Seòmar agus comataidhean

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.

The Covid-19 Clinical Guidance Cell has been established by the Chief Medical Officer to rapidly develop and revise guidance on clinical management of COVID-19 for the NHS.

The purpose of the Clinical Guidance Cell is to rapidly prepare guidance for the health and care system in Scotland on the clinical management of COVID-19.

Membership is drawn from key organisations and professional communities across Scotland who have a direct interest. This includes the Scottish Academy of Medical Royal Colleges and Faculties and Health Protection Scotland.

The Scottish Government is also advised by the COVID-19 Advisory Group, which was established to address the need for additional scientific analysis of the impact of COVID-19 in Scotland, based on regularly updated advice and modelling from the UK Scientific Advisory Group for Emergencies (SAGE), and other emerging scientific evidence.

The group is chaired by Professor Andrew Morris, Professor of Medicine at the University of Edinburgh, supported by vice chair, Professor David Crossman, Dean of Medicine at the University of St Andrews and Chief Scientist (Health) at the Scottish Government. Members are public health experts, clinicians and academics spanning the disciplines of epidemiology, virology, public health, behavioural sciences, global health, medicine and statistical modelling. Full details of the group’s membership are available on the Scottish Government’s website at https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/

As part of the Scottish Government response to the COVID-19 pandemic, on 25 th March 2020 the Chief Scientist Office (CSO) launched a call for rapid research in COVID-19. The call attracted 139 individual research project proposals. CSO convened an independent expert panel to review the applications. This panel, which met virtually on 21 April 2020 to consider the applications, comprised 35 expert members from the medical and wider health and social care research sectors and 3 lay members and was co-chaired by Professor Eleanor Davies from the Univeristy of Glasgow and Professor Shaun Treweek from the Univeristy of Aberdeen.

The outcome of the review was that 56 research projects were funded, led by 15 different research institutions from across Scotland. The work funded through this call involves researchers from the medical and wider health and social care research sector. This includes research to:

• Better understand the effects of COVID-19 infection in order to inform treatment and management of disease

• Develop and test new diagnostics and therapeutics

• Investigate novel disease surveillance approaches

• Inform interventions to prevent transmission of infection

• Support the resilience and mental health of frontline health and social care workers

• Understand the physical and mental health implications of social distancing and other restrictions and their impact on the general population and also a number of vulnerable groups

Details of the funded projects are available from the CSO website. https://www.cso.scot.nhs.uk/rapid-research-in-covid-19-programme/

We have been clear that throughout this pandemic, the NHS is there for those who need it. Our NHS is Open campaign was launched 24 April and we have seen a steady increase in the number of people presenting to their GP practice with symptoms that could be suspicious of cancer – now 86% pre COVID levels.

Our Clinical Director for Scotland, Jason Leitch also made a statement urging patients who have an appointment to attend hospital for these as it will have been deemed clinically safe to do so.

We are working hard to ensure vital and urgent care remains, including 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.

Our national expert body, Health Protection Scotland (HPS), jointly with the Department of Health and Social Care, Public Health Wales, Public Health Agency Northern Ireland, Public Health England (PHE) and NHS England published updated PPE guidance in relation to COVID-19 on Thursday 2 April (updated 12 June). The guidance is available here .

The guidance outlines what type of PPE frontline health and social care workers should be wearing in different settings and scenarios, including where a two-metre social distance is not possible. The guidance contains tables which clearly explain the PPE required for different common clinical and care scenarios. The first table relates to acute hospitals and the second and third are for primary care, outpatient and community care, ambulance staff, paramedics, first responders and pharmacy.

Given the recognised sustained community transmission of COVID-19, the guidance importantly includes detailed advice (table 4) around risk assessing use of PPE, including aprons, gowns, Fluid-Resistant Surgical Masks and eye protection, in a range of different clinical and care scenarios, including where a two-metre social distance is not possible.

Additionally, on 23 June recommendations on the wider use of face masks by staff within residential healthcare settings, such as acute adult (including mental health) and community hospitals and care homes for the elderly where staff are unable to physically distance were announced. The guidance recommends that staff working in a clinical area of an acute adult or community hospital, or in an care home for the elderly should wear a face mask at all times throughout their shift. Additional advice was also announced on the requirement for visitors to wear face coverings when attending adult hospitals or care homes for the elderly.

The Scottish Government continues to participate in the four nations approach to the procurement of tests and, subject to clinical recommendations and the availability/approval of an effective antibody test, can draw-down an allocation of the UK procured COVID-19 antibody tests for use in Scotland.

The exact information requested is not available centrally. Public Health Scotland collect social care information directly from Health and Social Care Partnerships; however, it is not possible to identify from this if social care packages have been withdrawn or the reason why a package may have been withdrawn or reduced.

It is possible to estimate the number of people receiving home care services each month and how many hours of home care were received. Table 1 provides this information for January to March 2018. Information for 2018-19 is not yet available.

Table 1. Number of people receiving home care 1 services and total number of hours 2,3,4 of home care by month and Health and Social Care Partnership 2,3,4 , January to March 2018

Scotland’s testing capacity fluctuates on a daily basis and for this reason, and given daily fluctuation in NHS capacity, it is not possible to give a definitive figure for the proportion of testing capacity that comes from UK regional testing facilities.

We are working hard to ensure we maximise use of our daily capacity, as we expect the number of daily tests to increase as we roll out Test and Protect. NHS lab capacity is currently around 10,000 tests a day and around 8,000 at the weekend, and is supported by non-NHS labs including: University of Edinburgh, University of Aberdeen, and the Scottish National Blood Transfusion Service.

In addition to this, we have further capacity through the Lighthouse Laboratory in Glasgow (run by the UK government), which has capacity to process approximately 20,000 tests a day. The Glasgow Lighthouse Laboratory may however process tests taken from across the UK.

I have asked all stakeholders, including NHS Unions and NHS Scotland employers, to work in partnership to examine options for arriving at pay settlements for both the immediate and longer term. Stakeholders will work together to agree a timetable for this. In addition, and in consultation with a wide range of partners across the health and social care sector, we are taking forward a raft of measures designed to provide support to staff at this difficult time. Information on these can be found at our National Wellbeing Hub - www.promis.scot 

We do not collect data relating to learning disabilities of people receiving testing. Consent would have to be provided by the individual to allow collection of this data.

As part of our activity we have worked with public and third sector partners to understand language and accessibility requirements, and have worked collaboratively to translate and distribute key coronavirus information. This has involved:

1. Digital marketing activity has been developed and undertaken to target those whose digital footprint highlights they are from a BAME community.

2. Scottish Government has been leading the coordination of translations of NHS Inform coronavirus content with NHS 24, NHS Greater Glasgow and Clyde, and NHS Lothian on a weekly basis from March to June. Content is translated into 12 different languages and formats.

3. Key promotional posters have been translated into various languages. For example, Household Isolation posters were translated into Polish, Mandarin, Arabic, BSL, Audio MP3, Easy Read, Kurdish, Sorani, Cantonese, Tigrinya, Vietnamese.

4. The two national door drops distributed by SG have been made available in a variety of language and accessible formats.

Scottish Government Policy teams are also working with relevant stakeholder and community groups to increase awareness of these resources and how to access them.