Ongoing talks to avert strike by nurses in Scotland

1. More talks will take place this week in a bid to avert nurses in Scotland going on strike, the first minister tells a news briefing on the state of the NHS
2. Nicola Sturgeon says discussions would be ongoing but the government has "no more money" for this year and is not "holding anything back"
3. The first minister says flu, Covid and Strep A have put enormous pressures on the hospital system with bed occupancy at 95%
4. She adds that a plan is being put in place to speed up discharges from hospital with additional care home beds being found
5. At the weekend, Dr Lailah Peel, deputy chair of BMA Scotland, said patient safety was now "at risk every day" in A&E departments
6. Ms Sturgeon is asked about Dr Peel's comment and says she would never criticise the concerns of clinicians as they see them, but points out that the vast majority of patients receive "excellent care"
7. The Scottish Conservatives say the government's winter planning is "too little too late"

Catch up on the main points

That brings our coverage of the Scottish government's media briefing to a close.

Here's a quick reminder of the main points from today:

Scotland's hospitals are "almost completely full", with bed occupancy exceeding 95% last week, the first minister has said.

Nicola Sturgeon said services were facing "truly unprecedented" pressures.

Demand for hospital beds had been driven up by "extraordinary" levels of winter flu, rising rates of Covid infections and cases of Strep A.

Ms Sturgeon said more work needed to be done to prevent unnecessary hospital attendances and to speed up discharges.

Sturgeon doesn't truly have faith in Yousaf - Tories

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Dr Sandesh Gulhane, the Scottish Conservatives' health spokesperson, has called Ms Sturgeon's statement "too little, too late".

He says there were no concrete measures announced and accuses her and the health secretary of being in denial over being "caught off guard" by NHS winter pressures.

Although the FM said Mr Yousaf was doing a very good job, Dr Gulhane believes she "doesn't truly have faith in him".

“While she recognised that most of the capacity problems stem from the SNP’s failure to tackle delayed discharge, she refuses to drop her reckless plans for a wasteful, centralised National Care Service," he added.

“Given his undeserved vote of confidence, the health secretary needs to spell out an alternative plan in his statement to parliament tomorrow, including the measures the Scottish Conservatives outlined in our Real Winter Recovery Plan.”

FM says she has never used private health care

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Next up is the topical issue of private health care.

Prime Minister Rishi Sunak has repeatedly refused to say whether he uses private healthcare, insisting it is "not really relevant".

Ms Sturgeon is asked if wealthier people should be encouraged to go private and whether the panel use private health care.

"No I don't. I never have." replies the FM.

Ms Sturgeon adds: "I wouldn't encourage people to go private."

The health secretary also says he has not used private health care, but the deputy chief medical officer says some of his family have.

Do care homes have bookable bed capacity?

Sticking with the care theme, Ms Sturgeon is asked how many care home beds will be needed as part of government plans to free up hospital beds.

The FM replies they will book as many care home beds as they can.

"We know there is some spare capacity there."

Sturgeon: I'd like to go further on social care pay

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The first minister is asked about pay rates for social care workers and says she would like them to be increased.

Ms Sturgeon says historically the job was “not valued as much as it should be” and she would like to offer further pay hikes to attract more people to the profession.

The first minister says the controversial plan for a national care service could pave the way for better and nationally-agreed pay and conditions.

Unions have previously questioned how social care workers would benefit from the proposed centralised system.

Changes 'will barely scratch surface' of crisis - Labour

While the FM's briefing goes on, Scottish Labour's health spokesperson Jackie Baillie has echoed the Tories' call to sack Humza Yousaf.

She says the role should go to someone "up to the job", adding the FM spent more time "making excuses than setting out solutions".

She said: "Faced with the most difficult winter in NHS history, the SNP are deflecting blame and rehashing the same old promises they have been making for years.

"These changes will barely scratch the surface of this deadly crisis and fail to grapple with the major structural problems clinicians are raising."

BACKGROUND: Nurses in Scotland to strike after rejecting pay deal

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Nurses in Scotland are set to strike after voting down the latest pay offer for NHS workers.

Royal College of Nursing (RCN) Scotland members rejected an average increase of 7.5%. The union said it was planning for industrial action and would announce dates early next year.

Royal College of Midwives (RCM) members also rejected the pay deal.

Health Secretary Humza Yousaf said he was disappointed but would continue negotiations with unions.

In the RCN, 82% voted against the offer.

Earlier last month, the GMB union also rejected the offer.

What is being done to avert strike action?

The FM is asked what is being done to avert strike action by NHS staff, given the RCN and GMB unions are going ahead with walkouts.

"We are doing everything and will continue to do everything we can to avert industrial action in the National Health Service," replies Ms Sturgeon.

She says Scotland is the only part of the UK that has so far averted industrial action.

The FM also points out the current pay offer has been accepted by unions representing the majority of NHS staff in Scotland and is considerably better than in the rest of the UK.

A 7.5% increase here compared with 4% in other parts of the UK, she explains, and adds: "Discussions are ongoing.".

'Delays matter and delays have consequences'

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Record delays at emergency departments are having consequences for patients, says Scotland’s deputy chief medical officer.

Asked about the Royal College of Emergency Medicine’s estimates on the number of patients dying as a result of waiting for a bed at A&E, Graham Ellis says “delays matter and delays have consequences”.

The Scottish government official says this is why changes to the health service which put prevention and tackling inequalities to the fore are vital.

Ms Sturgeon says it “would be wrong for me to say” A&E delays are not having any clinical impact and adds it would be a “dereliction of duty” to suggest there are easy solutions to the current crisis.

