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Microsoft are a key partner to NHS Scotland Boards. NHS Boards regularly engage directly with Microsoft regarding licencing and systems required.

As the member will appreciate, it would not be appropriate to disclose information publicly that may compromise the security of Scotland’s NHS.

The Network and Information System Regulations set out standards which NHS Scotland Health Boards must comply with. Boards must test themselves against these standards which cover managing security risk, defending systems against cyber-attack, detecting cyber security events, and minimising the impact of cyber security incidents. This is in addition to mandatory information security and data protection risk/impact assessments and routine penetration testing on all major IT systems.

The NHS Scotland Cyber Centre of Excellence (CCoE), works nationally across health boards to prioritise the security capabilities of existing technologies and deployment of new tooling. This allows real time discovery of vulnerabilities and potential issues across a national view.

The Fuel Insecurity Fund was first established in the winter of 2020, as part of the wider Winter Support Fund, to help households struggling with their energy costs who were at risk of severely rationing, or self-disconnecting entirely because they could not afford their energy costs.

The Scottish Government has distributed a total of £63.595 million to third sector partners to deliver the Fuel Insecurity Fund up until March 2024. The following table gives an overview of the budget and distribution since inception:

The Centre for Sustainable Delivery (CfSD) has developed strong clinically-led Specialty Delivery Groups (SDG) which promote multidisciplinary team working and support local adoption of service improvement programmes.

This includes the Cataract Sub-Specialty Delivery Group which brings together key ophthalmology clinical, operational and managerial experts from across NHS Scotland and Scottish Government which has been commissioned to support an increase in surgical throughout across cataract only surgical sessions. This short life working group has supported several new and innovative pathway developments, some of which are now being successfully scaled up in a number of sites across hospital eye services, including: high volume cataract surgery in ring-fenced sessions, and delivering one cataract every 30 mins, as per Royal College of Ophthalmologists’ guidelines.

In tandem with this, The National Eyecare Workstream is undertaking clinically led peer reviews which supports new and efficient ways of working and shares best practices across the country across a number of ocular sub-specialties, including cataracts.

Additionally, the national Trauma and Orthopaedic (T&O) planned care team based within the Centre for Sustainable Delivery (CfSD) are responsible for supporting both scheduled (elective) and unscheduled (emergency) orthopaedic service delivery through implementation of sustainable improvements in Scotland.

The orthopaedic services specialty delivery group is multidisciplinary and clinically led to design, develop and implement consensus driven national clinical pathways with focus on high impact opportunities in outpatient management (active clinical triage and patient initiated review), enhanced recovery and same day arthroplasty and also hip fracture standards of care, whilst reducing unwarranted variation. The National T&O team supports delivery of clinically led peer reviews for Health Boards across Scotland, with the cycle repeating every 3 years. These clinically led peer reviews were initiated from the innovative “Getting It Right First Time (GIRFT)” programme. This programme has been highly successful at leading change, reducing variation, improving clinical pathways as well as significantly reducing costs predominantly through reduction in length of stay and improved procurement.

In conjunction with Public Health Scotland (PHS), the T&O team also supports national audits namely the Scottish Hip Fracture Audit and Scottish Arthroplasty Project. These cost effective audits drive continuous improvements through research, standards of care and by a formal governance programme to monitor outcomes. Annual reports are produced for public information.

Furthermore, as part of our wider work to deliver sustained recovery of our Urgent Care services a whole system improvement approach has been adopted. We are working with local teams through the Urgent and Unscheduled Care Collaborative Programme to develop improvement plans which contain actions for the short and medium term focusing across 5 key areas.

This programme of improvement activity is being driven forward by the Centre for Sustainable Delivery (CfSD), which we have commissioned to support Health Boards implement a range of measures to reduce A&E waiting times and improve patient and staff experience.

Some Health Boards have already started to report improvements. These include:

• Improving urgent care pathways in the community and improving links across the primary and secondary care interface.
• Ensuring patients receive the right care in the right place by optimising Flow Navigation Centres and increasing the routes for professional to professional advice and guidance, signposting and scheduling of appointments to A&E where possible.
• Improving access to Hospital at Home services by supporting Boards and partnerships to adopt evidence-based best practice.
• Optimising assessment and care in our Emergency Departments by improving access to ‘same day’ services, the use of early and effective triage, rapid decision-making and streaming to assessment areas.
• Reducing the time people need to spend in hospital by promoting early and effective discharge planning and robust and responsive operational management.
  

The Centre for Sustainable Delivery is responsible for driving clinically-led service redesign and transformation in care across NHS Scotland. It consists of a number of national improvement programmes which are focussed on individual Scottish Government strategic priority areas.

The Programme Team workplans for 2024-25 are still in the process of being finalised and will be approved by Scottish Government.

