Seòmar agus comataidhean

We published the refresh of the Diabetes Improvement Plan today.

The Plan is available on the Scottish Government website and can be found at: https://www.gov.scot/isbn/9781800046788

At the outset of the pandemic, the four Chief Medical Officers (CMOs) published a list of six groups where people would be considered to be at the highest clinical risk from COVID-19.

The initial approach was based on best evidence at the time. We are committed to following the evidence and we have refined the shielding criteria as new evidence emerges.

For this reason the 4 UK CMOs and based on evidence from the British Liver Trust and from researchers at Oxford University https://www.sciencedirect.com/science/article/pii/S0168827820336679 agreed to include to the shielding list patients with liver cirrhosis (Child-Pugh class B and C).

Letters will be issued as soon as possible to those people affected to inform them that they will be added to the shielding list and to explain what it means for them.

The seasonal flu vaccination programme has been more important than ever this year, in light of the Covid-19 pandemic. That is why we expanded the programme to protect the most vulnerable and alleviate pressure on the NHS. We extended eligibility this season to include;

• social care workers who provide direct personal care,
• household members of individuals who are shielding,
• all those aged 60-64 (who are not already eligible), and
• those aged 55-59, dependent on vaccine supply.
  

All Health Boards worked closely with the Scottish Government and Public Health Scotland, focusing upon improved delivery approaches, whilst dealing with the unprecedented demand for seasonal flu vaccinations. The adoption of a phased approach has allowed those at the greatest clinical risk to be prioritised.

Public Health Scotland published provisional data to the end of Week 51, 2020 (20th December 2020 on influenza vaccine uptake for eligible cohorts in Scotland and estimated that:

• 79.0% for those aged 65 years and over

• 53.8% for those under 65 years old in an at-risk group

• 44.5% in pregnant women (including those with and without risk factors)

• 59.3% in preschool children (aged 2 to under 5 years, not yet in school)

• 75.3% in primary school children

• 39.6% in health & social care staff

• 54.1% in unpaid and young carers

Although it is not possible to directly compare with previous seasons, the data indicate that the overall vaccine uptake for Scotland is higher than last season in most eligible cohorts; notably for those aged 65 years and over the uptake at 79.0% compares with that of 74% in the previous two seasons.

Public Health Scotland publish weekly epidemiological information on seasonal influenza activity in Scotland and on 27 January this indicated that:

Influenza activity is currently at low levels.

• The rate of influenza-like illness (ILI) was at Baseline activity level (0.5 per 100,000).
• The swab positivity of influenza was at Baseline activity level (0.1%, 3/2,400).
• The incidence rate of influenza was at Baseline activity level 0.05 per 100,000 population).
• There were 3 influenza A cases detected: one type H3 and two untyped.

On that basis, emerging clinical evidence indicates that overall levels of seasonal flu circulating in the community are very low, and therefore associated risks are much lower than in previous years. The new Covid variant 'VOC - 202012/01' poses a further risk to public health given the increased transmissibility of this variant.

Given the prevalence of Covid-19 across Scotland, the Covid-19 vaccination programme is now being rolled out by Health Boards at pace. The workforce equipped to deliver these vaccinations will be pivoted, and resources redirected to the planning and delivery the Covid-19 vaccination programme.

As a result, groups in Phase 3 (55-59 years) of the Seasonal Flu Vaccination Programme will not be invited for vaccination. However, it remains important that those eligible, who have yet to book their vaccination appointment come forward so that they can benefit from protection for the remainder of the flu season. Pregnant women and those people who are clinically at risk of flu will continue to be offered flu vaccination.

We will write to all MSPs and Scottish MPs in the coming days to provide them with details on the continuation of the Seasonal Flu Vaccination Programme.

Additionally, the NHS Inform website has a dedicated flu section that will be updated to provide information to those who require it.

This year we have been able to increase the allowances paid to those who are self-funders in residential care.

Usually, these payment rates increase in line with inflation. However, emerging evidence shows that the cost of providing personal and nursing care has increased significantly and the payment made to providers by Local Authorities for self-funding residents has not kept pace with this. This year, these rates of allowances have increased well above inflation and bring the payments closer to the actual costs of personal and nursing care for those who are self-funding their residential costs.

