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Since 2019, NHS Tayside has been focusing on developing and stabilising breast cancer services. They have successfully recruited new Breast Oncologists to their local service, including two Breast Clinical Oncologists who work solely for NHS Tayside alongside a joint Breast Medical Oncologist post with NHS Lothian.

NHS Tayside is replacing a radiotherapy linac machine, which has generated some constraints in physical radiotherapy capacity. To ensure patients can access radiotherapy in a timely manner, NHS Tayside has collaborated with NHS Highland to offer faster access to radiotherapy for a small number of patients with breast cancer. Once the linac is fully replaced, and with the new breast oncologists now in place, NHS Tayside will deliver the full pathway of Breast Cancer Care locally with a continued drive to improve patient experiences and outcomes.

We intend to resume Tranche 1 of the Sustainability Loan Scheme in 2024-25 once we have completed the disbursement of funds for those loans already completed and confirmed a budget. This will likely not be until midway through the financial year.

Our preference remains to continue the loan scheme into Tranche 2 and beyond – however, this is dependent on whether the UK Government resumes the allocation of Financial Transaction Capital to the Scottish Government.

In November 2022 the Ministerial Population Taskforce published the research report ‘Attitudes to Family Formation in Scotland’ to update the evidence base about fertility, family planning, and ideal family size in Scotland.

Building on international engagement with other countries experiencing low birth rates, the Scottish Government is taking forward comparative work about family friendly policies in other European countries, to establish if successful interventions elsewhere could be applicable in Scotland.

The outputs of this work will be considered alongside recent Census data in order to develop next steps which reflect Scottish Ministers’ ambition for Scotland to be the best possible place for all families.

In line with the 2024-2025 delivery plan for the National Centre for Remote and Rural Health and Care, a range of practical education and training projects have begun, with an early emphasis on improved support and training for remote and rural dispensing practices, and developing supervisory training.

The current programme of work includes, but is not limited to, an education programme for Rural GP Dispensing Practices and a new Rural Advanced Practitioners Programme (RAP), MSc and PG Diploma.

In addition the Rural Practitioners Series of Learning is delivering two rural education sessions per month, with a menu of sessions agreed for the next 6 months, and more in the planning for the year ahead in response to priority educational needs.

The first stage of a Primary Care Community Training Hub Pilot project has also been initiated in partnership with three primary care practices.

Further detail on the work of the Centre can be found at the TURAS Information hub

We are committed to reducing waiting lists backed by an initial investment of £30 million has been allocated to Health Boards and will target reductions to the national backlogs that built up throughout the pandemic. This funding is being targeted at a series of national and local plans to reduce backlogs by maximising the use of local and national resources across Scotland. As part of this, we have allocated additional funding to Gynaecology services which we expect to l deliver around 3,500 New Outpatient Appointments.

NHS Scotland’s Centre for Sustainable Delivery (CfSD) is also playing a central role in working with Health 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.

CfSD programmes have developed strong clinically-led Specialty Delivery Groups (SDG), including one for Gynaecology, which promote multidisciplinary team working, and support local adoption of service improvement programmes. These groups are now well established and have supported several new and innovative pathway developments, many of which are now being successfully scaled up across Scotland, including Active Clinical Referral Triage (ACRT), Patient Initiated Review (PIR) and Enhanced Recovery after Surgery (ERAS).

This is all part of our programme to drive up productivity and tackle waiting lists, supported by the CfSD. Together, our actions will further enable NHS Scotland to maximise capacity, build greater resilience and deliver year-on-year reductions in the number of patients who have waited too long for treatment.

The anticipated cut by the UK Government to the Scottish Government's capital budget of up to £1.3billion in real terms over the coming years has consequences. In December 2023, given the extremely challenging capital funding position, NHS Boards were instructed to pause any project development spend and instead direct capital budgets towards maintenance of the existing estate and essential equipment and digital replacement. Boards were notified that the Scottish Government does not anticipate starting construction of any new project over the next two years at least. Obviously should the UK Government change course on capital investment we have an opportunity to look at this again alongside the capital review ongoing across the Scottish Government.

There is therefore no change to the position on NHS Capital Projects as a result of the ongoing review of the Infrastructure Investment Plan.

The Scottish Government remains wholly committed to supporting the development and deployment of CCUS, including the Acorn Project and the Scottish Cluster, including with up to £80 million in support. When we, the project and the Scottish Cluster, are provided with more details by the UK Government on the next stage of the process, timelines and funding, it will then be possible to assess when and how best to support the project with Scottish Government funding.

We are committed to delivering on the priority in the (WHP) to improve access for women to appropriate support, speedy diagnosis and best treatment for endometriosis.

We know that, for many women, diagnosis time for endometriosis is not acceptable. It is vital that we improve care and support throughout the whole diagnosis process.

To do this a number of actions have been taken including:

• The development of the Endometriosis Care Pathway for Scotland which aims to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms.
• A NHS Education for Scotland (NES) training package and framework focused on menstrual health for general practice and others working in Primary Care.
• A NHS NES ‘Masterclass’ on endometriosis for healthcare professionals.
• Improving the information available for women and girls on endometriosis and menstrual health through our work with NHS Inform, Young Scotland, the ALLIANCE and Endometriosis UK.

We are working closely with our stakeholders across Scotland to understand the effectiveness of these workstreams and their impact upon reducing diagnostic times for endometriosis.

The Scottish Government has been engaging with Health Boards regarding their current position in relation to job offers and supply. Health Boards remain committed to maximising opportunities for new qualified nurses to find employment.

The Scottish Government commissioned Healthcare Improvement Scotland to undertake a review to determine underlying causes of an increase in neonatal mortality in Scotland in 2021-22 and make recommendations for improvements in care.

The report, published in February 2024, found no evidence of systemic failures of maternity or neonatal care, unusual factors, or a cluster of any one factor that would account for the significant increase in neonatal deaths in 2021-22.

Following the publication, we are working with Healthcare Improvement Scotland and other partners on the recommendations of the review.