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Acute bed numbers must reflect patients' health care needs. Over time, patterns of care in acute hospitals have changed, with shorter lengths of stay and much greater use of day surgery. As a result, fewer acute beds have been necessary to support treatment of patients.Detailed decisions about bed numbers in the light of these service developments are most appropriately carried out at NHS board level, where local needs and priorities are best understood, and where decisions can best be made about meeting the health needs of the local population safely and sustainably.The Scottish Executive continues to monitor carefully trends in the level and pattern of care to ensure that resources are used in the most effective manner to meet patients' needs.

NHS Lothian successfully commissioned the first phase of the new Royal Infirmary on 27 January, and phase 2 will follow in early 2003. The new hospital will offer first class surroundings and state of the art equipment to match the excellent clinical care already delivered by health professionals in Lothian. Overall bed numbers are planned on a cross-Lothian basis. A review was undertaken in 1999 by Lothian Health Board of planned acute bed numbers for the new Royal Infirmary of Edinburgh. This confirmed that the proposed numbers were adequate in the context of the board's plans for developing community and primary care services. The balance between hospital and community services, and therefore the requirement for acute beds, is kept under regular review.NHSScotland will continue to respond to the needs of patients within the policy framework provided by the Scottish Executive, which emphasises the importance of patient-centred services and reductions in waiting to meet key targets.

Local authorities are required to produce and publish Community Care Plans every three years, and to review these annually. Officials scrutinise these plans for their content.

Our guidance to local authorities on community care planning contained in SWSG 35/1997 remains extant. Local authorities are required to update and roll forward annually their community care plans in partnership with health boards. All plans are produced jointly with NHS boards. In early 2000, we issued to health boards, trusts and local authorities a Scottish Needs Assessment Programme report on the needs of people with brain injuries, and invited these agencies to respond to the findings and recommendations intended to improve care planning and provision. Community Care Plans are primarily for use locally, and are intended to help agencies develop strategic thinking on a joint basis, and plans are a matter of public record. We also provide core funding to Headway Scotland, the brain injured association, which, in addition to providing support services locally for sufferers, also helps to raise awareness of the needs of the brain injured with the statutory service providers.

In September 2001, we established 15 new NHS boards to enhance local decision making in NHSScotland. The membership of the new boards - which now includes elected local councillors, NHS staff and clinicians - has been specifically designed to provide a better reflection of the communities they serve.Putting in place the new, unified local NHS systems has involved more than 100 new non-executive appointments to NHS boards and trusts since January 2001, each of which has been made in line with guidance issued by the Commissioner for Public Appointments. This process has included local and national advertising campaigns, most notably for the Chairpersons of 13 NHS boards and five trusts, which have attracted a wide range of applicants from diverse backgrounds.Additionally, Patient Focus and Public Involvement, published in December 2001, requires each new NHS Board to work closely with its community planning partners and voluntary organisations to develop a sustainable framework to support local public involvement.

Patient Focus and Public Involvement, published in December of last year, set out plans for developing the actions identified in the Involving People section of Our National Health: A plan for action, a plan for change. It also identified how the earmarked £14 million investment would be allocated across four complementary strands of building capacity and communications, patient information, involvement, and responsiveness to develop a patient-focused health service.

In 2000-01, Scotland's Health at Work scheme received resources from health boards of around £1 million. Following the commitment in the Scottish Health Plan, additional funding from the Scottish Executive of £0.450 million in 2001-02 and £0.750 million in 2002-03 was approved.

Following detailed discussion, the National Demonstration Projects Steering Group has agreed proposals for Scotland-wide Learning Networks. These will be implemented by the Public Health Institute of Scotland. Project manager posts will be advertised shortly.

The consistent development of clinical information systems across Scotland is being supported by the work of the Clinical Standards Board for Scotland, ISD and Audit Scotland. During 2001 they held two national meetings to review national databases in order to identify information sources suitable for monitoring the quality of direct patient care. A further meeting is planned with wider participation in spring 2002. In addition improving the quality of clinical information was a key strand of the recent CRAG Symposium, Improving Quality of Care for Patients: Sharing Principles and Practice. This showcased examples of good practice in developing consistent information systems to support direct patient care and to bring about improvements in patient management. CRAG has also supported the development of the Strategy Programme for Information & Management which sets out national and local programmes and targets for establishing greater collaboration and consistency of approach to the development of information management and technology (IM&T) across NHS Scotland. As part of this wider work CRAG will support a conference on IM&T systems in April.

The Scottish Health Promoting Schools Unit has not yet been formally established. The Scottish Executive Health and Education Departments are working with the Health Education Board for Scotland, COSLA, and Learning and Teaching Scotland to establish the Unit within the first half of 2002.