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We are in discussions with NHS Grampian on the point to which Ms White referred and the particular example that she highlighted, which she has also raised in the chamber. We have been working with NHS Grampian to look at what it is doing. That includes work to improve the flow through the hospital so that we are not seeing ambulances stacked up outside.

The national centre for sustainable delivery is doing work to look at how we ensure that those who are in our hospitals actually need to be there and at how we can improve the delayed discharge picture so that we have hospital beds available. Ultimately, that is at the heart of why we have had delays, certainly in Scotland. I cannot speak for the rest of the UK, but that is certainly what I am picking up here. If we are seeing delays in ambulances being able to turn around at hospital, that is largely because of a lack of availability of beds.

We are using the centre for sustainable delivery to identify patients who can be discharged and get them discharged as quickly as possible, and thereby bring down the average hospital occupancy time. We are also working on that with our local government partners. I work closely with Councillor Paul Kelly of the Convention of Scottish Local Authorities, and we have agreed on work that is to be done across Scotland on giving people patient discharge dates, discharging before noon and weekend discharge. We are looking at everything that we possibly can to get people to where they should be, which is either at home or in the community, rather than in hospital.

We are also doing more focused work with our health and social care partners in Grampian on whether anything further can be done to improve the delayed discharge picture and to improve integration in NHS Grampian. I would be happy to update the committee on that work.

That is under active consideration, as Ms White will understand, given what happened on Skye recently. Sir Lewis Ritchie undertook a review of the services on Skye; with him, I met NHS Highland, and I expect to have a delivery plan from the board for how that review and its recommendations can return to implementation. The review was implemented for a period, but there were issues with sustainability, for the pertinent reasons that we have heard around attracting and retaining staff in rural and island communities. I am keen to ensure that Highland can deliver on that.

That is a microcosm of what we need to see to a much greater extent across the country. We are working with our rural boards in the areas that I have set out, which include supporting our workforce and supporting the work that NHS Education for Scotland is doing to provide education and training so that urgent care services in remote and rural areas can continue to be sustainable.

I would be happy to follow up on that in writing, and Paula Speirs wishes to come in on that.

Integration has happened at a different pace in different parts of the country. There are some good examples of integration working well, as I was able to see, for instance, in Shetland, where there has been very strong integration in health and social care across all levels of public sector delivery, which allows decision making to be informed on the basis of service delivery. I point Ms Maguire and the committee to that very good example. There are other areas where levels of integration could definitely be better, however, and that is part of the reason why I believe that the national care service is the right thing for bringing things forward from a service delivery perspective.

I am conscious that Ms Maguire is looking at the wider issue of service delivery around social infrastructure, housing and childcare, for instance. I believe that that comes from the discussions that are taking place on an integration basis. Where we can improve on that, obviously we will.

First, I am pleased to hear that the committee was in Skye last week. Initially, there was a suggestion that I might have joined you there for that evidence session, but I am very pleased to be here this morning and grateful for the opportunity to discuss what is a very important issue for me, having been born and brought up in Orkney.

Like other colleagues around the table, I understand well the importance of delivering health and social care services in rural and island communities, and I also recognise the challenges therein. I am very much looking forward to seeing more of the work that comes through from the committee, and I am very grateful for the work that you are doing.

I will bring in colleagues on the progress that has been made off the back of the centre’s establishment, which has had financial support from the Scottish Government.

The centre has also led to the development of a rural and island workforce recruitment strategy by the end of this year, because the Government recognises that, for all elements of the health and social care service, but particularly in rural and island communities, the workforce is critical to ensuring that we can deliver services. Having that strategy is critical, and I believe that the task and finish group is meeting right now to discuss continuing that work. I do not know whether colleagues wish to add to that.

Yes. I co-chair the nursing and midwifery task force. There are areas of work that it is clear that colleagues on that group are keen to expand on, and given that recruitment and retention is obviously a very strong and live area, there will be a crossover between the work on the strategy and the work of the task force.

To follow up on Mr Sweeney’s question whether social care will be covered by the strategy, the advisory group includes the Convention of Scottish Local Authorities, Scottish Government officials and health board representatives, so social care will be covered.

That is a pertinent question on the wider issues that are beyond the control of the health and social care service in rural and island communities in being able to attract and retain staff. Mr Torrance rightly points to the issue of housing. I know from the most recent conversation that I had with NHS Highland about the situation at Portree that it is looking at what it can do from a housing perspective to support staff with their housing needs.

Wider measures such as the Scottish Government’s investment in the rural delivery plan and the emergency services key worker housing funds that we are bringing forward are designed to give local areas the ability to invest in ensuring that the social infrastructure is there to support people living and working in those communities and that those communities continue to be sustainable.

There are also wider political issues around attracting and retaining social care staff in particular. Mr Torrance and the committee will be aware of the recent decision of the UK Government to make it harder for social care staff to come to this country to work by stopping the dependants of those social care workers from being able to travel. Obviously, we are not in control of immigration and the decisions that are taken for us are having a detrimental impact on our ability to attract people to come and live and work here. Everybody is well aware that the impact of Brexit on our social care workforce was a near 10 per cent reduction in our social care staffing, almost overnight.

All of that strikes at the heart of the ability of social care providers to provide the services that we need them to provide, which has a knock-on impact not just on the people who we need to be providing those services for but on the rest of the health service, because there needs to be a clear flow through the health service and, if one part is under significant pressure, in this case social care, it has an impact elsewhere.

Paula Speirs would like to come in on the back of that.

It is the single island authority model. We are looking at what is possible with regard to local government and health boards working more closely together. Advanced discussions are going on with the island groups, with various levels of interest being expressed by those authorities.

In rural areas, there are more examples of that coming through.

Obviously, I am conscious of the need to ensure that we have as equitable access to health provision across Scotland’s geography as possible. Mr Sweeney points to an important conundrum on recruitment and retention. Typically, accident and emergency clinicians look for a fast-paced, ever-changing environment. That is what they thrive on. When I shadowed some accident and emergency shifts, that is what many of the A and E consultants told me. That is what drove them to go into accident and emergency, as opposed to any other specialty.

I have friends and family who use the Balfour hospital in Kirkwall. Far fewer people go through the accident and emergency department there than any of the accident and emergency departments in the central belt, for instance. That will have an impact on the attractiveness of the department. That is part of the reason why we have come through with the initiatives that Stephen Lea-Ross spoke about, to try to get people to specialise in remote, rural and island healthcare as early as possible. That means that they will probably take a more multidisciplinary approach to their training and will understand what they are going into. I hope that they will be more willing to stay in a remote and rural setting, understanding the fact that it is a very different environment from an accident and emergency department elsewhere.

I am also cognisant of the situation in Portree, which was a sad incident. My condolences go to the family of the person who lost their life. We are working with NHS Highland on bringing back 24-hour urgent care to Portree as quickly as possible.

I have not directly discussed the issue in relation to AHPs, but I am more than happy to take it away for Ms Mochan and report back. Indeed, I should probably be having such a discussion, so Ms Mochan’s suggestion is useful.