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Prior to the start of the Covid-19 Pandemic, there were six Health Boards in Scotland who had been escalated to Stage 3 or above within the NHS Boards Performance Escalation Framework. This is the stage at which Boards are considered to require a higher level of support and oversight, from Scottish Government and/or other senior external support.

Boards can be escalated for a number of different reasons and can have more than one status, reflecting their individual positions. Reasons for escalation include:

• Financial position and financial management
• Operational Delivery/Performance
• Governance, leadership and culture
• Quality and safety

The six escalated Boards escalated were as follows:

• NHS Ayrshire and Arran
• NHS Borders
• NHS Greater Glasgow and Clyde
• NHS Lothian
• NHS Highland
• NHS Tayside

Following a recent review of escalated Boards by the Health and Social Care Management Board, and despite the challenges of responding to the Covid-19 Pandemic, the majority of Boards were found to have demonstrated sufficient improvement in relation to the issues which had led to their escalation to justify a reduction in their escalation status. The following table shows the changes which have now been made.

The coronavirus outbreak remains a real and sustained threat to human life in Scotland as well as to social and economic well-being. The Scottish Government has always relied on a range of indicators and criteria, combined with clinical advice and local intelligence about the state of epidemic, to construct a full, reliable, and robust picture of the threat posed by COVID-19 across the four harms.

On 14 May, we published Coronavirus (COVID-19) protective measures: indicators and data which sets out the indicators to assess the threat of Covid-19, and inform when and how we introduce, adapt, or ease protective measures. This includes core indicators, measuring both community transmission and healthcare capacity at a local level, and secondary indicators which provide critical information on viral concentration, prevalence and incidence of COVID-19 cases, testing (including access), vaccination, mortality, and hospitalisations at any given local level.

The scale and extent of our successful vaccination programme is enabling us to consider how we can respond to the virus moving forward. We are growing increasingly confident that vaccination is helping break the link between case numbers and hospitalisation and death. However, currently the evidence base remains insufficient, especially in light of the Delta variant, which we are currently attempting to better understand. That is why it is still important to keep cases as low as possible, to reduce the chances of transmission and new variants developing.

Our Coronavirus guidance on reducing the risks in schools was developed in collaboration with local authorities, unions, parents representative groups and teaching bodies, with input from technical experts working across the UK. This includes a section on the potential use of CO2 monitors to assist in assessing whether adequate ventilation is being provided. Each local authority and school can utilise this technology as appropriate to their particular circumstances.

We have worked from the start of the COVID-19 pandemic with the Scottish Heads of Property Services forum to get input and feedback on guidance, and ventilation is a standing agenda item at each meeting. The forum was used to request progress information including: local authority plans to utilise CO2 monitoring, ventilation upgrades required, observations from operational schools and issues arising during different weather conditions where ventilation and thermal comfort could be in tension. The Scottish Heads of Property Services use this forum to share expertise and learning to ensure that efforts and resources are best deployed to optimise solutions across the whole learning estate in Scotland. Links have also been established with other expert groups representing the UK governments to help inform future guidance.

The Scottish Government is working with mental health organisations, employer groups and trade unions to improve mental health support in workplaces across Scotland.

In October 2020 we published our ‘Mental Health – Transition and Recovery’ plan which outlines our response to the mental health impacts of COVID-19. We have recently convened a short life working group aimed at addressing 3 key employment actions from the plan: Mentally Healthy Workplaces; Fair Work Practices; and Home Working.

The focus of the group will be on identifying the key challenges that businesses of all sizes, including self-employed people, will face in supporting the mental wellbeing of their workforce. We will review existing practice and identify any key gaps that may prevent a positive mental health and wellbeing culture within the workplace.

The number of times a mechanical problem has resulted in a delay to ferry services operated by CalMac Ferries Ltd between October 2016 to March 2021 is detailed in the following table.

Firstly, as means of clarification the Welsh Government did not commit to 50 percent of its fleet being assembled in Wales prior to its procurement. Both the Welsh and Scottish Governments must comply with relevant procurement law.

