04 Protecting and Reforming Our Public Services
High quality public services are essential to a fair and prosperous society. During our time in office we have undertaken a major programme of reform and improvement across our public services. We have done so against a backdrop of constrained public finances.
Our reform programme has already provided multiple benefits and will continue to do so for the long term. Some of our key achievements include:
- Integration of health and social care.
- Introduction of Curriculum for Excellence in our schools.
- Reshaping of our college sector to make it fit for the needs of a 21st- century economy.
- Establishment of the single fire and police services.
Our approach to public services and to public service reform continues to be informed by the findings of the Christie Commission on the Future Delivery of Public Services, giving us consistent and clear strategic direction built around the four pillars of reform: partnership; prevention; people; and performance. This approach demonstrates that we are focused on putting people and communities at the centre of public service delivery and policy making. It is designed to:
- Protect our public services.
- Target the causes rather than the consequences of inequalities.
- Make sure that our public services are sustainable in the face of the challenging economic climate, and reflect the changing shape of our society.
- Make best use of technology.
This Programme for Government sets out the foundations for the next phase of reform. In particular it describes the key reforms that we will take to ensure that our education system offers our young people a world-class education and that we have the evidence to prove it, that we have an NHS that is organised to respond to the demands of changing demographics and ever advancing technology, and a police service that is not only operates to a very high standard of efficiency but which also enjoys the trust and consent of all the communities which it serves.
This is a collective endeavour. Scotland's local authorities and public bodies share our focus on improving outcomes, and are key partners. The third sector also plays an important role in delivering public services, offering specialist expertise and a flexible and innovative approach. We recognise that the sector plays a valued and essential part in Scottish life. We believe that by involving and engaging citizens and communities in the design and delivery of services, by removing barriers where we come across them, and by working more collaboratively within and across public service boundaries, we will deliver the change needed.
Scotland's children and young people are our greatest asset and investing in their education is essential to achieving their aspirations and our ambitions as a country. We are taking the right steps to improve Scottish education - and we are seeing results.
We have a more coherent, flexible and child-focused curriculum which sets higher standards for achievement than ever before with the development and implementation of Curriculum for Excellence. Inspection evidence highlights that 69% of our schools are graded as good, very good or excellent. We are seeing record exam results, with students across Scotland achieving 156,000 Higher passes this year - up 5.5% on 2014, and with Advanced Higher passes increasing by 4.0% to a record level of 18,899. More of our young people are achieving Higher qualifications than ever before.
While Curriculum for Excellence is delivering a transformed learning experience for many of our children and young people, there is a longstanding and unacceptable gap in attainment between our least and most affluent areas. School leavers from our least deprived communities are still twice as likely to have a Higher qualification than those from our most deprived communities. Overall standards in literacy and numeracy remain high, but we are not seeing improvements - particularly in the early years of secondary school. Literacy and numeracy are the foundations of our education system and the gateway to learning; no child can be left behind.
We have a full and comprehensive picture of attainment in the senior phase (S4 to S6) of school, with information available through the Parentzone website and a new and innovative benchmarking tool, Insight, available to schools and local authorities. But we do not yet have a consistent, robust and transparent picture of how children are progressing in the earlier years of their education, nor a clear line of sight between action in the classroom and progress nationally.
As the next phase of Curriculum for Excellence, we will develop and implement a National Improvement Framework for Scottish Education which sets out our vision and priorities for Scotland's children and their progress in learning.
NATIONAL IMPROVEMENT FRAMEWORK
We will develop and implement a
National Improvement Framework for Scottish Education
to improve outcomes for every child in Scotland. The
purpose of the Framework will be to ensure, in an evidenced and
focused way, that our education system is continually improving,
that all children are being equipped with the skills they need to
get on in the world and that we are making progress in closing the
gap in attainment between those
in our most and least deprived areas.
The Framework, now published in draft, will:
- Set out our vision and key priorities in Scottish Education.
- Ensure a forensic focus on data to inform our approach to
at every phase of education in Scotland.
- Provide improved information for parents and carers to support their key role in their children's education.
- Underpin the professional development needs of teachers and other professionals and provide support where it is needed.
- Support school leadership to deliver outstanding results for children and young people.
The Framework will provide consistent evidence on the progress for every child in Scotland. This means that:
- Children can celebrate success and understand their areas for improvement.
- Parents have the information they need to provide more focused support where it is needed.
- Class teachers can provide the help and support needed for individual children to achieve their aspirations.
- Schools, local authorities and national agencies can access information that will inform improvement activity and any interventions required.
In the coming months, we will further develop the National Improvement Framework, first by designing a new system of national, standardised assessment at P1, P4, P7 and S3 to inform teacher judgement, which is at the heart of Curriculum for Excellence. This will bring consistency to the variety of different approaches to assessments currently followed in our 32 local authorities. This will be in place for piloting during 2016. The areas and schools involved in the Scottish Attainment Challenge will make use of the new assessment materials during 2016 before they are adopted by all local authorities in 2017. Interim reports, using available information, will be published later this year and at the end of 2016. The first full Framework report based on the new approach will be published at the end of 2017.
To give the Framework the appropriate status and to enhance transparency, accountability and consistency we will bring forward amendments at Stage 2 of the current Education Bill to place the Framework and reporting arrangements on a statutory footing. Our intention is for local authority partners to share key assessment data each year and for Ministers to report to Parliament annually on progress towards the priorities outlined in the Framework. The clear purpose of this reporting and use of assessment data is to drive collaboration, improvement and accountability throughout Scottish education and create a sense of shared purpose across the system.
Further phases of work will take place during 2016 and beyond to develop plans for reporting and the other aspects of the Framework more fully. We will work closely with local government, teachers, parents and other partners throughout the detailed development of the Framework. The timescales for implementation of the full Framework are included in the draft Framework.
We continue to invest in the quality of our teaching profession including through the implementation of Teaching Scotland's Future to ensure we have a professional and highly skilled teaching workforce. We have invested £51 million to maintain teacher numbers across Scotland and will maintain our commitment next year, recognising the key role that teachers have in improving our children's outcomes. The establishment of the Scottish College of Educational Leadership will deliver dynamic leadership within our schools.
