Seòmar agus comataidhean

Staff and carer wellbeing was highlighted as one of eight key objectives for safe and effective mobilisation across health and social care in “Re-mobilise, Recover, Re-design: the framework for NHS Scotland”, which was published on 31 May 2020.

The Scottish Government is working closely with partners across the health and social care sector, including NHS Boards, Health and Social Care Partnerships and local employers, to ensure a range of psychological and wellbeing support is in place for the workforce as normal services are remobilised.

A range of support is available at the national level, including through the National Wellbeing Hub (www.promis.scot), which continues to be widely used by the workforce. We are exploring with partners how best to respond to those who may need more specialist support and care over the coming months.

A safe and effective COVID-19 vaccination is dependent on success in at least one of over 170 vaccine trials underway worldwide in terms of both development and manufacture. When a vaccination might be available, and considerations about delivery and prioritisation, will depend in part on which vaccine candidates are successful.

While there is no guarantee of success in any of the trials, it is prudent that we plan on the basis of a vaccine becoming available. In Scotland we already deliver nearly 2 million doses of vaccine routinely every year and we have a comprehensive vaccine delivery infrastructure in place. We are currently working to upscale this in order to deliver a COVID-19 vaccine in the event that a safe and effective vaccine does become available.

Prioritisation and eligibility decisions will be founded on clinical evidence and advice.

The Scottish Government has been working with partners to explore options for transparent masks and face coverings. Currently, there are no commercially available transparent masks that are certified for use in clinical settings. However, £50,000 of funding from the Scottish Enterprise’s Pivotal Enterprise Resilience Fund (PERF) was recently awarded to an Edinburgh based company to expand its production of face coverings to include coverings with transparent panes, which enable lip-reading. This company is also being supported by the National Manufacturing Institute for Scotland (NMIS) to upgrade these face coverings to type IIR masks suitable for use in clinical settings.

The Scottish Government is aware that when face coverings and face masks are worn there may be additional challenges for those who are deaf or have hearing loss, as well as others with different communication needs. Guidance is being continually updated as to when face masks and face coverings should be use in health and social care settings. The latest guidance on the extended use of face masks recommends that staff working in clinical areas of an adult acute, community hospital or care home for the elderly should wear a medical face mask at all times. However the guidance also stipulates that where necessary and when safe to do so, staff can lower or remove their mask to allow for lip-reading, but must maintain 2m physical distancing. Where physical distancing is not possible, other communication methods should be used.

The Scottish Government does not hold this data however vital cancer services have remained throughout the COVID-19 pandemic where clinically agreed. We have been clear that throughout this pandemic, the NHS is there for those who need it most.

To ensure patients are seen based on their clinical priority Health Boards clinical teams have weekly Multi-disciplinary team meetings where patients are reviewed based on clinical risks and individual treatment requirements.

To support Health Boards in treating these urgent cancer patients capacity has also been identified within the Private Sector and the Golden Jubilee National Hospital providing a safe environment for both patients and staff.

A list detailing the title of Clinical Trials which were paused due to the Covid-19 pandemic can be found at NHS Research Scotland’s website: http://www.nhsresearchscotland.org.uk/uploads/tinymce/NRS%20Non-COVID-19%20Suspended%20Study%20Sites.pdf .

This identifies the Clinical Trials and the NHS Scotland Health Boards involved. As will be seen from the link, a number of Clinical Trials have since been reopened or terminated (e.g. because the trial was close to ending in any case). It should be noted that the Scottish Government’s Chief Scientist Office has created strategic and operational groups to lead efforts to re-open all research in NHS Scotland as quickly and safely as possible.

Digital consultations have played an important role in allowing people to continue to access appointments during Covid-19 with nearly 17,000 consultations being held each week across Health and Care services. Feedback on using our Near Me video consulting service remains extremely high and in mobilisation plans we have now asked for Health Boards to maintain and build upon this. We would expect a video consultation to take place whenever it is clinically appropriate to do so.

To support its wider uptake and awareness of the service, we are currently in the middle of a public engagement exercise to ensure that we gather feedback on areas where the service is particularly beneficial or where it may not be appropriate for such a consultation and we will use this feedback to adjust our approach to scale up once we have collated the information. The survey can be found here - https://www.nearme.scot/views .

