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NHS Lothian are in the process of developing a business case for a world-leading cancer centre in NHS Lothian and work is on-going. A decision on the funding will be taken when the business case is submitted to the Scottish Government for review. The target date of completion remains 2025, but will be updated once we receive more detailed plans from NHS Lothian.

While that major project is underway, NHS Lothian have taken the interim step of creating plans to enhance the current accommodation. This will allow their clinicians to continue to provide expert care for patients in the same building until they are able to move into a new facility. A significant amount of work has already been undertaken and the Scottish Government is planning on allocating additional funding to support these plans; the exact amount of support will be confirmed as the plan is developed but it is expected to be in the range of £15 million.

The Scottish Government last met with Universities Scotland on 19 December 2017, when officials met with them to discuss the impact of Brexit on the Scottish Higher Education Sector, including EU students.

Since 2016-17, we have provided £187,500 in project funding to support chronic pain research on behalf of the Scottish Government and NHS in Scotland, at the University of Dundee. This is looking at the development of better data and the collection of best evidence to help drive improvements in pain services, and is phased over a planned three-year period.

The research was initiated to collect detailed data on a one-year long pilot study across three NHS Pain Services (Lothian, Tayside and Fife) in Scotland. Its aim was to assess the process, utility and challenges associated with data collection within these services to improve these NHS services for people affected by chronic pain.

The initial stages of the research have been completed. The current stage aims to translate and implement the findings from the initial phase. Scottish Government receives frequent updates on activity and output from the research team, and these include;

- study of existing data collection from three chronic pain services

- analysis of the strengths and weaknesses of these, and the associated systems

- design of a draft core minimum dataset for collection by pain services across Scotland

- design of draft Quality Performance Indicators, for pain services across Scotland

- consultation with professional stakeholders around these data and QPIs

- initiation and completion of evidence-based guidelines for management of chronic pain in children and adolescents

-systematic review of interventions to support reduction of opioid treatment

- support for the Scottish Pain Research Community's Annual Scientific Meeting, and further development, to inform best management in Scotland.

Any future funding will be considered against progress made towards agreed outcomes.

I can confirm that in 2018-19 the City of Edinburgh Council will again receive an additional £3.9 million in recognition of the increased costs that are associated with Edinburgh being Scotland’s capital city.

The reporting of waiting times data was a standing item for discussion at the meetings of the Ministerial Steering Group (MSG) on Chronic Pain. Officials met with ISD on 13 January 2017 to provide feedback from patient representatives of the MSG following discussion of the waiting times publication at the MSG on 4 October 2016.

In relation to waiting times data for return appointments, the MSG maintained a position that as this data would not lead to better outcomes for people with chronic pain other options should be explored and subsequently approved progression of the development of a National Chronic Pain dataset.

The Ministerial group has been replaced by the National Advisory Committee for Chronic Pain, which met for the second time on 19 December 2017 and is chaired by Deputy Chief Medical Officer, Gregor Smith. That group, which includes patient representatives, will oversee the development of the National Chronic Pain dataset.

ISD adheres to the Code of Practice for Official Statistics which is underpinned by the Statistics and Registration Services Act (2007). This is achieved by listening to users of their statistics through consultations and adjusting their statistical outputs accordingly, ensuring their statistical reports are protected from any political pressures, and presenting statistics impartially and objectively.

As part of moving the Chronic Pain Waiting Times Publication from developmental status to Experimental Official Statistics, ISD carried out a consultation with users and published a report in October 2017. ISD will be implementing changes over forthcoming publications and are also happy to receive feedback on publications at any point in time.

In line with the commitment set out in the Cancer Strategy, I can confirm that two radiotherapy physics trainee posts per annum were filled in 2015-16 and 2016-17.

The Scottish Government supports NHS Health Boards in their efforts to ensure that they have the right staff in place to meet the healthcare needs of the local population.