The Scottish Attainment Challenge was announced in February 2015 and backed by a £100 million Attainment Scotland Fund over four years. Seven local authorities have been selected as the first 'Challenge' Authorities, to lead the way in supporting children from disadvantaged backgrounds to reach their full potential. A further 57 schools in 14 other local authorities have been selected as the next tranche of the Attainment Fund, providing support for some of the most hard pressed local communities in Scotland. A focus on literacy, numeracy and health and wellbeing in the primary years will provide a solid base for children to unlock the curriculum in future years, improving life chances.
We have delivered the expansion of the Raising Attainment for All programme, with 23 local authorities and over 250 primary and secondary schools now involved in this work. The valuable and positive lessons learnt from this and other programmes such as the School Improvement Partnership will be taken forward and spread through directly embedding them in the work of the Attainment Challenge and the Raising Attainment for All programme.
We have commissioned the OECD to undertake a review of Curriculum for Excellence, with a particular focus on the broad general education - P1-S3 - to report before the end of this year. Their findings will review our progress across the system and draw on international evidence of what works.
Education Scotland, our national improvement and inspection agency, will develop a new National Improvement Hub starting with a focus on supporting the Attainment Challenge. As a core element of this new Improvement Hub, Education Scotland will also launch a new updated version of our core national improvement guide for schools, How Good is Our School. This, together with the review of inspection, will shine a sharper spotlight on the issues around attainment in our schools and beyond, ensuring we have a clear understanding of the issues and when, and where, outcomes are improving.
We want to see further improvements in inspection outcomes overall - with the percentage of schools evaluated as good or better rising on a year-on-year basis. Broader support to improve literacy and numeracy is being provided through literacy hubs in Edinburgh, Fife, North Lanarkshire and West Dunbartonshire, and a national numeracy and mathematics hub providing web-based learning and teaching resources. This is being backed up by local authority champions to support teachers in numeracy and mathematics, as well as a national progression framework and guidance for teachers.
We continue to build new schools and improve existing schools through our Schools for the Future programme. More than 20% of the school estate has been transformed since 2007. However, there is more to do. We must also ensure there is an even greater focus on learning and teaching being firmly embedded in, and led by, evidence of what works. We know that there is already excellent practice in classrooms across the country and we will ensure that excellence is spread more widely and that we learn from local and international practice.
Alongside our National Improvement Framework for Scottish Education, we will continue to work in a range of other ways to raise attainment in our schools. A powerful new national network of Attainment Advisers, based locally but collaborating nationally to spread expertise and learning, is now in the process of being established.
Attainment Advisers have been secured to work with the seven Authorities involved in the first phase of the Scottish Attainment Challenge and will start work at the beginning of the 2015-16 school year. We are continuing the process of identifying suitable candidates for the roles and 24 will be assigned by the end of September. The remaining eight roles will be filled by November 2015, meaning that all local authorities will have a named Attainment Advisor.
Curriculum for Excellence is now embedded in schools across Scotland. For the first time this year, all pupils in publicly-funded Scottish schools are 'Curriculum for Excellence' students and new National Qualifications courses are being offered across the Senior Phase. New courses and qualifications were successfully introduced in 2013-14 and 2014-15 and new Advanced Highers will be introduced in 2015-16. Additional support of £1.0 million was provided in March 2015 to assist schools with implementation of the new qualifications.
Reflecting the central importance of school leadership in improving attainment, we announced that a masters qualification for headship will be mandatory for all new head teachers from 2018-19. The new qualification 'Into Headship' is being launched in September 2015 with the first cohort of aspiring head teachers. This recognises that highly trained, motivated and empowered teachers are key to driving improvements.
Civic participation and Community Empowerment continues to be a formative experience for children and young people in Scotland. A successful Children's Summit launch event took place in November 2014, bringing children and young people together from all over Scotland. This was followed by Summits in Inverness and Oban. This work will continue, linked to activity on Fairer Scotland and the work to scope out the 2018 Year of Young People.
We provided initial support for the work of the Children's University, giving children a passport to a wide range of learning and development experiences, expanding interests, activities and knowledge.
We redesigned and launched the new Parentzone web resource, with new, school level, senior phase data now included. This is helping to provide parents with all relevant information about their child's school and how to support their child's education. It will be supplemented in the near future with new evaluations of performance in primary and lower secondary schools. We also launched a web resource for schools to provide support to develop and implement effective parental engagement strategies.
We must give our children and young people the best start in life. A child's earliest years have a disproportionate effect on their life chances - from language development before school, attainment at school and beyond, through to their healthy life expectancy. That is why we will continue to put children and families at the centre of our service delivery.
EQUIPPING SCOTLAND'S CHILDREN TO LEARN AND THRIVE
We will implement a package of activity to better equip Scotland's children to learn and thrive , with specific focus on children from deprived backgrounds. Evidence suggests that most young people have high aspirations, and underachievement often results not from low aspiration itself but from a gap between aspirations and the knowledge and skills required to achieve them. In addition, recent research tells us that there are specific actions that we can take to avoid the intergenerational transfer of inequality during the teenage years. There is a package of interventions we will test to address underachievement and inequality. By March 2016, we will work with:
- The Children's University to provide a wider range of learning experiences for children and young people, so they can get a taste of different subject matter and develop early career awareness whilst still at primary school.
- Winning Scotland to provide support for schools on the development of Growth Mindset approaches, supporting children and young people and providing tools for them to enhance resilience.
- Includem who will support 'just coping' families with adolescents on the edge of exclusion, to encourage better engagement with education, participation in their community and more positive family and peer relationships, all leading to improved life chances.
In addition we will build on the continued success of our Children and Young People's Summits; learning from the views and experience of the children and young people who have participated. We will extend our year of engagement to continue our positive dialogue with Scotland's young people; specifically on the theme of Fairer Scotland and linked to the 2018 Year of Young People. This will include a Teenagers' Convention where young people and experts will come together to take advantage of our collective knowledge.
The Scottish Government will also encourage positive parenting in the early years as set out in the Early Years Framework and the National Play Strategy. Our 'PlayTalkRead' campaign supports parents and carers to play, talk and read daily with their young children to give them the key skills, motivation and abilities that make it easier for them to continue learning through their lives.
Evidence from the Growing Up in Scotland Study shows us that the introduction of 'PlayTalkRead' has been associated with an increase in the proportion of parents who frequently look at or read books to their children in the first year of their lives.
We will also use our Public Library Improvement Fund in 2015-16 to support projects in our local libraries - providing automatic library membership for babies and young children in all 32 local authority areas.
