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The Scottish Government works closely with the Centre for Sustainable Delivery (CfSD) to support delivery of improvement programmes, including the Urgent and Unscheduled Care collaborative, to ensure sustainable ways of delivering services, improving access for patients, and reducing unnecessary demand for services. While we monitor progress through discussion with CFSD and NHS Boards, we will provide updates on progress against specific pathways in our NHS Recovery Plan annual update.

Following open competition, the Picker Institute has been awarded the contract to evaluate the Redesign of Urgent Care pathway. The cost of the project was £90,000 and final report will be published on the Scottish Government website in the summer.

The Scottish Government is committed to ensuring safe and equitable access to screening for the eligible population. In collaboration with NHS National Services Scotland, NHS Scotland, and representatives from the third sector and academia, the Equity in Screening Strategy 2023-2026 was published in July 2023. The strategy commits to exploring opportunities to offer a greater variety of service provision, including appointments outwith core hours and in a variety of locations. An action plan is currently in progress, and a group has been established to take the recommendations within the Strategy forward.

In addition, the Breast Screening Modernisation Board is taking forward recommendations from the Major Review of the Breast Screening Programme , published in 2021. This includes increasing the convenience of appointments, such as providing more regular evening and weekend appointments for those who find it hard to adjust weekday commitments or rely on support from others.

Most cervical screening is performed within GP practices, and therefore the appointment times are dependent on their opening hours. However, the Scottish Government is committed to exploring the potential for implementing self-sampling in the home for cervical screening and acknowledges that it has the potential to increase uptake levels and reduce barriers to cervical screening.

The introduction of self-sampling within cervical screening is dependent on a recommendation by the expert UK National Screening Committee (NSC), based on an assessment of the available evidence. We are aware that the UK NSC is currently considering this actively.

Working with the other UK governments, the Scottish Government is introducing packaging Extended Producer Responsibility (EPR) from October 2025. Packaging EPR will see producers taking financial responsibility for the full net cost of responsible management of their packaging, including plastic packaging, at end-of-life. This will create a strong incentive for producers to reduce their use of packaging and drive more sustainable design choices.

As part of this process, the four governments meet regularly with industry representatives, including retailers, to discuss their perspectives on these proposals. A new packaging EPR Scheme Administrator Steering Group has been set up, with retailer representation, recognising industry’s significant role in delivery of the scheme; the first meeting of this group was on 2 February 2024.

The Scottish Government is working with the other UK governments to legislate to introduce extended producer responsibility (EPR) for packaging. Among other benefits, this will create a strong incentive for producers to reduce their use of packaging and drive more sustainable design choices.

The main legislation for packaging EPR will be a Westminster SI, with supporting legislation in Scotland where required. The draft text of this SI was made available for public consultation from 28 July 2023 to 9 October 2023 and is available online at the following link: Draft producer responsibility obligations (packaging and packaging waste) regulations - GOV.UK (www.gov.uk

Patient safety is of paramount concern and the Health Board has been clear that the interim ICU plans, first announced in February 2023, are to ensure adequate consultant medical cover; thereby maintaining the safety and sustainability of local critical care services.

The Programme Delivery Board last met on 31 January 2024. The Board discussed the Programme’s progress to date, including an update on the status of the NCS Bill and subsequent planning across the programme for 2024.

The Scottish Government has invested over £34 million since 2018 and this has supported the recruitment and retention of an additional 216.16 whole time equivalent school nurses.

This investment has meant that all Health Boards in Scotland have been able to recruit additional school nurses. Workforce numbers are published quarterly by NHS Education Scotland (NES) in the National NHS Workforce Statistics.

We continue to work with Health Boards to monitor school nursing recruitment and retention and the implementation of the transformed role.

While we work with Boards through planning to make best use of existing NHS resources and capacity, we will continue to use the private sector in a structured and prioritised manner. As we deliver new, better and more sustainable ways of delivering services to improve access for patients, we expect the need for private sector capacity to lessen. It is for local NHS Health Boards to determine how they use the private sector and to agree any contractual arrangements.

In 2022/23, total spend on use of the private sector in NHS Scotland represented just 0.7% (£116m) of the total frontline health budget, while in England, it was 6.5% (£11.5bn) of the Department of Health Budget.

Public Health Scotland’s Annual Acute hospital activity and NHS beds information provides information on non-NHS providers; NHS patients treated in non-NHS locations such as private hospitals, hospices, nursing homes, care homes etc. PHS's latest publication, covering 2022-23 shows that there were 2,958 consultant-led outpatient appointments performed by non-NHS providers in 2022-23, or 0.08% of the total that year (3,928,597) Table 1 – Outpatient Activity. During this period figures for new outpatient appointments are 1,988 by non-NHS providers out of 1,273,588 in total (0.16%), involving 1,943 new patients out of a total of 964,316 new patients. There were also 4,962 Continuous Inpatient Stays in non-NHS hospitals out of a total of 1,092,413 (0.45%). This involved 4,779 patients out of a total of 631,731 patients (0.76%) Table 2 – Inpatient and day case activity .

The first official meeting of the Flow Navigation Special Delivery Group was held on 4 October 2023. The group meet monthly with 4 meetings having taken place since its formation.

The group is led by the Centre for Sustainable Delivery and consists of clinical and operational leads, for Flow Navigation Centre’s, from each mainland Health Board. It also includes representatives from the Royal College of Emergency Medicine, the Royal Collage of General Practitioners, Primary Care, NHS 24, the Scottish Ambulance Service and the Scottish Government.

The Scottish Government places great importance on community sports and leisure facilities. They are crucial to the wellbeing of all our country and most importantly, for our children and young people to be healthy and active.

We have asked sportscotland to undertake a review of the facilities estate which will provide vital information in understanding the sport and leisure facilities provision in the long term. In addition, sportscotland and Scottish Swimming have recently published a detailed research study into the condition of Scotland’s swimming pools.

We are fully aware that local authorities are facing challenging financial circumstances, particularly in the maintenance and operating of facilities, largely due to energy costs and other cost of living pressures. sportscotland will continue to work with its local partners to help them assess the impact of any potential facility closures across the country. In addition, the Minister for Social Care, Mental Health and Sport and officials engage regularly with Community Leisure UK to discuss the local public facilities landscape.

In recognition of the importance of access to sports and leisure facilities, our Programme for Government sets out our intention to convene a working group, including representatives of sports organisations, community organisations and CoSLA, to explore how community access to community facilities, such as the school estate, can be enhanced.