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I recognise, as I did in my answer to Annie Wells, the fact that we have delivery agents with whom we need to work to make sure that decisions that are taken locally reflect the national policy direction that is set out in the documents. I also recognise that we need to continue to support local areas, as we are doing—our local authority partners received a record funding settlement, as did our health boards, this year; those are the funders of our health and social care partnerships.

I recognise that decisions are to be taken locally, but, in some of the areas that Patrick Harvie set out, they are not in keeping with what I have set out in relation to the population health or service renewal frameworks, or directed towards preventative areas of spending. That is why I will continue to work with local decision makers, as we have done in the development of the product through COSLA, to ensure that the importance of prevention is recognised.

Audrey Nicoll is absolutely right that general practice will play an ever more important role in the delivery of our services. For us to shift the balance of care and for our constituents to receive services within the community that they call home, we will be required to support general practice to play that role in a sustainable way.

A further £10.5 million has been invested this year to expand targeted interventions by GP practices on cardiovascular disease and frailty prevention. As part of that investment, we have already agreed an enhanced service with the British Medical Association that will increase the number of proactive interventions to prevent cardiovascular disease from having a significant impact on patients’ long-term health outlook.

By spring next year, we will offer a frailty enhanced service to general practices, enabling each GP practice to identify a frailty lead, which will help to drive improvements in frailty care through training, data optimisation and cross-sector collaboration.

I thank Brian Whittle for what I think was his support for what we have set out in the documents. I recognise that there has to be a continued emphasis on prevention. With regard to what Ms Robison set out when she was in my role, significant steps have been made to move to a more preventative model, including the work that has been done on urgent care pathways and the hospital at home service, for example.

However, the statement is an acknowledgement that we need to do more. We need to go further and we need to go faster. On delivery, both of the documents set out the progress that we wish to make over the coming years, and I expect to see some elements of them delivered quickly. Some changes will be happening now, such as those that I announced in relation to foods that are high in fat, salt and sugar, and our proposed structural changes to some of our national boards.

On Brian Whittle’s question about the digital front door, he is correct. The initial pilot is happening in Lanarkshire at the end of this year and we expect to roll it out to the rest of Scotland in 2026.

Improving access to urgent care services is a key priority for the Scottish Government. On 31 March 2025, we published the NHS Scotland operational improvement plan, which sets out how we plan to improve access to treatment, including in urgent care settings. As part of our wider £21.7 billion investment in health and social care services, the plan includes an additional £200 million to reduce waiting times and improve patient flow through hospitals, which will lead to a reduction in ambulance turnaround times and in delayed discharges. We are supporting boards to strengthen facilities such as flow navigation centres, so that they are able to refer patients to more services and avoid their unnecessary conveyance to hospital in ambulances.

I have already referenced a significant amount of intervention. The operational improvement plan, which was published earlier this year, will address some of the concerns that Mr Rennie is highlighting. It will increase the capacity of hospital at home and social care services, and it will ensure that we have call-before-you-convey services for our ambulance service. It will make sure that we have a whole-system response that looks after the individual patient, as opposed to the other way around.

There is already significant investment going on, and, in relation to oversight, we now have a national social care advisory board, which is ensuring that we respond to the needs of the social care system, because it is integral to the performance of our health service.

The member is absolutely right that the variance in delayed discharge performance among our health and social care partnerships is far too wide. The First Minister has said that on countless occasions, as have I. That is why the new Minister for Social Care and Mental Wellbeing and I have a regular meeting with the health and social care partnerships, so that we can ensure that best practice is learned across the system.

We are working with our health boards to improve the clinical pathways to ensure that patients who can be moved through the system quickly are discharged quickly. We do not see the picture that the member paints of delayed discharge being endemic across all parts of the system, because there is good performance in some parts of it. I want to learn from those best-performing areas to ensure that we can take that best practice to the areas that are most challenged. We are providing financial and practical support in order to do just that.

Thank you, Presiding Officer, for the opportunity to update Parliament on the Scottish Government’s progress in advancing the health and social care reform programme, following the vision that I announced to Parliament last year and what was set out in the First Minister’s speech in January.

