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Current guidance for ear irrigation services is that patients should speak to their pharmacist for minor problems and patients with particularly troublesome symptoms should contact their GP to discuss the most suitable treatment. This guidance is available online at NHS Inform and was last updated on 22 December 2020.

The Evaluation Guide and Award Criteria published as part of the Invitation to Tender determined the Quality: Price ratio for the evaluation process as 75:25. The emphasis placed on quality reflects the importance the Scottish Government attaches to delivering a high quality assessment resource to schools, and recognises the requirement for a range of technical, educational and psychometric expertise to deliver the complex and multi-faceted Services associated with the Contract.

The Award criteria for the Quality Analysis element of the evaluation identified a series of questions across a range of areas, including Assessments and Reporting; Technical; Service Management; Security; and Transition, Implementation and Business as Usual. Some of these questions were identified as mandatory, requiring a minimum score of 2 in order for the tender to progress to the Price Analysis. The rationale for this approach is that if suppliers are unable to fulfil particular aspects of the service, the service would not be viable, irrespective of cost. Mandatory items are clearly identified within the published Evaluation and Award Criteria.

The Procurement Reform (Scotland) Act 2014 Statutory Guidance (amended 2021) states that regulated contracts must be awarded to the most economically advantageous tender. The Guidance clarifies that this means contracts cannot be awarded on the basis of lowest price or lowest cost alone.

From 9 August, national guidance was updated to remove physical distancing requirements in most settings. This, however, did not extend to health and social care settings.

On 11 August, the Chief Nursing Officer Directorate (CNOD) commissioned NSS Antimicrobial Resistance and Healthcare Associated infections (ARHAI) and Public Health Scotland (PHS) to review current Infection Prevention and Control guidance as a matter of urgency, with a view to implementing a step by step reduction of physical distancing in non-clinical/para-clinical areas. ARHAI and PHS produced draft guidance which went out for consultation with key stakeholders including NHS Chief Executive Officers on 18 August with a closing date of 19 August.

ARHAI and PHS are currently drafting updated guidance which will issue to boards once this has been formalised.

The Scottish Government is not able to provide the information requested due to this level of data not being publically available. In particular, individual patients may be identifiable should such hospital level information be published.

Quarterly reports on Clostridioides difficile infection, Escherichia coli bacteraemia and Staphylococcus aureus bacteraemia are published, with the data broken down by Health Board, and are available her

Additionally, validated data on Covid-19 hospital acquired infection is published weekly, with information broken down by NHS Health Board to protect patient identity. This information can be accessed here.

I refer Mr Mundell to the answer to S6W-01932 on 25 August 2021.

The OECD’s Independent Review of Curriculum for Excellence (CfE) was conducted using their Implementing Policies: Supporting Change in Education Framework.

The OECD had responsibility for its programme of virtual school visits and the arrangement of focus groups, and was supported by both Scottish Government officials and the Scottish Practitioner Forum.

Details of how the OECD conducted their independent review can be accessed at Independent+Review+of+Curriculum+for+Excellence+-+Remit.pdf (www.gov.scot)

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/chamber-and-committees/written-questions-and-answers

The Scottish Government is in discussion with key stakeholders involved in the provision of swimming lessons and water safety education. We recognise the importance of swimming lessons in helping to build water confidence and learning to be safe in and around water, as well as the benefits swimming provides to physical and mental health. We would encourage parents/guardians to contact their local swimming lesson provider to discuss when their children are able to attend lessons.

The Scottish Government is committed to ensuring there is resilience and capacity in the health and social care system to aid us in our mobilisation, support staff to recover from previous COVID-19 waves, and to manage the need to remain vigilant against any future wave.

The most recently published data indicates a total of 258,269 patients were seen at new outpatient appointments during the first quarter of 2021. This is down 20.4% from the same period in 2020, prior to implementation of social distancing restrictions. At 31 March 2021, 48.1% of those waiting for a new outpatient appointment had been waiting 12 weeks or FEWER. This IS down from 74.4% in the same period in 2020. At 31 March 2021,184,224 new outpatients had experienced ongoing waits greater than 12 weeks, up 177.8% from the same period in 2020 (66,325).

