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There is already national guidance to support NHS Boards to fulfil their public involvement duties under the NHS Reform (Scotland) Act 2004.

The CEL 4 (2010) guidance to NHS Boards, “Informing, Engaging and Consulting People in Developing Health and Community Care Services”, which is available online at http://www.sehd.scot.nhs.uk/mels/CEL2010_04.pdf , sets out how NHS Boards should inform, engage with, and consult with patients and their local communities.

I wrote to all NHS Boards in June this year to remind them of their duties and the national guidance.

We are working jointly with COSLA to develop updated community engagement guidance which will apply across health and social care. This work was temporarily paused due to the pandemic and will restart when it is appropriate to do so.

The Scottish Government appreciates returning to work will be a worrying time for people living with an underlying health condition, such as diabetes.

The health and wellbeing of individuals, communities and the economy is the priority of the Scottish Government. All employers in Scotland should follow the existing Scottish guidance, support workers to follow health protection advice and have a statutory duty to ensure that workers’ health and safety is protected. This includes undertaking risk assessments of their work activity, assessing the risk from Covid-19 spread in the workplace, and putting in place appropriate mitigating measures.

We published guidance for employers and employees to support people who considered themselves at higher risk of contracting Covid-19 on 30 July 2020. This provides practical measures which should be taken, including risk assessments and prioritising their needs in planning phased returns to physical workplaces. This guidance can be found by following link:

https://www.gov.scot/publications/covid-shielding/pages/returning-to-work/

Robust arrangements for public engagement are in place for both NHS Boards and Integration Authorities.

Health Boards are subject to the public involvement duties set out in the NHS Reform (Scotland) Act 2004 and the national CEL 4 (2010) guidance on “Informing, engaging and consulting people in developing health and community care services”.

Integration Authorities have a range of duties conferred upon them through the Public Bodies (Joint Working) (Scotland) Act 2014, which requires a comprehensive approach to engagement and participation with a range of key stakeholders.

We expect NHS Boards and Integration Authorities to apply the principles of early and meaningful engagement proportionately when making decisions regarding the delivery of arthritis services. Healthcare Improvement Scotland - Community Engagement have also developed guidance to support engagement during this time.

National Records of Scotland (NRS), Northern Ireland Statistics and Research Agency (NISRA) and Office for National Statistics (ONS) publish statistics on deaths where Covid-19 was mentioned on the death certificate (including suspected COVID-19 deaths).

Due to differences in recording and diagnosis the most accurate figures to use to make comparisons in relation to the number and rate of deaths from Covid in any environment are those for all excess deaths over a particular period. Comparisons should also take account of differences in the demographics of care home residents across the UK.

Excess deaths are the total number of deaths registered in a week in 2020 minus the average number of deaths registered in the same week over the period 2015 to 2019. For all parts of the UK, figures are available for excess deaths from all causes, including Covid-19.

During weeks 11-25 of 2020, excess deaths in care homes in England and Wales have been 83% above the five year average compared to 66% for Scotland.

NRS statistics show Covid-19 deaths in care homes, year-to-date up to 21 June (week 25) as being 47% of Scotland’s deaths from Covid-19. NISRA statistics for this period also show 42% of deaths from Covid-19 in Northern Ireland as being in care homes. The percentage of Covid-19 related deaths occurring in care homes in Scotland is broadly in line with many other European countries.

Public Health Scotland publish data on bed occupancy on a quarterly basis. They have pre-announced that Acute Hospital Activity and Beds data to end March 2020, is scheduled for publication in September 2020 and that quarterly data for April to June 2020 is scheduled for publication in November 2020.

https://beta.isdscotland.org/forthcoming-publications/

Public Health Scotland also publish weekly data on hospital inpatient admissions as part of their weekly COVID-19 publication. This data shows that the number of hospital inpatient admissions dropped to its lowest level compared to the pre-COVID average during April and has steadily increased in recent weeks. The reduced number of admissions is likely to have had an impact on the overall occupancy during this period also. A link to this data is provided here: https://scotland.shinyapps.io/phs-covid-wider-impact/

Testing capacity fluctuates on a daily basis, but as at 1 July, the testing capacity of NHS Scotland laboratories, broken down by NHS board, was as follows:

From 20 March 2020, due to the impacts of the COVID-19 pandemic, sexual health services were necessarily limited to urgent and essential care only during lockdown.

Significant efforts have been made to maintain care provision to meet public health priorities such as preventing unplanned pregnancies and onward transmission of sexually transmitted infections and blood borne viruses. In responding to the major challenges posed by the COVID-19 pandemic, there has been significant and rapid service redesign in order to prioritise essential care while protecting patients and staff, with care being provided virtually where possible, including through the use of telephone or video consultations and assessments, postal testing kits and self-test kits.

In order to support the recovery and renewal of sexual health services as we move through the phases out of lockdown, the Scottish Government, following discussions with the Scottish Health Protection Network, has committed to developing an Interim Sexual Health and Blood Borne Viruses Framework. This Interim Framework will take stock of the impacts of COVID-19 on sexual health, and seek to build on the many examples of innovation and best practice developed at this time to transform sexual health services in the future.

The harms caused by the use of benzodiazepines in Scotland is a serious concern, especially as evidence indicates that the number of deaths involving them has increased over recent years. The Drug Deaths Taskforce is focused on ensuring that drug treatment services adapt to meet the specific needs of those individuals who are most at risk in their area by offering treatment and support services that focus on the use of a range of drugs, including benzodiazepines. The Scottish Government committed £20m of additional funding in the 2019 Programme for Government to support the taskforce between 2020-2022.

Furthermore we are also continuing to push the UK Government to commit to regulating the sale of pill press machines that are capable of producing counterfeit benzodiazepines on an industrial scale. I have raised this with UK counterparts on a number of occasions and will be following this up when I next meet with UK Ministers.

The latest information is available on the Public Health Scotland website in Table 5b of the National Drug-Related Deaths Database publication tables at https://beta.isdscotland.org/media/1502/2018-06-12-ndrdd-tables.xlsx .

The data in the table show annual statistics for calendar years from 2009 to 2016 (inclusive).