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The words “co-design” and “co-production” are often used interchangeably but, in this case, we are pursuing co-design. Just yesterday, I had a conversation with an elected member who used “co-production” and “co-design” as if they were interchangeable. I am interested to hear about what the co-design process really is and how distinct it is from co-production.

I will pick up on some of the issues about engaging with COSLA and the unions. We took evidence from the Scottish Partnership for Palliative Care and heard that

“The national care service is a real opportunity to be part of improving people’s experiences of living with serious illness, and of dying and bereavement.”—[Official Report, Health, Social Care and Sport Committee, 13 December 2022; c 5.]

Age Scotland said that the Scottish Government has made it clear that there is a commitment to involving people with lived experience.

I would be interested in hearing about engagement with unions. I read a statement from Unison that said that

“the bill leaves profiteering at the heart of care”

and I know that there are concerns about employment and pensions. In contrast with the position of the Health and Social Care Alliance Scotland, the Scottish Partnership for Palliative Care and Age Scotland, who all welcome the bill, others have concerns and may feel that they need to have a voice. Can you speak about that, minister?

I have a question for Jeff Ace, but before I ask it I remind everybody that I am a former NHS Dumfries and Galloway employee and was part of the Covid vaccination team as a nurse during the pandemic.

What particular changes have been made for service delivery? We met last Friday, as part of our normal updates. Parts of Dumfries and Galloway are really remote and rural, so one of the things that you talked about was the development of home teams. Will that help to manage the service in a better way—not necessarily to make savings, but to improve efficiency?

Yes—I have a quick point. The deputy convener mentioned the Shouldice approach. A Shouldice repair has strict criteria such as losing weight, having no alcohol and being able to exercise. It might be difficult to apply that in Scotland, where people who present as needing an inguinal hernia repair that uses mesh, for instance, might have additional comorbidities. We cannae compare apples wi oranges.

Jeff Ace talked about a Scotland-wide approach, with combined or joint services. Do you mean combined human resources as part of joint work and integration, or combined financial services? Is that something that could work for NHS Dumfries and Galloway, which is a small board, or does there need to be a Scotland-wide approach, as well?

I have a quick question for Jeff Ace about international recruitment. You have been quite successful in recruiting nurses. Not only a warm welcome, orientation and training are required; a wider holistic approach is required. Is housing a challenge in recruiting folk to remote or rural areas such as Dumfries and Galloway? If so, what can be done about that?

The recovery plan is a five-year plan; coming out of Covid is not an overnight fix. It will take time, and I know that as a nurse myself.

I am interested in the cancer diagnostics centres. One was created in Ayrshire and Arran, one in Fife and one in Dumfries and Galloway. Prevention and early diagnostics are happening in NHS Dumfries and Galloway, where there is a trial of self-sampling for cervical cancer diagnosis. Would Mr Ace like to comment on that?

You have said that it is about a holistic approach. As I read the papers, I saw information about continuing feelings of being let down, of prolonged and continued anxiety and of disappointment, because the expectations were already low and they were not being met. It seems that there is also conveyance of lack of empathy for their experiences. It is almost like there needs to be a Maggie’s centre equivalent for people who have had mesh injuries. It is quite difficult to read some of what has been presented. How would you describe the holistic approach? I know that psychologists and clinical nurse specialists are involved. How would you see progress being taken forward based on feedback from surveys about people’s experiences?

I will go directly to the communication theme. I am looking at the NSS website and the NHS Greater Glasgow and Clyde website. The NSS website is quite clear on the pathway and what the process would be, but the NHS Greater Glasgow and Clyde website is a bit clunky for finding the information that people need—that is obviously not something that you can control, Dr Lamont.

I am interested in how women are communicated with, from the start of the process through to referral and as the process goes on. Is there open dialogue and does it happen by contact with the direct clinical nurse specialist, for instance? What is the process for communicating to keep people feeling that they are well informed?

The Scottish Government published a Covid recovery document—the “NHS recovery plan 2021-2026”—in August 2021. How is that plan working out for the different boards and would you change anything in it after implementing some of its recommendations?