Seòmar agus comataidhean

The Scottish Government meet with NHS 24 on a regular basis to ensure that it delivers its functions in accordance with Ministers’ policies and priorities; to provide strategic leadership; to ensure financial stewardship; and to hold Chief Executives, senior management team and Board to account.

The Scottish Government review all monthly Board papers to keep appraised of Board business and also hold Annual and Mid-year review meetings with NHS 24. Due to the increasing pressures Covid-19 has had on the Service, regular sponsorship engagement has increased significantly with daily and weekly discussions now taking place with the Boards Chief Executive along with regular performance reporting from NHS 24 which allows us to maintain a focus on performance against their Key Performance Indicators (KPIs).

NHS 24 has played a key role in the response to Covid-19, completely altering the way in which they deliver their Service from a predominantly out of hours Service to 24/7 advice and support for patients both for Covid and in support of the re-design of unscheduled care.

In response to the re-design of unscheduled care programme, the Scottish Government has also successfully launched national media campaigns to help ensure clear and concise public information is delivered to support a reduction of unscheduled ED attendances by directing the public to access the right care from the most appropriate service for their needs.

Callers to 111 are encouraged to seek help from their own GP or from 999 in an emergency, if this is more appropriate and to access NHS inform for information and advice on seasonal illness information and self-help guides.

There has been significant pressure on mental health services throughout the pandemic, and the Scottish Government has responded with record-breaking levels of investment, including our £120 million Mental Health Recovery & Renewal Fund. As part of that work, we have made an additional £40 million available this year to improve Child and Adolescent Mental Health Services (CAMHS) and to clear waiting list backlogs by March 2023. We are also continuing to work directly with Health Boards with the poorest performance to ensure the 18 week waiting time standard is met.

As set out in the Mental Health Transition and Recovery Plan, we are taking a whole systems approach to improving children and young people’s mental health. Alongside investing in acute CAMHS, we are seeking to ensure community services and school counselling are also available in a responsive and timely manner. We are developing responses to young people experiencing crisis and distress, as well as investing in approaches that promote prevention, early intervention and reducing stigma.

To support this approach, an additional £15 million has been provided to local authorities this year to deliver locally based mental health and wellbeing support for 5-24 year olds in their communities, providing alternative treatment options and pathways to CAMHS, and we have also ensured access to counselling support services in all secondary schools. Additionally, we are committed to supporting every health board in Scotland with development of Infant Mental Health (IMH) provision through £3 million of funding per annum.

This package of commitments is designed to help ensure the right help is available, in the right place, at the right time. This additional investment will contribute towards delivering our commitment to ensure that, by the end of this Parliament, at least 10% of frontline NHS spend goes towards mental health, with 1% going towards CAMHS.

As a result of increased demand and changes to service delivery, we have increased funding to NHS 24 by over £20m this year for additional recruitment and the addition of a new call centre in Dundee, which opened in December.

This is supporting the additional recruitment of 575 full time equivalent call handlers and 140 full time equivalent clinicians to date, including through the recently established 24/7 mental health hub.

Engagement with patients has shown NHS 24 that a focus on ensuring patients receive the appropriate advice, first time, rather than answering their call as quickly as possible is preferable. However, patients with serious and urgent conditions will always be a priority.

Callers to NHS 24 will initially have their symptoms triaged by a call handler before being passed on to a clinician within the Service or to another area of the health service best placed to meet their needs as appropriate.

Both Scottish Government and NHS 24 is committed to ensuring that the patients journey through the health care system is a quick as is possible and patient safety remains the key focus as we continue to enhance the 111 service.

We know that the pandemic has been exceptionally difficult for the mental health and wellbeing of many children, young people and their families, and that there has been increased pressure on mental health services as a result of this.

As part of our £120 million Mental Health Recovery and Renewal Fund, we have made an additional £40 million available this year to improve CAMHS and to clear waiting list backlogs by March 2023. Long waits are unacceptable and we remain committed to meet the standard that 90% of patients start treatment within 18 weeks of referral. We are directing support to those Boards with the longest waiting lists to clear backlogs by March 2023 and are monitoring progress closely.

Additionally, in our NHS Recovery Plan we have committed to provide sufficient funding for around 320 additional staff in CAMHS over the next 5 years. This will have the potential to increase capacity for CAMHS cases by over 10,000.

We have also provided an additional £15 million to local authorities this year to deliver locally based mental health and wellbeing support for 5-24 year olds in their communities, providing alternative treatment options and pathways to CAMHS and ensured access to counselling support services in all secondary schools.

While the Scottish Government’s role is to set the strategic policy for the NHS in Scotland, NHS Boards are responsible for delivering safe, effective, person-centred care at a local level.

The Scottish Government published the National Personal Footcare Guidance https://www.gov.scot/publications/personal-footcare-guidance/ , which sets out clearly the difference between personal footcare and clinical podiatry in NHS Scotland and offers help and support to individuals, carers and families in the provision of personal footcare, including older and at-risk people.

People with the most urgent clinical need are seen by a registered podiatrist to ensure they are prioritised for treatment, and those that require personal footcare are advised how to self-manage their footcare or are signposted to other more appropriate services. As we emerge from the COVID-19 pandemic, those with the most essential or urgent clinical podiatry needs continue to be seen. We are working with NHS Boards to remobilise and reform services, including the development of services across Scotland to support future service sustainability and addressing the backlog of treatment.

To ask the Scottish Government how it plans to reach its target of investing 1% of the health budget in CAMHS services by the end of this parliamentary session. We are committed to increasing direct investment in mental health by 25% and to working with NHS Boards and other stakeholders to ensure that at least 10% of frontline NHS spend goes towards mental health and 1% goes on child and adolescent services by the end of this Parliamentary session.

The £40 million additional funding this year for improvement across child and adolescent mental health services from the Recovery and Renewal Fund and our plans for increased investment in next and future years will contribute towards delivering the commitment.

The Cancer Survival publication is due for release on 19th April 2022 and will be hosted by Public Health Scotland. Data on 1 and 5 year survival will be published for patients diagnosed between 2015 and 2019 as well as long-term trends in survival for patients diagnosed since 1995. Information is presented for 27 types of cancer, for Scotland as a whole and by age, sex and socio-economic deprivation.

The UK National Screening Committee (UK NSC) has not yet made a recommendation on the use of self-sampling in the national cervical screening programme. However the UK NSC continues to gather and evaluate evidence on the matter. Scotland is playing an active part in evaluating the benefits of self-sampling, through a study in NHS Dumfries and Galloway. We are taking the necessary steps to ensure that we can roll it out as soon as possible once a recommendation is made. Patient safety is our top priority and we will not act until we are assured it is safe to do so.