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NHS Lothian successfully commissioned the first phase of the new Royal Infirmary on 27 January, and phase 2 will follow in early 2003. The new hospital will offer first class surroundings and state of the art equipment to match the excellent clinical care already delivered by health professionals in Lothian. Overall bed numbers are planned on a cross-Lothian basis. A review was undertaken in 1999 by Lothian Health Board of planned acute bed numbers for the new Royal Infirmary of Edinburgh. This confirmed that the proposed numbers were adequate in the context of the board's plans for developing community and primary care services. The balance between hospital and community services, and therefore the requirement for acute beds, is kept under regular review.NHSScotland will continue to respond to the needs of patients within the policy framework provided by the Scottish Executive, which emphasises the importance of patient-centred services and reductions in waiting to meet key targets.

Acute bed numbers must reflect patients' health care needs. Over time, patterns of care in acute hospitals have changed, with shorter lengths of stay and much greater use of day surgery. As a result, fewer acute beds have been necessary to support treatment of patients.Detailed decisions about bed numbers in the light of these service developments are most appropriately carried out at NHS board level, where local needs and priorities are best understood, and where decisions can best be made about meeting the health needs of the local population safely and sustainably.The Scottish Executive continues to monitor carefully trends in the level and pattern of care to ensure that resources are used in the most effective manner to meet patients' needs.

Local authorities are required to produce and publish Community Care Plans every three years, and to review these annually. Officials scrutinise these plans for their content.

Our guidance to local authorities on community care planning contained in SWSG 35/1997 remains extant. Local authorities are required to update and roll forward annually their community care plans in partnership with health boards. All plans are produced jointly with NHS boards. In early 2000, we issued to health boards, trusts and local authorities a Scottish Needs Assessment Programme report on the needs of people with brain injuries, and invited these agencies to respond to the findings and recommendations intended to improve care planning and provision. Community Care Plans are primarily for use locally, and are intended to help agencies develop strategic thinking on a joint basis, and plans are a matter of public record. We also provide core funding to Headway Scotland, the brain injured association, which, in addition to providing support services locally for sufferers, also helps to raise awareness of the needs of the brain injured with the statutory service providers.

Patient Focus and Public Involvement, published in December of last year, set out plans for developing the actions identified in the Involving People section of Our National Health: A plan for action, a plan for change. It also identified how the earmarked £14 million investment would be allocated across four complementary strands of building capacity and communications, patient information, involvement, and responsiveness to develop a patient-focused health service.

Patient Focus and Public Involvement, published in December of last year, reported on steps taken to develop the actions identified in the Involving People section of Our National Health: A plan for action, a plan for change. It also set out more detailed proposals for work over the coming three years to develop the capacity of the NHS to provide patients and the public with information about their health, their treatment, the options for care, and the availability of health services.The Patient Information Initiative will:assure the quality of patient information, based on evidence;involve and engage with other sources of expertise such as expert patients;make information accessible and available in a variety of formats, andlink to future developments, for example NHS24 online. The initiative will develop proposals for establishing a network that will ensure that relevant high quality information is available where and when needed in a suitable format.

Our work to improve governance and accountability of NHSScotland has not been confined to the establishment of 15 new NHS boards across Scotland. We have also been concerned to ensure that the spirit of these changes is reflected in improvements in the governance of the Special Health Boards and other national bodies, whilst recognising their distinctive nature and activities.A number of initiatives, many of which were announced in Public bodies: Proposals for change (June 2001), are currently under way to ensure that national NHS bodies are fit for purpose and efficiently structured. These include: work to establish a new Special Health Board for education, training and lifelong learning for all NHSScotland staff in April 2002; an examination of the structure and relationships of all national bodies with an interest in clinical quality, such as the Clinical Standards Board for Scotland and the Health Technology Board for Scotland; anda review of the future governance of the State Hospitals Board for Scotland.

Following detailed discussion, the National Demonstration Projects Steering Group has agreed proposals for Scotland-wide Learning Networks. These will be implemented by the Public Health Institute of Scotland. Project manager posts will be advertised shortly.

Since the publication of Our National Health: a plan for action, a plan for change, a number of steps have been taken to improve communications with and by NHSScotland. For example, ministers meet regularly with NHS Board Chairs, the Chief Executive of NHSScotland holds regular meetings with NHS Chief Executives and senior officials have regular dialogue with key stakeholder groups. The importance of effective two-way communication features highly in these discussions.Effective communication with patients and the public is a key theme of the plans outlined in Patient Focus and Public Involvement published in December 2001.Additionally, the Health Department has introduced a web-based Weekly Bulletin aimed at alerting the NHS, local authorities and other key stakeholders to publications, guidance and other papers issued by the department. The department has recently appointed a Corporate Communications Manager who will have a key role in working with NHSScotland to develop a structured programme to further improve communications.

Patient Focus and Public Involvement, published in December of last year, reported on steps taken to develop the actions identified in the Involving People section of Our National Health: A plan for action, a plan for change. It also set out detailed proposals for work over the coming three years on building capacity and communications, patient information, involvement, and responsiveness to equip the NHS to communicate with, listen to and work in partnership with individuals and communities.