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The Scottish Government is committed to ensuring that all children in primary school receive at least two hours of physical education (PE) each school week.

To monitor progress on this commitment, local authorities have provided us with data about provision of PE in their schools since 2012. This data is reported through the annual Schools Healthy Living Survey Statistics Report, which is available through the following web link: Data and Methodology - School Healthy Living Survey: school meal uptake and PE provision statistics 2023 - gov.scot (www.gov.scot) .

Information about schools meeting PE targets is contained on Table 18 of the supplementary statistics spreadsheet in the Schools Healthy Living Survey.

In addition to regular physical education classes there are other physical activity initiatives available for primary school age children, such as The Daily Mile. The Daily Mile is a simple and effective concept which allows all pupils to either run, jog or walk for one mile each day at any time which best suits the needs of the class. Scotland became the world’s first Daily Mile Nation in October 2022.

The Scottish Government places great importance on community sports and leisure facilities. They are crucial to the wellbeing of all our country and most importantly, for our children and young people to be healthy and active.

We have asked sportscotland to undertake a review of the facilities estate which will provide vital information in understanding the sport and leisure facilities provision in the long term. In addition, sportscotland and Scottish Swimming have recently published a detailed research study into the condition of Scotland’s swimming pools.

We are fully aware that local authorities are facing challenging financial circumstances, particularly in the maintenance and operating of facilities, largely due to energy costs and other cost of living pressures. sportscotland will continue to work with its local partners to help them assess the impact of any potential facility closures across the country. In addition, the Minister for Social Care, Mental Health and Sport and officials engage regularly with Community Leisure UK to discuss the local public facilities landscape.

In recognition of the importance of access to sports and leisure facilities, our Programme for Government sets out our intention to convene a working group, including representatives of sports organisations, community organisations and CoSLA, to explore how community access to community facilities, such as the school estate, can be enhanced.

While we work with Boards through planning to make best use of existing NHS resources and capacity, we will continue to use the private sector in a structured and prioritised manner. As we deliver new, better and more sustainable ways of delivering services to improve access for patients, we expect the need for private sector capacity to lessen. It is for local NHS Health Boards to determine how they use the private sector and to agree any contractual arrangements.

In 2022/23, total spend on use of the private sector in NHS Scotland represented just 0.7% (£116m) of the total frontline health budget, while in England, it was 6.5% (£11.5bn) of the Department of Health Budget.

Public Health Scotland’s Annual Acute hospital activity and NHS beds information provides information on non-NHS providers; NHS patients treated in non-NHS locations such as private hospitals, hospices, nursing homes, care homes etc. PHS's latest publication, covering 2022-23 shows that there were 2,958 consultant-led outpatient appointments performed by non-NHS providers in 2022-23, or 0.08% of the total that year (3,928,597) Table 1 – Outpatient Activity. During this period figures for new outpatient appointments are 1,988 by non-NHS providers out of 1,273,588 in total (0.16%), involving 1,943 new patients out of a total of 964,316 new patients. There were also 4,962 Continuous Inpatient Stays in non-NHS hospitals out of a total of 1,092,413 (0.45%). This involved 4,779 patients out of a total of 631,731 patients (0.76%) Table 2 – Inpatient and day case activity .

The first official meeting of the Flow Navigation Special Delivery Group was held on 4 October 2023. The group meet monthly with 4 meetings having taken place since its formation.

The group is led by the Centre for Sustainable Delivery and consists of clinical and operational leads, for Flow Navigation Centre’s, from each mainland Health Board. It also includes representatives from the Royal College of Emergency Medicine, the Royal Collage of General Practitioners, Primary Care, NHS 24, the Scottish Ambulance Service and the Scottish Government.

The Scottish Government keeps the eligibility criteria for free school meals under regular review to take account of any developments which may impact upon it. The eligibility criteria was last amended in April 2023. We notify local authorities whenever any changes are made to the eligibility criteria to enable them to invite fresh applications for free school meals under the new criteria.

We are currently reviewing the existing eligibility criteria for free school meals in light of the latest increases to the National Living Wage, which were announced by the UK Government on 21 November 2023.

