69-605: NHS Lothian is one of the 14 regions of NHS Scotland . It provides healthcare services in the City of Edinburgh , East Lothian , Midlothian and West Lothian council areas. Its headquarters are at Waverley Gate, Edinburgh It is responsible for the care provided by around 29,000 staff at a number of locations: The Edinburgh Community Health Partnership (CHP) has responsibilities around delivering community health services and also addressing inequalities in Edinburgh for NHS Lothian. When
138-583: A private finance initiative scheme: Prescription charges were abolished in Scotland in 2011. Alex Neil defended the abolition in 2017 saying that restoring the charge would be a false economy , "Given that it costs on average £4,500 per week to keep patients in an acute hospital in Scotland, it's actually cheaper to keep them at home and give them the drugs to prevent them going into hospital." The National Health Service and Community Care Act 1990 introduced GP fundholding for certain elective procedures on
207-423: A comprehensive medical record, usually affording some continuity of care. There is no option to self-refer to specialists in Scotland unlike many European countries. GP surgeries consist of partner GPs who are responsible for running the practice, and may include GPs employed by the practice and paid a salary, but who do not have any responsibility in running the surgery. In some instances, GPs are directly employed by
276-449: A deficiency in the panel system , which required workers who earned less than £160 per year to pay 4d per week. Fourpence per week was beyond the means of most crofters at the time, who were subsistence farmers but often provided many troops for British armed forces. Average crofting families' income in some areas could be as low as £26 per annum (10/- or 120d per week) or even lower. The additional challenges of delivering medical care in
345-815: A detailed plan for the future of health provision based on the Cathcart report. Following the publication of the Beveridge Report in 1942, the UK Government responded with a white paper , A National Health Service ( Cmd. 6502) in 1944 led by the Conservative MP and Minister for Health Henry Willink . In its introduction, the white paper laid out the Government's intention to have the new health service operate in Scotland-- The UK Parliament passed
414-498: A go-between for the UK and Scottish Governments and Parliaments. However, due to the secretary's position as a minister in the British government, the convention of Cabinet collective responsibility applies, and as such the post is usually viewed as being a partisan one to promote the UK government's decision-making in Scotland, as adherence to the convention precludes doing anything else. With
483-562: A minister of state for England with responsibility for English local government . More broadly, the UK Government advocates that all UK Government cabinet ministers with responsibility for a territorial secretary of state position are responsible for: The post of secretary of state for Scotland existed after the Union of the Parliament of Scotland and the Parliament of England in 1707 till
552-523: A new devolved Scottish Parliament in 1999 following the Scotland Act 1998 . The office holder works alongside the other Scotland Office ministers . The secretary of state for Scotland is supported by their deputy, the parliamentary under-secretary of state for Scotland . The incumbent is Ian Murray , following his appointment by Prime Minister Keir Starmer in July 2024. The corresponding shadow minister
621-518: A new national Centre for Sustainable Delivery was established to bring together national programmes for scheduled and unscheduled care, waiting times and best practice – and ensure health boards are implementing them. There are 14 health boards (HBs) which are the upper tier of the Scottish health care system, reporting directly to the Scottish Government. They were created in 1974 as a result of
690-535: A plan for improving oral health and modernising dental practices was put into place, known as 'Childsmile', which provides preventive care such as proper brushing technique, tooth varnish and dietary advice. This has resulted in 60% of children in Scotland having no obvious signs of tooth decay. An incentive programme for GPs was established in 2004, known as the Quality and Outcomes Framework (QOF) were introduced in order to reward and incentivize good practice and provided
759-422: A prescription at very low prices in most chemists and supermarkets. Most optometrists in Scotland also provide NHS services, and provide eye examinations , which includes retinal health checks and other eye screening services in addition to sight tests. Entitlements are mainly for corrective lenses and a predetermined set of frames - which were once known as 'NHS glasses' which attracted some social stigma until
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#1732876564801828-539: A single health authority, overseeing the planning and delivery of all the region's local health services. In 2023, the health board of NHS Lothian publicly announced that they would be providing reparations for slavery after discovering that the Royal Infirmary of Edinburgh owned a slave plantation in Jamaica from 1750 to 1893 (with slavery being abolished on the island in 1833 ). The plantation, known as Red Hill Pen,