The Scottish Government is committed to education being based on the ability to learn, not the ability to pay. We want a child born today in one of our most deprived communities to have no lesser chance of entering higher education than a child born in one of our least deprived, and we therefore have a long-term goal that 20% of university entrants come from the most disadvantaged 20% of society.
To deliver this, the Scottish Government has established the Commission on Widening Access, which first met in April 2015 and is made up of key figures from business, education, early years and student representatives. The Commission has been asked to provide an interim report in Autumn 2015, followed by a final report in Spring 2016.
Delivering safer and stronger communities is an essential part of Scottish Government policy. People have a right to feel safe and have confidence that justice and fairness will prevail. However, when problems and disputes turn into crime and disorder we must ensure we have a fair and swift justice system, and a clear penal policy. The law-abiding majority must be served by a modern and efficient justice system.
Domestic Abuse and Sexual Offences
In last year's Programme for Government we committed to taking action to tackle the unacceptable levels of domestic abuse in our society, including enhancing support for the victims of abuse and consulting on measures to strengthen the law against those who commit abuse. Positive progress has been made. We have committed £20 million in additional funding over three years towards a range of measures to tackle all forms of violence against women and girls.
CHILDCARE AND EARLY LEARNING
Investment in early learning and childcare remains one of our most important policies to improve outcomes for children and support participation in the labour market, especially for women.
Our early learning and childcare policy supports parents to work, train or study, especially those who need routes into sustainable employment and out of poverty. The Scottish Government has committed an extra £330 million over 2014-15 to 2015-16 to implement increased hours of early learning and childcare to 600 hours a year; to extend this to 27% of two year olds; and, improve flexibility and choice based on local consultation.
The Scottish Government has committed to further expansion, and has started planning to double those hours to 30 hours a week from 2020, including significant expansion in the early learning and childcare workforce.
Working with the Courts and Crown Office, the additional funds are ensuring that cases involving domestic abuse and sexual offences are being heard more quickly, reducing inconvenience and distress for victims. The funds are also supporting specialist advocacy and support services for victims, including in rural and island locations, as well as training professionals to help identify the signs of abuse and initiatives in schools to address the attitudes and behaviours in our society that give rise to abuse.
In July 2015, Police Scotland confirmed that it would roll out across Scotland a National Disclosure Scheme for Domestic Abuse, allowing people to make a request for information about a partner's previous conduct if they are concerned about potential abuse.
Between March and June this year we consulted on a range of changes to the law to strengthen the powers of police and prosecutors to tackle domestic abuse and sexual offences, including seeking views on the potential for a specific domestic abuse offence, as well as a specific offence against the sharing of private intimate images and on directions to juries in rape trials.
Initial analysis of the consultation responses suggests strong agreement that the current law does not reflect the experience of victims, in particular those who are victims of ongoing coercive and controlling behaviour by partners or ex-partners. There was a wide variety of views about how best to frame an offence. We are committed to addressing this current gap and ensuring that the law is effective and can better protect victims. We are continuing to work with key stakeholders on the preparation of a specific offence and in November we will publish and seek views on the exact wording of a specific offence to deal with those who commit psychological abuse and coercive and controlling behaviour. We will also introduce a Bill to Parliament to take forward other measures arising from the consultation including a new statutory domestic abuse aggravator.
ABUSIVE BEHAVIOUR AND SEXUAL HARM BILL
The Abusive Behaviour and Sexual Harm Bill will modernise the criminal law to better reflect the nature and experience of domestic abuse. It will also reform the law in relation to acts of harassment and sexual offending. The Bill includes policy consulted upon in the Scottish Government's Equally Safe Reforming the Criminal Law to Address Domestic Abuse and Sexual Offences publication to help give the police, prosecutors and our courts additional powers to ensure effective action can be taken against those who commit domestic abuse, harassment and sexual offences.
In particular, the Bill will:
- Create a new statutory domestic abuse aggravator.
- Create a new offence of sharing private intimate material.
- Require judges to give juries specific directions when dealing with sexual offence cases.
- Enhance protections for victims of harassment.
- Give Scottish prosecutors and courts powers in relation to existing child sexual offences when committed elsewhere in the UK.
- Reform the system of civil orders to enhance the protections available for communities from sex offenders and to help prevent sexual harm.
A number of measures to improve the information and support available to victims and witnesses have come into force over the past year, including:
- New rights for victims and witnesses to access information about their cases.
- A new duty on key criminal justice agencies to set and publish standards of service for victims and witnesses.
In May 2015, the Scottish Government's Historical Child Abuse Inquiry chaired by Susan O'Brien QC was launched. This will be one of the most wide ranging public inquiries Scotland has ever seen and will consider instances of child abuse in a wide range of care settings. Additional funding of £13.5 million is to be invested over five years (2015-20) to develop a dedicated in-care support fund to enable survivors to get individual, needs based support for as long as they need it, and an additional £1 million for enhanced survivor support for all survivors.
Through grant funding the service will provide an affordable in-care survivor support fund, which provides the opportunity for individuals who have experienced harm in childhood as a result of abuse in care to access to redress in the form of support fund/services tailored to their individual needs and personal outcome goals. The service will provide case management through a trusting relationship with the survivor providing support and advocacy to access the services they require, which will be available for as long as required.
Burial and Cremation
We will take forward measures through the Burial and Cremation Bill to implement recommendations made by Bonomy Commission on the cremation of infants and children. The Bill will put in place arrangements to address the growing pressure on burial grounds in Scotland and will introduce new regulation and inspection arrangements for crematoria, burial authorities and the funeral industry.
The Scottish Government will introduce a new Community Justice Strategy in 2016 to support the reform of community justice. These developments will be underpinned by the Community Justice Bill, introduced to the Scottish Parliament in May 2015. The transition from the current arrangements to new structures will be supported by funding of £1.6 million a year for three years.
We will create a new national prison for women, along with a number of small community-based custodial units by 2019-20. This will be consistent with the recommendations of the Commission for Women Offenders and will deliver a bold new vision for how women in custody are looked after in Scotland, in keeping with a core set of principles that ensure:
- Where courts determine that a custodial sentence is appropriate, security should be proportionate to the risk posed by women offenders.
- Custodial facilities for women should support a recovery ethos.
- Custodial facilities for women should be located as close as possible to communities.
