Seòmar agus comataidhean

The safety of all school users is of paramount importance to the Scottish Government.

Evidence suggests that adequate levels of ventilation can limit the spread of COVID-19. As winter approaches, we have issued updated guidance to local authorities that balances the need for ventilation in parts of the school estate with the requirement to maintain adequate temperatures. This has been published as part of the latest version of school reopening guidance.

As set out in our strategic framework for the pandemic published on 23 October, our plans to develop the testing element of Test and Protect in the next three months are focussed on building capacity within NHS Scotland and deploying expansions in UK Government testing capacity and capability to its maximum effect in Scotland.

These increases in capacity will primarily be required to meet demand from people with symptoms of Covid, both those infected with Covid, and those with colds or flu, or other illness with similar symptoms and for clinical patient care. As testing capacity builds and in line with clinical and public health priorities identified though the review of our testing strategy, we will also extend routine weekly testing of asymptomatic groups in a way which focusses on protecting those most vulnerable to the most harm, including those at highest risk of mortality.

Further details on the Framework can be found here:

https://www.gov.scot/publications/covid-19-scotlands-strategic-framework/

Regular testing of this type sits alongside other measures such as strong emphasis on symptomatic individuals immediately self-isolating and arranging testing, use of appropriate PPE, physical distancing, environmental optimisation and decontamination and good social hygiene.

NHS Test and Protect is a complex public health intervention and uses a whole system approach for delivery across NHS Boards, local authorities and other key delivery partners. As spend may be incurred centrally, rather than by individual partners, costs incurred by NHS Boards do not constitute total programme spend. Overall expected costs for this programme include expenditure on testing, contact tracing and support for those isolating.

On 29 September 2020 the Cabinet Secretary for Health announced £1.1 billion in additional funding for NHS Boards and Health and Social Care Partnerships to meet COVID-19 related costs. A breakdown of the initial provision for Boards included for NHS Test and Protect – as included in this funded package – is set out below. Activities and costs remain under close review and funding to Boards will be revised through the year in line with agreed changes.

The Clinical and Professional Advisory Group (CPAG)is co-chaired by the National Clinical Advisor on Ageing and Health, Chief Medical Officer Directorate, and the Depute Chief Nursing Officer, Chief Nursing Officer Directorate in the Scottish Government.

Group membership includes clinical advisers with expertise in gerontology, nursing, general practice, academia, public health, and representatives from RCPE, RCN, RCPSG. Professional representatives include care home providers, social work, Care Inspectorate, SSSC, Scottish Care and third sector organisations.

The CMO and CNO commissioners have agreed with CPAG chairs an extension of remit to all adult social care and are currently reviewing membership to ensure alignment.

We are undertaking work across our health and social care settings to assess our preparedness for Winter. As part of this we are working with Boards and delivery partners to ensure that we are as prepared as we can be for the months ahead in the context of Covid-19 and other winter risks such as winter flu, winter pressures on Emergency Departments and restarting elective care.

The immediate focus of work is planning for the implications of a resurgence of Covid-19. The impact of Covid-19 is unlikely to fall evenly and so will be felt harder in some parts of the country than others. Our collective response will need to factor in strong mutual aid arrangements and logistics support to ensure there are safe levels of staffing throughout the system to manage winter pressures. A Health & Social Care Winter Planning team will work with Boards and delivery partners to assess winter preparedness.

On staffing capacity, we are working closely with Health Boards and at a national level to understand any concerns about staffing levels and explore effective mitigations. We continue to support the effective deployment of staff, including the use of temporary and emergency staffing through the National Health and Social Care Covid-19 Accelerated Recruitment Portal. The Portal was launched in March 2020, to allow returning health care professionals to come forward and support our health and social care services at this time of national emergency. We are prepared to make further use of the Portal to mitigate future staffing demand from NHS Boards.

Regarding staff absence, we have collected, monitored and published data on NHS and care home staff absences since the outbreak of this pandemic. Data is continually collated from NHS Boards and the Care Inspectorate on the number and rate of absences associated with Covid-19.

For the week to 20 October 2020, a daily average of 1.6% of the NHS workforce were recorded absent for reasons related to Covid-19. The rate of NHS Covid-19 related absence has remained below 2% since late July and below 4% since early May.

For the week to 20 October 2020, a daily average of 2.3% of the care home workforce were recorded absent for reasons related to Covid-19. The rate of Covid-19 related absences in care homes has remained at or below 2.5% since early August and below 4% since late June.

We will continue to pay close attention to staff absence data in the coming months.

The Clinical and Professional Advisory Group is a multi-disciplinary group of care home providers, clinicians, nursing, GP, social work and social care, scrutiny and third sector representatives which considers and advises on issues during the pandemic. Meeting weekly, all members including workforce representatives have the opportunity to shape the agenda and to inform guidance to the sector, including on visiting. Infection Prevention and Control and visiting focussed sub-groups also include the care home workforce.

The CPAG co-chair and representatives regularly attend a workforce surgery call/ webinars to discuss visiting and clinical and professional practice with Scottish Care members and will continue to engage in a range of ways with the sector.

The following table includes all eligible referrals on the 62 day cancer pathway for Urology for each quarter. It should be noted that this data cannot be broken down to specific prostate referrals.

NHS Boards are continuing to closely monitor all cancer referrals, including prostate, to ensure that capacity supports demand and patients can move through their pathway as safely and quickly as possible. Throughout the pandemic urgent cancer care has been prioritised supported by clinical guidance.

To support improvement for overall Cancer services a Recovery Plan is being developed with patients experience at the core and will be published in November. This plan will have an operational focus on diagnosis and treatment in cancer services.

The plan will focus on reducing the inequalities exacerbated by the pandemic and ensure patients are receiving treatment equally across Scotland using a Once for Scotland Approach.

In the latest reporting week (19 - 25 October) 39,461 care home staff were tested, comprising 5,421 staff in homes with confirmed covid , and 34,101 staff in homes with no cases of confirmed covid . This data is published weekly.

The Scottish Government has provided support to vulnerable people in various ways during the Covid-19 lockdown period, and recognises it is just as important now that we continue to make sure support is available and accessible to those that need it.

We have commissioned Public Health Scotland to provide analysis of alcohol sales data for the first six months of 2020 which will provide quantitative consumption data covering the lockdown period. This will help to inform us about the impact of Covid-19 on alcohol and also the potential impact on alcohol treatment services going forward.

During the pandemic, the Scottish Government has worked with a number of organisations addressing alcohol and drug harms. We have provided additional funding of £166,000 to fund activities such as the purchase of equipment to keep people in recovery connected, and increased the hours of our national helpline and webchat facilities. The Scottish Recovery Consortium has issued guidance to enable recovery groups to meet face-to-face where on-line meetings are not possible. I and the Interim Chief Medical Officer, Dr Gregor Smith, wrote to health boards and Integration Authorities on 16 April to ensure the need for continuation of care is prioritised for those with alcohol problems. Additional funding has been made available through NHS Mobilisation Plans to ensure support services remain open and accessible where possible.

Early on in the pandemic, we announced an expansion of the Distress Brief Intervention (DBI) pilot programme, supported by an additional investment of over £1m. In our recent Programme for Government we committed to extend the DBI programme across Scotland, for a transitional period to 2024, at which point we expect it to be fully embedded by boards. We have provided an additional £2.1 million to expand the NHS 24 Mental Health Hub, and £0.5m to expand the capacity of the Breathing Space helpline and web support service for people experiencing low mood, depression or anxiety. In April, we also launched our Clear Your Head campaign, which provides practical advice on how to stay active, keep connected with friends and family, and create healthy routines to help us get through these times.