NHS Lothian have advised that when the decision was taken to temporary close its Paediatric In-Patient Unit at St John's Hospital on 7 July 2017, a commitment was made to operate a Short Stay Paediatric Assessment Unit (SSPAU) between 08:00hrs to 20:00hrs, Monday to Friday. NHS Lothian have confirmed that since the introduction of the temporary model, the Board has been able to keep the SSPAU open at the weekends through staff undertaking additional shifts coupled with the use of locum cover. Due to unplanned absence, at short notice, the Board was unable to staff a safe rota for both the 3 and 9 December, resulting in the SSPAU closing on these days.

The Board commissioned the Royal College of Paediatrics and Child Health (RCPCH) to review the work undertaken to secure a sustainable 24/7 staffing model. The College has carried out a review and produced a report which was received by the Board in the Autumn. It concluded that option one remained both the RCPCH’s and NHS Lothian’s preferred option for St John's Paediatric services i.e. 24 hour consultant and Tier 2 [middle grade] cover. The College recognised that the development of this model was a long-term solution depending upon the successful recruitment of staff.

NHS Lothian has confirmed that the decision to close the SSPAU on the weekends of 23-24 and 30-31 December has not been taken lightly and was made following detailed discussion with consultant staff representation from St John’s Hospital. The Board advised that this discussion recognised the pressures staff were experiencing in supporting out of hours cover, over and above their normal shifts due to vacancies.

The Scottish Government is continuing to work with NHS Lothian to ensure that the services on offer at the St John’s in-patient paediatric ward remain safe and sustainable in the long-term. The Chief Medical Officer and the NHSScotland Director of Performance and Delivery met with NHS Lothian on 23 October. Amongst the issues discussed was the history on recruitment, sickness absence and the filling of rotas.

NHS Lothian has given an assurance that it is committed to increasing staffing levels and reinstating the 24/7 model.

In order to provide effective assistance to Ministers, special advisers work closely with the Ministerial team and with civil servants and may give assistance and advice on any aspect of Scottish Government business. Medical advice in relation to mesh is provided to both Ministers and officials by appropriately qualified and experienced clinical personnel.

The Scottish Government’s Capital Investment Group (CIG) oversees the approval process for business cases across NHSScotland and provides the necessary assurances that proposals are robust, affordable, deliverable, and that they are in line with wider NHS policy. Following consideration by the CIG, approval was given for the Initial Agreements for the NHS Highland “North of Scotland Elective Care Centre” and the Golden Jubilee National Hospital "Ophthalmology Unit Development’" on 28 September 2017. The Business Cases for these elective centres are now under development.

The Initial Agreements for the remaining centres continue to be developed, supported and informed by a range of national planning work, and will be considered by the CIG in due course. In line with the original commitment, the programme to deliver the elective centres remains on track for completion by the end of 2021.

The Scottish Government supports NHS Health Boards in their efforts to ensure that they have the right staff in place to meet the healthcare needs of the local population.

NHS Lothian have advised that when the decision was taken to temporary close its Paediatric In-Patient Unit at St John's Hospital on 7 July 2017, a commitment was made to operate a Short Stay Paediatric Assessment Unit (SSPAU) between 08:00hrs to 20:00hrs, Monday to Friday.

NHS Lothian have confirmed that since the introduction of the temporary model, the Board has been able to keep the SSPAU open at the weekends through staff undertaking additional shifts coupled with the use of locum cover. Due to unplanned absence, at short notice, the Board was unable to staff a safe rota for both the 3 and 9 December, resulting in the SSPAU closing on these days.

The Board commissioned the Royal College of Paediatrics and Child Health (RCPCH) to review the work undertaken to secure a sustainable 24/7 staffing model. The College has carried out a review and produced a report which was received by the Board in the Autumn. It concluded that option one remained both the RCPCH’s and NHS Lothian’s preferred option for St John's Paediatric services i.e. 24 hour consultant and Tier 2 [middle grade] cover. The College recognised that the development of this model was a long-term solution depending upon the successful recruitment of consultants, Advance Nurse Practioners (ANP) and Specialty and Associate Specialist Doctors.

NHS Lothian has given an assurance that it is committed to increasing staffing levels and reinstating the 24/7 model.