Seòmar agus comataidhean

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.

Since May 2021 we have a system in place through NHS Inform to provide people with a record of their vaccination status if they need this for international travel. Scottish residents who want to demonstrate their vaccination status can request a certificate through NHS Inform before they travel. This can take up to 14 days, but current turnaround is typically 2-3 days.

It remains the case that if people are returning from an amber list country and are not fully vaccinated in accordance with the exemption, they must self-isolate for 10 days at their accommodation in Scotland and must book a day 2 and day 8 testing package , prior to departure. Details of this can be found at the link below.

It also remains the case that if people they are returning from a red list country they should follow the managed isolation guidance as set out on:

Coronavirus (COVID-19): international travel and managed isolation (quarantine) - gov.scot (www.gov.scot) .

People need to be aware that countries may move between the red, amber or green list country at short notice. They are advised that they should not assume that a country on the green, amber or red list now will remain on the same list over the weeks and months ahead.

A table has been placed in the Scottish Parliament Information Centre (Bib Number 62617) that provides ongoing maintenance and repair costs per vessel within the Clyde and Hebrides fleet for CalMac Ferries Ltd. contract years 2016-17 to 2021-22.

I met with the Children and Young People’s Commissioner Scotland on 10 June 2021.

At this introductory meeting we discussed matters of mutual interest, including the UN Convention on the Rights of the Child (Incorporation) (Scotland) Bill and children and young people’s participation in decision-making.

The choice of disposal method for ordinance found on the Seagreen Offshore Windfarm will be a hierarchy of methods made up of leaving in situ , relocating the UXO, applying a low-yield method which disrupts and disintegrates the UXO without combustion of the explosive material, a low-order method which disrupts the UXO by deflagration without an explosive combustion of the main explosive filling and, only where those methods are unsuitable, to use a high-order method to penetrate the UXO casing and trigger detonation of the main explosive filling.

Bubble curtains are not being used as, due to the water depth at the site, they would be technically challenging and may be of limited effectiveness.

The use of the mezzanine deck on MV Hebrides is a primarily an operational decision for CalMac Ferries Ltd (CFL). CFL continue to engage with the communities and businesses who use the service regarding the use of the mezzanine deck and the potential impacts on timetables, number of sailings and overall capacity for passengers and vehicles. The mezzanine deck was brought back into use on sailings from 9 August 2021.

The £3 million funding was part of the emergency COVID-19 support for culture, protecting jobs and addressing some of the financial pressures facing the three organisations. It was announced on 17 January 2021, comprising £1.4 million for Aberdeen Performing Arts, £800,000 for Eden Court Highlands and £800,000 for Capital Theatres. Funding is being delivered through Creative Scotland. The funding agreements with the three organisations require that the funds must be used in addressing the problems linked to the COVID-19 pandemic, and in order to enable the organisations to be financially stable in order to develop and present cultural activity when restrictions allow. Later in 2021 Creative Scotland will require the organisations to provide information on the use of funding, including how they have spent it, whether it has allowed them to maintain their workforce and stabilised their financial position.

Proposals to the Bus Partnership Fund are assessed against criteria which focus on the climate benefits of mode shift from private car to public transport. The criteria and weightings are as follows:

• Evidence of congestion and ideas to reduce congestion, through improved bus services (40%)

• How the proposal fits with the partnership area’s overall strategy for integrated transport, to encourage a modal shift from cars to more sustainable transport and reduce emissions (25%)

• Partnership strength and demonstrated commitment, which will include match in kind (20%)

• Deliverability: the ability of the lead local authority and its partners to deliver the proposed developments, including local political buy-in (15%)

Successful bidders to the fund are required to submit monthly progress reports to Transport Scotland. Each subsequent tranche of funding will be dependent upon their passing gateway reviews, which will provide further assurance that the funded infrastructure developments support action on climate change.