Seòmar agus comataidhean

As part of the 2018 GP Contract, the Scottish Government amended regulations for the delivery of CTAC Services. Boards are now responsible for providing a Community Treatment and Care service. These services are being designed locally, taking into account local population health needs, existing community services, and optimising benefit to practices and patients.

Our annual statistical publication provides a progress update on implementation of the 2018 GP contract.

Transitionary funding, sometimes known as sustainability payments, were made to GP practices in 2021-22 and 2022-23 and reflected the status of the Primary Care Improvement Plans at that time. Since then we have continued to implement the plans and practices are now supported by over 4,900 multi-disciplinary team staff.

In 2024-25, we are investing over £190 million in the ongoing development of primary care multi-disciplinary teams.

We are committed to reducing waiting lists backed by an initial investment of £30 million has been allocated to Health Boards and will target reductions to the national backlogs that built up throughout the pandemic. This funding is being targeted at a series of national and local plans to reduce backlogs by maximising the use of local and national resources across Scotland. As part of this, we have allocated additional funding to Gynaecology services which we expect to l deliver around 3,500 New Outpatient Appointments.

NHS Scotland’s Centre for Sustainable Delivery (CfSD) is also playing a central role in working with Health Boards to ensure that they are able to continually identify new ways to increase capacity, and to respond to demand through service innovation and redesign.

CfSD programmes have developed strong clinically-led Specialty Delivery Groups (SDG), including one for Gynaecology, which promote multidisciplinary team working, and support local adoption of service improvement programmes. These groups are now well established and have supported several new and innovative pathway developments, many of which are now being successfully scaled up across Scotland, including Active Clinical Referral Triage (ACRT), Patient Initiated Review (PIR) and Enhanced Recovery after Surgery (ERAS).

This is all part of our programme to drive up productivity and tackle waiting lists, supported by the CfSD. Together, our actions will further enable NHS Scotland to maximise capacity, build greater resilience and deliver year-on-year reductions in the number of patients who have waited too long for treatment.

The anticipated cut by the UK Government to the Scottish Government's capital budget of up to £1.3billion in real terms over the coming years has consequences. In December 2023, given the extremely challenging capital funding position, NHS Boards were instructed to pause any project development spend and instead direct capital budgets towards maintenance of the existing estate and essential equipment and digital replacement. Boards were notified that the Scottish Government does not anticipate starting construction of any new project over the next two years at least. Obviously should the UK Government change course on capital investment we have an opportunity to look at this again alongside the capital review ongoing across the Scottish Government.

There is therefore no change to the position on NHS Capital Projects as a result of the ongoing review of the Infrastructure Investment Plan.

NHS Boards are responsible for implementing the National Code of Practice for GP premises.

The NHSScotland National Primary Care (GP) Premises Group has been set up to consider all matters relating to GP Premises including:

• Oversight of the implementation of the Code of Practice for GP Premises.
• Implementation of GP Sustainability Loans.
• Consideration and review of available guidance.
• Consideration of appropriate schedules of accommodation within Primary Care premises, and specifically that of General Practice occupied areas and how this may affect reimbursement.
• Provide a platform for the Scottish Government to present papers/proposals to the group.
• Provide a platform for the BMA to present papers to the group.
• Provide a platform for the NHS Boards to present papers to the group.
• Ensure the Rent Review Process is consistent and supports the intent of the GP contract where required.
• Standardise approaches, e.g. standardise leases across Scotland.

Health Boards are represented on a regional basis alongside the BMA, the Scottish Government and other stakeholders.

The Scottish Government remains committed to improving the care and wellbeing of people through the best use of digital technologies. We work closely with NHS National Services Scotland (NSS), who manage the rollout of the new national GP IT System, ‘Vision’ supplied by Cegedim Healthcare Solutions. Our focus always is on patient safety and the resilience of such systems. The recent performance issue referred to was quickly identified as due to bandwidth capacity and was quickly resolved, since when there has been stable and consistent service for GP practices using Vision.

The additional £30 million for planned care, initially announced in April, will support health boards across the country deliver around 12,000 inpatient procedures, over 40,000 extra diagnostic procedures and around 12,000 new outpatient appointments.

Funding will target reductions to pandemic backlogs, including orthopaedics, ophthalmology, diagnostics for cancer referrals and patients waiting the longest time.

The funding will be allocated to health boards for the activity set out above based on delivery. We are working closely with health boards to monitor progress.

Decisions on prescribing medicines are a matter of clinical judgement for the prescribing clinician in consultation with their patient. These should be based on individual clinical need, informed by relevant advice such as that issued by the General Medical Council (GMC) and guidance for the medicine.

The Scottish Government’s Menopause Clinical Reference Group, Chaired by Dr Heather Currie, has discussed the prescribing of testosterone for women in menopause. This group is exploring supplementary guidance for healthcare professionals on prescribing testosterone for loss of libido in menopause, in line with the British Menopause Society and National Institute for Health and Care Excellence (NICE) guidance.

In response to the increasing number of laboratory-confirmed cases of pertussis that have been reported in Scotland as well as other parts of the UK and Europe, the Scottish Government is working closely with Public Health Scotland (PHS) and NHS Maternity Services to raise awareness of the risks of pertussis, particularly to young infants and to promote timely vaccination uptake as well as emphasising the importance of pertussis vaccination during pregnancy to protect newborn infants.

A National Incident Management Team (IMT) was convened by PHS on 23 May to ensure best practice across all Boards, including addressing any issues locally that might cause vaccination to be delayed.

The National Pertussis Incident Management Team continues to meet regularly to consider and review all actions in response to the increase in pertussis cases.

The Chief Midwifery Officer wrote to Maternity Services on 15 May 2024 encouraging midwives to promote the offer of vaccination to pregnant women.

The Chief Medical Officer wrote to Immunisation Coordinators and Directors of Public Health on 27 May 2024 about the importance of timely vaccination of infants and young children. He also wrote to Medical Directors and health professionals on 30 May 2024 to encourage all health care staff in priority groups working with infants and pregnant women to keep up to date with their own pertussis vaccinations via their occupational health services.

Healthcare Improvement Scotland (HIS) is the national health and social care improvement organisation for Scotland which develops standards and indicators to support health and social care organisations improve the quality of care and support they deliver.

To support nationwide improvements in the quality of care, work is currently underway to develop a set of healthcare standards which outline the requirements for all healthcare services across Scotland.

Healthcare Improvement Scotland will publish draft National Healthcare Standards for consultation by 31 January 2025. It is anticipated that the final National Healthcare Standards will be published by end summer 2025.