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The Scottish Government has prioritised the largest programmes to help as many businesses as possible. Nearly £660 million of the £715 million, more than 92%, we have allocated to business support since October is already live and the vast majority of other funds will go live this month.

Information on the number of people in care homes that have received vitamin D supplements each month since the last of the pandemic is not held centrally.

The Chief Medical Officer issued a letter to all adult care home providers on Thursday 21st January 2021 providing advice on vitamin D supplements for care home residents. The letter states that residents should be assessed for vitamin D supplements (as per local formulary) as part of their regular routine clinical review and that decisions on whether to prescribe vitamin D for care home residents, including those who are shielded, should be taken on an individual basis.

In addition to this, the Chief Medical Officer also issued a letter to those individuals on the shielding list on 23rd October 2020 which included the offer of 4 months free supply of vitamin D. The letter stated that, for people in care homes, their GP or nurse will discuss whether vitamin D will be of benefit.

Supplies of 90,000 units of Vitamin D were procured with 71,833 people opting in to the offer. These were posted to individuals from W/C 23 November 2020.

Our advice for adults and children over one year of age to take a daily 10 microgram vitamin D supplement is based on the recommendations of the Scientific Advisory Committee on Nutrition (SACN), as set out in its 2016 report Vitamin D and Health.

The report is available at https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report

Ten micrograms is the average amount needed per day by the majority (97.5%) of the population to maintain adequate vitamin D levels when UVB sunlight exposure is minimal.

SACN published an updated rapid review on vitamin D and Acute Respiratory Tract Infections (ARTI) on 17 December 2020. It recommended the reference nutrient intake for vitamin D remain unchanged and reiterated that a vitamin D intake of 10 micrograms per day is recommended for the UK population aged 1 and above. The rapid review is available at https://www.gov.uk/government/publications/sacn-rapid-review-vitamin-d-and-acute-respiratory-tract-infections

We have no plans to set up a national programme for vitamin D for people living in care homes or care at home settings. Anyone who needs vitamin D should receive it. Decisions to prescribe it in care homes or care at home settings is a matter for the individual’s clinician.

The Chief Medical Officer wrote to care home providers, including NHS Directors of Pharmacy, and Community Pharmacy Scotland on 21 January outlining that residents should be individually assessed for vitamin D supplements as part of their regular routine clinical review.

We will continue to be guided by SACN as the evidence base on vitamin D develops.

People on the shielding list were offered a free 4 month supply of a daily supplement of Vitamin D in October 2020. Opt-in was via the Scottish Government shielding text messaging service or the free national helpline. The deadline for sign up was 11 November. Vitamin D was procured through NHS National Services Scotland National Procurement. 71,833 people opted in and supplies were posted from week commencing 23 November and arrived during December. The offer included residents in care homes and those in prison who will receive their supply through individualised discussions and prescriptions where it is of benefit.

Export Health Certificates (EHCs) are not dealt with by Marine Scotland.

EHCs for seafood exports are normally issued by Environmental Health Officers (EHOs) working for local authorities. However, given the anticipated massive increase in demand for EHCs arising from the UK leaving the EU single market, the Scottish Government, Food Standards Scotland (FSS), seafood businesses and logistics providers have worked to put in place a FSS-staffed certifying service at three logistics hubs in central Scotland, thereby reducing what would be an unmanageable burden on local authorities.

The disruption to Scotland’s high quality seafood export business is entirely a result of the UK Government’s reckless decision to pursue a hard Brexit in the middle of the pandemic.

It is difficult, at this stage, to provide an accurate figure for the average time being taken to complete the certification process. On some occasions the process can be completed in 45 minutes. In other, more problematic cases, it has taken almost 10 hours before all documentation is in order and a certificate can be issued.

Food Standards Scotland operational hubs are completing Export Health Certificate documentation to ensure that the EU authorities will accept them. Between 1 and 27 January 2021, the total number of EHCs completed across the three central logistics hubs in Scotland (Larkhall, Bellshill and Harthill) was 635*.

Single commodity load EHCs presented with complete and accurate paperwork can be processed in less than an hour. Multiple commodity loads, groupage or loads presented with incomplete or incorrect paperwork are taking longer.

Food Standards Scotland currently has the capacity and skills required at the sites to ensure efficient attestation of export health certificates and can increase resources further if that becomes necessary. SG and FSS are committed to supporting industry, and have hosted four well attended webinars highlighting the key challenges and improvements which can be made going forward, including correct completion of paperwork. These webinars can be accessed on FSS’ EU Exit food and drink exports webpage as well as other information to support businesses.

*Please note this does not represent a total number of EHCs completed in Scotland since EU Exit, only data for sites where FSS is operational (so doesn’t include EHCs issued by Local Authorities or by the private sector).

Everyone on the shielding list was offered a free 4 month supply of vitamin D as additional information attached to a letter from the Chief Medical Officer on 23 October 2020. The offer included advice, informed by clinical advisors and the Chief Pharmaceutical Officer, about contraindications and toxicity including that people should seek advice from their GP, pharmacist, midwife or health visitor if they had certain conditions or were taking certain medications or vitamin supplements already. Following further discussion with GP representative bodies, this advice was broadened to seeking advice also from clinicians and specialist nurses.

The Chief Medical Officer has issued advice to care homes that residents should be assessed for vitamin D supplementation as part of their regular routine clinical review. It is important that decisions on whether to prescribe vitamin D for care home residents are be taken on an individual basis. This approach ensures that the provision of vitamin D is considered for all care home residents, including those who are on the shielding list, and is prescribed where it is considered to be of benefit.

In relation to patients on the shielding list, they were advised that for most people taking a 10-microgram supplement of vitamin D daily is safe, but there are some who should seek advice first due to certain health conditions or medication. It was explained this is because taking too much vitamin D can cause calcium to build up in your body and this can weaken your bones and damage your heart and kidneys. As outlined above, they were advised to seek advice from their clinician, specialist nurse, pharmacist, midwife or health visitor if they were already taking a vitamin supplement.

Vitamin D is not available through the NHS Pharmacy First Service. Decisions to prescribe vitamin D to people in care homes or care at home settings is a matter for the individual’s clinician.

The Chief Medical Office wrote to care home providers and others including NHS Directors of Pharmacy and Community Pharmacy Scotland on Thursday 21st January 2021 outlining that, residents should be individually assessed for vitamin D supplements as part of their regular routine clinical review. This is to ensure that the supplements would be of benefit and to check the need for co-prescribing with calcium as well as for the other contraindications or side effect. Care home staff are encouraged to discuss this with clinical colleagues as part of routine communication arrangements.

The necessary quality standards, including the detailed product requirements, requirement for clear labelling of the strength or dose, as well as specifying the product as a food supplement and not a licenced medicine, were set out in the tender specification.

As the Vitamin D product is a food supplement rather than a licenced medicine, this means that it must comply with food standards regulations and legislation covering food supplements. This includes dosage instructions and the vitamins and minerals which may be added to them. The labelling of food supplements must also comply with the food information requirements under which claims to prevent, treat or cure disease cannot generally be attributed to food. In addition, separate rules on nutrition and health claims mean that only authorised claims may be made about food. As with other food, the relevant food hygiene requirements apply at all stages of production, processing and distribution for food supplements.

I refer the member to the answer to question S5W-34456 on‎ 29 January 2021. 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