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The Scottish Government is clear about the priority we place on ensuring people can access high quality palliative and end of life care.

Our Strategic Framework for Action on Palliative and End of Life Care sets out our ambition that we want those who would benefit from palliative and end of life care to have access to it by 2021. This ambition was re-affirmed in our Health and Social Care Delivery Plan which was published in December 2016.

Good care at end of life requires collaborative, multi-disciplinary support, which is why Integration Authorities have been given statutory responsibility for meeting this need. Integration Authorities regularly report on their progress using the 23 indicators (https://www2.gov.scot/Topics/Health/Policy/Adult-Health-SocialCare-Integration/Outcomes/Indicators/Indicators ) that support the statutory outcomes set out in the Public Bodies (Joint Working) (Scotland) Act 2014.

The indicator currently used nationally to gauge progress on improving the availability of palliative and end of life care is the percentage of last six months of life spent in the community. Since the publication of the Health and Social Care Delivery Plan in 2015-16, the percentage of time spent at home or in a community setting continues to increase from 86.7% to 88.1%. This is an encouraging shift as it equates to, on average an extra five days within the last six months of life being supported at home or in a community setting. However, we recognise that this indicator is not sufficient on its own. We are working with partners in local systems and health and social care professionals to improve our understanding of the quantity and quality of palliative care across Scotland.

Providing high quality, person centred care for people towards the end of life is an important priority for the Scottish Government.

We want people to get the care and support that is right for them and enable them to stay in their local community for as long as possible. Our ambition to ensure people get the care that is right for them in a community setting is reflected in our budget this year, which provides investment of more than £700 million to support social care services and speed up the pace of integration. We are on track to deliver our commitment that more than 50% of frontline NHS spending will be shifted to community health services by the end of this Parliament.

Details of NHS expenditure on general practice and dental services are made available each year in the annual NHS publication “Scottish Health Service Costs”, also known as the Cost Book. The latest available Cost Book is for 2018-19 and the report can be accessed at the following location: https://www.isdscotland.org/Health-Topics/Finance/Publications/ .

Information from a number of sources regarding the provision of workplace support across our health and social care services, is currently being considered on behalf of the Ministerial Short Life Working Group on Culture and Wellbeing, which I chair. The Group has a broad remit to examine and review existing provision, and will in due course publish a framework to support sustainable, longer-term cultural transformation.

One of the objectives of that framework will be to promote the implementation of practical strategies that ensure that all staff, regardless of their role or location have access to appropriate support services. An update to Parliament will be provided in the Spring, once the Short-Life Working Group has concluded its work.

Our Programme for Government 2019-2020 commits to establishing a Women’s Health Plan to reduce inequalities in health outcomes that affect women, including reducing inequalities relating to cardiac disease. In order to inform and develop the Plan, key stakeholders have been invited to join a Women’s Health Group which will be chaired by the Chief Medical Officer. The first meeting is due to take place in February 2020.

We continue to implement our heart disease improvement plan, which sets out the priorities and actions that we will take to deliver improved prevention, treatment and care for all patients.

ISD publish waiting times for endoscopy as part of the Diagnostics Waiting Times publication. The data published gives the number of people who are still waiting at the end of each month, and does not provide the completed waiting times for this test. Performance against the 6 week standard is only available from quarter ending June 2009. These can be accessed at the following web site: https://www.isdscotland.org/Health-Topics/Waiting-Times/Diagnostics/

The following table provides numbers of endoscopy procedures reported from inpatient, day case or outpatient settings from 2007 to 2018.

The Scottish Government, along with the rest of the UK, is advised on all aspects of screening by the UK National Screening Committee (UK NSC), an independent expert advisory group who assesses screening programmes against a robust set of criteria, and based on evidence, the UK NSC recommend routine breast screening for women aged between 50 and 70. If a woman has symptoms which could be suspicious of cancer, she should raise this with her General Practitioner as soon as possible, regardless of her age.

We know that screening remains the best way to detect cancer early and help reduce health inequalities in cancer outcomes. Breast screening is a vital public service and plays an important role in detecting cancer at an early stage.

The following table sets out NHS Scotland’s spend on both goods and services from other UK NHS bodies, as reported by NHS Boards in their annual accounts.