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Our national Health and Care Standards set out what everyone should rightly expect when using health and social care services in Scotland. The Care Inspectorate carries out a rigorous programme of inspections to ensure registered services are meeting these standards and take action where necessary. Through these inspections, we know that the vast majority of our care services, including publicly-owned care homes, are providing high quality care and support.

The following tables gives information about the use of temporary accommodation for all homeless applications that closed in the financial years
‎ 2016-17, 2017-18 and 2018-19 that were assessed as unintentionally or intentionally homeless or threatened with homelessness.

Cases where a household is assessed as homeless but did not require temporary accommodation might include cases where the household was able to organise their own accommodation, or where they were moved directly to settled accommodation.

2016-2017:

The reason for the reduction in GP practice numbers since 2009 is mainly due to a number of smaller single handed practice closures and the patient list being absorbed into larger neighbouring practices.

This is in line with a national trend as we see a reduction in smaller single handed practices in favour of larger practices that offer wider variety of services to patients to make sure they see the right person at the right time in like with the new GP contract.

The Scottish Government expects health boards to engage and support patients where there are changes in circumstances to the services they receive at their practice.

We are supporting remote, rural and island general practice with a comprehensive package of measures:

We have significantly enhanced recruitment incentives in the 2019/20 GP contract, investing £400,000 in recruitment incentives for rural GP posts across Scotland, and £200,000 for relocation costs for GPs moving to rural posts. This includes £10,000 payments to GPs taking up posts in rural practices for the first time and support with relocation costs.

We have increased GP relocation packages from £2,000 to £5,000 and widened eligibility to all remote and rural practices.

Since 2016 we have supported the Scottish Rural Medical Collaborative to develop recruitment and sustainability measures. In 2019.20 this included £69,450 to NHS Shetland to support the Rediscover the Joy in General Practice Project. The project has so far seen 33 doctors recruited from other areas to work up to 18 weeks a year in practices that previously found it difficult to attract a GP.

Scotland’s first Graduate Entry Medicine programme (ScotGEM) has a focus on careers in general practice and remote and rural working.

We are providing £500,000 for a new pilot shortened midwifery course at the University of Highlands and Islands. 19 registered adult nurses started the programme in January 2019 to become fully qualified midwives in just 20 months, and then work in the region. Funding has already been made available for 300 pre-registration nursing places through the University of the Highlands and Islands.

The Shaping the Future Together Report from the Remote and Rural General Practice Working Group describes the Group's first year of work. It sets out recommendations designed to support the ongoing process of implementing the contract as well as support future developments in rural General Practice and Primary Care.

The NHS Scotland Global Citizenship Programme was launched in June 2018. The aims of the Programme are to: (a) reflect and support our existing international development commitments to our partner countries, and to support capacity strengthening in the area of health; and (b) make it easier for all NHS Scotland staff to participate in global citizenship both here in Scotland and globally by ensuring better guidance, co-ordination and support. The synergy between remote and rural work in NHS Scotland and global health volunteering has been recognised and we are working to maximize opportunities that will benefit NHS Scotland by attracting staff to take up permanent posts in Scotland’s more remote areas, where recruitment, despite innovative approaches has been challenging.

As part of this, NHS Highland and NHS Western Isles, in partnership with the University of Edinburgh’s Global Health Academy, have developed a Test of Change which aims to recruit up to 6 permanent consultants and/ or generalist clinicians. For a fixed term of 3 years, these posts offer the opportunity to participate in a global health project (either partnership or research work) in one of the Scottish Government’s International Development partner countries. This work is evolving and NHS Highland have successfully recruited a junior doctor global citizen fellow who will be working with the global health academy from April. Further recruitment for these posts is ongoing.

The Scottish Government put in place funding for an additional 30 pre-registration places from September 2018, increasing the number of places available from 170 to 200 and we will continue to work with NHS National Education for Scotland to explore options and to put plans in place to recruit an additional extra 40 preregistration places per year over the next 3 years.

Golden Hellos were introduced for General Medical Services GP contractors for the financial year 2014-15. Before then all GP contractors taking up a new post in Scotland received a standard payment and those starting work in specified Health Board areas received an additional payment.

In 2014-15 the general entitlement was removed and 3 types of Golden Helloes were created:

• Deprivation
• Remote and Rural
• Special Circumstances

As part of the new GP contract in 2018, the entitlement to a Remote and Rural Golden Hello was extended to all GPs regardless of contractual status.

Table 1 = Golden Hellos made

The training programme described in the integrated plan aims to upskill consultant interventional radiologists (known as interventional radiologists) to deliver the new and innovative treatment of mechanical thrombectomy (MT) for stroke patients. As such it will not be available for all current consultant radiologists. In the first instance, the aim of the training programme is to enable the specialist interventional radiologists based in NHS Tayside to deliver MT for the North of Scotland region.

The training curricula and pathways for trainee doctors in radiology is determined and agreed on a UK basis and is unaffected at this stage.

The proposed training for MT is competency and capability based and participants will be supervised and mentored by an experienced neuro-interventional radiologist. Participants are required to have extensive previous endovascular experience in vascular interventional techniques and training will include practise on state of the art simulation facilities, and is supported by the University of Dundee for the clinical training aspects and post-procedure care. The knowledge-based element has been developed based on an international training guideline that requires certification of both the operators and the proposed stroke centre. MT for stroke is currently being considered by the GMC for recognition as a credential. This means that the GMC as the Regulator will need to be satisfied that the training meets its standards.

The training programme will be evaluated to ensure it meets the needs of patients, service providers and clinicians and, subject to satisfactory outcomes, to make this training more widely available to clinicians from other Health Boards to upskill them in preparation for delivering stroke thrombectomy across Scotland. When the initial 6 interventional radiologists are trained in MT, service will commence in Dundee and for the North of Scotland region by Autumn 2020, with MT services based in Edinburgh from 2021, and rolling-out across Scotland from 2022.

Transport Scotland anticipates receiving the draft one-year after evaluation report in the Spring. A technical review of the evaluation will then take place to ensure its robustness and the report will be finalised as soon as possible thereafter. Timescales depend on the review outcomes and approval process, both of which are undertaken routinely by Transport Scotland prior to publishing technical reports. Further evaluations will be undertaken at 3 and 5 years after motorway opening.