Any wider reforms of the way that residential and nursing care is paid for and delivered will be an important part of how we respond to the Independent Review of adult social care.

An additional £10.1 million has been allocated to Local Authorities to cover this rise.

The Scottish Government has established walk-through local test sites to support universities with students’ return in August and September, increase urban testing access, and fill drive-through provision gaps to provide equal access to testing across Scotland – when Scotland’s mobile testing unit fleet had not been scheduled to increase.

The Scottish Government plans to expand and improve the mobile testing fleet significantly by the beginning of March. Subject to local partners’ agreement, these plans mean a mobile testing unit will be able take drive-through bookings and walk-ins in Stranraer seven days a week – up from the current two days a week – with immediate effect.

In order to achieve our primary objective of reducing interactions and helping to drive down community transmission of Covid-19, the number of key worker children presenting to schools during the current strict lockdown must be kept to an absolute minimum. The purpose of the exceptional key worker arrangements initiated in January 2021 is therefore to ensure that workers who are critical to supporting essential and lifeline services in Scotland can request places for their children in schools or with childcare providers, when alternative options have been exhausted.

Where the agriculture and dairy sector are critical to food supply and / or support essential or critical services as set out in the published guidance , employers and staff would be eligible to request access to key worker child places in schools as potential Category 3 workers. As not all agriculture and dairy workers supports such services, it would not be appropriate to explicitly include those sectors in the key worker categories.

It is for local authorities, schools and providers to consider and respond to individual requests. Employers are therefore asked to strictly prioritise and only request places for staff who are critical to the provision of essential services and have no alternate childcare or working options.

In considering requests to schools, local authorities are expected to take account of the diverse needs of their local communities, families and young people when applying these arrangements and managing demand for places.

Whilst the need to protect non COVID-19 healthcare activity remains paramount, it will inevitably be affected by the degree to which we can suppress the virus. Consequently, given the differing levels of virus prevalence we are seeing across the country, we need to give our clinicians and NHS Boards flexibility to manage the demands of this continuing emergency situation.

Due to these demands, NHS Boards are stepping back their non-urgent routine procedures consistent with the Framework for Clinical Prioritisation of Elective Care . To support NHS Boards and to ensure that urgent elective and cancer patients continue to receive treatment, and following the arrangements set out in the NHS Scotland - winter preparedness plan: 2020 to 2021 - gov.scot (www.gov.scot) , we have secured further capacity from the private healthcare sector in Scotland. Our strategy for using the private sector is to ensure that there is a green pathway for those patients who require vital planned care. The private sector hospitals will provide support for breast surgery, urology, and gynaecology.

This support comes on top of the additional capacity already being provided by NHS Golden Jubilee and NHS Louisa Jordan for a number of elective treatments and outpatient appointments. This will allow NHS Boards to concentrate on the front line response to the impact COVID19.

The Scottish Government will continue to work closely with NHS Boards to ensure those requiring urgent care can be seen as quickly and safely as possible.

Even as we expand our vaccination and testing programmes, the number of COVID patients within our hospitals remains very high – so it is absolutely vital that people continue to stay home, protect the NHS, and save lives.

While cancer services have remained a priority throughout the pandemic, we recognise there continues to be an impact on cancer services due to the necessary reduction in some areas of clinically determined non-urgent care. Today, we have published and launched our Recovery and Redesign: An Action Plan for Cancer Services which details how we will continue to prioritise cancer services and steps that will be taken in order to ensure resilience in the future, and adopt new innovations. The Plan, which will be live from now until March 2023, is operationally focused with an emphasis placed on diagnosis and treatment. We have outlined 68 actions in total, including 4 flagship innovations. We will establish two Early Cancer Diagnostic Centres within existing NHS infrastructure, a Single Point of Contact Framework to aid patients navigate through cancer services, a programme of Prehabilitation to prepare patients for treatment and achieve optimal outcomes, and a National Dedicated Resource for Cancer. This plan will be backed by up to an additional £17 million, bringing our planned total investment in cancer services up to £114.5 million by March 2023.