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Meeting Papers for 25 February 2021

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Meeting Papers for 25 February 2021 PAPLS/S5/21/7/A PUBLIC AUDIT AND POST-LEGISLATIVE SCRUTINY COMMITTEE AGENDA 7th Meeting, 2021 (Session 5) Thursday 25 February 2021 The Committee will meet at 9.00 am in virtual meeting and broadcast on www.scottishparliament.tv. 1. Decision on taking business in private: The Committee will decide whether to take agenda items 4, 5, 6 and 7 in private. 2. Major Capital Projects: The Committee will take evidence from— Alyson Stafford, Director-General, Scottish Exchequer, Gary Gillespie, Chief Economist, Rachel Gwyon, Deputy Director, Infrastructure and Investment, and Alan Morrison, Deputy Director, Health Infrastructure, Scottish Government; Bill Reeve, Director of Rail, Transport Scotland; Kerry Alexander, Director of Infrastructure Finance and Programmes, and Gemma Boggs, Senior Associate Director, Social Infrastructure, Scottish Futures Trust. 3. Section 23 report - NHS in Scotland 2020: The Committee will take evidence from— Stephen Boyle, Auditor General for Scotland; Angela Canning, Audit Director, Leigh Johnston, Senior Manager, and Eva Thomas-Tudo, Senior Auditor, Performance Audit and Best Value, Audit Scotland. 4. Section 23 report - NHS in Scotland 2020: The Committee will consider the evidence heard at agenda item 3 and take further evidence from— Stephen Boyle, Auditor General for Scotland; PAPLS/S5/21/7/A Angela Canning, Audit Director, Leigh Johnston, Senior Manager, and Eva Thomas-Tudo, Senior Auditor, Performance Audit and Best Value, Audit Scotland. 5. Major Capital Projects: The Committee will consider the evidence heard at agenda item 2 and take further evidence from— Stephen Boyle, Auditor General for Scotland; Graeme Greenhill, Senior Manager, Performance Audit and Best Value, Audit Scotland. 6. Post-legislative scrutiny - The Lobbying (Scotland) Act 2016: The Committee will consider responses to the consultation on its draft report. 7. Work programme: The Committee will consider its work programme. Lucy Scharbert Clerk to the Public Audit and Post-legislative Scrutiny Committee Room T3.40 The Scottish Parliament Edinburgh Tel: 0131 348 5390 Email: [email protected] PAPLS/S5/21/7/A The papers for this meeting are as follows— Agenda Item 2 Note by the Clerk PAPLS/S5/21/7/1 PRIVATE PAPER PAPLS/S5/21/7/2 (P) Agenda Item 3 Note by the Clerk PAPLS/S5/21/7/3 PRIVATE PAPER PAPLS/S5/21/7/4 (P) Agenda Item 6 PRIVATE PAPER PAPLS/S5/21/7/5 (P) PAPLS/S5/21/7/1 Public Audit and Post-legislative Scrutiny Committee 7th Meeting, 2021 (Session 5), Thursday 25 February 2021 Major Capital Projects Introduction 1. At its meeting today, the Public Audit and Post-legislative Scrutiny Committee will take evidence on the Scottish Government’s most recent update on Major Capital Projects (MCP), which covers the six months’ period ending September 2020. The update is available here. Background 2. The Scottish Government provides the Committee with biannual updates on major capital projects in response to recommendations contained within the Session 3 Public Audit Committee's report Major Capital Projects. Upon receipt of a report, it is up to the Committee to decide what further action to take. 3. This is the ninth update provided this session. The Committee last took evidence on the MCP update in January 2019. Further background about the Committee’s scrutiny of MCP updates can be found on the Committee’s webpage. 4. The Committee also took evidence on the Auditor General’s report, Privately financed infrastructure investment: The Non-Profit Distributing (NPD) and hub models, in February 2020 and September 2020. The Committee’s scrutiny of this report can be found here. The most recent correspondence received by the Committee is set out below: Letter from the Scottish Government, 13 November 2020 Letter from the Scottish Futures Trust, 19 November 2020 Submission from Dr Jim Cuthbert, 25 January 2021 5. SPICe have prepared a briefing on “Regional patterns and impacts of infrastructure investment”. A link to the briefing can be found here. Clerks to the Committee 22 February 2021 1 PAPLS/S5/21/7/3 Public Audit and Post-legislative Scrutiny Committee 7th Meeting, 2021 (Session 5), Thursday 25 February 2021 Section 23 report - NHS in Scotland 2020 Introduction 1. At its meeting today, the Public Audit and Post-legislative Scrutiny Committee will take evidence from the Auditor General for Scotland on the section 23 report, NHS in Scotland 2020. 2. The Auditor General has prepared a briefing on the key messages from the report and this, along with a copy of the report, is attached in the Annexe. Key audit themes – Leadership and workforce challenges 3. At its meeting on 5 March 2020, the Committee held a roundtable session to examine leadership and workforce challenges within the health and social care sectors as part of issues arising from its Key audit themes report. A summary of the evidence received can be found here. The Committee subsequently wrote to all participants to seek an update on their views in light of the Covid-19 pandemic. Responses to the Committee can be found here. Clerks to the Committee 22 February 2021 Annexe REPORT BY THE AUDITOR GENERAL FOR SCOTLAND NHS IN SCOTLAND 2020 1. The Auditor General’s report on NHS in Scotland 2020 was published on 17 February 2021. The report focuses on the NHS and Scottish Government’s response to Covid-19. It also covers how well prepared the NHS was for the pandemic and includes a brief overview of the financial and operational performance of the NHS in 2019/20. 