SUPPORT FOR VICTIMS AND WITNESSES
The Scottish Government will continue to improve the information and support available to victims and witnesses. Ongoing implementation of the Victims and Witnesses (Scotland) Act 2014 will ensure that, from September 2015, vulnerable witnesses have wider and more effective access to supportive measures - including automatic eligibility for measures such as giving evidence via video link for alleged victims of sexual offences and domestic abuse. We will also extend the availability of such measures to the Justice of the Peace courts, to ensure that support measures are available throughout the court system.
BURIAL AND CREMATION BILL
The current legislation for burial and cremations is over 100 years old, and much of it is inadequate for modern needs. The Bill will create a system that is fit for 21st-century Scotland.
In particular, the Bill will:
- Provide a modern, robust and consistent framework for all burial and cremation authorities.
- Address pressure on burial grounds and support their long-term sustainability through a range of measures, including allowing the reuse of full burial lairs in carefully controlled circumstances.
- Provide burial authorities with greater powers to maintain burial grounds.
- Improve the process involved in cremating pregnancy losses, babies and infants.
- Improve the safeguards around cremation.
- Introduce new inspection powers.
The Scottish Government will invest a further £1.5 million in community-based justice services for women in 2015-16. This will help sustain existing services and provide additional funding for local services that should help reduce the number of women being remanded and receiving short sentences. This funding follows the £3 million invested by the Scottish Government from 2013-15 to support 16 projects delivering new or enhanced services for women offenders in communities across Scotland.
The Reducing Reoffending Change Fund ( RRCF) has funded six mentoring services for male and female offenders across Scotland. It allocated £10 million in grant funding to third sector organisations in 2012-15, and has been extended for 2015-17 by a further £8 million bringing its total value to £18 million overall. This approach recognises that early diversion/community sentences are more effective than custodial sentences in reducing reoffending.
INDEPENDENT MONITORING SERVICE FOR PRISONS
A new system of independent monitoring of prisons under the auspices of HM Chief Inspector for Prisons is being established to meet our obligations under the Optional Protocol to the UN Convention Against Torture. The new arrangements, which came into force on 31 August 2015, will involve weekly prison visits by independent prison monitors who are members of the public drawn from local communities. It will ensure that all aspects of the prison are independently monitored and provide a system for identifying improvements to the conditions in prisons and the treatment of prisoners.
The Scottish Government will protect public safety by ensuring long-term prisoners whose risks cannot be managed in the community serve more of their sentences in custody. The Prisoners (Control of Release) Act will end the system of automatic early release for long-term prisoners. The Act also provides new flexibility to tailor the exact date of a prisoner's release to help improve access to support services in the community such as housing and social security. Minimum supervision in the community of six months was also introduced for all long-term prisoners leaving custody.
We will continue to improve the safety of those who are vulnerable to harm or exploitation. Our Human Trafficking and Exploitation Bill will clarify and strengthen the criminal law against those who seek to traffic and exploit adults and children and will strengthen substantially the rights of the victims of these crimes to access appropriate help and support. Alongside legislation, we will prepare with key agencies a Human Trafficking and Exploitation Strategy for Scotland.
The Inquiries into Fatal Accidents and Sudden Deaths Bill will provide the legislative framework needed to modernise the way fatal accident inquiries are handled in Scotland. The Bill will extend the categories of death in which it is mandatory to hold a fatal accident inquiry and place a clear requirement to respond on those to whom sheriffs direct recommendations at the conclusion of the inquiry.
The Air Weapons and Licensing Act became law in August 2015. The Act makes provision for the licensing and regulation of air weapons, and improves aspects of locally-led alcohol and civic government licensing in order to preserve public order and safety, reduce crime and to advance public health. There will be a public information campaign before the licensing regime for air weapons comes into force, so that people are fully aware of their new obligations.
As well as protecting safety, it is important that the law can address fairly the interests of families and individuals. We will progress the Succession Bill to implement Scottish Law Commission recommendations to make the law on succession fairer, clearer and more consistent.
We will also look more widely at the interests of children and families within the justice system. While many important reforms have been made to Scotland's courts cases involving family law can still take too long. In line with the UN's Convention on the Rights of the Child, it is also essential that the voice of the child is heard within this context. We will work with the courts, legal and social work professions, parents and children to improve the experience of children and families involved in family justice matters. We will ensure that important decisions affecting children's lives are not delayed inappropriately, that the voice of the child is heard and that each child's welfare and wellbeing is paramount.
Embedding Police Reform
The successful transition to the new single police service on 1 April 2013 has placed Scotland at the forefront of UK policing, with recorded crime now at a 40-year low. The introduction of Police Scotland has enhanced access to specialist expertise and equipment whenever and wherever it is needed, complementing strong local policing.
The establishment of the single police service was the biggest public service reform in a generation. It has made policing in Scotland more accountable both locally and nationally, and has already delivered significant savings while maintaining our commitment to 1000 additional officers in the face of Westminster cuts.
Now that delivery of the reform programme is well advanced, it is time to take stock of the lessons learned to date and ensure we have a police service which meets the needs of the people of Scotland in the future. To deliver this we will:
- Strengthen the community focus of policing. Policing must be carried out with the support of communities throughout Scotland. We will provide opportunities for members of the public, communities and local police scrutiny committees to discuss and develop new national priorities for policing in Scotland. These national priorities will be agreed and published by Summer 2016 and will provide a clear mandate for the Scottish Police Authority and Police Scotland going forward. The Scottish Parliament, the Scottish Police Authority and local scrutiny committees will have a shared responsibility for holding the police to account for the implementation of these priorities.
- Enhance accountability and scrutiny of policing at a local level. The Chief Constable will undertake a new programme of public scrutiny sessions to provide more direct accountability for the performance of policing in local areas. These will be organised across three regional groupings with two to three sessions in each region every year. Over time, the aim will be that each local scrutiny committee has the opportunity to host such a session. Through a local scrutiny Summit to be held in September, we will identify further ways to enhance local accountability.
- Use the opportunity of the appointment of the new Chair of
the Scottish Police Authority to undertake a review of police
governance at national level. This will ensure accountability
arrangements for policing can build on the lessons learned during
the operation of the single force to date and ensure robust
are in place for the future.
- Work with the Scottish Police Authority to consider the implications of changing demands on Scottish policing by Summer 2016. This will ensure that, in the future, Scotland continues to have a Police Service which improves the safety and wellbeing of persons, localities and communities in Scotland.
- Introduce a Statutory Code of Practice for Stop and Search that puts into practice the recommendations of the independent Advisory Group chaired by John Scott QC.
