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My officials previously proposed a phased commencement of the Health and Care (Staffing) (Scotland) Act 2019 (the Act) and this remains the Government’s intention. Commencement of the Act will also require regulations to be made and there is very limited parliamentary time left in this session to progress secondary legislation. Due to pressures on that limited time caused by the priority of Covid-19 and EU Exit legislation, the current focus has been on critical legislation that requires to be progressed before the dissolution of Parliament for the 2021 election.

Prior to Covid, the Act Implementation Team were undertaking a programme of preparatory work to lay the way for implementation. This included the preparation of statutory guidance; a series of stakeholder engagement events to consult on the guidance, including visits to every Board and establishing 13 distinct working groups for specific guidance chapters; the instructing of regulations, and the preparation for detailed end to end testing of the Act’s statutory guidance at four Health Boards. Following on from this process a public consultation would take place.

This work had not concluded pre-Covid when the Act became one of a number of areas of policy/legislation to be suspended in order to prioritise the Government’s response to the pandemic. A significant amount of work was undertaken to draft guidance prior to the pandemic, however further work is still required. It will also be important to reflect on learning from Covid-19 and whether some redrafting of the current draft guidance will be required as a result.

Given that Covid-19 has considerably stretched resources within Boards and the wider health and social care sector, as well as the continuing uncertainty facing us, we believe it is not practical to establish a definitive implementation timetable for bringing the Act into force. However, the Scottish Government is resolute in its continuing commitment to the Act and its principles. Health and social care staff across Scotland have risen to the very significant challenges posed by Covid, showing incredible resolve and flexibility, and we will ensure this Act is implemented effectively to drive positive change for NHS staff and patients.

The actions that the Scottish Government has taken to develop its duties which correspond to the Health and Care (Staffing) Scotland Act 2019 (the Act) have, as with most aspects of health and social care policy, been significantly affected by our need to respond to the global pandemic emergency.

While the implementation of the Act has been paused, Boards have continued to use workload tools where there has been capacity to do so. Therefore, since the initial lockdown we have focused on supporting Boards with necessary workload and workforce planning as part of their response.

Scottish Government has been funding and overseeing the development of a range of resources in recognition that Covid-19 has required changes to staffing resulting from increased demand, reduced availability of staff and implementation of social distancing in clinical areas, including the development of:

• staffing models for intensive care units and the Louisa Jordan Hospital;
• professional judgement templates with associated specialty specific guidance for adult acute wards, maternity and neonatal services, mental health and learning disability services, community nursing and AHP services;
• a care management safety huddle tool and professional judgement template for use in care homes.

Additionally, Scottish Government has continued to provide funding for workforce lead posts in each Board to provide local leadership and expertise, in recognition of the importance of support being available to NHS Boards for staff at this time. The use of workload tools are not currently mandated in recognition that Boards may not have capacity, though they remain available to Boards should they wish to use them. Scottish Government also continues to fund the Healthcare Staffing Programme (HSP) within Health Improvement Scotland (HIS), which is responsible for work to support implementation of the Act, although understandably the focus this year has been on supporting workforce planning required as a result of the pandemic.

Health Improvement Scotland (HIS) is responsible for both the Healthcare Staffing Programme National Steering Group and Education sub-group of that National Steering Group.

The Healthcare Staffing Programme National Steering Group last met on 6 November 2019. The Education Sub-group last met on 28 January 2020.

The Programme was stepped down in March 2020 as a result of the pandemic and remobilised in September 2020.

HIS has not yet agreed a firm date for the Healthcare Staffing Programme National Steering Group, but has confirmed that it will take place sometime before 5 February 2021. The first meeting of the reconvened Education Sub-group is scheduled to take place on 19 January 2021.

The development of the guidance was divided into 13 work streams representing the 13 guidance chapters, each with an associated working group of external stakeholders and an initial draft document provided to each group. Thus far drafts of guidance have been developed on 8 of the 13 work streams.