It is difficult to quantify the impact that the two-metre social distancing restrictions have had on capacity and throughput in outpatient settings, not least because of the differences in Wave one where elective services halted and Wave two where services began to remobilise. In addition to this there is considerable variance in the layout, structure and fabric of NHS facilities across Scotland.

Whilst the two metre distancing restrictions will have played a part in capacity and throughput, other factors will also have influenced them. These include bed closure, staff absences (including those who have been deployed elsewhere to assist with the pandemic or were shielding) and throughput lost to other IPC controls, which include removal of beds to reduce potential risk of COVID-19 transmission.

There has been a change in the way services have been delivered in outpatient settings, for example – staggered waiting times to avoid overcrowding within these areas/ reduce footfall, one-way access/egress and the use of Near Me where possible to avoid face to face consultations.

We currently have no plans to revise our advice on vitamin D supplementation. We will continue to be guided by the Scientific Advisory Committee on Nutrition (SACN) and others as the evidence base on vitamin D develops. We will review our advice as necessary based on their recommendations.

Our current advice on vitamin D supplementation, which is based on recommendations by SACN, advisors to the four UK nations, is available at https://www.gov.scot/publications/vitamin-d-advice-for-all-age-groups/

In terms of supplement dosage, our advice is a supplement containing 10 micrograms of vitamin D (400 IU). This applies to adults and children over one year of age. Ten micrograms per day is the average amount needed by the majority (97.5%) of the population to maintain adequate vitamin D levels when UVB sunlight exposure is minimal to maintain bone and muscle health. Our advice is based on SACN’s 2016 report; Vitamin D and Health.

This report is available at:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf

In December 2020, the National Institute for Health and Care Excellence (NICE), SACN, and Public Health England published updated guidance on vitamin D in relation to COVID-19 following a rapid review of recent evidence. The guidance states that there is still currently not enough evidence to support taking vitamin D solely for the prevention or treatment of COVID-19. It reiterates that people should continue to follow current advice on vitamin D supplementation to maintain bone and muscle health.

The NICE guideline is available at https://www.nice.org.uk/guidance/NG187

SACN published an updated rapid review on Vitamin D and acute respiratory tractinfections (ARTI) in December 2020. In it, SACN recommended the reference nutrient intake for vitamin D remain unchanged, at 10 micrograms per day.

The review is available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/945179/SACN_December2020_VitaminD_AcuteRespiratoryTractInfections.pdf

In June 2021, SACN published a paper summarising monitoring of recent evidence on nutrition and COVID-19. It did not identify any new trials in relation to vitamin D and COVID-19 that would require the re-review of the current rapid guideline from NICE, SACN and PHE, or that would change current dietary advice.

The paper is available at:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/992875/SACN_Process_for_monitoring_evidence_on_nutrition_and_COVID-19__June21_.pdf

SACN will continue to support NICE with their monitoring of evidence on vitamin D.

The UK COVID-19 Therapeutic Advisory Panel (UK C-TAP) continues to monitor ongoing COVID-19 related Vitamin D trials. It is responsible for reviewing and prioritising suitable compounds based on promising scientific evidence. Evidence on vitamin D and on COVID-19 is also being monitored by RAPID-C19, a multi-agency initiative aiming to get treatments for COVID-19 to NHS patients quickly and safely, as well as by the National Institute for Health Research (NIHR) Innovation Observatory (IO), a national medical horizon scanning facility at Newcastle University. SACN has agreed it will no longer monitor evidence in relation to vitamin D and COVID-19/ARTI, as monitoring is being continued by these organisations.

The OECD had responsibility for stakeholder engagement.

The OECD’s Independent Review of Curriculum for Excellence (CfE) was conducted using their Implementing Policies: Supporting Change in Education Framework.

Details of how the OECD conducted their independent review can be accessed at Independent+Review+of+Curriculum+for+Excellence+-+Remit.pdf (www.gov.scot)

You may also wish to note that the name of stakeholders who participated in engagement interviews are credited in the OECD’s final report.