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Estimated numbers of people affected by the pause to breast screening were published when the pause to the programme was announced on 30 March. The figures, which are based on the most recent information available to Information Services Division at the time of the pause, indicate that 46,596 people may have had their breast screening appointment delayed as a result of the pause to the breast screening programme over the past three months.

The resumption of screening services is taking place safely, carefully and in a series of stages, as part of the remobilisation of the NHS in Scotland. The breast screening service is currently assisting acute services to prioritise high-risk familial clinics and post-treatment surveillance screening, while preparing for the resumption of the national programme.

In the meantime, it is absolutely vital for those in between screening appointments or awaiting a rescheduled appointment to be aware of any symptoms or signs of the conditions screened for. Anyone having these symptoms should contact their GP practice.

The Scottish Government cannot comment on individual cases but in general terms NHS Scotland does not pay for or subsidise private health care arranged independently by a patient. This matter was discussed in the Chamber on 25 June 2020 in response to oral question S5O-04436, the full transcript can be found here: http://www.parliament.scot/parliamentarybusiness/report.aspx?r=12720&i=115044 .

I refer the member to the answer to question S5W-30230 on 8 July 2020. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at: http://www.parliament.scot/parliamentarybusiness/28877.aspx

The Scottish Government were concerned to read the findings of this tragic incident. NHS Lothian have accepted the findings of the Fatal Accident Inquiry and have confirmed that a number of actions have taken place since 2014 to improve the number of staff incorporated within ward establishment figures. Firstly, the Royal Edinburgh Hospital was given an uplift in budget of £3 million which allowed it to review establishment levels. In addition, when the new Royal Edinburgh Building was built, it allowed for an improved number of nursing staff per bed ratio.

NHS Lothian has produced a draft action plan in response to the FAI which includes implementation of the standards within Healthcare Improvement Scotland’s (HIS) "From Observation to Intervention" 2019 guidance. This is being taken to the NHS Lothian Health Care Governance Committee for discussion on 24 th July 2020.

On December 16 2019, the Scottish Government published the first Integrated National Health and Social Care Workforce Plan in the UK. Developed in partnership with COSLA, the Integrated Plan sets out how health and social care services will meet growing demand to ensure the right numbers of staff, with the right skills, across health and social care services. Covid-19 has led to widespread disruption to Health Boards' models of service delivery and we are carefully considering the Integrated Plan to ensure its content and associated guidance are, going forward, reflective of the full range of current and developing planning requirements on Boards and the changing circumstances regarding Covid-19.

In addition, implementation of the Health and Care (Staffing) (Scotland) Act, which is the first multi-disciplinary workload and workforce planning legislation in the UK, will support the wider workforce planning process by enabling a rigorous evidence based approach to staffing decisions. Health Boards have also been supported in planning their nurse staffing in response to the pandemic by the development of a professional judgement decision making template, including for mental health.

The Scottish Government will also shortly reconvene the National Mental Health Quality and Safety Board. This Board will be considering all issues that impact upon the quality and delivery of safe and effective services, including inpatient and community settings.

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.

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 .

Test and Protect programme is run by NHS Scotland using NHS staff and resources. Spend on private contractors by Scottish Government to support delivery of the programme is to date limited to support for marketing campaigns, contact centre telephony, data analytics and modelling, and systems development. Detail of spend to date is set out in the following table. A minimum threshold of £10,000 has been applied. Spend on governance support has been excluded as it does not relate to programme delivery. Further expenditure on private contractors may have been incurred by NHS territorial health boards. This information is not held centrally.

Data on patients recruited from NHS Scotland in each of the last 12 months into non-COVID-19 Trials in Scotland are set out below.

June 2019 1,678

July 2019 1,839

Aug 2019 1,725

Sept 2019 1,358

Oct 2019 1,647

Nov 2019 1,431

Dec 2019 991

Jan 2020 1,500

Feb 2020 1,293

Mar 2020 789

Apr 2020 34

May 2020 19

Notes

1. The data does not take account of patients recruited into other types of research.

2. The number of patients recruited in previous years and still involved in Clinical Trials is not captured by NHS Research Scotland.

3. The data has been provided by research teams working in NHS Scotland and may not be complete.

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.

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.