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The Scottish Government is aware that the current situation may be placing additional strain on young carers.

Although most local carer and young carer services are unable to provide face to face support at present, many are offering alternatives such as telephone counselling and online sessions. We have therefore created a new fund of £500,000 to help local carer organisations and young carer services transition to supporting carers remotely. This will include tailored advice and training to help them understand how best to keep in touch with carers and young carers in their communities

We are working with Young Scot to ensure their young carer package is suitable for those who are social distancing or self-isolating. New digital opportunities have already been launched and will continue to be added to in the coming weeks. There are also plans to launch a social media campaign to support young carers to identify themselves and sign up for these opportunities.

The Young Carer Grant is available for young carers to apply for over the phone, online or by post. As with other carer benefits certain rules have been relaxed around the application process to ensure no young carer misses out. If a young carer could not apply before their 19th birthday due to the disruption caused by the COVID-19 outbreak, they can still apply now and their application will be viewed as being made on time.

Finally, SQA and Education Scotland are working directly with Carers Trust Scotland to understand how best to support young carers and ensure they receive fair appraisals in the absence of exams.

NHS Boards and GP Practices are responsible for the delivery of immunisation programmes locally, including training of staff. There is, however, a significant multi-disciplinary workforce in place to deliver the Scottish Immunisation Programme, including practice nurses, midwives and NHS Immunisation Teams. This workforce supports the delivery of over 2 million doses a year across a range of adult and childhood vaccinations, including administering over 1.5 million flu vaccines each year to various age groups within 10 to 12 weeks.

The Scottish Immunisation Programme Group (SIPG) has a well-established structure in place to support existing immunisation programmes and the introduction of new programmes across Scotland. The Group supports activity for immunisation programmes across a number of areas including workforce training requirements, which are delivered by NHS Education for Scotland.

The Scottish Government is clear that the Scottish Immunisation Programme should continue where safely and practicably possible throughout the COVID-19 outbreak.

The Interim Chief Medical Officer, Chief Nursing Officer and Chief Pharmaceutical Officer wrote to NHS Boards, most recently on 9 April, to highlight the crucial importance of the Programme, which will help to avoid outbreaks of vaccine-preventable diseases and provide important protection to children and other vulnerable groups. The letter recognises that the delivery of some individual programmes will be logistically difficult at this time, and sets out how this should be managed. This is published at https://www.sehd.scot.nhs.uk/cmo/CMO(2020)10.pdf .

Officials are in regular communication with Public Health Scotland and NHS Boards, through the Scottish Immunisation Programme Group, to monitor successful delivery of the Programme and to provide support to delivery partners if required. This includes keeping the public updated on immunisations via www.nhsinform.scot/immunisation or by following @NHSImmuniseScot .

I am leading work to support the psychological welfare and resilience of NHS staff during the COVID-19 outbreak. I have written to Health Boards about the importance of support for workforce wellbeing, highlighting key messages and approaches, and this was included in recent Scottish Government directives issued to Health Boards on mental health services.

All Boards have developed responses to support their staff in response to the Covid-19 outbreak. These responses include staff wellbeing ‘hubs’ and services, staff helplines and phone services, links with Occupational Health and Chaplaincy services, wellbeing and mental health guidance and digital offerings in relation to staff mental health and wellbeing.

NHS Education for Scotland (NES) is taking forward national resources, training models and systems of practice support for local delivery to promote and address staff psychological wellbeing and resilience arising from the Covid-19 response. The intention is to provide a ‘ladder’ of support spanning early intervention (Psychological First Aid) to complex care. This will help with prevention, early intervention and treatment of stress, anxiety, burn out, depression and post-traumatic stress disorder (PTSD).

The education and training of psychological professionals will continue through the work of NHS Education for Scotland (NES), with adaptations to take account of current circumstances. Training numbers are being expanded. NES is also delivering a programme of education and training to equip the wider workforce in health and social care with psychosocial skills and knowledge.

In relation to (a) psychological initiatives:

I refer the member to my response to S5W-28198 on 27 April 2020. Staff working in temporary hospitals will be included in these initiatives.

All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: http://www.parliament.scot/parliamentarybusiness/28877.aspx

In relation to (b) physical welfare:

A programme of work is in progress to ensure that a range of wellbeing and practical support is in place for health and social care staff, covering guidance for staff, accommodation, catering and rest spaces.

The four UK nations’ Chief Medical Officers have identified six categories of people at highest risk of severe illness from Covid-19. This includes people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD and, people with all forms of Interstitial Lung Disease/Sarcoidosis. We have provided further details on how people in these groups have been identified on the Scottish Government website - https://www.gov.scot/publications/covid-shielding-contacts/pages/highest-risk-classification/ .

Using national NHS databases and prescribing data from GP systems we are identifying and writing to these patients with advice on how to protect themselves and access the care and treatment they need during the COVID-19 incident. This is an ongoing identification process and we are also asking GP’s and hospital clinicians to help ensure that those within the six high risk groups have received a letter.

It is important to remember that only those identified at the highest clinical risk of severe illness from COVID-19 because of their underlying health condition are being asked to take forward shielding measures. People who are in the highest clinical risk group will have received a letter giving them further advice. This letter will also include advice on how to access support for food and medication.

For people with asthma and other respiratory conditions who do not fall into the category above, the Scottish Government has published guidance and this will be reviewed and updated regularly: https://www.gov.scot/publications/coronavirus-covid-19-tailored-advice-for-those-who-live-with-specific-medical-conditions/ .

Psychologists and psychological therapists are being deployed across NHS Scotland to support the mental health and wellbeing of staff.

In terms of accessibility, digital services such as computerised Cognitive Behaviour Therapies (cCBT) are developed with a maximum reading age of 10, with the option of subtitles for those users with hearing difficulties. cCBT and internet enabled CBT are delivered through web browsers so work with the various accessibility tools such as "Read Aloud". Like telephone contact, they can be particularly helpful to those in remote and rural areas.

Language can be a significant issue in terms of equity as the majority of products will be in English. However as part of the procurement process we will only select those products that we know can be adapted to include additional language choices.

The safety and security of clients remains paramount in the current Covid-19 situation. For example, NHS 24 continues to follow its standard procedures within the Mental Health Hub in terms of the triage and assessment procedures in place. All calls to the 111 service, including the Mental Health Hub, are managed within the NHS 24 clinical and governance processes so there is no compromise of governance and security during the Covid-19 situation.