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While the Scottish Government provides the policies, frameworks and resources for high quality healthcare, it is for each individual NHS Board to decide best how to utilise funding, facilities and staff while taking account of national and local priorities to meet local health needs. We expect NHS Boards to plan their facilities and workforce to deliver these services, ensuring the provision of safe, effective and high quality patient care, delivered by the right professional at the right time.

Our prevention agenda has seen the implementation of various strategies, addressing the fundamental drivers of inequality; encouraging early intervention and support; and promoting environments that support healthy lifestyles.

This has included tackling some of the root socioeconomic drivers of heath inequalities with the allocation of around £3 billion a year to a range of actions to tackle poverty and mitigate the impacts of the cost-of-living-crisis. We are also delivering Community Link Workers and Welfare Rights Advisors to offer advice on housing, social security and employability issues within GP practices across our rural and deprived communities.

To support and encourage positive health behaviours SG has continued to take forward a range of actions. This includes the implementation and subsequent expansion of Minimum Alcohol Pricing to reduce drinking at harmful levels by setting a floor price for each unit of alcohol. We are tackling the adverse effects of smoking through our Tobacco and Vaping Framework. We continue work to ensure that everyone eats well and has a healthy diet through our Diet and Healthy Weight Delivery Plan, we are currently consulting on a set of proposed regulations to restrict promotions of less healthy food and drink.

The Scottish Government remains committed to our ambition to improve the health of our population and tackle health inequalities. We know that to achieve this we must focus on preventing illness and promoting wellbeing and tackling some of the wider determinants of health. Going forward, we will build on this progress and continue to prioritise prevention as a key component of our wider healthcare strategy.

Under the Health and Care (Staffing) (Scotland) Act 2019, Health Boards / Special Health Boards / NHS National Services Scotland must follow the common staffing method, which only applies to certain types of health care, provided in certain locations by certain employees (see annex A), at least once every financial year. It must then decide if any changes are needed as a result, both to the staffing establishment, for example an increase or decrease, and the way in which it provides health care, for example service redesign.

Health Boards / Special Health Boards / NHS National Services Scotland are required to publish and submit an annual report to Scottish Ministers on how they have carried out their duties in the Act, with the first report due by 30 April 2025. Scottish Ministers must then present these reports to Parliament with an accompanying statement detailing how the information will be used in designing policies for staffing of the health service.

However, results from the common staffing method are only one factor in providing information on workforce and service delivery and the Scottish Government continues to implement policies for workforce and service reform.

Overall nursing and midwifery staffing is at a record high, up by 17.8% since September 2006, by 10,100.4 WTE to 66,883.6 WTE. Since September 2006, qualified nurses and midwives have increased by 16.3%, by 6,698.7 WTE to 47,724.9 WTE. Initiatives on international recruitment provided around £18m in funding to Boards to recruit 1,250 international nurses, midwives and allied health professionals, with well over 1,000 already in post across Scotland so far and many more arriving in the coming weeks.

Controls were introduced by Boards from 1 April 2023 in order to gradually reduce the number of shifts being filled by nurse agency workers and from 1 June 2023 Boards were no longer using off-framework nurse agencies unless in exceptional circumstances. Boards have reported significant progress in reducing reliance on agency nursing staff as a result of these changes. Further controls were introduced from 1 April 2024, and Boards are no longer using agency workers to fill Health Care Support Worker (HCSW) / unregistered shifts.

The Nursing and Midwifery Taskforce (NMT) was announced in February 2023 at the request of staff side organisations, including the Royal College of Nursing and Royal College of Midwives to understand the challenges facing nurses and midwives across Scotland. The NMT continues to be a Ministerial priority and will recommend a workplan of actions which will seek to improve workplace culture, practice, flexibility, recruitment and retention, alongside the diversification of education and training pathways to support longer-term workforce sustainability. The NMT is making good progress with the development of its recommended actions and will continue to work until members have agreed a comprehensive action plan. We anticipate the publication of a report later in 2024.

Annex A

Types of health care, locations and employees subject to the common staffing method

As set out in answer S6W-26380 on 16 April 2024, the Nursing and Midwifery Taskforce has held four ministerial led meetings in April, July, December 2023 and March 2024. The Taskforce has also held two official led meetings in June 2023 and March 2024.

Lead responsibility for Ayr Station Hotel rests with South Ayrshire Council while Network Rail has lead responsibility for the railway station itself.

All parties are aware of the disruption to travel caused by the dreadful vandalism which set fire to the Station Hotel. Rather than conduct post-event impact assessments, the focus of all partners involved is on working collectively to restore services to normal as soon as it is safely possible to do so.

Until rail services can be restored, a replacement bus service is in place to enable passengers on the affected route to access work, leisure, education and any other personal matters, including medical appointments.

Officials from Transport Scotland are in regular dialogue with South Ayrshire Council, ScotRail and Network Rail regarding the ongoing disruption caused by the fire at the Ayr Station Hotel. Officials have separately kept the Regional Transport Partnership apprised of developments.

Feedback from ScotRail is that demand for the replacement bus service on the routes South of Ayr has been low.

Officials in Transport Scotland, and the rail industry, are working closely with South Ayrshire Council to ensure that every effort is made to complete the required safety related works affecting services as swiftly as possible to enable the restoration of rail services as soon as it is safe to do so.

I refer the member to the answer to question S6W-27091 on 10 May 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 know that diagnosis time for endometriosis is not acceptable and needs to improve. We recognise the time to diagnosis is not itself an effective measurement of improved health and well-being outcomes for those living with endometriosis. It is vital that we improve care and support throughout the whole diagnosis process.

To do this we have taken a number of actions including:

• Supporting the Centre for Sustainable Delivery to raise awareness and implement the Endometriosis Care Pathway for Scotland which aims to provide a holistic approach and timely care for those with endometriosis and endometriosis-like symptoms.
• Increasing education among healthcare practitioners by working with NHS Education for Scotland to deliver an endometriosis masterclass session for health care professionals, covering diagnosis, treatment and current research.
• Developing information on NHS Inform and working with charities such as Endometriosis UK and Young Scot to ensure that women have access to information that can support them to recognise when their symptoms might not be a normal period and enable more informed conversations with clinicians.

Assessment of the safety of walking routes is a responsibility of local authorities under section 51 of the Education (Scotland) Act 1980.

The Scottish Government expects local authorities to keep their criteria for providing school transport under review and be flexible enough to take into account factors relative to the nature of the route, which might affect pupil safety. These factors are set out in paragraph 18 of the - School Transport Guidance 2021 (www.gov.scot) .