Chamber and committees

Our clear ambition is that no one should be inappropriately delayed in hospital once they are clinically ready for discharge. However, given the current challenges health and social care partnerships are experiencing in relation to recruitment of care staff, and the increased level of needs people are presenting with, we need to set a realistic trajectory for reduction. Our intention is therefore to see a return to the position seen between the Summer of 2020 and Spring of 2021, freeing up at least 500 beds for winter.

The Scottish Government has released almost £5.3 million to NHS Highland to support the Health Board to support planned care for 2021/22. Of this more than £822,000 was allocated to support the delivery of orthopaedic procedures.

A further £701,000 was allocated to NHS Highland to enable the Health Board to deliver an additional day case procedures, a proportion of this activity will be utilised for orthopaedic procedures.

People who received their vaccination during the early stages of the national COVID-19 vaccination programme started to receive booster injections from 20 September. This follows advice from the Joint Committee on Vaccination and Immunisation (JCVI) which advised that the booster dose can be given alongside the flu jab and should be offered no earlier than six months after completion of the primary vaccine course.

Frontline health and social care workers were able to book their appointment online at NHS Inform from 20 September. Residents in care homes for older people were also being offered both flu and COVID-19 boosters from this date. Adults aged 70 years and over and adults aged 16 and over who are on the highest risk list (previously known as the shielding list) are being contacted, either by letter or by their GP.

All those aged 16 to 49 years with underlying health conditions, adult carers, unpaid and young carers, adult household contacts of immunosuppressed individuals and all adults over 50 will be able to book online soon.

As most younger adults will only receive their second COVID-19 vaccine dose in late summer, the benefits of booster vaccination in this group will be considered by the JCVI at a later time when more information is available.

The National Services Division (NSD) in NHS National Services Scotland (NSS) have commissioning responsibility for the Scottish Genetic Laboratories. NSD are currently conducting a review of NHS Scotland’s genomic services which includes a review of the Scottish genomic test directory and genomics infrastructure. The review is expected to be completed by the end of the 2021-2022 financial year.

The outcomes from the review will be considered by the Scottish Genomics Leadership Group (SGLG), chaired jointly by Professor David Crossman, Chief Scientist for Health for the Scottish Government, and Susan Buchanan, NSD Director, who are supporting the Scottish Government in ensuring appropriate planning and robust decision-making processes are in place for genetic testing availability in Scotland.

In addition, the SGLG and NSD are working closely with the Scottish Genetics Laboratory Consortium and the Scottish Medicines Consortium to understand the laboratory capacity requirements for current and future medicines requiring a companion diagnostic test.

Any decisions to scale back elective activity, including decisions to cancel consultant clinics, are being taken on an evidence basis and where the need to support COVID-19 patients and provide urgent care exceeds capacity for elective care.

However, the NHS in Scotland continues to work to deliver appointments in new and innovative ways to avoid as many cancellations as possible. For example, Active Clinical Referral Triage (ACRT), which is being supported within NHS Scotland via the Centre for Sustainable Delivery, enables Senior Clinicians to triage patients to the most appropriate pathway for their individual needs. For example, some patients will receive written clinical information outlining treatment options, including self-care and the option to ‘opt in’ for a face-to-face discussion if required (e.g. EQuIP pathway for Inguinal Hernia). Other patients, where appropriate, will be offered a virtual consultation or may be sent straight onto a diagnostic test. By embedding the ACRT process within routine care, it will support clinical prioritisation and enable services to provide patients with the optimum pathway to meet their needs, and lead to fewer appointments being cancelled.

Importantly, ACRT also facilitates the continuous monitoring of patients awaiting review e.g. Endoscopy Services continue to validate both new and routine waiting lists using a 3-stage validation and clinical guidelines where appropriate.

Recovering our NHS is our top priority. Addressing the backlog of care, while continuing to meet the ongoing urgent health and care needs of the country, is the central aim of our NHS Recovery Plan.

The Plan is backed by over £1 billion of additional investment to support delivery of improvements throughout the 5 years of this Parliament. Amongst other things, it will increase primary care investment by 25% and restore face to face consultations in GP surgeries. It will reduce A&E attendances by 15% to 20% and increase outpatient capacity by 10% compared to pre-Covid levels.

While it is not possible to determine when NHS performance will return to pre-pandemic levels, we will continue to work to identify ways of adding additional activity, through new facilities or through improvements to existing ways of working in order to reduce the length of time patients are waiting and bring waiting times back within standards.

The Net Zero Technology Centre has not provided any funding directly for the benefit of any of the three Operators in question.

The Net Zero Technology Centre model provides funding for developers with a prerequisite that the project has industry support in order to provide match funding, industry engagement and access to the facilities and expertise that is required to prove the technology. This is in line with the Business Case approved as part of the Aberdeen City Region Deal, in which joint Government funding of £180m over ten years was to be matched by industry and academia to a target amount of £174.1m.

The NHS Recovery Plan, launched on 25 August and backed by over £1 billion of additional investment, strives to recover NHS performance over the 5 years of this Parliament in order to ensure Treatment Time Guarantees and other waiting time standards can be met by every Health Board across Scotland.

Dealing with the direct and indirect impacts of the pandemic has resulted in the most significant challenge in 73 year existence of the NHS.

While it is not possible to anticipate when NHS Scotland will begin meeting the TTG in all instances, we know that it will take time and a series of targeted actions to build back capacity and redesign patient pathways to bring waiting times back within targets.

We engaged closely with islands communities as part of the policy-development process for DRS, culminating in an Islands Communities Impact Assessment ( Deposit return scheme for Scotland: islands communities impact assessment - gov.scot (www.gov.scot) ).

We consider that our design for DRS takes full account of the needs of businesses, including retailers, operating in islands communities. In particular, the DRS scheme administrator will be required to collect containers free of charge from retailers to ensure they do not incur costs associated with transporting scheme articles for recycling.

The breakdown of Scottish Government funding through Zero Waste Scotland, to support Local Authorities aligning their services with the Household Recycling Charter, is outlined in the following table: