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A PARTNERSHIP FOR A BETTER SCOTLAND: PARTNERSHIP AGREEMENT

DELIVERING EXCELLENT PUBLIC SERVICES

Improving Public Services

Introduction

People deserve and expect public services that are of the highest possible quality and offer the greatest possible choice. We will continue to use the record level of investment in our public services to secure new and better facilities, particularly for our schools and hospitals. We will also match this investment with continued reform so that our public services are designed and delivered around the needs of individuals and the communities within which they live.

To make certain that everyone across Scotland can be sure of the quality of service they can expect, we will set, where appropriate, national standards to be met or, ideally, exceeded.

The interests of the pupil, the patient, the passenger and the victim of crime will always come first. We will continue the process of reform by bringing forward legislation to improve the effectiveness of health, education, fire, police and criminal justice services, and take forward social work reform across Scotland.

To ensure that services match the needs of individuals and communities, we will continue to devolve decision making to the most local level wherever possible. We want frontline staff to be empowered and local communities to have the freedom to take local decisions wherever practical.

Community Planning will continue to be one of the main methods through which we promote and share best practice in the planning and delivery of public services. And our Best Value arrangements will ensure that every public body tests its services against the highest standards in other public bodies.

We will invest in and reform public services to cut through bureaucracy, simplify funding and ensure services are flexible and focused. We will monitor progress by both regular and targeted independent inspection of performance and action against common standards, to ensure good practice is shared and to identify poor performance.

We will evaluate all new spending commitments for their economic and social impact and value for money.

HEALTH

Introduction

Improving Scotland's health is central to the welfare of our society. Our poor health record is well known. New initiatives are required to create a step change in improving health.

We will take strong action to promote good health, introducing a range of measures to encourage safer, healthier lifestyles. To prevent ill health we will tackle issues associated with poor diet and secure improvements in treatment services for drug and alcohol related problems.

We will continue to develop our radical agenda to secure improvements in Scotland's health services, placing the patient at the heart of the design of services. We will make changes where needed to structures and boundaries. We will devolve power to the lowest level.

We will work with health staff and Health Boards to improve the quality and consistency of care through national standards, inspection and support. Where the steps of development, inspection and support do not secure the improvement needed, we will extend Ministerial powers to intervene, as a last resort, to direct the Health Board to take the specified action to secure the quality of healthcare required.

We will continue to improve the delivery of services - making the NHS more efficient by continued effort to reduce bed blocking; supporting key sectors such as community based centres and hospitals; and securing the improvement of mental health services for some of the most vulnerable members of our communities.

We can best deliver improvements to our National Health Service through the empowerment of our workforce. We will continue to develop and support our staff, increasing the overall numbers in key sections of the workforce, confirming our commitment to the 'Agenda for Change', developing more flexible working patterns, supporting continuous professional development and ensuring that we have appropriate measures in place to meet gaps in provision in key sections of the workforce or different parts of the country.

High level commitments

We will increase our programme to train, recruit and retain nurses and midwives, bringing 12,000 into the NHS by 2007 as part of our overall improvements in workforce planning in the NHS.

We are committed to improving waiting times for patients and will continue the work we have started by guaranteeing treatment for:

• Inpatients within 9 months of diagnosis from the end of 2003, reducing this time to 6 months by the end of 2005;
• All coronary heart disease patients within 18 weeks of diagnosis, from 2004;
• A maximum wait of 26 weeks for all outpatient appointments by the end of 2005.

We will reform the NHS to abolish NHS Trusts and establish Community Health Partnerships.

We will add emphasis to the promotion of good health in Scotland, taking particular action in the areas of diet and healthy lifestyles.

We will tackle the problem of alcohol abuse in Scotland and implement a package of measures including doubling the level of resources currently available for treatment.

We are committed to the improvement of mental health services across Scotland. We will commission research on lessons to be learned from successful approaches across the world. In conjunction with service users we will develop community services including innovative approaches to addressing crisis episodes such as 24-hour support services and multi-disciplinary care.

We will invest in health promotion and, as a priority, we will systematically introduce free eye and dental checks for all before 2007.

Supporting activity

Stepping up action on health improvement

Improving health

• We will continue to support community planning as the key framework to develop a shared plan for health improvement in a local authority area. Local government has a critical role to play in improving health in the community. Working in partnership with health boards, local authorities should produce Local Health Improvement Plans. Significant resources are being made available to local authorities through the new Health Improvement Fund established in the Scottish Budget and we will continue to ensure that resources to tackle the root causes of ill health are available to local authorities as well as health boards.
• We will support a Glasgow Centre for Population Health.

Tackling the problem of alcohol abuse in Scotland

We will implement a package of measures to tackle the problem of alcohol abuse in Scotland including:

• A review to determine the scale of alcohol abuse and its consequences on a national basis, including assessing the resources currently devoted to tackling alcohol abuse and the costs incurred by its consequences
• Doubling the level of resources currently available for alcohol treatment and rehabilitation services in Scotland, to deliver for example increased provision of support services for families affected by alcohol abuse.

Improving diet

• We will support measures to improve the availability of affordable, quality healthy food in low income areas.
• We will ensure adequate nutritional standards for food served in care homes, hospitals, day centres and prisons.

Preventing ill health

We will support further improvements to health screening services and improve accessibility to those services by developing and piloting a range of innovative programmes, including:

• • well man clinics;
  • piloting Personal Health Plans for different population groups, including geographical areas, age groups, and specific medical conditions;
  • consulting clinicians on a programme of targeted health checks;
  • establishing a national advisory framework for employers to offer health screening and services.
• We will introduce hearing tests for all new-born babies.

Promoting safer lifestyles

• We will develop and implement a National Sexual Health Strategy.
• We will urgently review the provision of drug rehabilitation services across Scotland including issues of accessibility, quality, and security of funding. We will invest additional resources in drug treatment and rehabilitation services.
• We will continue to support the successful Know the Score campaign.
• We will consult on an action plan to achieve considerably more smoke free restaurants and pubs; and we will consider in consultation with transport operators further measures to enforce restrictions on smoking in public transport.

Redesigning health service provision

• We will legislate for NHS reform and will abolish NHS Trusts and establish Community Health Partnerships.
• We will review the boundaries of local health care co-operatives and health boards to facilitate joint working with local authorities.
• We will devolve management responsibility to the frontline, and require NHS Boards to implement local health plans to improve patient care and reduce ill health.
• We will ensure public involvement in health service reorganisation plans by obliging health boards to consult stakeholders more effectively.
• We will spread good practice in service redesign through the Centre for Change and Innovation.
• We will continue to review the range of national health targets, and increase the focus on a set of strategic priorities for service improvements and patient guarantees. We will keep NHS Scotland focused on no more than 12 priorities each year and publish a core set of key performance indicators relating to the NHS priorities and drawn from the Performance Assessment Framework.
• We will develop the NHS Scotland environment policy statement to require more efficient fuel, energy and water use in all NHS buildings.

Reducing the number of people who are in hospital longer than they should be.

• We will build on the delayed discharge action plan process. We will invest 30m a year for 3 years to provide 1,000 community and convalescent care places for people leaving hospital.

We will take action to tackle hospital acquired infection, including:

• rigorously monitoring how hospitals are meeting cleaning standards;
• supporting increased training for medical professionals to understand their role in hospital acquired infections;
• encouraging the introduction and empowerment of more specialist Infection Control Nurses who will work alongside ward managers to prevent the spread of infection.

Public service guarantees and service standards

• We will support the achievement of the national waiting time targets for cancer.
• We will maintain our commitment to free personal and nursing care for the elderly.
• We will deliver a maximum wait of 26 weeks for all outpatient appointments by the end of 2005.
• We will ensure that anyone contacting their GP surgery has guaranteed access to a GP, nurse or other health care professional within 48 hours by April 2004.
• From the end of 2003 we will guarantee treatment for inpatients within 9 months of diagnosis reducing this time to 6 months by the end of 2005.
• We will guarantee treatment for all coronary heart disease patients within 18 weeks of diagnosis, from 2004.

Addressing inequalities in health provision

• We will end postcode prescribing by ensuring drugs approved by NHS QIS are made available in each health board area.
• We will set up a review of prescription charges for people with chronic health conditions and young people in full time education or training.

Improving provision of services

• We will develop Community Health Service Centres that bring together treatment, diagnosis and support services within a single centre, to improve wellbeing. We will develop similar structures in rural areas by using, for example, outreach facilities and IT and video link technology.
• We will develop the important role of Community Hospitals and develop a strategy for sustaining small, rural and community hospitals where they are safe and effective, including the provision of minor surgery and to act as a resource to GPs.
• We will continue to protect the status of community pharmacies.
• We will ensure the resources are available to allow the routine issue of digital hearing aids and support where they are the most clinically effective option.
• We will ensure that local authorities in Scotland continue to deliver existing levels of respite care each year.
• We will strengthen patient advocacy services through the Advocacy Safeguards Agency and the Scottish Independent Advocacy Alliance.
• We will complete the programme to end the use of mixed sex wards.

Delivering improvements through our staff

Developing and supporting our workforce

• We will increase our programme to train, recruit and retain nurses and midwives bringing 12,000 into the NHS by 2007, as part of our overall improvements in workforce planning in the NHS.
• We will treble existing numbers of nurse consultants to 54.
• We confirm our commitment to the implementation of 'Agenda for Change'.
• We will develop an entitlement to continuous professional development for all staff and require all Health Boards to increase flexible working, starting with nurses, including a more diverse range of working practices and contracts.
• We will introduce further measures to attract and retain GPs and other health staffwith a wider range of incentive packages. In respect of allied health professionals and in cases of shortage, that wider range of incentives may include contributions to student loan repayments.
• We will continue our guarantee of one year's employment for all newly qualified nurses and midwives.
• We will continue to develop a wider role for nurses to get the full benefit of their skills and give them greater career opportunities.
• We will aim to increase the number of consultants in the NHS by 600 by 2006 and continue to build on that increase thereafter.
• We will ensure a total of 1,500 extra allied health professionals, such as radiographers, physiotherapists, dieticians and chiropodists.

Right time, right place

• We will implement nationally co-ordinated nursing bank arrangements to assist nurse placement across Scotland, to improve patient services and cut the costs of agency nursing.
• We will further pursue mechanisms which encourage preventive dentistry and design appropriate reward measures to support that objective.
• We recognise the need for an increase in the number of dentists and dental graduates in Scotland. We will undertake an assessment of the reasons for the shortfall in the number of dentists in some areas of Scotland and the options for addressing that.
• We will expand the capacity of dental training facilities in Scotland by establishing an outreach training centre in Aberdeen. We will consult further on the need for its development to a full dental school.

EDUCATION

Introduction

Our schools play a vital part in unlocking the potential of our children. Our goal is for every school in Scotland to be an excellent school. We will modernise comprehensive education to secure the highest standards for every child.

High level commitments

We will ensure that our children have better schools with more modern facilities to provide first class places to learn and develop:

• We will develop the largest ever school building programme in Scotland's history, renewing 200 more schools by 2006, rising to 300 by 2009. These schools should be available to the whole community and include high quality facilities for drama, music, sport, IT and in secondary schools, science laboratories
• New schools should demonstrate commitment to the highest design and environmental standards
• We will make sure that by 2007 every school is an integrated community school.

We will deliver more teachers and support staff in schools to provide more focused attention to their individual learning and development in order to improve attainment, particularly in literacy and numeracy, and to help close the attainment gap:

• We will significantly increase teacher numbers to 53,000 by 2007 and increase support staff, mostly in secondary schools
• We will target these additional teachers on reducing class sizes to a maximum of 20 in S1 and S2 for Maths and English, 25 in P1 and increasing the number of specialists working across the boundary between secondary and primary
• We will ensure that teachers have the right skills, through implementation of the national agreement on their pay and conditions, and that classroom assistants have access to development opportunities in further education.

We will provide more flexible learning and development opportunities so that pupils' experience of education is matched to their individual needs:

• We will reform the curriculum to increase pupil choice, simplifying it and making it more stimulating
• We will provide more time for learning by simplifying and reducing assessment, ending the current system of national tests for 5-14 year olds
• We will promote assessment methods that support learning and teaching
• We will measure improvement in overall attainment through broad surveys rather than relying on the national tests
• We will improve the transitions between nursery and primary and primary and secondary education so that the system fits the needs of the children
• We will introduce more flexibility in the curriculum for 3-6 year olds. We will improve pupils' confidence and attainment by changing the ethos of P1, freeing up the curriculum, introducing less formal teaching methods and enabling early professional intervention
• We will increase the number and range of specialist teachers working with primary pupils, particularly by allowing teachers to move between secondary and primary
• We will ensure that pupils have access to summer schools and camps, and that all schools have access to home-link workers and develop access to out-of-hours activity and facilities for all children
• We will enable 14-16 year olds to develop vocational skills and improve their employment prospects by allowing them to undertake courses in further education colleges as part of the school-based curriculum.

Supporting activity

A modern curriculum

• We will reform the school curriculum, to ensure that the school experience equips our young people with the skills and values they will need to live a healthy, productive and happy life in the modern world.
• We will encourage creativity with 12 months' free music tuition by Primary 6.
• We will guarantee the opportunity to learn a modern European language starting in Primary school.
• We will make sure that every pupil has the opportunity to benefit from 'Enterprise in Education'.
• We will develop curriculum materials to promote environmental awareness.
• We will emphasise citizenship, community involvement and environmental education throughout the school years, including voluntary sector and environmental involvement through work experience.
• We will encourage schools to include parenting skills in the secondary sector.
• We will continue to invest in Gaelic-medium education, including the provision of more teacher training places.

Maximising schools' performance

• We will use technology to link schools to access staff and share resources.
• We will increase devolved decision making in the use of school budgets. We will issue guidance on how to bring the proportion of the budget under the control of the Headteacher up to a minimum of 80% and move it towards 90%.
• We will support giving Headteacher Associations a place on the Scottish Negotiating Committee for Teachers.
• We will promote improved assessment of individual schools' progress as a better measure than national league tables.
• We will tackle under-performance through inspection and support.
• We will continue to work in partnership with teachers, parents and education authorities and through the national improvement framework for school education to raise standards in Scotland's schools. We will support Her Majesty's Inspectorate of Education in their responsibility to inspect and support the quality of local authority management and the improvement of school education to meet the agreed national standards. Where the established steps of inspection, professional support and development do not secure the improvements identified for the local authority, we will extend Ministerial powers to intervene, as a last resort and on the recommendations of the Inspectorate, to ensure that the action identified by the Inspectorate as necessary is taken by the local authority.

Giving every child the best start in life

• We will maintain free nursery places for every 3 and 4 year old in Scotland, helping to give every child the best possible start in their primary school.
• We will continue to work to improve the health of our children, with free fruit in Primary 1 and 2 and closer working between schools and the NHS.
• We will continue support for breakfast clubs.
• We will improve nutritional standards for school meals; end advertising of unhealthy foods in schools; work with local authorities to promote healthy eating; and actively discourage the availability of unhealthy food and drinks in schools as a condition of becoming health promoting schools.

Putting children and young people and their families first

• We will introduce financial support for all 16 to 19 year olds from low income families, to allow them to continue their education.
• We will work to strengthen the link between parents and schools, improving the quality of information that parents receive about their children's progress at every stage, replacing reports with Annual Progress Plans.

Ensuring children are safe and do not threaten the safety of others

• We will tackle violence, bullying and disruption in our schools, by building on the work of the Discipline Task Force and making truancy action schemes a priority for all education authorities.

Promoting equality, inclusion and diversity

• We will continue to include pupils in mainstream schools where this is in their best interest, but also recognising that some young people will require specialist provision, including access to specialist schools which may require co-operation across education authority boundaries.
• We will legislate to end the current bureaucratic hurdles faced by children with additional support for learning needs. We will provide a mediation and tribunal service. We will give parents and carers a greater say in the education and support provision for their child, and introduce flexibility to make sure children's education takes place in a setting and with the support that best meets their needs.
• We will put in place a national strategy for special educational needs.
• We will encourage diversity and permit local authorities to fund specialist schools.
• We will ensure gifted children have the opportunity to fulfil their talents, with appropriate access to national initiatives to give support in drama, music, sport or academic pursuits.

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