897-460: A ten-digit number known as the CHI Number . These are used to uniquely identify individuals, avoiding problems such as where health records of people with similar birth dates and names may be confused, or where ambiguously spelled or abbreviated names may lead to one patient having several different health records. In addition, CHI numbers are quoted in all clinical correspondence to ensure that there
966-442: A voluntary basis. Fundholding gave GPs significant influence over Trusts' decision making as a significant source of funding. GP Fundholding was subsequently abolished with the function transferring to Primary Care Trusts in 1998. In 2001, NHS 24 , was established to provide advice and triage services for patients outside of the 'core hours' of 08:00–18:30 on any working day. They can also advise of pharmacy opening hours. In 2002,
1035-600: A way for GP surgeries to increase their income. This was abolished in Scotland in 2015 as QOF compliance was a significant administrative burden for GPs. The Scottish Government and the British Medical Association agreed the 2018 Scottish General Medical Services Contract that came in to force 1 April 2018. In 2008, the Scottish Government introduced the Scottish Patient Safety Programme, which aimed to reduced iatrogenic illness by changing
1104-449: A way that might improve public representation. This plan was abandoned in 2013 after trials in Fife and Dumfries and Galloway resulted in low voter turnout . Local health boards are supported by seven national special health boards providing national services, some of which have further publicised subdivisions, including: The seven boards are supported by Public Health Scotland , which
1173-458: Is a substantial effort to develop a drone delivery service. The University of Strathclyde , NHS Grampian , NATS Holdings , AGS Airports and other partners form a consortium, Care and Equity – Healthcare Logistics UAS Scotland known as 'CAELUS' which has designed drone landing stations for NHS sites across Scotland and developed a virtual model of the proposed delivery network. It is testing whether drones will improve logistics services, including
1242-601: Is additionally responsible for partnership between the UK Government and the Scottish Government , as well as relations between the Parliament of the United Kingdom and the Scottish Parliament . Much of the secretary of state for Scotland's responsibility transferred to the office of the first minister of Scotland upon the establishment of a new Scottish Executive , since renamed the Scottish Government, and
1311-515: Is an estimate that helps to take account of full and part-time work patterns. Scotland's healthcare workforce includes: Prior to the creation of NHS in Scotland in 1948, the state was involved with the provision of healthcare, though it was not universal. Half of Scotland's landmass was already covered by the Highlands and Islands Medical Service , a state-funded health system run directly from Edinburgh, which had been set up 35 years earlier to address
1380-626: Is no uncertainty over the patient in question. A similar system of NHS reference numbers has since been instituted by NHS England and Wales. In 2000, the NHS boards were starting to help out researchers with their studies. The Scottish Dental Practice Board , for example, was helping out a study which looked at the significance of orthodontic treatment with fixed appliances. The SDPB shared 128 subjects with these researchers for analysis. The SNP led Scottish Government, elected in May 2007, made it clear that it opposed
1449-578: Is responsible for public health, including national health protection, and health education from April 2020) NHS Health Scotland , Health Protection Scotland and Information Services Division were succeeded by Public Health Scotland in April 2020. This new agency is a collaborative approach by both the Scottish Government and COSLA as a result of the Public Health Reform Programme. The NHS in Scotland does have some services provided by
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#17328765648011518-607: Is the shadow secretary of state for Scotland . The post was first created after the Acts of Union 1707 created the Kingdom of Great Britain from the Kingdom of England and the Kingdom of Scotland . It was abolished in 1746, following the Jacobite rising of 1745 . Scottish affairs thereafter were managed by the lord advocate until 1827, when responsibility passed to the Home Office . In 1885
1587-1354: The British Medical Association , attacked the decision to release weekly reports on the Accident and Emergency 4-hour wait target in June 2015. In June 2015, 92.2% of patients were admitted or discharged within 4 hours against a target of 95%. He said, "The publication of these weekly statistics completely misses the point and diverts attention from the real issues in our health service." Secretary of State for Scotland Charles III William , Duke of Rothesay Swinney government The Rt Hon John Swinney MSP The Rt Hon John Swinney MSP Kate Forbes MSP Sixth session Alison Johnstone MSP Angela Constance MSP Dorothy Bain KC The Rt Hon Lord Carloway KC PC United Kingdom Parliament elections European Parliament elections Local elections Referendums Starmer ministry The Rt Hon Keir Starmer MP The Rt Hon Ian Murray MP The secretary of state for Scotland ( Scottish Gaelic : Rùnaire Stàite na h-Alba ; Scots : Secretar o State fir Scotland ), also referred to as
1656-758: The General Dental Council , optometrists by the General Optical Council , pharmacists by the General Pharmaceutical Council , and allied health professionals by the Health and Care Professions Council . Inspection of premises is undertaken by Healthcare Environment Inspectorate and the Care Inspectorate . There are separate institutions, independent of government such as Academy of Medical Royal Colleges and Faculties in Scotland ,
1725-567: The Hospital for Tropical Diseases in London. These trusts also treat patients from healthcare systems outside the UK. The Mental Welfare Commission for Scotland is an independent statutory body which protects people with a psychological disorder who are not able to look after their own interests. It is funded through the Scottish Government Health & Social Care Directorate, and follows
1794-529: The Jacobite rising of 1745 . After the rising, responsibility for Scotland lay primarily with the office of the home secretary , usually exercised by the lord advocate . Office thereafter vacant. The secretary for Scotland was chief minister in charge of the Scottish Office in the United Kingdom government . The Scotland Office was created in 1885 with the post of secretary for Scotland. From 1892
1863-493: The National Health Service (Scotland) Act 1947 , which came into effect on 5 July 1948. This foundational legislation has since been superseded. This Act provided a uniform national structure for services which had previously been provided by a combination of the Highlands and Islands Medical Service , local government, charities and private organisations which in general was only free for emergency use. The new system
1932-609: The National Health Service (Scotland) Act 1972 and are based on groups of the local government districts that existed between 1975 and 1996. There were initially 15 HBs in 1974 but the Argyll and Clyde HB was abolished and its area absorbed into the Highland and Greater Glasgow HBs on 1 April 2006, with the latter renamed to NHS Greater Glasgow and Clyde. The part of the NHS Argyll and Clyde area which transferred to NHS Highland corresponds to
2001-579: The National Waiting Times centre to address waiting lists and limit use of the private sector. To have access to NHS services, patients should register with a General Practice . Most often this will be an independent contractor who has agreed to provide general medical services to patients, funded on a capitation basis, with weighting given for the age distribution, poverty, and rurality. Various services are provided free of charge by General Practitioners (GPs), who are responsible for maintaining
2070-734: The Nuffield Trust and the Health Foundation produced a report comparing the performance of the NHS in the four countries of the UK since devolution in 1999. They included data for the North East of England as an area more similar to the devolved areas than the rest of England. They found that there was little evidence that any one country was moving ahead of the others consistently across the available indicators of performance. There had been improvements in all four countries in life expectancy and in rates of mortality amenable to health care. Despite
2139-560: The Royal College of Physicians of Edinburgh , the Royal College of Surgeons of Edinburgh , and the Royal College of Physicians and Surgeons of Glasgow which are distinct from their counterparts elsewhere in the United Kingdom which support professionals in Scotland. Other subdivisions of the Scottish NHS include: During the COVID-19 pandemic , NHS Scotland established Test and Protect as
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2208-779: The Royal Hospital for Sick Children . Performance has been rated the poorest in Scotland. Only 89.4 per cent of emergency patients were treated or admitted within four hours in November 2017. The Royal Infirmary of Edinburgh and Western General Hospital have nurse-practitioner led Minor Injury Units. They are open every day of the year and treat bone breaks, dislocations sprains, wounds and burns. The Royal Infirmary of Edinburgh's Minor Injury Unit also treat eye problems. They are an alternative to Accident and Emergency departments and helps to appropriately treat patients whilst helping to reduce unnecessary A & E attendance. NHS Lothian
2277-495: The Scotland Office . From June 2003 to October 2008, the holder of the office of secretary of state for Scotland also held another Cabinet post concurrently, leading to claims that the Scottish role was seen as a part-time ministry. With the advent of legislative devolution for Scotland in 1999, the role of secretary of state for Scotland was diminished. Most of the functions vested in the office since administrative devolution in
2346-460: The Scottish Parliament . It is currently administered through the Health and Social Care Directorates of the Scottish Government . The current Cabinet Secretary for Health and Social Care is Neil Gray , and the head of staff is the director-general health and social care and chief executive of NHS Scotland, Caroline Lamb. NHS Scotland had an operating budget of £ 15.3 billion in 2020/21. Health and social care are devolved issues in
2415-652: The Scottish secretary , is a secretary of state in the Government of the United Kingdom , with responsibility for the Scotland Office . The incumbent is a member of the Cabinet of the United Kingdom . The Secretary of State for Scotland serves as the custodian of the Scottish devolution settlement as outlined in the Scotland Act 1998 , and represent Scottish interests within the UK Government as well as advocate for UK Government policies in Scotland. The secretary of state for Scotland
2484-433: The 19th century were transferred to the newly established Scottish Ministers upon the opening of the Scottish Parliament , or to other UK government ministers. Most of the functions and powers of the secretary of state for Scotland transferred to the first minister of Scotland as the head of the Scottish Government . Donald Dewar served as the first first minister of Scotland between 1999–2000, having previously served as
2553-548: The Argyll and Bute council area. According to Public Health Scotland data, the 2019 population sizes of the regional health boards were estimated to be: In January 2008, the Scottish Government announced plans for legislation to bring in direct elections as a way to select people for non-executive positions on health boards. The Health Committee of the Scottish Parliament had supported plans for directly elected members as
2622-516: The CHPs were established in 2005 they provided a single management structure, taking over control of community services which were transferred under their control. On 1 April 2007, Edinburgh Community Health Partnership was formed by the merging of 2 CHPs: Edinburgh North and Edinburgh South. Accident and emergency departments are located within the Royal Infirmary of Edinburgh , St. John's Hospital and
2691-486: The NHS in England – such as NHS Business Services Authority , which processes the payment of dental, optical and pharmacy vouchers and negotiates with pharmaceutical suppliers to negotiate prices per-item down. The costs for the medicines consumed is borne by the health board that patient's GP surgery is based in. Some very complex, low volume, highly-specialist hospital services are also provided by NHS trusts in England, such as
2760-490: The NHS treatment and pays for the composite restoration as temporary private patient, but remains an NHS patient for future checkups. Community pharmacies in Scotland also provide prescribed medicines free of charge, where the patient is registered with a GP Surgery based in Scotland, and where the appropriate prescription-voucher is given. Like GPs, they are private providers who deliver NHS services under contract. Pharmacists are increasingly delivering services which were once
2829-607: The Scottish Parliament in Edinburgh . Moreover, the secretary of state for Scotland cannot introduce any bill or legislation in the UK Parliament relating to a devolved matter under the convention that the UK Government will not introduce legislation on devolved areas without the agreement of the Scottish Parliament. The secretary of state is also the group leader of the Scottish MPs from the government party. The office mainly acts as
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2898-670: The Scottish Parliament Acted to introduce free personal care for patients aged over 65 in Community Care and Health (Scotland) Act 2002. The Scottish Parliament abolished Primary Care Trusts in the National Health Service Reform (Scotland) Act 2004, which abolished the internal market in Scotland and replaced NHS Trusts with 15 territorial health boards. In 2004, GPs were no longer required to provide out of hours services unless they opted into doing so. In 2005,
2967-410: The United Kingdom and the separate public healthcare bodies of Scotland, England and Wales are each commonly referred to as " National Health Service ". The NHS in Scotland was created as an administratively separate organisation in 1948 under the ministerial oversight of the Scottish Office , before being politically devolved in 1999. This separation of powers and financing is not always apparent to
3036-416: The four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland . At the founding of the National Health Service in the United Kingdom, three separate institutions were created in Scotland, England and Wales and Northern Ireland . The NHS in Scotland
3105-428: The general public due to the co-ordination and co-operation where cross-border emergency care is involved. Approximately 160,000 staff work across 14 regional NHS Boards, seven Special NHS Boards and one public health body, More than 12,000 of these healthcare staff are engaged under independent contractor arrangements. Descriptions of staff numbers can be expressed as headcount and by Whole-Time Equivalent (WTE) which
3174-423: The hotly contested policy differences between the four countries there was little evidence, where there was comparable data, of any significant differences in outcomes. The authors also complained about the increasingly limited set of comparable data on the four health systems of the UK. In 2014–2015 more than 7,500 NHS patients were treated in private hospitals to meet waiting times targets. Dr. Peter Bennie, of