There is currently insufficient clinical evidence to conclude that people who have recovered from COVID-19 are protected from either a second infection or from infecting others.

Until such evidence exists the main public health benefits are for research purposes or in the clinical management of patients. The World Health Organisation and SAGE have warned there are potentially negative impacts on public health if individuals assume immunity from a positive result and adapt their behaviour in a way which could increase the risk of continued transmission.

On this basis, the CMO advised health boards on 23 rd June 2020 not to offer on-demand antibody testing. This applies equally to care or NHS staff.

Our approach is being kept under ongoing review. If clinical evidence around immunity changes we will swiftly roll out a national antibody testing programme in order to realise the potential health, social and economic benefits this would offer, and are preparing now for that prospect.

On 11th June 2020 the Association of Medical Research Charities (AMRC) published on their website an article entitled COVID-19: The risk to AMRC charities.

https://www.amrc.org.uk/covid-19-the-risk-to-amrc-charities .

The published AMRC figures do not distinguish between cancer and other medical research charities.

On 30 th March Cancer Research UK released a press release that referred to an estimated 25 percent drop in fundraising income in FY 2020-21

https://www.cancerresearchuk.org/about-us/cancer-news/press-release/2020-03-30-cancer-research-uk-estimates-25-per-cent-drop-in-fundraising-income-due-to-coronavirus?_ga=2.60513902.2117832912.1593763662-1469902633.1572445696

The impacts of COVID-19 on medical research are being considered by the UK Office for the Strategic Coordination of Health Research Board, which includes representation from the AMRC and the Scottish Government’s Chief Scientist Office through the Chief Scientist for Health as well as from the other UK Health Departments, and UK research councils.

The UK Government has announced on 27 June that, from this autumn, UK universities will be able to access a series of UK Government grants and long-term, low interest loans covering up to 80% of each institution’s income losses caused by a decline in international students, up to the value of non-publicly funded research activity in that university. In addition, around £280 million UK Government funding will be made available to universities and research organisations for costed extensions of UK Research and Innovation and National Academy research projects impacted by the pandemic.

We welcome the recent announcement by the UK Government which builds on the Scottish Government’s commitment last month to provide an additional £75 million to ensure our universities can protect their world-leading research against the financial impact of COVID-19. However, we are concerned about the emphasis on loans in the UK Government’s stabilisation package, as not all universities will be in a position to take advantage of those. We will work with the UK Government not only to agree how this package will be implemented in Scotland, but also to address the long term sustainability of our sector to ensure it plays a key role in Scotland’s economic and social recovery.

The Data requested by the member is not held centrally by the Scottish Government.

Whilst the majority of cancer treatments have continued throughout this pandemic, some patient’s treatment plans may have changed to minimise their individual risk. Those that require changes will always be done on a clinical basis and will be in discussion with the patient and clinical team.

It has been made clear that vital cancer services should remain where clinically agreed during the Covid-19 pandemic, this includes the use of private hospitals to treat these NHS patients. By utilising the private sector capacity we are able to provide a COVID free environment for urgent cancer procedures. The Golden Jubilee is also supporting the treatment of urgent cancer patients.

Targeted clinical guidance has been issued to support decision making in a range of areas including clinical prioritisation. This includes:

• Clinical and patient guidance disseminated to clinical and oncology teams on the 30 April which has been kept under constant review.
• The Framework for Recovery of Cancer Surgery to assist NHS Scotland prioritise those most in need of cancer treatment.
• Clinical guidance has been published on q(FIT) testing to specifically support decision making for those colorectal cancer symptoms.
• Published Re-mobilise, Recover, Re-design: The Framework for NHS Scotland on 31st May to support clinical decision making as NHS Boards begin to restart paused services. This Framework sets out how NHS Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of services while maintaining COVID-19 capacity, resilience and providing appropriate support for social care.

Throughout the pandemic we have been clear that urgent, emergency, Maternity and Cancer services should continue to be available and that the NHS is open for those who require medical attention.