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The Scottish Government's vision is for GPs to fulfil the role of the Expert Medical Generalist in the community; focussed on complex care, undifferentiated presentation and local clinical leadership. The role will be supported by an expanded team of health professionals who can help patients to access the right treatment, by the right professional at the right time. In areas of high deprivation, this could include a multidisciplinary approach to patient care, including advanced nurse practitioners, mental health professionals, and links workers, who are dedicated individuals working in GP surgeries to support people one-to-one to address issues such as poverty, debt and isolation which are making them feel unwell. This multidisciplinary team approach will free up GP time to fulfil the Expert Medical Generalist role for more complex clinical care, including for patients with multi-morbidities living in deprived areas.

As part of this vision, in 2016-17 the Scottish Government introduced GP Clusters, small groups of practices working together to address the health needs of their local communities. This will be instrumental in addressing unmet need and improving care in areas of high deprivation.

In the joint memorandum with the British Medical Association Scottish General Practitioner Committee (BMA SGPC) the Scottish Government undertook to extend the current pay stability agreement for GPs to April 2018, [http://www.gov.scot/Publications/2016/11/7258].

The Scottish Government and the SGPC agree, in principle, that we need better information and evidence to inform both accurate recompense of expenses and options for the long term overall development of GP pay in Scotland. To this end, we have commissioned a review of general practice funding, pay and expenses to provide a proper, robust evidence base for improved decision making. This review builds on and incorporates the findings of the Review of the Scottish Allocation Formula, and will inform options from 2018.

Tackling health inequalities and the 'inverse care law' is one of our primary care outcomes, as published in a joint memorandum with the British Medical Association Scottish General Practitioner Committee (BMA SGPC) [http://www.gov.scot/Publications/2016/11/7258]. One way of delivering on this outcome as part of contractual change would be to adjust the Scottish Allocation Formula (SAF), which weights general practice funding by various factors that affect workload, including deprivation, rurality and age.

The Review of the Scottish Allocation Formula highlighted that more evidence was needed to accurately inform new options for general practice funding. To this end, with the agreement of the BMA, we have commissioned a review of general practice funding, pay and expenses to provide a proper, robust evidence base for improved decision making. The Review will gather and analyse earnings and expenses data from a range of practices, including in areas of high deprivation. It will also take advice from expert stakeholders on key considerations such as unmet need and high levels of multimorbidity. This is taking place in 2017, and alongside the findings of the Review of the Scottish Allocation Formula, will inform options from 2018.

The Scottish Government, with the agreement of the Scottish General Practitioners’ Committee of the BMA, have commissioned a review of general practice funding, pay and expenses. The Review will gather and analyse earnings and expenses data from a range of practices, including in areas of high deprivation. It will also take advice from expert stakeholders on key considerations such as unmet need and high levels of multimorbidity. The Review is taking place in 2017 and will inform options from 2018.

The Review of the Scottish Allocation Formula highlighted that more evidence was needed to accurately inform new options for general practice funding. To this end, with the agreement of the BMA, we have commissioned a review of general practice funding, pay and expenses to provide a proper, robust evidence base for improved decision making. This is taking place in 2017, and alongside the findings of the Review of the Scottish Allocation Formula, will inform options from 2018.

Tackling health inequalities and the 'inverse care law' is one of our primary care outcomes, as published in a joint memorandum with the British Medical Association Scottish General Practitioner Committee (BMA SGPC) [http://www.gov.scot/Publications/2016/11/7258]. One way of delivering on this outcome as part of contractual change would be to adjust the Scottish Allocation Formula (SAF), which weights general practice funding by various factors that affect workload, including deprivation, rurality and age. The Scottish Government is clear that we need to look beyond the GP contract to other interventions and ways of supporting general practice in areas of high deprivation. Changes outwith the contract such as multidisciplinary working and the manifesto commitment to introduce 250 Links workers will be vital for supporting patients in deprived areas.

