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Dr Brian Montgomery considered the views of a wide range of diverse stakeholders across Scotland as part of his independent review into access to new medicines and these influenced his final report and 28 recommendations. We continue to work with a diverse range of stakeholders and partners as we implement the recommendations.

I wrote to Vertex Pharmaceuticals in March to encourage them to take forward discussions about the cost of Orkambi® with colleagues in National Health Services Scotland who are best placed to advise them on pricing approaches and a fair price that could support the securing of a positive recommendation from the Scottish Medicines Consortium for the prescribing of these products in NHSScotland. Those talks are underway.

Through those discussions we hope that the manufacturer will make their best offer on price and indicate that they will re-submit an application for Orkambi® to the SMC.

Dr Montgomery’s independent review on access to new medicines recognised that the Scottish Government has made significant reforms and investment to improve access to newly licensed medicines in recent years.

I announced in December 2016 that we will be taking forward the recommendations from the review. We are working at pace, in collaboration with stakeholders, including the Scottish Medicines Consortium, NHS Scotland, and the pharmaceutical industry to implement the recommendations as quickly as possible.

NHS Lothian’s resource budget allocation for 2017-18, is £1,342.0 million. The Board’s budget has increased in cash terms by £473.3 million (54.5%) from 2006-07 to 2017-18.

Since September 2006, all staff (whole time equivalent) has increased within NHS Lothian by 12.4%, or 2,229.6 (from 18,022.2 to 20,251.8.)

As employers NHS Boards have full delegated powers in relation to employment issues, including recruitment. While the Scottish Government works in close partnership with all Boards to provide the policies, frameworks and resources for high quality health care in Scotland, it is for each NHS Board to decide how best to deliver those services to meet the needs of the population.

Recruiting from Scotland and elsewhere is the UK, and also European Economic Area, is the most common route for taking on new staff. Generally via advertisement either online or through specialist medical journals. Where there are no suitably qualified staff from the UK or EEA, Boards may seek to fill vacancies from out-with these areas. Boards can either use the UK or the Scotland only Shortage Occupation List (SOL) that notes certain nursing and medical specialists where evidence of shortages exist. In using either of these list, Boards are free to recruit internationally to any of the medical occupations listed on the UK or (SOL) List, without the need to go through a Resident Labour Market Test.

The Scottish Government published Part 1 of the National Health and Social Care Workforce Plan, which will strengthen and harmonise workforce planning practice, take full account of the future demand for safe and high quality services for Scotland’s people and work to accurately identify gaps in supply. These are complex issues which will require an incremental approach. The production of a National Plan will be the first step in this process, with future benefits and improvements impacting on all service users across Scotland.

The content of the Excel publication tables has not changed – all information previously available is still available within the Excel tables.

The content of the chronic pain waiting times publication is determined by the Information Services Division (ISD) of NHS Scotland, who publish the information.

ISD adheres to the Code of Practice for Official Statistics which is underpinned by the Statistics and Registration Services Act (2007). This is achieved by listening to users of their statistics through consultations and adjusting their statistical outputs accordingly, ensuring their statistical reports are protected from any political pressures, and presenting statistics impartially and objectively.

For example, changes to their Chronic Pain publication summaries were made recently as a direct result of feedback from users and patient representatives. Officials met with ISD on 13 January 2017 to provide feedback from patient representatives of the Ministerial Steering Group (MSG) on Chronic Pain. This was following discussion of the waiting times at the MSG on 4 October 2016, and is captured in the minutes from the meeting which are available on the Scottish Government website:

http://www.gov.scot/Topics/Health/Services/Chronic-Pain/MSGCP/MSGCP-Minutes

ISD ‘s Head of Profession for Statistics has responsibility for deciding on statistical methods, standards and procedures, and on the content and timing of statistical releases. ISD can be contacted directly by any user of their statistics by emailing NSS.isdSHIS@nhs.net

The content of the chronic pain waiting times publications is determined by the Information Services Division (ISD) of NHS Scotland, who publish the information. ISD keeps the format of its publications under review and is currently considering different approaches to publishing, including greater use of visuals to aid user interpretation. ISD is planning a programme of user engagement for the later part of 2017 to seek user views on the format of its publications.

The National Health and Social care Workforce Plan will help to address workforce planning requirements for the NHSScotland workforce, ensuring the delivery of safe and sustainable local, regional and national clinical services.   NHS Lothian continues to implement the new model of care agreed with the Royal College of Paediatrics and Child Health and we can advise that five consultants are now in post working between the Royal Hospital for Sick Children and St John’s Hospital.   We have also asked the Chief Medical Officer, National Clinical Director and NHSScotland Director of Performance to support NHS Lothian to ensure the services it provides including the in-patient paediatric ward remains safe and sustainable in the long term.

NHS Lothian has reiterated that the safety of children within its paediatric services is its highest priority and has confirmed its aim to return to a full service within the children's ward at St John’s Hospital as soon as possible after the summer.

The Scottish Government will set the overall intake number for the new graduate level medical course. The first intake is expected to be around 40 students. In line with academic freedom, the selection and recruitment of individual students admitted to the course is a matter for the universities concerned, however.

In order to encourage Scottish domiciled students to apply, the Scottish Government will, by way of exception to the normal position for applicants who already hold a degree, pay the course fees of all successful Scottish domiciled and EU applicants.

In order to encourage retention of Scotgem graduates in NHS Scotland, it is the Scottish Government's intention that the course will have an element of bonding. Details of the bonding scheme will be announced shortly.

Families in receipt of social security benefits, who are on a low income, should be entitled to help with travel costs to the Royal Hospital for Sick Children Hospital (RHSC). In that instance, when families attend the RHSC, they should request a certificate of attendance from reception in the department they are visiting. This certificate should then be taken to the Cashiers Office within the RHSC where they will be reimbursed.

The RHSC also has a Family Support Team who work with families and are able to support families to arrange travel and offer additional support.

In the event that families attend RHSC by ambulance, and had no transport to return home, then NHS Lothian would normally arrange, and pay for, a taxi for them to return home.