Seòmar agus comataidhean

As outlined in our operational improvement plan, we are committed to expanding hospital at home services across Scotland to at least 2,000 beds by December 2026, as part of the £200 million that has been allocated from the record £21.7 billion for health and social care this year. Officials are in regular contact with each of the territorial boards, including NHS Borders, in support of their local planning process, and the expansion of hospital at home services should build on the success of services that are already in place and which are delivering positive outcomes for patients and staff.

Like Willie Rennie, and as I said in answer to Stuart McMillan, I recognise that with increased awareness of such conditions has come massively increased demand for services. I want the NHS to be able to respond to that. We are working with bodies such as the Royal College of General Practitioners and supporting publication of the national autism implementation team’s guidance, to ensure that we are doing exactly what Willie Rennie asks of us.

I thank Stuart McMillan for raising the matter on behalf of his constituents, with whom I absolutely sympathise and empathise. Awareness of neurodevelopmental and neurodivergence issues in adults has increased, which has seen demand on services grow. That poses challenges to which we seek to respond. Some NHS boards might have shared care policies, but it remains within the clinical discretion of individual general practitioners to decide the best course of action for their patients.

A private specialist’s recommendation for a particular medicine does not entitle the patient to receive NHS prescriptions for that medicine. In April 2022, the national autism implementation team published guidance on prescribing ADHD medication to adults following a private sector diagnosis in Scotland, and that guidance is available to both practitioners and patients. Furthermore, my officials are engaging with the Royal College of General Practitioners Scotland to understand what more can be done to ameliorate the situation involving private diagnosis of ADHD and voluntary agreements.

As I said, there are different elements at play here. One element is those children who meet CAMHS criteria, which may include children with neurodevelopmental conditions, and the direct intervention that is required to support children with neurodevelopmental conditions. As I said in my initial answer, it should not be dependent on a diagnosis for that support to be put in place, regardless of the setting, whether it is education or another setting.

We are directly allocating £123.5 million to NHS boards and integration joint boards for a new enhanced mental health outcomes framework, which provides a single flexible funding stream to support continued improvements and better outcomes across a range of mental health and psychological services, including neurodevelopmental services. We have also granted £250,000 to fund a range of individual projects to improve neurodevelopmental support for children and young people, including the use of digital tools for assessment. We have provided councils with £65 million since 2020 to develop and further deliver community-based mental health support for children and young people.

CAMHS waiting times statistics capture children who meet the CAMHS criteria. Children who require autism or other neurodevelopmental support are not reported in those statistics unless they have a comorbid mental health condition. Our focus should be on improving support regardless of the existence of a formal diagnosis. The neurodevelopmental specification places an expectation on the national health service and local authority children’s services to work together to provide support to meet a child’s needs when they need it. That should not be dependent on the child having a formal diagnosis.

I thank Emma Harper for recognising the significant milestone that 90.6 per cent of children and young people started treatment in CAMHS within 18 weeks of referral. I am incredibly grateful to the dedicated CAMHS staff, who play a critical role in achieving that. We have allocated £123.5 million to NHS boards and IJBs in 2024-25 to support the improvements and better outcomes across mental health services, including CAMHS and neurodevelopmental services. We will continue to work closely with boards to ensure that that progress continues, and that having reached that significant milestone, the achievement is sustained and we ensure that all children and young people can access the support that they need.

My officials were in communication with NHS Greater Glasgow and Clyde in November regarding shared care agreements for adults with such diagnoses. Colleagues from the board set out its policy and approach to private diagnosis.

Additionally, in March, the director of mental health wrote to the chief executives of all health boards with a baseline survey of locally available neurodevelopmental assessment and support services for adults. It included a question on the protocol followed when a board is approached by an adult with a private diagnosis who wishes the national health service to ratify it.

We have been clear in the support that we provide to NHS Grampian that the way in which it delivers its services should not impact on front-line services, in spite of its financial difficulties. The repayment of that money can come only when NHS Grampian is on a more sustainable financial footing. We are not going to be requesting repayment to the detriment of front-line services. I hope that that will reassure Mr Ross and others.

Some of the key improvement works that we expect to be done include optimising and enhancing pathways that streamline patients away from the emergency department to be seen more quickly and in more appropriate areas, such as the rapid ambulatory assessment centre—

Of course.

I recognise the disparities in delayed discharge performance, not just in the NHS Grampian area but in other parts of Scotland.

Mr Stewart’s ask of me is to ensure that lessons are learned from the better performing areas. At the weekly collaborative response and assurance group, which is chaired by me or Maree Todd, we ensure that exactly what he asked for is conveyed across Scotland.