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The legislative functions of Healthcare Improvement Scotland (HIS) are broadly similar to those of the Care Quality Commission.

The functions and powers of HIS include: supporting, ensuring and monitoring the quality of healthcare provided or secured by NHS Scotland and the provision of quality assurance and accreditation. HIS also has powers in relation to inspections and registration of independent healthcare services.

In addition, Scottish Ministers have direction making powers under Section 10A(3) of the National Health Service (Scotland) Act 1978: in carrying out its functions, HIS is to act subject to, and in accordance with, such directions as may be given by the Scottish Ministers.

The consultation ‘Promoting professionalism, reforming regulation’ is not due to close until 23:59 on 23 January 2018. As such, it would not be appropriate to comment on future options for the development of professional healthcare regulation.

It is open to anyone to refer a registered health professional to the appropriate regulator when concerns arise about their fitness to practise. Complaints handling procedures vary from regulator to regulator and the wide-ranging consultation seeks views on all aspects of regulation, up to and including the structure and number of the regulators themselves. It is important to note that the professional healthcare regulatory bodies operate on an independent basis, according to their respective legislation, and it is for them to consider and take appropriate action on complaints about registrants’ fitness to practise.

When a complaint is made against an employee, it is right that the Health Board as the employer is allowed the opportunity to investigate properly before making a decision about referring the matter to a professional regulator. However, where clear and serious concerns arise, Boards are entitled to and will often make an immediate referral in the interests of patient safety. The ability of a Board to look into complaints enables them to learn from mistakes and take immediate action to support effective clinical governance.

The Scottish Government has regular discussions with NHS Lothian regarding the delay at the new Royal Hospital for Children and Young People in Edinburgh and these discussions will continue until the project is complete.

NHS Lothian have suffered unexpected initial delays on site, which included the liquidation of a crucial sub-contractor, severe weather and issues surrounding piling works.

NHS Lothian remain committed to delivering this flagship facility in a timely manner and to the highest of standards. They are working with the contractors to open the hospital as soon as possible and aim for moves to take place by autumn 2018. Their forensic work with IHSL and Multiplex will continue through regular meetings over the coming weeks and the Scottish Government will be kept fully informed of developments.

The information requested is provided in the following table. The results of each iteration of the Health & Care Experience Survey (and its predecessor), including numbers of responses, are available at www.gov.scot/GPSurvey.

A variety of changes have been made for the 2017-2018 Health & Care Experience Survey to maximise efficiency and keep costs down, including:

• A number of aspects of the project which were previously contracted out have been brought in house.

• A survey contractor has been used for administrative aspects of the survey that, for logistical reasons, cannot be completed in house. Value for money was a key criteria in the evaluation of tenders submitted for this work.

• The look of the survey materials has been refreshed to better engage with survey respondents and increase response rates. This has included reducing the length of the questionnaire by a third.

• The sampling and weighting methodologies for the survey have been reviewed to ensure that they remain suitable and proportionate.

• Changes to the mail-out approach for the survey to encourage respondents to complete the survey online.

• Local level results, which have previously been published as static reports, will be presented via an interactive dashboard which will allow individuals and organisations to interrogate the data in different ways to meet their particular needs.

The Scottish Government supports NHS Health Boards in their efforts to ensure that they have the right staff in place to meet the healthcare needs of the local population.

NHS Lothian have advised that when the decision was taken to temporary close its Paediatric In-Patient Unit at St John's Hospital on 7 July 2017, a commitment was made to operate a Short Stay Paediatric Assessment Unit (SSPAU) between 08:00hrs to 20:00hrs, Monday to Friday.

NHS Lothian have confirmed that since the introduction of the temporary model, the Board has been able to keep the SSPAU open at the weekends through staff undertaking additional shifts coupled with the use of locum cover. Due to unplanned absence, at short notice, the Board was unable to staff a safe rota for both the 3 and 9 December, resulting in the SSPAU closing on these days.

The Board commissioned the Royal College of Paediatrics and Child Health (RCPCH) to review the work undertaken to secure a sustainable 24/7 staffing model. The College has carried out a review and produced a report which was received by the Board in the Autumn. It concluded that option one remained both the RCPCH’s and NHS Lothian’s preferred option for St John's Paediatric services i.e. 24 hour consultant and Tier 2 [middle grade] cover. The College recognised that the development of this model was a long-term solution depending upon the successful recruitment of consultants, Advance Nurse Practioners (ANP) and Specialty and Associate Specialist Doctors.

NHS Lothian has given an assurance that it is committed to increasing staffing levels and reinstating the 24/7 model.

The Scottish Government supports NHS Health Boards in their efforts to ensure that they have the right staff in place to meet the healthcare needs of the local population.

NHS Lothian have advised that when the decision was taken to temporary close its Paediatric In-Patient Unit at St John's Hospital on 7 July 2017, a commitment was made to operate a Short Stay Paediatric Assessment Unit (SSPAU) between 08:00hrs to 20:00hrs, Monday to Friday. NHS Lothian have confirmed that since the introduction of the temporary model, the Board has been able to keep the SSPAU open at the weekends through staff undertaking additional shifts coupled with the use of locum cover. Due to unplanned absence, at short notice, the Board was unable to staff a safe rota for both the 3 and 9 December, resulting in the SSPAU closing on these days.

The Board commissioned the Royal College of Paediatrics and Child Health (RCPCH) to review the work undertaken to secure a sustainable 24/7 staffing model. The College has carried out a review and produced a report which was received by the Board in the Autumn. It concluded that option one remained both the RCPCH’s and NHS Lothian’s preferred option for St John's Paediatric services i.e. 24 hour consultant and Tier 2 [middle grade] cover. The College recognised that the development of this model was a long-term solution depending upon the successful recruitment of staff.

NHS Lothian has confirmed that the decision to close the SSPAU on the weekends of 23-24 and 30-31 December has not been taken lightly and was made following detailed discussion with consultant staff representation from St John’s Hospital. The Board advised that this discussion recognised the pressures staff were experiencing in supporting out of hours cover, over and above their normal shifts due to vacancies.

The Scottish Government is continuing to work with NHS Lothian to ensure that the services on offer at the St John’s in-patient paediatric ward remain safe and sustainable in the long-term. The Chief Medical Officer and the NHSScotland Director of Performance and Delivery met with NHS Lothian on 23 October. Amongst the issues discussed was the history on recruitment, sickness absence and the filling of rotas.

NHS Lothian has given an assurance that it is committed to increasing staffing levels and reinstating the 24/7 model.

In order to provide effective assistance to Ministers, special advisers work closely with the Ministerial team and with civil servants and may give assistance and advice on any aspect of Scottish Government business. Medical advice in relation to mesh is provided to both Ministers and officials by appropriately qualified and experienced clinical personnel.

While the whistle-blower raised concerns about St Johns Hospital specifically, NHS Lothian subsequently carried out an internal review of three of its acute hospitals. The independent Review, led by the Professor Derek Bell, will not only investigate the allegations made by the whistle-blower but will also review the findings from NHS Lothian's internal review, including St Johns Hospital, the Royal Infirmary of Edinburgh and the Western General hospital.

As I said to the member, I expect the review to conclude early in the New Year.

From the December 2017 timetable change some services on the North Berwick route serving Wallyford and Musselburgh have been strengthened from three to six cars providing more seating capacity. Services on the route continue to be provided by Class 380 trains, with plans for further capacity to be provided by the end of 2018 when all peak services will be provided with 6 cars.