FIRE AND RESCUE SERVICE
The Fire and Rescue Service in Scotland's programme of integration is at an advanced stage and progress towards a truly integrated single service will continue into 2016 and beyond. There have been many successes since the new Scottish Fire and Rescue Service was established in April 2013, helping to deliver key benefits, such as more equitable access to specialist equipment and protecting local services despite financial cuts from Westminster.
We will review the Fire and Rescue Framework set out by this Government in April 2013 and will consult widely as part of this process. We will ensure that new fire priorities guide the approach taken by the Scottish Fire and Rescue Service as it continues its key role in making Scottish communities safer.
HEALTH AND SOCIAL CARE
Improving Scotland's health is fundamental to the Scottish Government's purpose of creating a more successful country, with opportunities for all of Scotland to flourish through sustainable economic growth. We want to have a healthier population, achieved by taking a more holistic approach to the promotion of healthy lifestyles and to the tackling of significant and persistent inequalities.
Our ambition will be supported by a health and social care system that provides high quality, compassionate, effective help at the right time where and when people need it. Our approach is central to our broader aims of creating social justice and protecting public services. We will encourage cross-service working to address inequalities and provide better links to housing, social security and employability, for example, to support sustainable and inclusive economic growth.
Scotland has made significant improvements to the health of our citizens and to the quality of health and social care. We have a clear programme for improving health and care. At its core is a fundamental transformation of our services through the integration of health and social care. We will build on the changes already made and, over the period out to 2030, we will further shift the balance of care, transform primary and community care services, introduce new models of care, develop our health and social care workforce and focus on health outcomes both at the population and individual levels. In doing so we will focus on developing services that provide quality care, regardless of the time or day of the week, and on a basis which is sustainable in the long term. As part of these changes we will also look to the needs of the hospital estate, planning effectively for future needs to maintain quality and safety in elective care.
Our vision of the future will be shaped by public and
professional expectations. The Scottish Government launched a
public conversation on the future of Health and Social Care on 23
June 2015. It is pro-actively engaging the public, patients and
their families, those in need of support and their careers,
professional bodies, local authorities, the third sector,
politicians, various interest groups and
NHS staff in a
conversation to help shape a transformational change in Scotland's
approach to population health and to the delivery of health and
social care services by 2030. We will put in place a plan to meet
our future workforce requirements
for health and care.
Since 2011, we have been engaged in the process of integrating health and social care services. Disjointed systems of health and social care do not help the increasing number of people who are living longer into old age, often with multiple, complex, long-term conditions and who, as a result, need joined-up, integrated services.
In the next year adult health and social care services will be formally integrated around the needs of individuals, their carers and other family members. Providers of those services will be held to account for improved delivery. Services will be underpinned by flexible, sustainable financial mechanisms that give priority to the needs of the people they serve rather than the needs of the organisations through which they are delivered. These arrangements will be characterised by strong and consistent clinical and professional leadership.
We now have in place the necessary legislative framework for integration and health boards and local authorities are putting their integrated arrangements in place now, with new Health and Social Care Partnerships bringing together planning, delivery and resources for local health and social care services. All the new Partnerships will be up and running by April 2016, supported by additional funding of over £500 million to support innovation and new models of care.
We are already seeing signs of real progress with partnerships adopting the new integrated approach in advance of the formal vesting of powers:
- In Glasgow, the Health and Social Care Partnership has adopted a new approach to allowing people to leave hospital and to return home or to a short-term intermediate care setting. In overall terms it has reduced by a quarter the number of that people are delayed by staying in hospital.
- In Fife, the Health and Social Care Partnership has achieved a reduction of approximately 20% in delays in hospital by taking an integrated approach to budgets and service solutions.
- In Aberdeen, the Health and Social Care Partnership is addressing recruitment challenges in the care sector by establishing a centre of excellence alongside affordable staff accommodation.
- Highland's Health and Social Care Partnership has introduced an innovative collaborative commissioning approach that will improve the capacity and quality of care at home.
PROVIDING QUALITY CARE IN OUR COMMUNITIES
In future we want to significantly enhance primary and community care - so that we can provide a better service and better outcomes to patients, families and carers and deliver an enhanced Community Health Service. We also want to better support people to live with and manage their illnesses in a way that is best for them.
Through examining at least 10 primary and community care test sites over the coming year, in both urban and rural settings, we will determine the next stage of service reform. Those sites will be in Glasgow, Edinburgh, Fife, Tayside, Forth Valley, Campbeltown, West Lochaber, Islay, Mid-Argyll and Clackmannanshire. Our aims are based on some simple principles:
- To deliver as much care as possible at or close to home.
- To ensure that care is delivered by the individual or team with the most appropriate skills, helping individuals plan for their care.
- To ensure that people are only admitted to hospital when they are in real need of hospital treatment. and
- To ensure that when someone is admitted to hospital their journey out of hospital is planned and straightforward.
Our models will extend the care currently delivered by GPs and multi-disciplinary teams to provide a wider range of services for each local area. Alongside these improvements will be continued developments in techniques at the boundary of primary and secondary care. Currently these include, for example, important and innovative approaches such as 'hospital@home', 'step-up/step-down' beds, intermediate care at home, frailty clinics and community wards.
We know that one size does not fit all. Our approach will build on innovations already underway that reflect local priorities, for example: in reducing health inequalities (in Craigmillar and Govan); improving mental health (in Fife); and helping people to age well (in Tayside). Equipped with this flexibility, care will develop in ways that match the needs of different individuals and communities in cities, towns, villages and rural areas.
The integration of different types of care is already the practice at Clackmannanshire Community Healthcare Centre. It provides primary care through three GP practices while also providing wider services such as outpatient services, two inpatient wards, a Day Therapy Unit and a local Mental Health Resource Centre. The Centre is a base for district nurses, health visitors, community rehabilitation teams, health improvement and a wide range of support services and classes. These include rehabilitation exercise classes for patients with chronic lung conditions, smoking cessation classes, carers support groups, hearing aid repair clinics and cancer support nursing staff. A range of services and treatment is provided for people with mental health problems and the 45 inpatient beds provide flexibility to be used either for older people following treatment in an acute hospital, patients who need palliative care or to provide long-term continuing care for people with complex, medical, physical or mental health needs.
ENHANCEMENT OF PRIMARY AND COMMUNITY CARE
By the end of 2015-16 we will already have invested an additional £10 million in enhancing primary care. This will be further supported by a total investment of £50 million over the next two years. The £60 million fund sets out the first steps in the transformation of primary care and supports new roles to meet patients' needs within primary care including primary mental health services.