2. Key messages from the report are: • Covid-19 has presented the most significant challenge the NHS in Scotland has had to face. NHS frontline staff have put themselves at risk to meet the demands presented by Covid-19, reflecting their extraordinary commitment to public service. The NHS and Scottish Government acted quickly to increase capacity in Scotland’s PAPLS/S5/21/7/3 hospitals. The NHS implemented several actions that prevented it from becoming overwhelmed, such as increasing intensive care capacity and stopping non-urgent planned care during the first wave (paragraph 6). There are longer-term risks associated with some of these decisions, but the Scottish Government needed to prioritise increasing capacity for Covid-19 patients. • The Scottish Government's Test and Protect strategy is crucial to suppressing the virus and will remain so until Covid-19 vaccinations are fully rolled out. The Scottish Government has significantly expanded testing capacity in recent months (exhibit 1), and it should implement its plans to use this additional capacity to expand testing to asymptomatic groups. Contact tracing is working well, with enough contacts of people testing positive being reached within 72 hours (84 per cent between 26 October 2020 and 24 January 2021) for the system to be effective. • Staff across the NHS have been under considerable pressure during the pandemic, with high levels of work-related stress reported. The Scottish Government has put in place measures to support the wellbeing of the NHS workforce, and it is important for NHS boards and the Scottish Government to monitor the impact of these measures to determine whether sufficient progress is being made. • Covid-19 has so far caused or contributed to the deaths of almost 9,000 people so far across Scotland. The pandemic has not affected everyone equally however, with those from the most deprived areas twice as likely to die from Covid-19 than those in the least deprived areas. Those from certain ethnic minority backgrounds have also been more likely to be hospitalised or die after contracting Covid-19. Long-standing systemic issues were exacerbated during the pandemic, leading to the disproportionate impact experienced by these groups. • Covid-19 has led to a significant backlog of patients waiting to be seen (exhibit 5), and the clinical risks associated with patients waiting longer for treatment need to be monitored. Remobilising the full range of NHS services is challenging. Operating theatres, clinics and waiting rooms cannot currently be used to their full capacity because of the need for physical distancing and the additional time needed for replacing PPE and cleaning. NHS boards are also still managing high numbers of Covid-19 cases, which is taking priority over resuming non-urgent services. The Scottish Government published a clinical prioritisation framework for NHS boards to use during the pandemic - people in most urgent need are being prioritised; those who are of lower clinical priority are having to wait longer. Performance against the clinical prioritisation categories should be published, to enable transparency about how boards are managing their waiting lists. PAPLS/S5/21/7/3 • The Scottish Government is committed to rebuilding the NHS differently. Many new ways of working have been established at pace - such as the widespread use of virtual appointments and the Covid-19 community hubs and assessment centres. Maintaining innovation and learning from the pandemic will be essential. The NHS needs stable, collaborative leadership to deal with the ongoing challenges caused by Covid-19 and to remobilise services. There remains an issue with high turnaround and short-term tenure, with 32 new appointments of Board Chairs, Chief Executives and Directors of Finance since April 2019. The Scottish Government should ensure that all NHS leaders, particularly those who are newly appointed, have the support they need to do this. • The Scottish Government could have been better prepared for a pandemic. It based its initial response on the 2011 UK Influenza Pandemic Preparedness Strategy but planning for a pandemic had not been sufficiently prioritised and improvements identified following subsequent pandemic preparedness exercises were not all fully implemented, such as publishing flu pandemic guidance for health and social care in Scotland. The Scottish Government should update and publish this guidance as a priority. The scope of the guidance should not be limited to only a flu pandemic and should include lessons learned from Covid-19.
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