Seòmar agus comataidhean

Excessively long waiting lists are not acceptable and we offer our sympathies to all patients waiting for treatment. Pausing of non-urgent activity has taken place across the health system and has inevitably led to a build-up of patients waiting for treatment, and the emergence of Omicron is continuing to have an impact on existing significant pressure.

Remaining covid restrictions and infection prevention control measures mean that Audiologists are working on reduced capacity and a reduced numbers of patients have access to the services.

Additionally, all services have seen a surge in referrals since restrictions have started to ease and GPs have become more accessible. Waiting lists have grown as a result and services have to balance ensuring that patients receive good quality, efficient and effective treatment with reducing waiting times.

We published an NHS Recovery Plan in August 2021 which sets out our plans for health and social care, including audiology services, over the next 5 years.

Backed by over £1 billion of funding, the Plan will support an increase in inpatient, daycase, and outpatient activity to address the backlogs of care, which will be supported by the implementation of sustainable improvements and new models of care.

The precise number of problematic spaces will be dependent on a range of factors over time, such as weather and occupancy levels, and many of the problematic spaces will already have been addressed. The Scottish Government has agreed formal reporting requirements regarding the number of remaining problematic spaces with local authorities. This information will be used to update the Education, Children and Young People’s Committee in due course, subject to receipt of local authority returns.

The Scottish Government and COSLA published a National Workforce Strategy on 11 March 2022. This Strategy sets out a new framework to shape Scotland’s Health and Social Care workforce over the next decade; which places training, wellbeing, job satisfaction and the principles of Fair Work at its heart.

The Scottish Government has not engaged with this organisation specifically but a collaborative partnership approach has been taken to develop the Strategy. We have engaged with key partners across Health and Social Care, including NHS Boards, Local Authority representation, third and independent sector and staff-side representation through the National Workforce Planning Group and the Scottish Partnership Forum.

Moving forward with implementation of the strategy, we have committed to continuing to work jointly with partners across Health and Social Care.

The Strategy commits to publishing new workforce growth projections in the autumn, once we have had the opportunity to consider Health Board and Health and Social Care Partnerships' three year workforce plans. The staffing needs for services and professional specialties across NHS Scotland will be, in partnership with stakeholders, factored into the development of those projections.

Clinical guideline implementation is the responsibility of NHS Boards. The ultimate decision about a particular clinical procedure or treatment will always depend on each individual patient’s condition, circumstances and wishes, and the clinical judgement of the healthcare team.

Scottish Intercollegiate Guidelines Network (SIGN) guidelines have primacy in Scotland however NHS Boards and Integration Authorities may also choose to consider National Institute for Health and Care Excellence (NICE) guidelines in the planning and delivering services. Where there is not a current SIGN guideline in place Boards are expected to use other guidelines, such as NICE.

The decision to create, update and/or replace any SIGN guideline is not made by Scottish Government, it is made independently by the Evidence Directorate Work Programme Committee in Healthcare Improvement Scotland (HIS). Proposed guidelines under consideration can be found on the SIGN website: Our guidelines (sign.ac.uk) .

We will commission and support the Understanding Scottish Places (USP) consortium to review evaluation and data needs and share that understanding so that local partners can develop solutions that respond to the local circumstances.

In addition, the approach adopted via the Scotland Loves Local programme works with local partners to shape local opportunities that encourage and motivate people to change behaviours by thinking local first and supporting their local businesses and communities.

NHS 24 aims to provide high standards of care and despite the substantial increase in demand placed on the Service by the outbreak of COVID-19, NHS 24 continues to provide a highly effective, safe triage system to the people of Scotland.

As a result of this increased demand, and changes to service delivery, we have increased funding to NHS 24 by over £20m this year for additional recruitment and the addition of a new call centre in Dundee, which opened in December 2021.

This is supporting the additional recruitment of 575 full time equivalent call handlers and 140 full time equivalent clinicians to date, including through the recently established 24/7 mental health hub.

Calls to the 111 Service can be abandoned for a variety of reasons, including telephony providers ending calls after a period of time or patients choosing to end the call after being connected and hearing the options available to them. These include accessing self-care advice via NHS Inform, or contacting another area of the health service better placed to meet their needs.

NHS 24 is undertaking a piece of work to evaluate abandoned calls and determine how many of these callers are accessing other advice/support as directed and how many are re-dialling the Service after their call has been cut off by telephony providers or they have hung up the call. This will involve working closely with telephony provider and significant engagement with callers to the Service and will help the Service reduce instances of abandoned calls.

Reducing health inequalities is a clear priority for the Scottish Government and one of the biggest challenges we face, exacerbated by the Covid-19 pandemic. Providing people with the right support locally and connecting them to the right services is crucial if we are to improve their wealth and their health.

The SG established a Short Life Working Group (SLWG) in October 2020 in acknowledgement of the key role of Primary Care in relation to tackling inequalities. The purpose of the group was not to conduct an academic or systematic review of the literature but to draw on the expertise of a wide range of stakeholders with extensive experience in this field. The group has also worked closely with an expert reference group of people who have lived experience of suffering the impact of health inequality first hand.

The SLWG’s remit was to identify service improvements and actions specifically for Primary Care to help reduce health inequalities and improve health equity. The report of the Primary Care Health Inequalities SLWG can be accessed here: https://www.gov.scot/isbn/9781804351642 . It makes a series of recommendations which cover a range of short-term and long-terms actions, which will tackle health inequalities and inequity head-on in primary care settings and wider communities. These include actions to improve equalities data in general practice, strengthening the focus of inequalities through the GP contract and a new Enhanced Service for the first time focussed on activating practices’ full potential to proactively support vulnerable people at risk of poor health outcomes.

I intend to give detailed consideration to the recommendations made and implementation options. I also wish to place on record my sincere thanks to the SLWG and the Chance to Change Group, both of whom gave considerable time and energy to this key priority during Covid-19.