A political edge to the NHS debate

Philip Sim

BBC Scotland political correspondent

For all the issues it is facing, the NHS is obviously still a prized national asset – and that means there is always a political edge to discussion of how governments are looking after it.

For example, Ms Sturgeon has repeatedly insisted that services in Scotland are performing better than those elsewhere in the UK.

Meanwhile, Prime Minister Rishi Sunak claimed on Sunday that England’s A&E waiting times were better than those in Scotland and Wales.

This is a bit like the rows we tend to see over budgets – there are enough statistics and measurements out there that both governments can cherry-pick some which back their own position.

But what is probably more important than the political rhetoric is the experience that patients have on the front lines.

People waiting to be seen in A&E won’t care who has the statistical edge in which part of the country.

That’s why the immense demand on services is also piling pressure on politicians in both Edinburgh and London – both need to be seen to be doing their utmost to prioritise and protect the NHS, and getting services back on track.

GP surgeries opening on Saturdays is a good idea, says FM

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An initiative to open some GP practices in Lanarkshire on Saturdays is praised by Ms Sturgeon.

The first minister says the move by NHS Lanarkshire was a good one and that the Scottish government wants to “support health boards who want to do that and feel it will make a contribution to what they are dealing with”.

Graham Ellis, the deputy chief medical officer, adds “the way in which we deliver care is likely to change” over time with more and more patients seeing someone other than a GP.

FM defends Health Secretary Humza Yousaf

The first minister is asked if she accepts her government's handling of the NHS has contributed to the pressures.

The health secretary is then asked if he is out of his depth in this crisis.

The first minister replies she will answer for him, saying: "Humza is a health secretary doing a very good job under very difficult circumstances."

Ms Sturgeon adds that being health secretary is perhaps the toughest job in government.

She points out: "Health services everywhere are dealing with these pressures."

Mr Yousaf says the role of health secretary is the toughest he has undertaken but he pledges to continue.

Boards can declare critical incidents, says Yousaf

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Back at the briefing, and Humza Yousaf says health boards can declare critical incidents if they feel it will help them deal with the pressures facing the NHS.

The health secretary says the Scottish government is currently reluctant to take steps such as a blanket cancellation of planned operations as they are “not benign acts” and would add to waiting times.

But Mr Yousaf says he has issued guidance to health boards to say that if they want to declare a critical incident then “there’s no in principle objection from the government”.

The health secretary says these decisions should be taken at a local level.

Tories call for Humza Yousaf to be sacked

The Scottish Conservatives have tweeted The Scotsman's front page, which is based on comments from Dr Lailah Peel, deputy chair of BMA Scotland.

Dr Peel told the BBC Scotland's hospitals are "not safe" for patients under current winter pressures on the NHS - something a number of papers splashed today.

The Tories say Health Secretary Humza Yousaf should be sacked since he "failed to act" on his own warnings about a looming NHS crisis.

Hospitals are safe, insists Sturgeon

Asked about the BMA Scotland verdict that some Scotland’s hospitals are dealing with unsafe levels of demand, Ms Sturgeon says she did not underestimate the “exceptional” situation.

But she adds it is important to stress the “NHS is there safely for those who need it”.

Graham Ellis, Deputy Chief Medical Officer for Scotland, adds “we do think hospitals are a safe place if you need emergency medical care".

FM being seen to be leading from the front

Philip Sim

BBC Scotland political correspondent

Nicola Sturgeon didn’t come along today with a big new year announcement about NHS reforms or funding.

As with many of the pandemic-era briefings delivered from the same familiar stage, this was more about being seen to be leading from the front on an issue of significant national concern.

We all learned during the Covid-19 years how important communication and messaging can be during a public health crisis.

It was in that spirit that the first minister wanted to acknowledge the pressures facing the health services, and provide some updates on what is being done about them.

And she also wanted to send a message to the public about “unnecessary attendances at hospitals” – something which is also the subject of a new series of TV ads fronted by another familiar pandemic-era face, Prof Jason Leitch.

Ms Sturgeon underlined that “the NHS is there for those who need it” – but that there is an expanding range of other advice and support available short of actually attending at overstretched hospitals.

FM details face covering advice

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Anyone with symptoms of a respiratory infection should try to stay at home if at all possible, says the FM.

If you have to leave home then wear a face mask, she says.

Ms Sturgeon says those over the age of 12 should wear face coverings when on public transport or in public indoor spaces.

More on that NHS statement in Holyrood tomorrow

The first minister concludes by raising the issue of escalation contingencies.

She says ministers have emergency powers and can direct health boards.

Ms Sturgeon reiterates the NHS faces exceptional pressures across the country.

There will be more detail from Health Secretary Humza Yousaf in the Scottish Parliament tomorrow.

The FM calls on people to take precautionary measures to avoid Covid and flu.

'More does need to be done now'

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"More does need to be done now," continues the FM, pointing to reducing unnecessary attendance in hospitals as well as tackling delayed discharges.

She confirms NHS 24 staffing will increase further and there is a new app coming, as well as extensive self-help guides.

Ms Sturgeon says primary care capacity is being maximised.

She says there will be more cash for health and social care partnerships, with details to come in a statement in Holyrood tomorrow.

£1bn increase in health revenue spend next year

NHS staff continue to deliver excellent care, says the FM.

However, in some key areas the system is not providing the speed of treatment desired.

Ms Sturgeon says significant action to address this is already under way, for example £600m extra funding in October.

She points to the draft budget and an increase in health revenue of £1bn in the next financial year.