Seòmar agus comataidhean

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.

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 convened the National COVID19 Cancer Treatment Response Group (CTRG) on 18 th March to form national clinical consensus in Scotland on changes to cancer treatment in response to the new risks associated with COVID-19 ensuring those most urgent cases were prioritised.

The group has produced clinical advice on an ongoing basis and throughout the pandemic the majority of cancer treatments have continued.

We have now established a National Cancer Recovery Group which has been established to offer national arbitration on overall clinical priorities. It will also oversee national data and modelling work in relation to cancer recovery and advise on patient and public communications.

Any cancer patient worried about symptoms should call their existing cancer treatment helpline or the national cancer treatment helpline. Individuals with serious or worrying signs or symptoms are encouraged to use the NHS as normal and contact their local GP practice.

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/

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.

I refer the member to the answer to question S5W-27044 on 3 February 2020. This confirmed that routine health data records hernia operations, bladder operations, etc., using prosthetic implants, not those specifically using mesh implants. Furthermore, NHS Information Services Division (ISD) confirmed that reported complications or problems following surgery cannot accurately be established from routine health data because readmissions are recorded according to the symptom reported, not the underlying cause.

All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: https://www.parliament.scot/parliamentarybusiness/28877.aspx .

Urgent and emergency care has been maintained throughout this pandemic to ensure those with life threatening conditions were and continue to be seen as a matter of priority.

Through the Re-mobilise, Recover, Re-design: The Framework for NHS Scotland , Health Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of some paused services whilst continuing to protect emergency, urgent, Cancer and maternity care. Health Boards will plan to resume services while maintaining COVID-19 capacity and resilience and providing appropriate support for social care, and also protecting the safety of all patients and staff. Health Boards are taking a careful and considered approach to this, balancing the treatment of COVID-19 patients with the all potential impacts of longer waiting times, including assessing the impact of this on excess death rates.

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.

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.