Through this fund we will:
- Support GP practices to test new ways of working to improve services for patients and influence the GP contract. These include currently developed innovations being tested by Lothian Headroom (including Wester Hailes and Craigmillar), Govan Medical Centre and with GP clusters in Grampian where GPs are working with their community to better understand what patients need and design better local services.
- Recruit 140 new pharmacists with advanced clinical skills training to work directly with GP practices to deliver consistency of pharmaceutical care to patients. We are exploring how to continue to support the developing pharmacy workforce into new roles through our work on Prescription for Excellence.
- Support and accelerate use of digital services by GP practices, e.g. by improving access for patients to on-line appointments and repeat prescriptions.
- Increase the number of medical students choosing to train as GPs, encourage those wanting to work in rural or deprived areas, continue the Enhanced Returners programme supporting GPs who wish to return to the profession and develop a programme for local GP leadership and networking. We will, in consultation with others, increase the output from medical schools, encouraging and improving training in General Practice.
- Buy specialist equipment for opticians to improve screening for glaucoma reducing the number of patients requiring hospital admissions.
- Fund the Scottish School of Primary Care to improve research and training for primary care leading to better outcomes for patients.
- Invest in innovative ways of encouraging better identification and management of patients in the community with mental health needs.
As part of our tranformation of primary care, two of the 10 sites where we plan to test new approaches in the coming year will be in Forth Valley and Fife where we will establish two innovative community health hubs. Through the hubs the local population will be able to access a range of services in a community setting, for which they would normally have to travel to an acute hospital. A unique feature of these hubs is that part of the healthcare team will be a new type of doctor - qualified GPs who will receive an additional year of training to give them the skills to work across primary and acute care. The hub will also offer opportunities for innovation in the roles of nurses and other health professionals to maximise the contribution of the whole workforce. We will start training the staff this Autumn.
Between now and March 2017, we are also testing new mocels of care in the following remote and rural areas, to ensure that we deliver care in a way which meets local nneds:
- Campbeltown: the community hospital will work alongside three local GP practices to provide 24/7 care with the support of an enhanced Scottish Ambulance Service response.
- West Lochaber: (comprises GP practices based in Mallaig, Acharacle and the Small Isles) set up a multi-practice model for the provision of GP and out-of-hours care. This will enable GPs from several practices to work together with the wider health and care team to provide care to patients across the local area.
- Isle of Islay: Three existing GP practices are working to put in place a new service, exploring a multi-practice model, to enable a more stable and sustainable healthcare service for residents centred around the community hospital and care home, with future plans to look at whether this could be extended to include the Isle of Jura.
- Mid Argyll: implement a similar arrangement to Campbeltown but also look at options for a multi-practice model. The aim is to enhance the workforce including working with NHS Education Scotland to implement enhanced training, and sustaining and improving the local services available to patients.
Enhancing primary and community care needs premises that are designed for 21st-century services and are welcoming for patients and staff alike. Next year will see many substantial further improvements.
In the future, GPs must be able to focus on complex diagnosis, organise the management of conditions and drugs as part of multi-disciplinary teams, and tackle the challenges that come with managing more people in the community. We are making good progress with delivering a new GP contract for Scotland for the period from 2017 onwards. As part of the transformation we will be testing aspects of this significant reform over the coming year. This innovation has been made possible through our efforts to support GPs through a three-year stability deal from 2014 which has allowed us to work effectively in partnership with the British Medical Association and the Royal College of General Practitioners.
We will also act upon the findings of the review that we commissioned by Sir Lewis Ritchie on primary care 'out-of-hours' services. This will provide added insight in sustaining and improving multi-disciplinary primary care for those who need urgent help.
SUBSTANTIAL INVESTMENT IN COMMUNITY FACILITIES
Current plans for 2015-16 are for new community facilities in:
- NHS Dumfries & Galloway - a new Women and Children's Hub (£3.3 million) is due in Summer 2016.
- NHS Greater Glasgow & Clyde - Eastwood and Maryhill Health Centres - is due in March 2016 (£25 million).
- NHS Greater Glasgow & Clyde - Lennoxtown Community Hub - a shared project with East Dunbartonshire Council is due to complete in January 2016.
- NHS Grampian - Stonehaven Dental Hub (£1.5 million) is due in early 2016.
- NHS Lanarkshire - Wishaw Health Centre is due in Autumn 2015; part of £50 million development with Kilsyth and East Kilbride Health Centres that is already open.
These new developments will build on those completed in the last year, including:
- NHS Shetland - Scalloway Health Centre - £2 million contribution to a joint project with Shetland Council opened in August 2015.
- NHS Greater Glasgow & Clyde - Shields Health and Care Centre £2.7 million opened in August 2015.
IMPROVING HOSPITAL CARE
We are developing a new National Clinical Strategy which will be completed this Autumn. It will set out an overall vision for the development of clinical services over the next 15-20 years. It will present evidence that supports both the need for change, and how that change might be shaped at national, regional and local level.
What is already clear is that our changing demography means that the demand for routine hospital care is changing too. In the course of the year we will set out our plans to meet the demand for an increased number of procedures such as hip, knee and cataract operations. We will develop plans to provide a greater separation of non-emergency (elective) planned services compared to unscheduled care (emergency) services. This could have a significant impact on the shape and resilience of our hospital services in the future.
TRANSFORMING ACUTE SERVICES
We will introduce a 20-year strategy to deliver planned care swiftly, effectively and in line with best modern medical practice. The strategy will: (a) effectively eliminate use of the private sector for planned care; (b) significantly reduce the chances of cancellation of surgery; (c) deliver in full a world-leading performance on waiting times; (d) deliver increased efficiency and productivity; (e) secure greater resilience around the impact of winter; (f) lead to the creation of new facilities and the redevelopment of some of our older hospital sites as part of the overarching strategy.
This multi-million pound investment will create new jobs in construction and permanent additional staffing for the NHS thereafter. New facilities will be completed and delivered during the lifetime of the next Parliament.
The £5 million committed in the Programme for Government 2014-15 formed part of a total investment of £18 million to support the reduction in the total number of delayed discharges over winter. This resulted in a reduction of delays over three days from 947 in October 2014 to 646 at April 2015, with the overall level of bed days associated with delayed discharges also reducing by over 10% in the last quarter.