Scottish Government officials met with NHS Scotland Board Chief Executives on 12 December where they discussed medical locum staffing as one of their priority actions. This follows detailed engagement with Boards regarding the arrangements currently in place for contracting agency staffing, the outputs of which are being used to inform targeted improvement activity in this area.

The Scottish Government has commissioned the Centre for Sustainable Delivery (CfSD) to improve Community Urgent Care (CUC) pathways as part of the wider Urgent and Unscheduled Care Programme. In addition to validated nationally collected data from Public Health Scotland, an Unscheduled Care Improvement Dashboard is in creation which will consist of ‘data for improvement’ collected manually by each Health Board Area, which supports tracking of locally held data to reflect the impact of improvement activity, creating visibility of progress.

Work is also underway through an external partner to evaluate the Redesign of Urgent Care pathway through NHS 24 111 service which launched in 2020 and provides access to local Flow Navigation Centres and virtual A&E teams.This evaluation will assess impact on a range of measures, including patient and staff experience and assess what other outcomes are impacted by the service.

• The Scottish Government has commissioned the Centre for Sustainable Delivery (CfSD) to improve Community Urgent Care (CUC) pathways as part of the wider Urgent and Unscheduled Care Programme.
• In addition to validated nationally collected data from Public Health Scotland, an Unscheduled Care Improvement Dashboard is in creation which will consist of ‘data for improvement’ collected manually by each Health Board Area, which supports tracking of locally held data to reflect the impact of improvement activity, creating visibility of progress.
• Work is also underway through an external partner to evaluate the Redesign of Urgent Care pathway through NHS 24 111 service which launched in 2020 and provides access to local Flow Navigation Centres and virtual A&E teams. This evaluation will assess impact on a range of measures, including patient and staff experience and assess what other outcomes are impacted by the service.

While Scottish Government is responsible for the strategic direction of the NHS, territorial Health Boards are responsible for delivering services in their areas, and providing appropriate community spaces for midwives and allied health professionals.

Community-based maternity services should have access to appropriate accommodation to provide face to face appointments. ‘The Best Start: a Five Year forward Plan for maternity and neonatal care’ outlines the expectation that Boards provide routine care and maternity services through Community Hubs.

We are also supporting development of primary care multi-disciplinary teams (MDT), including allied health professionals, with investment of £190 million in 2023-24 through the Primary Care Improvement Fund.

Integrated Authorities must work closely with local communities and other stakeholders to ensure that Primary Care Improvement Plans address specific local challenges and population need.

While making significant progress in these reforms, we recognise that implementation gaps remain, including around accommodation barriers.

We are now also introducing an additional ‘phased investment programme’ working with a small number of areas to demonstrate what a model MDT can look like in practice. The findings from this programme will build understanding of the national context for further implementation and inform future long-term Scottish Government investment.

A Flow Navigation Centre has been established in every mainland Health Board as part of the Redesign of Urgent Care Programme. They provide expert clinical advice, referrals to alternative services and, when necessary, schedule appointments at A&E. They play a key role in ensuring patients receive the ‘Right Care, in the Right Place’ by diverting patients to more appropriate pathways of care and reducing unplanned attendances to A&E departments.

The RUC Programme was introduced during the Covid-19 pandemic (December 2020), impacting on the comparability of statistics. However, in the 12 months to October 2023, A&E attendances where down by more than 11 percentage points compared to 2019 levels. Whilst we do not have comprehensive data available, we understand through discussions with Health Boards that the reduction in attendance is in part due to Flow Navigation Centre’s.

In order to realise the full potential of Flow Navigation Centres, the Centre for Sustainable Delivery (CfSD) have established a Flow Navigation Specialty Delivery Group to drive the development and delivery of high quality Flow Navigation services across Scotland. The group brings together key stakeholders to establish the optimal Flow Navigation Model and reduce unwarranted variation. Developing and capturing the relevant data to measure the impact of this work and to understand and evidence outcomes is part of the SDG workplan which is being taken forward over the next year.

Scottish Government officials met with NHS Scotland Board Chief Executives on 12 December where they discussed agency nurse staffing as one of their priority actions. This follows detailed engagement with Boards regarding the arrangements currently in place for contracting agency staffing, the outputs of which are being used to inform targeted improvement activity in this area.