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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.

I refer the member to the answer to question S5W-08253 on 7 April 2017. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx

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.

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 Scottish Government, with agreement of the Scottish General Practitioners’ Committee of the BMA, have commissioned Deloitte to review general practice funding, pay and expenses.

The remit of the review is to gather and analyse general practice earnings and expenses data, and consult with expert stakeholders to provide evidence for future mechanisms for the delivery of funding to general practice.

The Review will cost £95,260 (excluding VAT) and the relevant information will be published at an appropriate time following the successful conclusion of GMS contract negotiations.

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.

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.

Supporting economic growth by tackling inequality is a key driver of devolved employment support. This aligns to our child poverty strategy, in particular our ambitions to maximise the potential for parents to increase family incomes through good quality, sustained employment and to break inter-generational cycles of poverty, inequality and deprivation.

A number of groups will have early access to Fair Start Scotland, which will commence in April 2018, including unemployed lone parents and those living in the 15% most disadvantaged areas. The pricing model for Fair Start Scotland is weighted towards job outcomes sustained for 12 months, emphasising our ambitions to help move those who participate in the service into permanent employment, rather than temporary job opportunities.

Further, in bidding to deliver Fair Start Scotland, which will commence in April 2018, Service Providers have been asked to demonstrate clearly how they will deliver support that reflects the needs of all customers, including women seeking employment. They will be expected use levers at their disposal to encourage employers to consider flexible working approaches, which enable more women to take up sustainable jobs that meet their needs, for example, to align with caring responsibilities.

The Scottish Government is preparing an Equality Impact Assessment for both the 2017 and 2018 devolved employment services, the results of which will be published.

Devolved employment services will support the Scottish Government’s fair work ambitions, in particular by supporting individuals into sustained work which offers a route out of poverty. We will set clear expectations within the programme on the level of employment which constitutes a job outcome and underline our expectation that individuals have the skills and resilience to be able to sustain and progress in work.

Sustained employment outcomes are a key priority for Fair Start Scotland, which will commence in April 2018. To support this, the contract pricing model is weighted towards the achievement of 12 months’ sustained employment.

There will be ongoing review of the delivery of the services from the outset. A rigorous performance management process will be in place which will monitor both outcomes, such as jobs, but also the quality of service delivery.

Aligned to that, we are committed to long-term, independent evaluation of the transitional and full employability services. The evaluation will be integrated with performance management activity to enable a cycle of continuous improvement of services. Evidence of the types of employment entered and where available, earning levels, including numbers achieving the real Living Wage will be one element of the evaluation.