We are also supporting the NHS and its partners to plan for winter to help ensure that safe and effective services continue over the Winter period. In the coming year, we will continue to provide additional support which will supplement the direct investment already included within Boards' financial plans. In addition:
- We have strengthened Winter planning for health and social care. Winter guidance has already been issued for this Winter to help support the NHS to provide safe and effective care for patients and have effective levels of capacity and funding to support service delivery and expected activity levels. Local plans are being developed and will be published by the end of October 2015. Integrating health and social care and the £100 million being invested to improve delayed discharge are key priorities for the Scottish Government. The Scottish Government has also developed a fresh approach to improving unscheduled care across Scotland - in Winter and all year round - which is based on six essential actions.
- To provide more transparency and openness we now publish monthly statistics on delayed discharge.
- A report on last year's Winter has been published to support the NHS and its partners learn from the pressures it faced.
SUPPORTING RURAL HOSPITALS
We are taking action to support our rural hospitals in recruiting and retaining their medical staff.
Working with NHS Boards we are developing networks between rural and urban hospitals. These networks will support doctors working in rural areas to maintain and develop their skills - ensuring that patients receive safe care. In some areas this will involve rotating staff between rural and urban hospitals to ensure that we continue to provide services close to communities.
This work has already delivered early success in supporting the delivery of general surgical services in the Belford Hospital. Working with NHS Highland, we are now putting in place a network between Caithness General Hospital and Raigmore Hospital in Inverness, which will involve rotating staff between the two hospitals. This will support the delivery of the majority of surgical care and all out-patient care close to the community in Wick, while NHS Highland engages with local stakeholders to develop options for high quality, safe and sustainable services at the hospital and throughout Caithness.
We are also supporting an enhanced training programme for GPs who will be able to support the general medical services delivered in Caithness General.
DETECTING CANCER EARLY AND PROVIDING EFFECTIVE CARE
As our screening programmes roll out across Scotland and as we consider the requirements for planned and unscheduled care in the future, we will also consider the need for additional investment in diagnostic techniques. This will help us to improve cancer care. Cancer mortality rates have fallen over the last 10 years. The overall age-standardised cancer mortality rate (excluding non-melanoma skin cancers) has fallen by over 11% for both males and females between 2003 and 2013 (by 15% in males and over 5% in females). Since 2008, the Scottish Government has invested substantially in improving cancer treatment services in Scotland including:
- £11.5 million invested since 2011 to improve cancer service capacity in NHS Boards.
- £22 million for the new Beatson Satellite Centre, now being built at Monklands Hospital, to help meet the rising demand for radiotherapy treatment over the next 10 years (operational by end of 2015).
- £17.4 million to deliver the breast, bowel and cervical screening programmes.
- £39 million has been invested since 2012 in the Detect Cancer Early Programme. Most of the investment has been directly in NHS Boards and has been used to support improvements in diagnostic and treatment services. Early indications from the Programme are that it is having a positive effect.
We have consistently achieved the 31-day cancer access standard ensuring that once a patient has had a decision to receive treatment they have timely access to that treatment. We continue to work towards achieving the 62-day standard across all NHS Boards and tumour groups.
For the second consecutive year we have doubled our investment in the New Medicines Fund. £90 million will be available in 2015-16. The Fund supports treatments for people with rare or end-of-life conditions.
IMPROVING MENTAL HEALTH SERVICES
We will use our £100 million investment in mental health to:
- Further improve child and adolescent mental health services and bring down waiting times.
- Improve access to services and in particular psychological therapies.
- Respond better to mental health needs in community and primary care settings.
Third sector service providers will be key to delivering new services and there will be a focus on innovation and providing services in community settings.
BETTER MENTAL HEALTH SERVICES
This year we have announced investment of £100 million over five years to improve mental health. This will allow us to continue to build on the valuable work already started to improve access to mental health services and to improve and develop more person-centred approaches to supporting people's mental health and wellbeing.
Work will continue to reduce and prevent suicide and to address stigma and discrimination around mental health. There has been a significant increase in demand in recent years for child and adolescent mental health services and we will work with a wide range of partners to develop a strategic approach to promoting wellbeing, prevention, care, treatment and recovery.
IMPROVED PATIENT SAFETY
The Scottish Government will continue to support the Scottish Patient Safety Programme ( SPSP), a world-leading initiative which started in January 2008 aimed at improving safety and reducing unintentional harm, and the only country-wide patient safety programme in the world. The SPSP has delivered significant successes and has contributed to the 16.1% reduction in hospital mortality rates. We will build on this work to improve patient safety in Scotland by: maximising opportunities to learn; encouraging spread of the work into all health and social care settings; aligning work with improvement work on person-centred care; and moving towards an approach that is more responsive to local safety priorities.
As part of this we announced in June 2015 the aim of reducing pressure ulcers by 50% across all healthcare settings by the end of 2017. This will build on the excellent work already taking place in acute care.
We will improve patient safety by introducing regulation of private healthcare clinics providing services such as botox as well as the small number of wholly private dental practices in Scotland.
NEXT STEPS FOR PATIENT SAFETY
We will build upon the successes we have already seen from the Scottish Patient Safety Programme ( SPSP) to further improve the safety and reliability of health care. We will work with Healthcare Improvement Scotland ( HIS) and Health Boards to improve safety wherever and whenever care is delivered. We will expand this improvement work across social care as well as ensuring that the SPSP reflects person-centred care approaches more effectively. To support this integrated approach and to provide a more flexible response to local challenges, we will bring Quality Improvement expertise for health and social care together within HIS.
REGULATION OF PRIVATE HEALTHCARE CLINICS
We will use secondary legislation to give Healthcare Improvement Scotland powers to regulate independent clinics whose services are provided by specified healthcare professionals. To support this we have commissioned a social marketing campaign to find out how to improve the knowledge and choices made, especially of young women from socio-economically deprived groups, before they use a variety of cosmetic interventions. Both the legislative and the social marketing work will be developed during 2015 and be in place in 2016. The planned outcome from both is safer environments for the delivery of services, and better informed public and potential clients.
A STRONGER PATIENT VOICE
We want health and social care services that are open and responsive, that listen carefully to people about what matters to them and that use feedback to drive and inform improvement. In June 2015 we launched a social marketing campaign aimed at families, carers and the public to help them engage purposefully with health and social care providers to continuously improve and transform services. People will be provided with feedback on the impact of their engagement or shown how their views have been considered.
