ScotRail’s performance as a whole, has fallen below the expectations of passengers, and the demanding performance targets set by Scottish Ministers. The contractual targets are intentionally challenging, demanding a consistent improvement in punctuality and reliability over the life of the franchise, leading to 92.5% of trains being at their destination on time, as measured by the rail industry’s Public Performance Measure, by April 2019. ScotRail’s current performance here nationally is 89.6% over the last twelve months, against a target for the end of the second year of the franchise of 91.3 percent.

The mid-Scotland and Fife area falls into the ‘Suburban East’ franchise sector. In this sector, ScotRail’s current performance is sitting at a moving-annual-average of 89.5 percent, against a specific target for that sector for the end of the second year of the franchise, of 92.5 percent.

Under the terms of the Franchise Agreement, Transport Scotland (an agency of the Scottish Government) requested that ScotRail provide an Improvement Plan, which will outline their plans to address performance issues and achieve their contractual targets. This was received by Transport Scotland on 16^th September, and is now being reviewed, with the actions within the plan to be monitored.

The Improvement Plan has three points of focus: infrastructure, fleet and operations:

For the infrastructure, much is being done to improve signalling and cabling:

For the fleet, the emphasis is now much more on focussed maintenance initiatives, especially for the radiators on the Class 158 rolling stock, as these have been a particular source of concern;

For the operations, a specific focus on reviewing staff and passenger behaviours on the lines which are known to facing significant levels of delay.

Cancer waiting times data for quarter 2 (April - June) 2016 published by ISD on 27 September 2016 show 95.7% of cancer patients across Scotland received treatment within 31 days of a decision to treat with the median wait being only six days.

Challenges remain to the 62-day pathway with known capacity pressures for diagnostic scopes and radiological investigations. The Scottish Government continues to support improved performance across NHS Scotland and are actively engaging NHS Boards where there are challenges to sustained delivery against the 62-day standard. This is backed by additional funding of £5 million in 2016-17.

Breakdown of performance by NHS board can be found in the quarterly ISD statistical publications.

Under this Government, the number of GPs employed in Scotland has risen by 7.4 per cent to nearly 5,000 – the highest ever on record. Investment in GP services has gone up every year under this Government and we are committed to an increasing share of the NHS budget going to Primary Care in each year of this parliament.

We recognise recruitment into General Practice is an on-going challenge. We are supporting health boards to encourage GP recruitment and retention with a number of short and long term investments. We are investing £85 million over three years to develop Primary Care workforce and infrastructure. Additionally, in March we announced a further £20 million investment to ease workforce pressures over the next year.

We are testing community hub models in NHS Forth Valley and NHS Fife. By offering community hub fellowships in Fife and Forth Valley we have been able to attract young, recently qualified GPs to areas to which it has previously been difficult to recruit through the offer of portfolio careers and extended roles in the hubs.

Responsibility for delivery of the project to re-structure police call handling rests with Police Scotland, with appropriate oversight by the Scottish Police Authority.

It is every patient's responsibility to keep their NHS appointment and it is important that they let their primary care team or the hospital know when they cannot attend. However, we also recognise that the NHS has to be flexible in helping make appointments convenient to patients.

The Scottish Government is committed to supporting health boards implement policies to reduce missed appointments such as providing reminder services through text, emails and social media. This will allow reminders services to be tailored for patients who are most likely to not attend.

By end of March 2016 , the Scottish Government’s investment in the Digital Scotland Superfast Broadband (DSSB) programme had extended fibre broadband access to at least 89% of premises in Fife, 90% of premises in Clackmannanshire and 67% of premises in Perth and Kinross. By the end of 2017, when DSSB deployment completes, those coverage figures will rise to at least 98% in Fife, 99% in Clackmannanshire and 90% in Perth and Kinross.

In terms of how NHS Fife is supporting Forth Valley Royal Hospital the Scottish Government does not hold this information centrally.

However, the Scottish Government is working closely with health boards, including NHS Fife and NHS Forth Valley, as part of an improvement approach to ensure improvements are made on a sustainable basis. This approach aims to minimise long waits in A&E and Assessment Units and ensure the whole NHS system works together effectively - beginning from a patient’s first contact with the NHS right through to, if they require admission, their discharge from hospital.

Through the National Unscheduled Care - six Essential Actions Improvement Programme NHS Fife has implemented a number of actions at the Victoria Hospital, which has seen performance at, around or above 95% over the last few months. The board has developed an integrated team of Nurses, allied health professions (AHP’s) (Physiotherapists and Occupational Therapists) and Frailty Practitioners (support workers), who share skills to provide a comprehensive assessment of patients screened as frail who attend the Accident and Emergency Department (A&E) as well as the acute admissions areas within the acute hospital. It enables the frailty team to gather as much relevant details from the patients and their family/carers on their previous level of function, as well as how they are functioning presently; which in turn aids timely clinical decision making on the best pathway for the patient. This work has supported the continued reduction in the length of time these patients spend in hospital.

NHS Forth Valley has seen some variable performance but often performs at, around or above 95%. The Hospital has also implemented a number of actions to support sustainable improvement against the four hour A&E target. They have recently standardised the emergency referrals process to the acute medical unit, which has led to a reduction in delays for patients attending this unit.

The Police Service of Scotland Regulations 2013 set out that officers can only hold a business interest with the consent of the Chief Constable, or in the case of a Senior Officer, the Scottish Police Authority. Police officers are not able to take on any second job that might conflict with their policing duties.

Each and every one of the drug related deaths in Scotland is tragic. We are continuing to tackle the devastating impact that drugs have for individuals, families and communities, and making recovery a reality, through our national drugs strategy, the Road to Recovery. The Scottish Government is continuing to invest significant resources to support this strategy and to tackle problem alcohol and drug use, having provided £630 million since 2008.

Whilst drug taking among the general population is falling and the number of young people taking drugs is at the lowest in a decade, we remain determined to tackle problem use. With our partners, we are engaged in a range of activities to reduce the harm caused by problem drug use, both in understanding the problem, supporting innovation in services and examining alternative approaches.