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On 29 August, the creation of an expert group which will provide support to transform scheduled care and put services on a sustainable footing was announced. The Elective Access Collaborative Programme will bring together experts from the Scottish Government, NHS Scotland and the Presidents and Chairs of the Royal Colleges – to provide support to health boards in improving the way elective services are configured.

The work of this group is supported by additional investment of £50 million which is being made available to Boards to improve waiting times for all parts of the patient journey, and £5 million confirmed on 5 October 2017 to support winter planning and enhance resilience across the services, making sure patients are seen quickly, efficiently and without delay.

The Scottish Government is also investing £200 million in five new elective treatment centres and the expansion of the existing Golden Jubilee National Hospital.

The Scottish Government expects all Boards to take all reasonable steps to live within their means and make best use of the available resources as part of a balanced approach to performance. Within this context, the Scottish Government continues to follow the twin approach of investment and reform, and shifting the balance of care to community health services.

All Boards were able to obtain the necessary financial information from the relevant integration authorities for inclusion in the final accounts. All Boards received an unqualified audit opinion for the 2016-17 annual accounts.

It is important to note that 2016-17 was the first full year that integration authorities were fully operational. Areas for improvement are being identified and addressed as part of the approach to be taken by relevant bodies for subsequent years.

The welfare of NHS staff is critically important, every health board is required to have policies in place and to comply with national policies on managing health at work, which includes activity to support staff wellbeing.

Scotland has led the UK in the development of nursing and midwifery workload and workforce planning tools. A Nation with Ambition – the Government’s Programme for Scotland 2017-18, published on 7 September 2017, published our commitment to introduce Safe Staffing legislation, enshrining our world leading workforce planning tools in law, commencing with the nursing and midwifery professions.

The Nursing 2030 Vision, launched by the Chief Nursing Officer earlier this year, sets a direction for nursing through to 2030. It recognises that when nurses are happy and valued, patient outcomes improve and services flourish. The Vision prioritises activity to support nurses’ health and wellbeing.

As part of the existing approach to planning and identifying savings, NHS Boards focus on delivering recurring savings.

To ensure that public resources are used as effectively as possible and to help meet increasing demand and deliver reform, the Scottish Government has established a Sustainability and Value Programme to maximise the benefit from efficiency and productivity savings.

This Programme supports NHS Boards in identifying recurring savings which are then retained for local reinvestment. Savings plans are continually developed throughout the year, to deliver better services, better care and better value.

I refer the member to the answer to question S5W-12300 on 20 November 2017. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx.

The Scottish Government agrees that a new GP contract is critical to delivering more care in the community. Scottish Government and the BMA have negotiated a new contract (published 13 November), details of the contract offer can be found at http://www.gov.scot/Topics/Health/Services/Primary-Care/GP-Contract

In 2016-17, there were 978 incidents of domestic abuse recorded by the police in the Scottish Borders. This represents an increase of 47% from 665 incidents recorded in 2008-09. The rate of incidents recorded per 10,000 population in the Scottish Borders has increased from 59 in 2008-09 to 85 in 2016-17. However, this rate has been consistently below that of the Scottish average which in 2016-17 was 109 per 10,000 population.

The Scottish Government is investing almost £30 million (2017-20) from the Equalities portfolio to support a range of projects and initiatives – including support for a range of front line specialist services working with women and children who have experienced domestic abuse. Separately, we committed an additional dedicated £20 million over 2015-18 from Justice budgets to be invested in a range of measures to tackle all forms of violence against women and girls.

We are also implementing Equally Safe, Scotland’s strategy to tackle all forms of violence against women and girls. This aims to prevent violence from occurring in the first place, build the capability and capacity of mainstream and specialist services to support survivors and those at risk, and strengthen the Justice response to victims and perpetrators. A Delivery Plan for Equally Safe will be published by end 2017.

We are also improving the justice system response to domestic abuse. The Domestic Abuse (Scotland) Bill, which is currently before Parliament, will create a new offence criminalising a course of abusive behaviour towards a partner or ex-partner. The offence will help law enforcement agencies in dealing with domestic abuse with a law that reflects a modern understanding of domestic abuse and will cover all the types of behaviour that can constitute domestic abuse; crucially this includes psychological harm. This new offence will help our justice partners such as Police Scotland and the Crown Office to more effectively deal with domestic abusers.

Utility Costs

The Scottish Public Sector Utility contract, managed by Scottish Procurement, covers electricity, gas, water, some liquid fuels and biomass pellets. All public sector partners actively manage the purchase of energy on the wholesale market through a national Risk Management Committee run by Scottish Procurement. Through this committee, maximum target costs are set to ensure the least risk of exposure to market changes.

Agency Staff

The Scottish Government in conjunction with NHS National Procurement has implemented monthly reporting of Nursing and Medical Agency spend. This data, collated from the general ledger of each Health Board, is distributed to executive leads, allowing each NHS Board to see their exact month on month spend which is benchmarked against that of other Boards. Reports available also include the cost of individual locums used by Boards. Data is also provided all other aspects of agency staff spend.

Through a national procurement approach we also have framework contracts in place for Medical and Nursing agency which limit the agencies on this contract to rates of pay consistent with NHS rates, ensuring best value for money when agency staff need to be sourced. The sourcing of agency staff however should be a very last resort and the majority of temporary shifts are filled through the NHS Staff Bank which employs NHS staff on NHS contracts at NHS rates of pay.

The Scottish Government is working to develop a medium term financial framework, within the context of the budget settlement that the Scottish Government receives. This will outline the broad direction for the NHS and care services to meet the changing needs of the people of Scotland, including shifting the balance of care.

The Scottish Government recognises the need to offer Boards appropriate flexibility between financial years, and this is already reflected in the Scottish Government’s approach. In recent years, for example, banking of funds to be drawn down in future years and brokerage arrangements have been agreed with NHS Boards.

We will consider the scope to develop further the mechanisms already used to provide financial flexibility for NHS Boards, within the wider regulations in which the Scottish Government requires to operate, as set out by HM Treasury.