As the lead public body for our historic environment Historic Environment Scotland (HES) promotes the use of traditional building materials (which can be locally sourced) in relation to the care and maintenance of historic building stock, where appropriate, including in relation to historic properties in the care of public bodies. HES works closely with the Scottish Stone Group and wider stone industry sector to support the production and use of natural Scottish stone. HES has an ongoing Collaborative Partnership Agreement with the British Geological Survey in order to promote the use and production of natural stone in Scotland. As part of this Agreement, HES launched a publicly accessible Building Stone Database for Scotland in June 2018 to provide information on historic and current sources of traditionally used building stone across Scotland.

As part of the organisation's Action Framework for traditional building materials, due to be finalised later this year, HES is committing to producing guidance on the specification and procurement of traditional Scottish materials, including stone, for public bodies. HES has also produced a ‘Managing Change in the Historic Environment guidance note on External Walls’ which acknowledges local materials and traditions as an important element in defining the character of the building in question. The guidance note also promotes maintenance and appropriate repair as the best means of safeguarding the character of historic buildings.

Scotland’s built environment has a rich legacy of the innovative use of stone and we are keen to capitalise on and promote the use of our national assets wherever possible. The then-Minister for Business, Innovation and Energy met with the three founders of the Scottish Stone Group in November 2017, which was established to raise awareness of locally sourced stone.

Although it is for local authorities to determine where to source materials the Scottish Government’s architecture and planning policies encourage new development that responds appropriately to its context and which reinforces local identity and character. The use of appropriate materials is recognised as a key consideration in this.

Data collection processes connected to the introduction of PACS Tier Two are currently in progress. Initial PACS Tier Two application statistics will be made available as part of the previously announced reviews of the process after six and twelve months.

The first set of quarterly statistics are expected by mid-October.

The Scottish Government and NHS Greater Glasgow and Clyde have been in regular contact to discuss NHS Greater Glasgow and Clyde's plans to ensure easy access into their buildings. NHS Greater Glasgow and Clyde, the Royal Hospital for Children's project team and the Contractor have ongoing meetings since March 2018 to ensure that all matters that may impact on the patients and staff due to these works are kept to a minimum.

The temporary relocation of the entrance to the Royal Hospital for Children has been planned in conjunction with the site management team and appropriate safety precautions and temporary signage directing patients and visitors to the reassigned principal entrance are in place.

This phase of the works to the Children’s Hospital is scheduled for completion by the 6th March 2019, given the current progress of the works on site it is considered that this date will be brought forward and the front entrance will be reinstated quicker than the current programme.

We are continuing to work towards the implementation of the recommendations from the Review of Access to New Medicines.

Recent developments include the publication of the Access to Medicines Data Scoping Taskforce Report “Building Capability to Assess Real-World Benefits, Risk and Value of Medicines: Towards a Scottish Medicines Intelligence Unit”. The new “Ultra-Orphan” decision pathway will also begin to come into place from October 2018. And the Scottish Medicines Consortium (SMC) continues to enhance its effectiveness and accessibility to the public, and has now begun to publish new explanatory leaflets about individual decisions.

From August 2018, the SMC also introduced interim accepted advice for medicines with a conditional marketing authorisation from the European Medicines Agency.

The ePharmacy Programme is a multi-year programme that has helped revolutionise the way GP prescriptions are issued, dispensed at community pharmacies and processed for payment by the NHS, using Electronic Transmission of Prescriptions.

Over 100 million prescriptions are dispensed in the community annually in Scotland, with over 90% of these prescribed by GP practices and dispensed at a community pharmacy. Over 97% of GP prescriptions in the community are now issued electronically; of these over 93% are claimed by the pharmacies electronically and of these over 90% of these items are processed for payment automatically. This means that over 75 million items per year are now fully automated, with no transcription errors between prescribing and dispensing, delivering efficiency savings, and improvements in payment accuracy. All this has been achieved through the electronic prescription and pharmacy dispensing systems provided through the ePharmacy Programme.

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Scottish procurement legislation, which implements EU public procurement Directives, requires that any technical specifications in relation to public contracts assures equal access of suppliers to the contract and must not narrow competition. In most cases, therefore, it is simply not possible to specify Scottish materials when placing public contracts. There may be some exceptions to this, for example where the materials in question have unique characteristics and they are required to be used under the contract in order to retain a building’s characteristics.

Access to stem cell therapy for septo-optic dysplasia depends on the needs of the patient and should be discussed with the appropriate specialist / multidisciplinary team. If the treatment is recommended it will be funded, either within the specialist Paediatric Stem Cell Transplant here in Scotland or at another site in the UK.

I recognise the waiting times for orthopaedics in NHS Lothian are very much below the level I require, with patients experiencing exceptionally long waits to be seen and treated. NHS Lothian has received £3.7 million as part of the £25 million initially issued to Boards from the £50 million announced at the end of May. The Board are using £500,000 of this funding, plus £1.5 million from Access Support funding to improve waiting time performance for orthopaedics. The further £25 million funding will be issued to NHS Boards shortly

NHS Lothian recognise the issue of growing demand and has undertaken significant work to redesign the musculoskeletal pathway in the community, first for lower back pain through the development of an integrated back pain pathway, and now a foot and ankle and upper limb integrated community pathway. The foot and ankle and upper limb musclosketal allied health professional community pathways has reduced orthopaedic demand by 2,700. They have also redesigned their arthroplasty service to provide a service better aligned to realistic medicine which reduces the number of return appointments. These initiatives have created more additional new outpatient capacity. This combined work has effectively reduced acute orthopaedic demand, and increased service efficiency and productivity - as result of the changes the Board now have 810 more new outpatient capacity which has brought the outpatient service into balance.

The Board are also taking action to reduce the number of cancelled elective orthopaedic operations caused by long stays of hip fracture patients by providing

• Additional Occupational Therapy resource - enable patients to be returned home quicker.
• Additional resource for orthopaedic supported discharge and orthopaedic rehabilitation - to reduce delayed discharges
• Enhanced AHP resource in Midlothian IJB - enable faster flow of patients from Edinburgh Royal Infirmary to rehabilitation

The Board will also make use of the independent healthcare sector to see and treat between an estimated 580-690 of the longest waiting outpatients.

I will be raising the issue of waiting time performance with the Chairs of all Boards at their next meeting.