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If obvious good practice is having a positive impact, what pressure would be put on other boards to follow the example?

Good morning, Auditor General and colleagues. In your “NHS in Scotland 2023” report, you recommended that the Scottish Government confirm which indicators will be used to measure year-on-year reductions in waiting times, but this year’s report states that that has not been done. Will you explain why transparency is so important in assessing progress and planning future activity? Has the Scottish Government made any progress in implementing the recommendation? What are the barriers to progress?

It would be helpful if that update comes out.

We note from your report that, unless the NHS in Scotland increases hospital activity and transforms services to focus on prevention and care close to home, it is likely that waiting lists and waiting times will continue to grow. That has already been discussed to some extent, but in your view, what more could the Scottish Government do to try to address that, other than, for example, through the £200 million that it has committed to in the budget?

If the infrastructure budget had not been cut so drastically, the national treatment centres could have been up and running and helping to lower waiting times, which should have had a positive impact, but we are where we are.

I have a question about the positive changes made by NHS Forth Valley and NHS Tayside to improve their performance against national waiting time targets for child and adolescent mental health services. Do you have any more information about how those changes came about? Does the Scottish Government have mechanisms in place to ensure that best practice can be shared across all boards to meet its aim of clearing backlogs by December 2025?

Will you clarify what you mean by productivity in the NHS?

Some changes are being made or have recently been made. Do you expect it to take some time before you see the impact of those? Is there anything in particular that you have suggested to the Government that it should take forward?

I have one more question about waiting list times. Earlier, you talked about England being ahead of Scotland in bringing down the number of people who are on waiting lists for more than two years. There are reports that Scotland is ahead of the rest of the UK for A and E waiting times. Is there a correlation between those two things? Is there a focus on one aspect, to the extent that it causes a delay in the other?

I would not have attempted to either, if it had not been brought up earlier. I thought some work might have been done that showed that there was some sort of correlation with regard to the issues of people waiting more than two years and the A and E waiting times.

I have one more question, Auditor General. Your report notes that new out-patient attendances and in-patient admissions have increased steadily over three years, yet planned activity remains lower than pre-pandemic levels. In your assessment, what factors are contributing to that, particularly in relation to specialties such as orthopaedics, where waiting lists are the longest? What steps can be taken to ensure that progress in reducing long waits for treatment is accelerated?

Thank you. That is me finished, convener.

I go back to the same question. You said that colleges can make their own decisions. Is there any oversight of that? What if those decisions would clearly be harmful for the college and course delivery and so on? Is it just up to the college, and we then suffer the consequences or get the benefit from that decision?