Seòmar agus comataidhean

As outlined in the Mental Health in Primary and Community Care Progress Report (Dec 2024), we remain committed to delivering increased mental health and wellbeing workforce capacity in general practice when it is feasible to do so. As the member will be aware, the Emergency Budget review meant that recruitment of additional roles was paused. We are prioritising investment to maintain mental health capacity in primary care through Action 15 of the Mental Health Strategy 2017-2027 and the Primary Care Improvement Fund.

The Mental Health in Primary and Community Care Progress Report also sets out what is needed to improve access to support, assessments and treatment from general practice. It contains a range of actions, including improving access to adult mental health treatment – expanding the NHS 24 Mental Health Hub, by December 2025, to provide access to digitally enabled psychological interventions and therapies for people who may benefit from early treatments.

This is in the context of wider support for general practice: the Scottish Government has already allocated over £1.3 billion to primary medical services this year with a further £56 million on course for pay rises and to provide new preventative services.

This follows an increase of £59.6 million last year to meet the Review Body on Doctors' and Dentists' Remuneration recommendations and to cover population growth as well as a further £13.6 million to help GP practices meet the costs of inflationary pressures and deliver local enhanced services.

The Scottish Government have not received reports of any extended delays for patients contacting NHS 24. We monitor NHS 24’s performance closely and remain satisfied that it continues to meet its statutory and clinical obligations.

NHS 24 has taken significant steps to improve performance, including increasing staffing levels to 1,556.9 WTE (2,199 headcount) as of March 2025 – an increase of 48.3% over the past decade. The service has also revised its key performance indicators to better capture unmet demand and identify risks where callers may have made multiple unsuccessful attempts to access 111.

The Scottish Government remains committed to supporting NHS 24’s efforts to improve service delivery and ensure that the 111 service continues to meet the needs of the public.

The Scottish Government continues to work closely with NHS 24 as it trials and implements new approaches to service delivery.

NHS 24 is also collaborating with key partners, including the Scottish Ambulance Service, to explore improved models of joint working. These efforts aim to enhance efficiency and ensure the 111 service remains responsive, effective, and aligned with the needs of patients across Scotland.

The Scottish Government does not hold this information.

Public Health Scotland (PHS) uses the national waiting times data mart to collect electronic patient records covering the waits that patients experience waiting for treatment as an inpatient or day case under the Treatment Time Guarantee. This data source can be used routinely to identify the specialty of treatment. However, although the records are designed to collect coded information on the procedure that is planned for the patient, this information is often either incomplete, lacking in essential detail and/or its accuracy cannot be assured. In addition, for patients who have completed their wait the procedures that was planned may not always reflect the procedure actually performed after they were admitted for treatment. The latter is not captured through the national data mart. Consequently, PHS is not currently able to report accurately on waiting times to this level of detail.

More detailed information on the procedures that is planned or undertaken for a patient will be held locally by NHS boards.

The Scottish Government does not hold this information.

Public Health Scotland (PHS) uses the national waiting times data mart to collect electronic patient records covering the waits that patients experience waiting for treatment as an inpatient or day case under the Treatment Time Guarantee. This data source can be used routinely to identify the specialty of treatment. However, although the records are designed to collect coded information on the procedure that is planned for the patient, this information is often either incomplete, lacking in essential detail and/or its accuracy cannot be assured. In addition, for patients who have completed their wait the procedures that was planned may not always reflect the procedure actually performed after they were admitted for treatment. The latter is not captured through the national data mart. Consequently, PHS is not currently able to report accurately on waiting times to this level of detail.

More detailed information on the procedures that is planned or undertaken for a patient will be held locally by NHS boards.

I understand that the Royal College of Ophthalmologists has recently written to Stephen Kinnock MP, Minister of State for Care, calling for a review into the use and oversight of independent sector providers for NHS-funded cataract surgery in NHS England.

NHS Scotland continues to make best use of existing NHS resources and capacity. Our National Treatment Centres (NTC) programme provides additional protected elective capacity and infrastructure for ophthalmic activity and a number of Health Boards also have additional cataract slots at Golden Jubilee National Hospital.

While NHS Scotland makes limited use of the independent sector, in certain circumstances limited use of alternative providers, including independent sector providers, may be required in response to capacity constraints.

The Scottish Government commissioned Centre for Sustainable Delivery (CfSD) is working with NHS 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.

In January 2022, Scottish Government commissioned CfSD to establish the Scottish National Cataract Short Life Working Group. This multi-professional group developed a 'Blueprint for Success' to deliver higher volume cataract surgery in operating theatres across Scotland; the aim being to deliver a minimum of 8 procedures per core 4-hour session or a minimum of one procedure every 30 minutes. The adoption of these minimum standards to deliver higher volume activity will reduce variation and waiting times for planned care across NHS Scotland.

The Blueprint for Success can be accessed here: https://www.nhscfsd.co.uk/media/5sofmknr/cataract-surgery-blueprint-2022.pdf

Furthermore, our additional investment of £110 million in 2025-26 has been targeted to specialty areas and NHS Boards where it can have the greatest impact against the longest waits, including for ophthalmology.

Finally, Our National Treatment Centres (NTC) programme provides additional protected elective capacity and infrastructure for ophthalmic activity. NTC capacity is a national resource and allocations are based on the latest Waiting Times management information available to Scottish Government at the time of decision. This approach ensures the NTCs are targeting the longest waiting patients that meet the clinical criteria for NTCs and allocations of activity have been determined on this basis.

We recognise long waits are unacceptable and I apologise to all patients waiting too long for treatment. We are determined do more and our Budget which will provide a record £21.7 billion for health and social care, with more than £110 million allocated to health boards to help tackle the longest waits for procedures and operations. This includes more than £12 million for ophthalmology.

Work is ongoing to support local surgical teams to increase efficiency and consequently the number of patients that can be treated across the cataract surgical pathway, in line with the Royal College of Ophthalmologists guidelines.

The Scottish Government is responsible for setting the strategic policy direction for NHS Scotland and its workforce. Operational matters, including the staffing of individual services, are the responsibility of each NHS Scotland Health Board.

At a local level, the Health and Care (Staffing) (Scotland) Act 2019 places duties on Health Boards to ensure that at all times suitably qualified and competent individuals are working in such numbers as are appropriate for the health, wellbeing and safety of patients, the provision of high-quality care and the wellbeing of staff.

The Scottish Government works with a stakeholder group (which includes NHS Education for Scotland, the British Medical Association, the Academy of Medical Royal Colleges and various Health Board representatives including regional workforce planners) to undertake annual reviews of the number of specialty training places (for resident doctors) needed across all specialties in order to meet anticipated future service demand and consultant need.

Workforce statistics, including statistics on certain roles within ophthalmology services across NHS Scotland, can be found at: NHS Scotland workforce | Turas Data Intelligence.

The information requested is not held centrally by the Scottish Government. More detailed information on cancellations and rescheduled appointments will be held locally by NHS boards.