3243-462: The local health board, such as in parts of the Highlands and Islands. The NHS in Scotland also covers dentistry for patients who have registered with a dentist who has agreed to provide services to NHS patients. Most dentists in Scotland have a mixture of NHS patients and private patients . Check-ups are free, however dentists charge patients a regulated fee. Patients in Scotland must pay up to 80% of
3312-412: The management of NHS boards. Local authority nominees were added to board membership to improve co-ordination of health and social care . The remaining 16 Trusts were dissolved from 1 April 2004. Hospitals are now managed by the acute division of the NHS board. Primary care services such as GPs and pharmacies would continue to be contracted through the NHS board, but from 2004 were considered part of
3381-531: The national contact tracing service to minimise the spread of the virus within Scotland. The Central Register keeps records of patients resident in Scotland who have been registered with any of the health systems of the United Kingdom. It is maintained by the Registrar General . Its purposes include keeping GPs' patient lists up to date, the control of new NHS numbers issued in Scotland and assisting with medical research. Scottish patients are identified using
3450-400: The post of secretary for Scotland was re-created, with the incumbent usually a member of the Cabinet . In 1926 this post was upgraded to a full secretary of state appointment. After the 1999 Scottish devolution , the powers of the Scottish Office were divided, with most transferred to the Scottish Government or to other British government departments , leaving only a limited role for
3519-647: The range of frames was extended. Hospital services are delivered directly by the National Health Service in Scotland. Since devolution, Scottish healthcare policy has been to move away from market-based solutions and towards direct delivery, rather than using the private or voluntary sectors. Proposals for the establishment of fifteen NHS boards were announced by the Scottish Executive Health Department in December 2000. Further details about
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#17328765648013588-465: The remit of Community Health Partnerships (CHPs), structures based largely on local authority boundaries and including local authority membership of their boards. By April 2014, there were new joint working arrangements in place between the NHS boards and local authorities came into effect that also included responsibility for social care. Their new organisations, which took over from CHPs are called Health and Social Care Partnerships (HSCPs). In 2021
3657-450: The responsibilities of GPs, such as flu vaccinations as well as offering advice on skin problems, gastrointestinal problems and other minor illnesses. Pharmacies in Scotland are frequently located inside Chemists' shops and supermarkets. While there are no prescription charges in Scotland, prescription-vouchers are not ordinarily given in Scotland for certain medicines - such as acetominophen and ibuprofen - as these are available without
3726-604: The rise of the Scottish National Party (SNP) in both the Scottish Parliament and the British Parliament and the resultant interest in Scottish Independence, the secretary of state's role has also subsequently increased in prominence. The Scotland Office itself has received a cumulative increase in budget of 20% from 2013 to 2017, with a 14.4% increase in 2015/16 alone. The UK government's website lists
3795-415: The role and function of the unified NHS health boards were provided in May 2001. From 1 October 2001 each geographical health board area had a single NHS board that was responsible for improving health and health services across their local area, replacing the previous decision-making structures of 43 separate boards and trusts. In April 2004, Scotland's health care system became an integrated service under
3864-503: The safety culture to be more in line with the aviation industry, by providing clinicians with skills in improvement methodology and root cause analysis. In 2022 an extra £82.6 million was announced to bolster pharmacy support for repeat prescriptions and medication reviews in GP practices. The same year, NHS Scotland recruited 191 nurses from overseas. The nurses were recruited from several countries, including India and Philippines. A plan
3933-533: The same financial framework as the NHS in Scotland. The Scottish Health Council took over from local Health Councils on 31 March 2005. Regulation of most medical practitioners is a reserved matter, with doctors regulated by the General Medical Council of the United Kingdom, nurses by the Nursing and Midwifery Council , dentists, dental therapists, dental hygienists, dental technicians and dental nurses by
4002-618: The secretary of state for Scotland between 1997–1999. However, the secretary of state does represent Scotland in the Cabinet of the United Kingdom on matters that are not devolved to the Scottish Parliament, and also holds Scotland Questions on the first Wednesday of every month between 11:30 am and 12 noon, when any member of Parliament can ask a question on any matter relating to Scotland. However, devolved issues are not usually raised by MPs, as these are decided solely by Scottish Government policy, and influenced, discussed and voted on by members of