Since 23 March, progress in drafting the necessary guidance in consultation with key stakeholders has been directly and severely impacted upon by capacity issues within Scottish Government, the Care Inspectorate and Health Boards. The suspension of preparatory work such as this for enactment was necessary due to the requirement to free up staff to work on Covid both at Government and Board levels. The work that was planned to develop guidance for care services was also paused. Accordingly, with significantly reduced capacity it has not been possible to progress work on the guidance as previously planned. However, Scottish Government is absolutely committed to directing resources and recommencing work on the development of the guidance with Healthcare Improvement Scotland, the Care Inspectorate and Boards as soon as is practically possible for us and our key stakeholders.

I refer the member to the answer to question S5W-34263 on 20 January 2021. 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 .

Additionally, my officials have had regular contact with both Healthcare Improvement Scotland (HIS) and the Care Inspectorate in relation to support they have given to Health Boards and care home providers throughout the pandemic. Government officials have held informal monthly meetings with HIS to discuss the programme work plan for the year, to focus on supporting workload and workforce planning during the pandemic, and progress that HIS could make during this time in relation to securing analytical and digital support from NHS Education for Scotland (NES Scotland), in preparation for developing approaches to multidisciplinary tool development.

The Care Inspectorate had commenced a scoping exercise relating to development of workload tools for care homes for adults. This work was paused due to the pandemic and will be re-established when appropriate, given the significantly stretched nature of available time and resources for those working in the sector during the ongoing pandemic. However, Scottish Government has supported them in developing a Care Management safety huddle tool during this time. This tool enables care homes to identify areas of concern and risk, including workforce, and supports a consistent approach to escalation to the Care Inspectorate and Health and Social Care Partnerships, which helps support them now and in preparation for the implementation of the Act, along with the duties this will impose on them. This tool will further inform future development of workload tools and methodologies in care homes for adults.

I refer the member to the answer to question S5W-34257 on 20 January 2021. 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 .

I refer the member to the answers to questions S5W-34257 and S5W-34264 on 20 January 2021. 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 .

Additionally, the Healthcare Staffing Programme has been established within Health Improvement Scotland (HIS) and this programme will assist Boards in meeting their obligations under the Health and Social Care (Staffing) (Scotland) Act 2019 (the Act), providing support and guidance while monitoring compliance. The programme will also be responsible for the development of staffing tools and methodology, as well as their review. The programme has been overseeing the use, development and regular review of the existing tools on behalf of Scottish Ministers until the Act is commenced. This programme was paused at the beginning of the pandemic, but has now restarted, although slowly in light of the continuing pressures of Covid-19. This work will support Boards in understanding how to prepare to meet their obligations under the Act, and will also undertake a revised range of roles, including supporting Boards in understanding workforce requirements in relation to it and to their Re-mobilisation plans.

Throughout 2020 the Scottish Government’s Cardiac Rehab Champion, in conjunction with the British Heart Foundation, was in contact with health boards across Scotland and worked with them to discuss alternative, Covid-appropriate options to traditional face-to-face rehabilitation.

Our overriding priority is to keep people safe, in their homes and in healthcare settings. Individual decisions based on the benefits and risks of treatment may have to be made for people living with a heart disease. Alternative therapy options involving fewer visits to hospital are being offered to individuals where these are considered clinically appropriate.

The Minister for Public Health, Sport and Wellbeing meets the Lord Advocate from time to time to discuss matters of mutual interest.

The Chief Medical Officer, Chief Nursing Officer and National Clinical Director most recently wrote to hospices on the 22 December 2020 to offer updated advice on visiting over the winter period.

This letter emphasised that Scottish Hospices are expected to follow the visiting guidance that is most closely aligned to the physical attributes of their service. It is important to reflect that the majority of patients cared for in this type of setting will fall under the visiting guidance exemption for end of life care. In such instances, we support hospices in taking a compassionate and bespoke approach to visiting to allow those nearing the end of life to be with their loved ones.

The Scottish Government remains in regular communication with Scottish Hospices, through the auspices of the Scottish Hospices Leadership Group, to provide further advice and support as required.