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Admissions to care homes are managed locally, and as such, this data is not collated by the Scottish Government. As announced on 21 April, all people being admitted to care homes whether from the community or from hospital should be tested for COVID prior to admission. Care Homes are operated by the public, the private and the independent sectors. The care home manager at each home is responsible for admissions and ensuring that appropriate risk assessment takes place. We cannot always compel providers how to act, but by providing guidance, advice and support we are supporting them to comply with the guidance and protect residents.

Local Oversight Boards, which include Directors of Public Health, Nurse Directors and Chief Social Work Officers provide support to care homes and they ensure that appropriate admission arrangements are in place.

Scottish Government and Health Protection Scotland guidance Information and Guidance for Care Homes confirms that the presumption should therefore be that all residents being admitted to a care home should have a negative test before admission unless it is in the clinical interests of the person to be moved and then only after a full risk assessment. Health Protection Scotland advice is available on the Stepdown of Infection Control Precautions and Discharging COVID-19 Patients from Hospital to Residential Settings at: https://hpspubsrepo.blob.core.windows.net/hps-website/nss/3012/documents/1_covid-19-step-down-guidance.pdf

For admissions from the community, the guidance states that everyone should have at least one test performed before or on admission, and be isolated on admission for 14 days. Risk assessment prior to admission should be undertaken to ensure that appropriate isolation facilities are available, taking into account requirements for the patient’s care. The guidance is available at https://www.hps.scot.nhs.uk/web-resources-container/covid-19-information-
and-guidance-for-care-home-settings/

We are continuing to ensure that support is available for all care homes and all NHS Board areas have care home oversight boards in place. These boards are engaging with the care homes affected to support them with increased infection prevention control requirements as part of outbreak management.

We have allocated a total of £150 million this year for social care as part of our additional COVID funding to help the social care sector deal with the financial implications of the pandemic. Our Winter Plan recognises that to ensure winter preparedness this year, that additional resources will be required and the Plan is being supported by further funding of up to £112 million. We are working with COSLA, and wider partners, immediately on effective allocation of this funding through mechanisms that promote additionality of services and value for money. We would expect that where care homes are unable to fill vacancies in order that they may continue to comply with guidelines, that this is flagged up at a local level.

I announced on 21 April that all people being admitted to care homes whether from the community or from hospital should be tested for COVID prior to admission. Scottish Government and Health Protection Scotland guidance states a presumption that everyone being admitted to a care home should have a negative test before admission, unless it is in the clinical interests of the person to be moved. This clinically-led decision is for exceptional circumstances and after a full risk assessment, consulting the resident, family and care home on what is right for the individual and putting appropriate mitigating actions and support in place. The guidance is available at https://www.hps.scot.nhs.uk/web-resources-container/covid-19-information
-and-guidance-for-care-home-settings/

Public Health Scotland publish monthly data on stillbirth rates in Scotland as part of their monitoring of the wider impacts of COVID-19 on the healthcare system. Whilst the data does show increases in some recent months in stillbirths, it is not possible at this stage to say whether this is indicative of a sustained increase or due to monthly fluctuation.

However, in light of these monthly increases, the Maternity and Children’s Quality Improvement Collaborative team, part of the Scottish Patient Safety Programme, is currently working with Health Boards to review the causes of the stillbirths that have occurred during the COVID-19 pandemic and identify any risks or patient safety issues. The initial outcomes of this work will be discussed by the Scottish Government multidisciplinary expert Stillbirth Group at their next meeting in December 2020.

Our approach to providing substance use education is the same for both alcohol and drugs. Through the Health and Wellbeing component of Curriculum for Excellence, Scottish schools aim to provide helpful, engaging information about substances that, crucially, empower children and young people to make positive decisions about their health.

Education Scotland published health and wellbeing benchmarks for schools, which included substance use, in 2017. These benchmarks set out clear statements about what learners need to know and be able to do to achieve a particular level of learning. More recently, Education Scotland has published a thematic report which includes a review of Personal and Social Education (PSE) in schools.

Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) published a report in October 2016 where it confirmed around 70% of 15 year olds say they have received lessons or discussions in class on drugs. While this is encouraging there is still room for improvement to ensure that all young people have access to drug and alcohol education, based on best practice, and of relevance to them.

Our drug and alcohol strategy ‘Rights, Respect and Recovery’ sets out a range of commitments in this area, for example: to develop a comprehensive approach to early intervention amongst those who are at risk of developing problem drug use; to revise and improve the programme of alcohol and drug use education in schools to ensure it is good quality, impactful and in line with best practice; and to further develop our online resources to ensure they provide accurate, evidence-based, relevant and up to date information and advice around alcohol and drug use and how to access help. This work was detailed in the action plan published in 2019 and work had started with Public Health Scotland to take this forward, this was paused due to the COVID-19 pandemic.

To ask the Scottish Government how much of the funding available to the Drug Deaths Taskforce has been used to reduce the consumption of benzodiazepines, or so-called "street Valium", and what projects have been funded.0

The availability and use of street benzodiazepines is a serious concern in Scotland, particularly given the link to increasing numbers of drug related deaths in recent years. The Scottish Government has been lobbying the UK Government to work with us on the regulation of the pill presses which are used to produce these pills, this was last raised with UK Government ministers on 17 September.

The Drug Deaths Taskforce (DDTF) is examining a range of issues relating to problem drug use, including the risks posed by benzodiazepine use. The DDTF recently co-hosted two webinars on this subject with the Scottish Drugs Forum to examine the evidence and possible responses, such as drug checking, as well as the issues around prescribing of benzodiazepines.

The DDTF has awarded funding through its research fund to Stirling University to carry out research around benzodiazepine prescribing (more information on this can be found here: https://drugdeathstaskforce.scot/about-the-taskforce/funding/funded-research-31-july-2020/ ). In addition, through the DDTFInnovation and National Developments Funding Programme, the DDTF is considering an application related to benzodiazepine use and prescribing, the decision on this application will be announced in the coming weeks.

The Scottish Government’s response is published on the Scottish Parliament’s website and can be viewed here: http://external.parliament.scot/GettingInvolved/Petitions/PE01825

Further briefing will be published on the page linked above in due course.

The Scottish Government acknowledges the obvious operational difficulties caused by Covid-19 and lockdown. Although Boards responded creatively to treat significant numbers of people during lockdown, people requiring emergency and urgent care were prioritised, meaning that some people have had to wait longer.

Whilst it is not possible to assess the exact impact that COVID-19 restrictions have had on mental health waiting times, the latest published statistics show that more people waiting for treatment had waited longer than 18 weeks in April-June 2020 compared with the same quarter last year.

Services are working hard to return to previous activity levels and to deal with any backlogs that have developed. We have also set out in our Mental Health Transition and Recovery Plan, published on 8 October, our plans to provide a tailored programme of enhanced improvement support for individual NHS Boards to improve their waiting times performance.

Table 1: Waiting Times (with Adjustments) for CAMHS Patients Seen – Scotland

NHS Boards have provided the following figures for current ICU capacity and surge capacity:

We are committed to ensuring that people living with respiratory conditions in Scotland can access clinically appropriate, safe, effective and person-centred care treatment and support.

That is why, this year’s Programme for Government has committed to delivering a Respiratory Care Action Plan for Scotland, which will contain a set of commitments to drive improvement in the prevention, diagnosis, care, treatment and support of people living with respiratory conditions in Scotland.

We are committed to continuously improving the diagnosis, care, treatment and support of people living with respiratory conditions, which is why we set out in our Programme for Government a Respiratory Care Action Plan to deliver these key priorities.

Work is now underway in developing the final Plan, in partnership with a wide range of key stakeholders including clinicians and third sector organisations such as Asthma UK – British Lung Foundation and Chest Heart & Stroke Scotland.

As we continue to develop our understanding of the impact the virus has had on the health of the people of Scotland, the final Plan will play a key role in responding to the implications and consequences for many aspects of respiratory care going forward, including pulmonary rehabilitation.