The Scottish Government and the SGPC agree, in principle, that we need better information and evidence to inform both accurate recompense of expenses and options for the long term overall development of GP pay in Scotland. To this end, we have commissioned a review of general practice funding, pay and expenses to provide a proper, robust evidence base for improved decision making. This is taking place in 2017, and inform options from 2018.

A review on the legislation governing small landholdings was laid before Parliament on 30 March 2017 and published on the Scottish Government website on 31 March 2017 http://www.gov.scot/Publications/2017/03/4234

Consultant-led adult immunodeficiency and allergy services in Scotland are provided by Grampian, Tayside and Greater Glasgow and Clyde NHS Boards. An immunology service has been in place in NHS Lothian from early last year, following the recruitment by Scottish National Blood Transfusion Service and Edinburgh University of the Consultant Immunologist. For anyone in NHS Lothian requiring specialist anaesthetic allergy testing, this service is provided by NHS Tayside.

For some rare conditions where there are very small numbers of patients, highly specialised immunodeficiency and allergy services are provided outwith Scotland to ensure that the highly specialised care they need is as safe, effective and sustainable as possible.

The Scottish Government’s Home Energy Efficiency Programmes for Scotland: Area Based Schemes (HEEPS: ABS) are designed and delivered by local authorities, in conjunction with utility companies and local delivery partners, targeting fuel poor areas to provide energy efficiency measures to a large number of Scottish households and help reduce fuel poverty.

Responsibility for programme delivery falls to local authorities because they are best placed as the relevant strategic housing authority to understand local housing needs and prioritise provision across their area. Local authorities are expected to use a range of sources of information to target households whose properties have the lowest levels of energy efficiency and/or highest levels of fuel poverty. It is up to each local authority to define the areas within which projects will deliver and the detail of those projects.

The basis for distributing HEEPS: ABS funding is agreed with COSLA each year. In the current year all of the available funding for HEEPS: ABS is allocated on the basis of need, which takes into account levels of fuel poverty and reflects the different types of properties within those local areas. When submitting proposals for tackling fuel poverty Councils are asked to set out how these fit with existing national and local strategies, including Local Housing Strategies.

We are also working with local authorities to develop Scotland’s Energy Efficiency Programme (SEEP), including funding pilot projects to test new and innovative ways to improve the energy efficiency and decarbonise the heat supply of all Scotland’s buildings. And we are consulting on how we might design the detail of the policy and delivery framework, on the role that Local Heat and Energy Efficiency Strategies, and on regulation of district heating. The Scottish Government’s consultation on Scotland’s Energy Efficiency Programme runs until 30 May 2017 and the Local Heat and Energy Efficiency Strategies, and Regulation of District Heating is open until 18 April 2018. A series of workshops and events have been held to support this and numerous local authorities have been involved.

To support the overarching aims set out by indicators in the National Performance Framework, the Housing and Regeneration Outcomes Framework sets out more specific outcomes relating to its policy area. Progress on tackling fuel poverty is included in this: http://www.gov.scot/About/Performance/scotPerforms/partnerstories/HARO/Indicators

We recognise the importance of frontline workers in communities, who can readily identify householders who would benefit from help. Home Energy Scotland, funded by Scottish Government, currently undertakes outreach work, providing free training to local partners and raising awareness of the service available. This outreach will increase the provision of advice and support in our communities and enhance the partnership approach to delivering support where it’s needed most.

Home Energy Scotland has also put in place a referral portal that gives our partner organisations a quick and easy way to refer clients and customers to support, including funding to improve the energy efficiency of their homes. Training has been put in place to support the range of organisations that have already signed up to use this new tool – including NHS Boards and energy suppliers.

In addition to this, we launched ‘HES Homecare’, delivered by Home Energy Scotland, on 8 March 2017. The service is being piloted in two rural areas and will join up with local services to give targeted and specific in-home support to people who are in the greatest need – helping them to make their homes warmer and cheaper to heat.