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Notwithstanding NHS Lanarkshire’s staffing levels are at a record high, with 33% growth under the SNP government compared to 22.1% across NHSScotland, we are providing continued assistance by investing in domestic labour supply, international recruitment, training, and retention.

That is why we have a £600 million package of measures that will get us through the winter, which includes hiring up to 750 nurses, midwives and allied health professionals from overseas and 250 additional support staff across acute, primary care and mental health.

Over the last 10 years we have doubled the number of funded places for Nursing and Midwifery to a target intake in 2022-23 of 4,837. Scotland already trains more doctors per head than elsewhere in the United Kingdom, and we’re working to increase Scotland’s medical undergraduate intake by 500 by the end of the parliament.

The Scottish Government believes that the independent contractor model of general practice is the model preferred by most GPs and is committed to maintaining it to ensure general practice remains an attractive profession (the BMA’s “The future of general practice” survey 2015 found that 82% of GPs supported maintaining the status quo).

It is for Health Boards to decide who to contract with to provide primary medical services, making use of such resources as the Health and Care Experience Survey which provides an indication of satisfaction rates across a range of local services, including GP practices, in Scotland as they do so.

The Scottish Government does not hold data on emergency presentations.

We are committed to reducing emergency diagnoses for cancer and have established three Rapid Cancer Diagnostic Services (RCDS) across NHS Scotland, with a further two sites announced by the First Minister on 10 October 2022.

RCDS provide primary care with access to a new referral pathway for patients with non-specific symptoms suspicious of cancer. The Clinical Leads for two of the Services are Haematologists, reflecting the role that this new model can play in diagnosing blood cancers including leukaemia earlier.

In addition, the Scottish Government will continue to work closely with primary care clinicians, including the Scottish Primary Care Cancer Group, to identify possible symptoms as early as possible and support appropriate referral via the Scottish Referral Guidelines for Suspected Cancer.

Work is underway to develop a new earlier diagnosis vision in Scotland - this will form part of the new cancer strategy, due to publish Spring 2023. Measurements such as emergency presentation data, to track progress and improvements, are being considered.

The Scottish Government does not hold this data. Requests for these data should be sent to Public Health Scotland or direct to Health Boards.

The Scottish Government does not hold data on emergency presentations of cancer.

We are committed to diagnosing cancer as early and as quickly as possible which is why we continue to invest in our Detect Cancer Early (DCE) Programme and are rolling out Rapid Cancer Diagnostic Services. Work is underway to develop a new earlier diagnosis vision in Scotland - this will form part of the new cancer strategy, due to publish Spring 2023.

NHS Scotland Health Boards determine consultant requirements locally, based on their service provision responsibilities and service configuration needs. Scottish Government workforce planning guidance requires Boards to take a demand-led approach by determining future staffing requirements in line with healthcare needs within their locality.

Under this Government, however, the number of Consultant Haematologists working in NHS Scotland has increased by 18.9% or by 15.5 WTE, from 82.1 WTE as at September 2006 to 97.6 WTE as at June 2022.

Future medical workforce needs are considered annually by the Scottish Shape of Training Transition Group (SSoTTG) wherein existing training numbers are reviewed and additional ‘expansion’ posts can be added where there is evidence of increasing future demand for specialist services within a particular discipline. Ministers have created 725 additional training places since 2014 following recommendations made by the SSoTTG, 152 of which were agreed to through the most recent consultation. This represents the largest annual expansion to date. The SSoTTG will review the number of training places in haematology within the upcoming consultation which will take place in 2023.

Furthermore, we are developing a new 10 year Cancer Strategy to launch in Spring 2023 which will take a comprehensive approach to improving patient pathways from prevention and diagnosis through to treatment and post-treatment care. This will be supported by a 3-year action plan.

As I stated in Parliament in May, community hospitals form an integral part of local health-care delivery systems, providing care closer to people’s homes which is personalised, holistic and patient-centred.

In April 2020, following the emergence of the COVID Pandemic all areas developed surge plans. As part of this surge planning Dumfries and Galloway command and control took the decision to temporarily close 4 cottage hospital in-patients facilities to allow for surge. It also allowed the partnership to support more people at home, which we knew was the safest place for their care. Additionally, the partnership opened 18 intermediate care beds in Mountainhall Treatment Centre.

Following the pandemic it is essential that services continue to evolve and develop new ways of working that can keep people safe at home, or in a homely setting for as long as possible. However, decisions regarding the future of local services are best done at a local level, in consultation with the local population who use them.

A clinical refresh of the Scottish Referral Guidelines for Suspected Cancer was completed in 2018 with revised clinical guidance published January 2019. The guidelines support primary care clinicians in ensuring those with symptoms suspicious of cancer are put on the right pathway at the right time.

The Scottish Government continues to work closely with primary care clinicians across NHS Scotland, including the Scottish Primary Care Cancer Group, to raise awareness of symptoms and best referral practice for all cancer types.

Scotland’s first three Rapid Cancer Diagnostic Services are live, providing primary care with a new referral pathway for patients with non-specific symptoms i.e. fatigue, nausea, weight loss – this can often include patients with Haematological cancers. A suite of tests, including blood tests, are undertaken in primary care at the point of referral. The Scottish Government is committed to working towards equitable access to a RCDS across Scotland, for eligible patients.

Asthma patient hospitalisations, age-sex standardised rate per 100,000

The National Audiology Review Group continues its independent review of services having most recently convened on 25 October. The Cabinet Secretary will shortly be meeting with the Review’s Chair for an update on their progress and their developing recommendations.

The review is pursuing four workstreams encompassing the lived experience, governance, quality assurance and education and will fully report in the new year.