A summary of the CfSD national programmes of work are as follows:

Modernising Patient Pathways (MPP) Programme: The MPP team deliver national improvements in planned care and support front line clinical teams to develop and implement sustainable improvements in service delivery. A key focus of the team is on developing national clinical pathways and supporting boards to increase the use of Active Clinical Referral Triage (ACRT) and Discharge Patient Initiated Review (PIR).

National Elective Coordination Unit (NECU): The NECU team supports improved access to care by providing a consistent approach to national demand and capacity assessment and allocation as well as providing waiting list validation to ensure lists are up to date.

Unscheduled Care Programme: The Unscheduled Care Programme delivers support and develops improvement tools to help Boards to manage urgent and unscheduled care capacity and capability, including Optimising Flow Navigation Centre (FNC) services, hospital-at-home models and developing pathways to support care home access to urgent care.

Cancer Improvement and Earlier Diagnosis Programme: The Cancer Improvement and Earlier Diagnosis team drives NHS Scotland’s cancer strategic priorities and plays a key role in delivering Scotland’s 10-year cancer strategy, including working with Boards to ensure the Framework for Effective Cancer Management (FECM) is embedded.

National Endoscopy Programme: The National Endoscopy Programme supports Boards to deliver the Endoscopy and Urology Diagnostic Recovery and Renewal Plan. This includes supporting the deployment of the new Endoscopy Reporting System and working with NHS Scotland Academy to promote and maximise training opportunities around non-medical endoscopy and cystoscopy.

Innovation Programme: The Innovation team manages the Accelerated National Innovation Adoption (ANIA) Pathway, which is designed to identify and support national adoption of high-impact innovations at pace.

National Green Theatres Programme: The Green Theatres Programme supports NHS Boards to meet the net zero commitments for NHS Scotland through reducing the carbon footprint of theatres and delivering more environmentally sustainable surgery.

Planned Care Programme: The Planned Care Programme is responsible for monitoring planned care performance across all NHS Scotland Boards. It also leads national improvement work around Trauma and Orthopaedics, Ophthalmology and Radiology.

As part of Keeping The Promise by 2030, the Scottish Government is committed to ensuring that all adoptees and adoptive families can access the support they need, when and where they need it throughout life.

Furthermore, under the Adoption and Children (Scotland) Act 2007, local authorities have a duty to assess someone’s needs for adoption support services and then provide that support.

The Care Inspectorate collects data from local authority adoption services as well as voluntary adoption agencies in their annual returns, which includes data on the rate of adoption breakdown. This information is published in the Care Inspectorate’s annual Fostering and Adoption statistical bulletin. The latest bulletin was published in August 2023 careinspectorate.com/images/documents/7251/Fostering and adoption stats report 2022-23.pdf

The Mental Health Strategy 2017-2027 set out a 10-year vision of where mental health funding would be focused. This included areas such as additional investment for mental health workers and improved provision of services including CAMHS.

In addition, our Mental Health Transition and Recovery Plan was introduced in 2021-22 which set out the key commitments in responding to the mental health needs resulting from COVID. This included funding for Children, Young People and Families, Older People, Distress Interventions and other areas listed in the Plan. This was backed by a £120 million Recovery and Renewal Fund which has subsequently been included in the overall budget allocation for mental health services in each financial year since.

From the £12 million earmarked to expand Hospital at Home and provide additional capacity over winter, we have confirmed funding of more than £3.5 million, of which the majority of health Boards will get a share, for delivery of additional capacity in 2023-24.

Work is ongoing with Boards to finalise the conclusions around impact of the enhanced services over winter but NHS Boards have reported patient feedback has been extremely positive for the new services.

he Framework for Effective Cancer Management provides NHS Cancer Teams with the tools to effectively manage people with a suspicion of cancer, from the point of referral to first treatment. A refresh of the Framework will take place in 2024 to ensure each key element has been reviewed and updated, providing NHS Cancer Teams with the tools to effectively manage patients with a suspicion of cancer, from the point of referral to first treatment.

Work is underway to redesign cancer diagnostic services with new optimal cancer diagnostic pathways published for Lung Cancer and Head & Neck Cancers. Work is underway to redesign the colorectal cancer diagnostic pathway.

In addition we have now established five Rapid Cancer Diagnostic Services to provide primary care with a new referral route for patients with non-specific symptoms of cancer in NHS Ayrshire & Arran, NHS Borders, NHS Dumfries & Galloway, NHS Fife and NHS Lanarkshire.

The recommendations made by the UK Government's Animal Welfare Committee are still being considered. Improving aquaculture health and welfare is an ethical responsibility and is one of the main priorities that is enshrined in our Vision for Sustainable Aquaculture.

The Scottish Government is committed to the highest possible welfare standards for animals, including fish. It is now standard practice for all farmed salmon and large farmed trout in Scotland to be killed using a percussive or electrical stunning methods delivering irreversible instantaneous unconsciousness. Small farmed trout are killed using electrical stunning methods and all salmon killing facilities in Scotland operate CCTV on a voluntary basis. These were both recommendations made by the UK Government’s Animal Welfare Committee.