4071-540: The secretary of state for Scotland's responsibilities as being: This seeming lack of responsibility has in recent years seen calls from opposition MPs for the scrapping of the role and the Scotland Office. Robert Hazell has suggested merging the offices of secretary of state for Northern Ireland , Scotland and Wales into one secretary of state for the Union, in a department into which Rodney Brazier has suggested adding
4140-749: The sparsely populated highlands and islands with poor infrastructure were also funded by the Highlands and Islands Medical Service. During the Second World War, the Emergency Hospital Service (Scotland) built many hospitals intended to treat wartime casualties and injuries. These hospitals initially lay idle and so the Scottish Secretary at the time decided to use the hospital capacity to reduce long waiting lists for treatment. Scotland also had its own distinctive medical tradition, centred on its medical schools rather than private practice, and
4209-430: The total cost of the treatment unless they qualify for free treatment or help with costs. Dentists are remunerated through a voucher towards treatment and patients can choose to have more expensive treatments if they are willing and able to do so. This is mostly commonly seen with dental amalgam restorations on molars, which are available on the NHS, whereas composite resin restorations are not. The patient 'opts-out' of
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#17328765648014278-405: The transport of laboratory samples, blood products, chemotherapy and medicines. It is hoped that this will provide equity of care between urban and remote rural communities. At present patients in remote areas may have to travel for hours to reach a hospital able to provide specialised treatment. Skyports , a drone operator, is running flight trials and live flights should start in 2023. In 2014
4347-579: The treatment of more than 4,500 patients in order to meet waiting time targets. In an attempt to comply with the Scottish Treatment Time Guarantee, a 12-week target for inpatient or day-case patients waiting for treatment, the board spent £11.3 million on private hospital treatment for NHS patients in 2013-14. NHS Scotland NHS Scotland , sometimes styled NHSScotland , is the publicly–funded healthcare system in Scotland and one of
4416-430: The use of partnerships between the NHS and the private sector. Health Secretary Nicola Sturgeon voiced opposition to what she termed the "creeping privatisation" of the NHS, and called an end to the use of public money to help the private sector "compete" with the NHS. In September 2008, the Scottish Government announced that parking charges at hospitals were to be abolished except 3 where the car parks were managed under
4485-524: Was accountable to the Secretary of State for Scotland rather than the Secretary of State for Health as in England and Wales. Prior to 1948, a publicly funded healthcare system, the Highlands and Islands Medical Service , had been established in Scotland in 1913, recognising the geographical and demographic challenges of delivering healthcare in that region. Following Scottish devolution in 1999, health and social care policy and funding became devolved to
4554-542: Was based at the Deaconess House until 2010 when it moved to Waverley Gate, an office development within the facade of the former GPO in the centre of Edinburgh. NHS Lothian was established in 2001 as the 'umbrella' organisation for all Lothian health services. There were also three NHS trusts operating in the area - Lothian University Hospitals, Lothian Primary Care and West Lothian Healthcare. The dissolution of these bodies in 2003-2004 meant that NHS Lothian would act as
4623-640: Was funded from central taxation and did not generally involve a charge at the time of use for services concerned with existing medical conditions or vaccinations carried out as a matter of general public health requirements; prescription charges were a later introduction in 1951. Current provision of healthcare is the responsibility of 14 geographically based local NHS boards, seven national special health boards, supported by Public Health Scotland , plus many small contractors for primary care services. Hospitals, district nursing services and healthcare planning are managed by health boards. Government policy has been to use
4692-461: Was left to the Royal Infirmary of Edinburgh through the will of Scottish surgeon Archibald Kerr along with 39 slaves . According to the BBC , the Royal Infirmary of Edinburgh used the wealth generated from Red Hill Pen to "buy medicines, construct a new building, employ staff, and heal Edinburgh's "sick poor"." Between April 2014 and February 2015 the board paid out almost £8 million to private hospitals for
4761-485: Was made to hire another 203 foreign nurses through recruitment agencies. A contract was awarded to Inhealthcare for remote monitoring services across Scotland. This will enable patients to record relevant information at home and relay the readings to NHS teams for analysis using a mobile app or landline telephone. It will be used to manage hypertension, chronic obstructive pulmonary disease, asthma, heart disease, diabetes, depression, malnutrition, cancer and COVID. There
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