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The majority of spending on mental health is delivered through NHS board budgets, and this is not directly affected by the in-year budget changes impacting on the direct mental health programme budget. Between the Scottish Government and NHS boards we expect spending on Mental Health to be well in excess of £1.3 billion in financial year 2023-24.

We are working with partners towards delivery of the commitment to increase spending on mental health services to 10% of the total frontline NHS budget by the end of this Parliamentary session in 2026. We will continue to work with NHS Boards to monitor delivery through the Scottish Health Service Costs Book and the process of setting and monitoring priorities in Annual Delivery Plans.

The majority of spending on mental health is delivered through NHS board budgets, and this is not directly affected by the in-year budget changes impacting on the direct mental health programme budget. Between the Scottish Government and NHS boards we expect spending on Mental Health to be well in excess of £1.3 billion in financial year 2023-24.

We are working with partners towards delivery of the commitment to increase spending on child and adolescent mental health services to 1% of the total frontline NHS budget by the end of this Parliamentary session in 2026. We will continue to work with NHS Boards to monitor delivery through the Scottish Health Service Costs Book and the process of setting and monitoring priorities in Annual Delivery Plans.

Transport Scotland keeps forecasting methodology under review to ensure best practice. The Borders Railway business case demand forecasts were based on modelling that was informed by surveys of residents regarding their potential use of the line. This resulted in forecasts that underestimated demand from Borders stations and overestimated demand from Midlothian stations.

Rail demand forecasting has developed considerably since the demand forecasts for the Borders Railway business case were first developed in 2008. A post-opening hindcast from the South East Scotland Transport Partnership (SESTran) Regional model for those Borders stations gave forecasts within 30% of actual demand. Where available, Transport Scotland recommends to promotors the use of Regional models for new station demand forecasts .

Difficult decisions have had to be made to allow us to balance the Scottish Government budget while still progressing implementation of our mental health and wellbeing and other strategies from a revised direct budget of £260.3 million.

The in-year budget changes impacted on a number of planned new programmes which could not proceed as anticipated. Planned increased funding to existing programmes were also not able to be progressed. This included programmes related to Mental Health and Primary Care; regional CAMHS developments; full implementation of Coming Home; full implementation of the new Mental Welfare Commission Patient Records System; and improving prisoner mental health.

Despite the savings made, we have continued to focus on delivery of our mental health and wellbeing strategy and recently published delivery plan, which includes commitments around mental health services and specific programmes of work around learning disability and autism, and cross-cutting trauma work.

I refer the member to the answer to question S6W-23811 on‎ 8 January 2024. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

We are approaching the end of the first year of implementing the National Carers Strategy (published in December 2022). The implementation of the strategy is monitored by the Carers Rights and Support Steering Group (CRSSG), made up of representatives from national and local carer organisations, statutory sector representatives and unpaid carers - so that carers are directly involved in measuring and monitoring the impact of the strategy during its lifespan.

The CRSSG agreed 43 actions to be prioritised for Year 1. The actions cover a broad range of topics including COVID-19 and cost of living as well as outlining employment, financial and mental health support. Examples of actions that have been progressed this year include:

• We distributed £560,000 to carer centres in 2022-2023 to improve local capacity for carer support.
• We funded the Carers Parliament and the Young Carers Festival in 2023, with record numbers attending the Young Carers Festival this year. We will continue to fund events which enable carers to engage directly with decisionmakers.
• We have engaged with carers in 2023 to produce the National Dementia Strategy, the Mental Health and Wellbeing Workforce Action Plan, the Mental Health and Wellbeing Strategy and we have involved carers in the review of the National Outcomes and the National Care Service co-design. We will continue to engage with carers to ensure their voices are heard and reflected in policy across the Scottish Government.
• We are continuing to fund and promote increased uptake of the Carer Positive employer accreditation scheme, with 264 employers now signed up who are responsible for 493,000 employees (as of November 2023).
• Social Security Scotland successfully launched the initial pilot for Carer Support Payment in November 2023, with the benefit to be available nationally by autumn 2024. The benefit is a key milestone in improving support for unpaid carers and will be available to many carers in full-time education who cannot currently get Carer’s Allowance.
• Through the Communities Mental Health and Wellbeing Fund, we invested £15 million in 2022-23 in community-based initiatives to promote good health and wellbeing and tackle the mental health issues for people, including unpaid carers.

The Strategy is kept under review so that we are able to respond to changing circumstances and ensure progress towards meeting the actions contained within it.

The National Care Service Bill makes changes to the Carers (Scotland) Act 2016 to deliver a right to personalised short breaks support for any carer who is not currently able to access ‘sufficient breaks’ – accessed via their personalised plan under the Carers Act.

We are working with a group involving carers, local and national carer organisations and social care practitioners to develop the guidance and regulations required to deliver a right to personalised short breaks support for carers who need it under the proposed legislation. As caring roles vary in nature and intensity, carers will need different amounts and types of support to achieve ‘sufficient breaks’, depending on factors such as the type of caring role, help from other family members and wider support.

Ahead of the proposed legislation, we increased the voluntary sector Short Breaks Fund by £5m to £8m in 2022-23, to expand easy-access short breaks support, and have maintained the fund at £8m per year since then. This is in addition to £88.4m per year Carers Act funding in the local government block grant.

Table 1 shows funding allocated to each NHS Health Board in 2021-22 for clearance of any backlogs on waiting lists for CAMHS.

Table 1:

It is not possible to report accurately on the number of additional CAMHS cases taken on since 2021 as the current aggregate data set does not allow identification of separate individuals, it only gives a snapshot of the total number of open cases at any one time.

In the NHS Recovery Plan, published in 2021, we committed to provide sufficient funding for around 320 additional staff in CAMHS over the next 5 years, with the potential to increase capacity for CAMHS cases by over 10,000. This estimate was based on the Choice and Partnership Approach (CAPA) capacity model, where each full time clinician can hold around 40 open cases at any one time, and manage around 40 new cases per year.

From March 2021 to September 2023, 295 WTE CAMHS staff have been added to the workforce, significantly increasing capacity to manage CAMHS cases. We see this reflected in numbers waiting - the total number of children and young people waiting for treatment has fallen from 10,499 in December 2021 to 5,344 in September 2023.