The procurement strategy for new rolling stock, to be produced by the wholly owned Scottish Government company named ScotRail Trains Limited, will be subject to approval by Transport Scotland. Through that process, the Scottish Government will seek to maximise opportunities for the involvement of the local supply chain.

Transport Scotland has already undertaken informal market testing with manufacturers to ensure the importance of local input is clear and any procurement will restate this. The current Class 314 conversion project at Bo’ness is focussed on developing a local supply chain which will support the need for diesel train replacement by zero emissions fleets.

Transport Scotland are preparing robust estimates for the all the works involved with the repairs to the viaduct. However, the current estimate for the propping to enable the M8 restrictions to be removed and facilitate the repair works is £33.36million. This estimate, and the delivery programme, is being refined to ensure value for money as detailed design progresses. Costs for the subsequent concrete repair works to the supports will be provided by Transport Scotland’s Operating Company, Amey, when the extent of the repair works and repair method is agreed.

The Open with Care guidance, published on 24 February 2021, recommends a minimum of two indoor visits per resident per week (where they so wish), as long as certain conditions are met. This was a starting point to enable care homes to increase the frequency, duration and quality of visits through local assessment and support from local oversight arrangements. The guidance should be adopted to reflect the Protection Level of each care home’s local authority area.

Additional advice on supporting residents to make outings and overnight stays away from the care home was published on 17 May www.gov.scot/publications/coronavirus-covid-19-
adult-care-homes-visiting-guidance/ . The general principle is that when a resident wishes to go on outings away from the care home, that these should take place in line with general population COVID-19 permissions relevant to the local area, unless there is clear evidence justifying a more restrictive approach.

The Open With Care National Oversight Group is monitoring implementation of the guidance, identifying any additional support that might be required, and will report on progress in June .

We acknowledge how challenging this past year has been for everyone in our society, including places of worship. We are grateful to all of Scotland’s faith and belief communities for all they have done to keep their congregations safe and to support our communities during this unprecedented time.

From 26 April, we moved towards greater easing of the health protection restrictions, with the removal of the 50 person limit in places of worship; instead the numbers of people who can attend are limited according to the building capacity and physical distancing of two metres, along with other measures informed by a risk assessment.

The Scottish Government is reviewing physical distancing including its impact on places of worship and an announcement, which will consider the faster spreading Delta variant, is expected in the near future. Sectoral guidance will be further updated at that time to reflect the outcome of the review, including proposals for as clear a route as possible to the reduction/removal of physical distancing to enable people and organisations to plan effectively for a full reopening. Physical distancing has been an important tool for controlling the virus, but as with all restrictions, we will only have this in place as long as is necessary

The Scottish Government has to balance the harms from the virus which are potentially fatal, with the impact on faith and belief communities of the restrictions on places of worship. However, please be reassured that the Scottish Government understands the important role of congregational worship in supporting spiritual, mental and social wellbeing and will continue to engage with faith and belief communities regarding the scope for further easing.

The virus continues to have severe direct impacts on people’s health, and the potential to put significant pressures on NHS capacity. For this reason, and to tackle the new, faster-spreading Delta variant, we have made the difficult decision to delay a move to Level 1 for some Local Authorities which have displayed high or rapidly increasing levels of incidence.

The decision to allocate areas to a Level, finely balances the need to control the virus and to minimise the wider economic and social harms of the restrictions. Consideration of the economic harms from Covid (Harm 4) is factored into the design of the Levels themselves, and a 4 Harms Assessment was undertaken on these Levels when they were last updated and published.

On 1 June, we published Coronavirus (COVID-19): Protection Levels allocation to local councils which explains the basis on which Levels 2 and 1 were applied to local council areas in Scotland. The Government also has a legal duty to undertake statutory Impact Assessments when Regulations concerning the Levels are changed. These include Equalities, Islands, Child Rights/Wellbeing, and Business and Regulatory Impact Assessments, and they are now published.