce Supply, which will coordinate national and international recruitment campaigns and support Health Board recruitment teams.

We have also worked with Boards to take forward a nationally coordinated recruitment campaign for midwives, and will undertake a focused national marketing campaign for the recruitment of Band 5 Nurses early in the new year.

We continue to invest in the domestic supply of nurses and midwives through the long-term growth of funded education programmes. Student nurses and midwives entering funded degree programmes will increase in 2022-23 to a total recommended intake of 4,837. This will be the 10th successive intake, doubling the number of students in the last decade.

A clinical refresh of the Scottish Referral Guidelines for Suspected Cancer has been completed with revised guidance published in January 2019. The Guidelines support primary care clinicians in ensuring those with symptoms suspicious of cancer are put on the right pathway at the right time, including possible skin cancers.

In December 2021, the Scottish Government published a refreshed Framework for Effective Cancer Management. This Framework provides NHS Cancer Teams with the tools to effectively manage USC patients from the point of referral to first treatment to improve patient experience and cancer waiting times. Tailored support will be provided to all NHS Boards to ensure the eight key elements are embedded, where relevant, across cancer pathways and specialties, including dermatology.

The Centre for Sustainable Delivery (CfSD) is working with a number of Health Boards to implement the Digital Dermatology app, which allows patients to interact with a clinician at a time convenient to them, without having to attend hospital. This will support dermatology teams in conducting more virtual appointments. CfSD also supports a Dermatology Pathways app and website which provides clinically validated pathway information to GPs and other health professionals for many of the most common skin conditions, with the aim of supporting access for patients who most need treatment in the most appropriate care setting. As part of this, CfSD is working with the British Association of Dermatologists to increase the number of pathways covered by this approach.

The most recently published ten year percentage change tables show some upward incidence trends and downward mortality trends. This reflects improved survival.

We are committed to finding cancer early when the chance of survival and even cure is higher – this is reflected in our £44 million Detect Cancer Early (DCE) Programme. Melanoma was added to the Programme in 2016 following a robust options appraisal exercise (this included reviewing a wealth of data from incidence and survival to mortality and staging).

Since then, over £400,000 has been invested across NHS Scotland to support skin cancer CNS workforce, enhance image capturing and sharing, provision of equipment for GPs/ANPs i.e. dermoscopes and the development and delivery of lesion training programmes.

Public Health Scotland (PHS) publishes quarterly statistics relating to the waits patients experience for new outpatient appointments and inpatient or day case admission at specialty and health board level using the links below.

https://beta.isdscotland.org/find-publications-and-data/healthcare-resources/waiting-times/

The latest statistics were published on 30 th November 2021 and the following tables will be of interest.

New outpatient appointments (tab: 1.4 Table):

https://www.publichealthscotland.scot/media/10563/newop_nov21.xlsx

Inpatient or day case admission (tab: 2.4 Table):

https://www.publichealthscotland.scot/media/10487/ipdc_nov21.xlsx

The statistics published in the tables above include additions to the waiting list and not referrals as the national data captures only those referrals that lead to a patient being added to the waiting list for an appointment or admission.

The NHS Centre for Integrative Care (CIC) is a facility that all NHS Boards across Scotland have the option of referring patients to for services not available locally.

The Scottish Government is providing £12.4 billion for frontline NHS boards, which is a £327 million (3.2%) increase. This is the first step to ensuring that frontline funding - which directly supports patient services - increases by at least £2.5 billion by 2026-27.

Over 50% of frontline spend will go towards community health services, delivering on our commitment to increase primary care funding by 25% over this Parliament, providing more care for people in a place and way that meets their needs.

The Scottish Government has no plans to make changes to rights of appeal in the planning system.

A number of amendments that sought to introduce a third party right of appeal were considered, and rejected, by the Scottish Parliament during consideration of the Planning (Scotland) Act 2019.

Because of the unpredictable lifecycle of this particular organism, it is not possible to routinely test buildings for an Aspergillus infection. Where water ingress creates the conditions for mould, NHS Greater Glasgow and Clyde’s staff work to remedy faults as soon as they are found and remove any mould with oversight from Infection Prevention and Control (IPC). Patients with Aspergillus are visited by an infection prevention and control nurse. Advice on the correct antibiotics to administer to patients is given by a Microbiology/ICD/antimicrobial pharmacist on request of the clinical teams.

A variety of risk assessments are undertaken across all wards in the Hospital, including 4a and 4b, covering social distancing, hand hygiene, infection control precautions (SICPs) audits every 6 months, patient placement, and the verification of the specialist ventilation systems in ward 4b. The new and innovative Infection Prevention and Control (IPC) dashboard available to all staff enables real time review of IPC data, and allows for a quick and effective response to any risks reported.