Today marks an important milestone in that journey. I am pleased to announce the publication of “Scotland’s Population Health Framework” and the “Health and Social Care Service Renewal Framework”, which are two vital components in delivering our shared vision for a healthier, fairer and more resilient Scotland. Together, the frameworks represent a significant step forward in shaping a future where people live longer, healthier and more fulfilling lives.

As the First Minister outlined earlier this year, we are taking bold and ambitious action to reform our health and care systems, delivering the transformation that the people of Scotland need and expect. Alongside the “NHS Scotland Operational Improvement Plan”, published in March, which is about improving service delivery now, the frameworks will drive forward public service reform in health and care, with a focus on prevention and on joined-up, efficient services. They provide clear direction on how we will plan and deliver services for the whole population over the next decade, while tackling the deep-rooted inequalities that continue to impact health and wellbeing across Scotland. As the First Minister set out just yesterday, they are part of an essential shift to a front-foot focus on prevention. They are public service reform in action in our health and care system.

The population health framework, which was co-developed with the Convention of Scottish Local Authorities, reflects our shared, long-term commitment to improving health and wellbeing across Scotland through a preventative, system-wide approach that addresses the broader drivers of health. Improving health and reducing inequality remains central to the Government’s ambition, yet we must face a hard truth: people in Scotland still experience vastly different health outcomes depending on where they live and the circumstances that they face. Too many people in our most deprived communities live shorter lives and spend more of those years in poor health. That cannot continue.

The core purpose of the population health framework is to improve life expectancy for everyone in Scotland and to reduce the unjust and avoidable gap between our most and least deprived communities. By shifting the focus from treating illness to preventing it, addressing the root causes of poor health and targeting our efforts where they are needed most, we can ensure lasting improvements for this generation and the next.

Most of what affects our health happens outside health and care settings; it happens in homes, in nurseries and schools, in workplaces, and in parks and green spaces—it happens in each and every one of our communities. That is why the framework contains 30 initial actions across these drivers of health: good early years, jobs, income and powerful communities.

The framework focuses on two early priorities: hardwiring prevention into our systems—how we plan, deliver, budget and account—and improving healthy weight. We know the toll on the health of our people from being overweight or living with obesity, and we know that that is preventable. The evidence tells us that tackling the environment is key. That is why one of the first actions of the population health framework will be to legislate to make the balance of foods that are available on promotion healthier and to restrict the location of less healthy foods in our supermarkets. That is what clinical leaders who treat our people have called for, and we will align with similar legislation in England and Wales, which is what our business leaders have called for.

This is the whole-system approach in action, delivering the decisive shift to prevention that the First Minister has called for. The approach follows the evidence; tackles the environment without blaming the individual; works with business and not against it; and involves all of us, across all our sectors and interests, working together.

As we move through the next decade, the framework will evolve and adapt to future challenges, meeting emerging needs and driving progress where it is needed most. Today, alongside the framework, we have published four sector summaries on the roles that the whole system plays in creating health. Developed by our business sector leaders, our community and voluntary sector leaders, our local government colleagues and national health service leaders, the summaries demonstrate the role that all sectors play in health and the opportunity that they all have to do more to improve health.

The business sector influences health through good employment with fair incomes, through the goods and services that it produces and by supporting thriving local economies. The NHS plays a central role in improving health, not only through the delivery of healthcare but as an anchor institution that works in partnership with local communities to improve the building blocks of health. Local government offers a critical leadership role and collaborates through local partnerships to deliver public services that strengthen health. The community and voluntary sector is uniquely situated to build trust, reach key population groups and support prevention through person-centred approaches, the delivery of critical services and the creation of community assets. That is the whole-system approach that public service reform requires, and we are grateful to our system leaders across all sectors for their work in developing the summaries.

In tandem with the population health framework, the health and social care service renewal framework sets out a clear path to ensuring a sustainable, high-performing health and social care system that can meet the future demands and evolving needs of our population. It will ensure long-term financial sustainability, reduce health and care inequalities, further harness the benefits of digital technology and improve health outcomes for people in Scotland.

Five principles that will shape the future of care in Scotland are at the service renewal framework’s core. The first is prevention. The population health framework looks to prevent illness occurring in the first place; the service renewal framework builds on that, with a focus on early detection and supporting those living with long-term conditions.

