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Tackling health inequalities and the 'inverse care law' is one of our primary care outcomes, as published in a joint memorandum with the British Medical Association Scottish General Practitioner Committee (BMA SGPC) []. One way of delivering on this outcome as part of contractual change would be to adjust the Scottish Allocation Formula (SAF), which weights general practice funding by various factors that affect workload, including deprivation, rurality and age. The Scottish Government is clear that we need to look beyond the GP contract to other interventions and ways of supporting general practice in areas of high deprivation. Changes outwith the contract such as multidisciplinary working and the manifesto commitment to introduce 250 Links workers will be vital for supporting patients in deprived areas.

The Scottish Government and the SGPC agree, in principle, that we need better information and evidence to inform both accurate recompense of expenses and options for the long term overall development of GP pay in Scotland. To this end, we have commissioned a review of general practice funding, pay and expenses to provide a proper, robust evidence base for improved decision making. This is taking place in 2017, and inform options from 2018.

The specific details of the Primary Care Fund are being determined at present, but it will include measures to build the primary care workforce, address GP workload, improve infrastructure and transform primary care. This will include investment in areas of high deprivation.

Tackling health inequalities is a key outcome of the Scottish Government’s transformation of Primary Care and the Scottish Government continues to support various initiatives to support general practice in areas of high deprivation. These include:

•Funding the Links Worker programme in Dundee and Glasgow. Over the next five years, we will increase the number of community Links Workers in disadvantaged areas to 250.

•Funding Govan SHIP through the Primary Care Transformation Fund. The aim of this project is to achieve service transformation through new and innovative models of integrated care in the four Deep End practices in Govan Health Centre.

•Funding the Deep End Pioneer Scheme through the Recruitment and Retention Fund which is recruiting young GPs to Deep End practices, release the time of experienced GPs for service development, and develop educational and training materials for GPs working in deprived areas.

The Scottish Government's vision is for GPs to fulfil the role of the Expert Medical Generalist in the community; focussed on complex care, undifferentiated presentation and local clinical leadership. The role will be supported by an expanded team of health professionals who can help patients to access the right treatment, by the right professional at the right time. In areas of high deprivation, this could include a multidisciplinary approach to patient care, including advanced nurse practitioners, mental health professionals, and links workers, who are dedicated individuals working in GP surgeries to support people one-to-one to address issues such as poverty, debt and isolation which are making them feel unwell. This multidisciplinary team approach will free up GP time to fulfil the Expert Medical Generalist role for more complex clinical care, including for patients with multi-morbidities living in deprived areas.

As part of this vision, in 2016-17 the Scottish Government introduced GP Clusters, small groups of practices working together to address the health needs of their local communities. This will be instrumental in addressing unmet need and improving care in areas of high deprivation.

I refer the member to the answer to question S5W-08253 on 7 April 2017. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at

The Scottish Government, with the agreement of the Scottish General Practitioners’ Committee of the BMA, have commissioned a review of general practice funding, pay and expenses. The Review will gather and analyse earnings and expenses data from a range of practices, including in areas of high deprivation. It will also take advice from expert stakeholders on key considerations such as unmet need and high levels of multimorbidity. The Review is taking place in 2017 and will inform options from 2018.

In the joint memorandum with the British Medical Association Scottish General Practitioner Committee (BMA SGPC) the Scottish Government undertook to extend the current pay stability agreement for GPs to April 2018, [].

The Scottish Government and the SGPC agree, in principle, that we need better information and evidence to inform both accurate recompense of expenses and options for the long term overall development of GP pay in Scotland. To this end, we have commissioned a review of general practice funding, pay and expenses to provide a proper, robust evidence base for improved decision making. This review builds on and incorporates the findings of the Review of the Scottish Allocation Formula, and will inform options from 2018.

A review on the legislation governing small landholdings was laid before Parliament on 30 March 2017 and published on the Scottish Government website on 31 March 2017

Consultant-led adult immunodeficiency and allergy services in Scotland are provided by Grampian, Tayside and Greater Glasgow and Clyde NHS Boards. An immunology service has been in place in NHS Lothian from early last year, following the recruitment by Scottish National Blood Transfusion Service and Edinburgh University of the Consultant Immunologist. For anyone in NHS Lothian requiring specialist anaesthetic allergy testing, this service is provided by NHS Tayside.

For some rare conditions where there are very small numbers of patients, highly specialised immunodeficiency and allergy services are provided outwith Scotland to ensure that the highly specialised care they need is as safe, effective and sustainable as possible.

Supporting economic growth by tackling inequality is a key driver of devolved employment support. This aligns to our child poverty strategy, in particular our ambitions to maximise the potential for parents to increase family incomes through good quality, sustained employment and to break inter-generational cycles of poverty, inequality and deprivation.

A number of groups will have early access to Fair Start Scotland, which will commence in April 2018, including unemployed lone parents and those living in the 15% most disadvantaged areas. The pricing model for Fair Start Scotland is weighted towards job outcomes sustained for 12 months, emphasising our ambitions to help move those who participate in the service into permanent employment, rather than temporary job opportunities.

Further, in bidding to deliver Fair Start Scotland, which will commence in April 2018, Service Providers have been asked to demonstrate clearly how they will deliver support that reflects the needs of all customers, including women seeking employment. They will be expected use levers at their disposal to encourage employers to consider flexible working approaches, which enable more women to take up sustainable jobs that meet their needs, for example, to align with caring responsibilities.

The Scottish Government is preparing an Equality Impact Assessment for both the 2017 and 2018 devolved employment services, the results of which will be published.

The majority of Scottish Government employability programmes are managed by our national skills body, Skills Development Scotland (SDS). As such, it is an operational matter for SDS to satisfy itself that staff delivering its employability programmes are appropriately qualified.

The Scottish Government fund other programmes that are specifically focussed on supporting those young people who face the most significant barriers to employment. Programmes such as Community Jobs Scotland and Inspiring Scotland’s 14:19 Fund are delivered by organisations with a strong track record of engaging with those young people. Our grant management processes ensure that those organisations have staff in place with the appropriate skills and experience to continue to deliver positive results.

As part of the recent Work First Scotland Procurement process, Scottish Government assessed Providers against their response to the technical evaluation questions set criteria part of which was to ensure the competence of staff delivering this service. In addition we required detailed responses on their recruitment and selection policies including induction and ongoing training along with timescales, to ensure full delivery of the Work First Scotland service from day one.

Provider responses were scored under a competitive environment to ensure that the successful Providers have offered full assurance that all staff will be qualified and trained to deliver the Services in adherence to the programme requirement.