Through 'Our Voice' we will ensure that the voice of the system user is heard and responded to at every level of the health and social care system:
- At individual level it will empower and support individuals to provide feedback about the care and services they receive. This feedback will be used to drive and inform continuous improvements to services.
- At local level we will establish a peer network by the end of 2015, to support people to engage purposefully in local planning processes.
- At national level we will create a citizen network by the end of 2015, to support people to engage purposefully in local planning processes. lt will drive and inform continue involve as wide a range of people as possible in improving services. Citizens' panels or juries will be convened from 2016 to involve people in deliberating on national policy.
A Leadership Coalition, representing service users of all ages and professionals and chaired by a member of the public, will be established initially to guide the development of the three-level system, and will over time maintain momentum, evaluate impact and make recommendations for continual improvement.
Around 759,000 adults and nearly 30,000 young people care for people. Over 170,000 carers look after a relative or friend for at least 35 hours every week. This is a significant contribution upon which our society depends. The Scotland Bill will transfer powers over social security benefits for disabled people with long-term health conditions and their carers.
The Carers Bill, which is currently being scrutinised by the Scottish Parliament, is an important part of our Government programme of health and social care reform. The Bill will extend the rights of carers, including young carers. The implementation of the Bill's provisions will make a meaningful difference to carers and will contribute towards the improvement of their health and wellbeing, ensuring that they can continue to care and to have a life alongside caring.
This Government remains focused on "getting it right for every child" and that includes making sure our most vulnerable children and families get the practical and financial support they need. From October 2015, eligible kinship care families (where family members or friends step in to care for children who can no longer live at home) will receive the same allowance from their local authority as foster carers. This shift will potentially benefit 5200 of Scotland's most vulnerable children in the first year alone. This year, work will also begin to explore and consider how to develop a national kinship care allowance so families can receive the same financial support no matter where they live in Scotland.
We are committed to improving the health of Scotland's people and tackling the very significant and serious inequalities in health that damage the life-chances and wellbeing of many people. Some of the significant developments will be as follows. We will expand the Link Workers programme, enabling GP practices to provide better services to patients in deprived areas. Alongside this, we will support a pilot to work with local people to allow them to draw on the assets and capacities of local communities, equipping them with the knowledge and confidence to develop the most relevant responses to that community's health issues.
The issue of teenage pregnancy and young parenting should rightly be seen in its widest context as being about improving the lives and opportunities of young people. In early 2016 we will deliver our commitment to the Scottish Parliament's Health and Sport Committee to publish plans to further reduce the rate of pregnancy amongst teenagers and provide better support for young parents. Although rates of teenage pregnancy in Scotland have been falling since 2007 (and are now at their lowest level since at least 1994) Scotland continues to have high levels of teenage pregnancy in comparison to other countries.
We will update the
Sexual Health and Blood-borne Virus Framework that sets
out the Scottish Government's policy on sexual health,
viral hepatitis. The first Framework was published in 2011. Our new
approach will set out plans for the next five years including a
reduction in health inequalities amongst those infected with
a blood-borne virus or poor sexual health, and reductions in stigma.
We will introduce a new meningitis B vaccination programme from September 2015 for infants. The programme will add meningitis B vaccination to the routine infant vaccination schedule, providing additional protection against this potentially serious strain of meningitis. The Scottish Government has funded the costs of the vaccine and the NHS will meet the costs of administration of the vaccine by GPs.
The Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill was introduced in June 2015 and is due to complete its passage through Parliament by March 2016. The Bill will implement a range of measures building on our tobacco control strategy: Creating a Tobacco Free Generation. Tobacco use remains the primary preventable cause of ill health and premature death in Scotland with costs to the health service estimated to exceed £300 million. The Government also supports the principles of Jim Hume's Member's Bill to ban smoking in cars which is currently being scrutinised in Parliament.
We will develop the next phase of our Alcohol Framework for commencement in early 2016 with a focus on reducing health inequalities. Average weekly alcohol consumption is far higher in Scotland's lowest income communities, where most harm is experienced. Those in the 10% most deprived areas are over eight times more likely to be admitted to hospital due to alcohol use than those in the most affluent communities. Further, alcohol-related mortality in the most deprived 10% of communities is over 7.5 times higher than in the most affluent areas of Scotland. The 41 measures in the existing strategy have contributed to deaths in Scotland falling faster than in the rest of the UK and maintaining that improvement in the face of economic recovery producing greater affordability is crucial.
We will update our Preventing Overweight and Obesity Route Map to allow us to identify new actions to adopt to help prevent obesity. There is now a clearer link developing between obesity and inequalities and the update will allow this to be highlighted and appropriate responses to be prioritised.
We will also improve the oral health of people in Scotland with a clear focus on reducing inequalities. By further reducing dental decay we will address the most common reason for admitting a child to hospital. We will transform the outdated and complex dental system to meet the needs of younger people who need to maintain a preventive focus whilst ensuring that the treatment needs of the older population are met. An eDental programme will improve the assurance, governance, efficiency and information on quality of services.
The Scottish Government recognises that access to voice equipment is vital to children and adults who find speaking difficult or are at risk of losing their voice. We will therefore bring forward an amendment to the Health Bill that is currently in Parliament to provide a right to voice equipment when required.
Additional health visitors will be put in place in order to deliver a universal service to all families. Health visitors have a significant public health role to play in relation to individuals, families and communities by providing critical support for all children under five. Following a review of the service, additional visits will be offered to provide enhanced support to families. This will include additional child health review points as an opportunity to work with parents to review a child's development.
IMPROVING CARE AT THE END OF LIFE
People have told us that they want to see more emphasis placed on care at the end of life. That is why we will publish a Palliative and End of Life Care Strategic Framework for Action by the end of 2015. This Framework, which is being co-produced with the NHS and the third sector, will enable everyone to identify the actions needed to deliver changes and improvements. These will ensure that everyone in Scotland no matter where they live and no matter what clinical condition(s) they have will receive high quality care from a health and social care system at the end of life that involves them and people who matter to them in the dialogue.
There is a stronger will in Scotland than ever before to ensure that access to high quality palliative and end-of-life care becomes a reality for everyone. The Scottish Government will support this through £0.5 million in start-up costs in 2015-16, along with £1 million each year in 2016-17, 2017-18 and 2018-19.
Email: Cabinet Secretariat, CabinetSecretariate3@scotland.gsi.gov.uk