The second principle is people. We will design care around individuals and not systems. People will be empowered to be more in charge of their care and more involved in the decisions about their support and treatment.

The third principle is community. By rebalancing our resources, it will be easier for people to access services and a broader range of treatments closer to home.

The fourth principle is population. We will plan services based on the needs of our populations and not according to administrative or geographical boundaries.

The fifth principle is digital. We will embrace technology to improve people’s access to modern, joined-up and efficient services. People will have the choice to access information and services digitally in an inclusive manner. That means that more treatment will be delivered safely closer to home, whether someone lives in a town, in a rural village or on an island. For example, our digital front door service will mean that you can manage your condition, co-ordinate your appointments and see your diagnostic results all from your own phone.

For our workforce, our effort to capitalise on digital innovation means having the right digital access and information that they need to do the best job possible. That will streamline support, reduce their administrative workload and free them up to spend more time with patients and people.

Digital systems and smarter ways of working are not just enhancements but essential enablers of reform. The ability to meet our health and social care reform objectives hinges on how effectively digital tools are deployed and making digital transformation a strategic imperative for sustainable, high-performing health and social care services. The transformation will be underpinned by strengthened governance, providing clear accountability, robust oversight and empowered leadership.

Through those principles and the major changes that we have set out in them, people will experience faster and fairer access to services; the workforce will have new opportunities to deliver care more effectively and efficiently; and we will create a system fit for the future.

As the First Minister highlighted yesterday during his visit to the Queen Elizabeth university hospital, the renewal of Scotland’s essential public services must be rooted in a long-term vision that prioritises prevention and early intervention. Both the population health framework and the service renewal framework place prevention at their core.

To support this transformation, we are bringing together existing national resources, which are currently spread across several national boards, into a single, co-ordinated body to be called NHS delivery. As part of that change, we will merge NHS National Services Scotland and NHS Education for Scotland. That will ensure that we are better equipped to deliver key priorities, including making progress on our digital ambitions. It will enable us to provide clear, streamlined support to local systems to deliver on once for Scotland services, both for NHS Scotland and, potentially, for the wider public sector.

We are not proposing structural changes for the Scottish Ambulance Service and NHS 24, but we expect them to work much more closely together, supported by enhanced joint planning and co-ordination, building on existing collaboration. That will support transformational improvements in urgent care, so that people can access timely, appropriate support wherever and whenever they need it.

I want to acknowledge the vital partnership with COSLA to develop both the frameworks. I call on partners across the Government, local authorities, the NHS, the third sector, business and communities to continue to work with us to deliver this ambition. We developed the frameworks together and I want to implement them together.

I spoke earlier about all of us, with all our interests, working together to improve health. That applies to members in this chamber, too. I know that all members want our people to enjoy good health and for our services to be modern, joined up and efficient. Together, through shared purpose and co-ordinated action, we can build a system that not only treats illness but helps people to live longer, healthier and more fulfilling lives.

I did, indeed, meet Dr Lockhart on Friday, and I was very pleased to do so. We had an informative discussion, including with the community council, which Mr Lochhead also took part in. The areas that relate to the latter part of Douglas Ross’s question are currently matters of discussion and negotiation with the British Medical Association. We are discussing how we can continue to support general practice and its sustainability, and how it can deliver more in our communities, as both Dr Lockhart and I want to see.

That is not what we have set out. We expect the framework to inform decision making from now on. The decision-making process that the service renewal framework and the population health framework set out is about taking those considerations into account. We will continue to work with our boards—including those that represent rural and island communities—to ensure that service parity is available.

I was born and brought up in an island community; I know what it is like to travel to receive services; I therefore recognise that, for some, travel will inevitably be needed. I want to ensure that that is done equitably, fairly and supportively, so that there will be a better situation for island communities such as the one that I am from, and for the communities that colleagues across parties represent—and a better system for the people of Scotland.

If Mr Stewart is asking me about reform within local government, that is not for today. However, the Convention of Scottish Local Authorities provided collaborative support for the two documents that have been published, so we are seeing a willingness on its part to engage and recognise the role that its members play as delivery agents for our national policy ambitions.

This is a shared endeavour of ambition; we want to see a step change and generational shift in the way that we deliver services and in the balance of care. I am confident that COSLA will continue to support us in that endeavour.