Meeting of the Parliament

Meeting date: Tuesday, October 4, 2022

Official Report 1147KB pdf

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Health and Care Recovery (Winter Planning)

The next item of business is a statement by Humza Yousaf on health and care recovery in winter planning. The cabinet secretary will take questions after his statement, so there should be no interruptions or interventions.

17:39  

I welcome the opportunity to provide an update to Parliament on the continued recovery of the national health service from the Covid-19 pandemic and to set out our resilience plans for the coming winter. The past year has been immensely challenging for our workforce, which has, nevertheless, continued to deliver excellent services in the face of multiple waves of Covid-19, increased demand and the most difficult winter period yet experienced.

This year, we could face an even more challenging winter that will be made more difficult by the escalating cost of living crisis and by economic mismanagement by the United Kingdom Government. Our NHS recovery plan and the specific measures that we are taking to ensure resilience this winter represent system-wide solutions to the system-wide challenges.

Resilience and recovery go hand in hand. We have spent months planning for the winter ahead. I turn first to our recovery plan update. Our resilience plans for the winter and beyond are made possible by the commitment that we have made to invest in and reform our NHS. Our plan commits to £1 billion of targeted funding during this parliamentary session to increase NHS capacity, to deliver reform and to support timely access to treatment.

We know that the NHS will not recover in weeks or even months; to be frank, I say that it will take years. We will always be clear, up front and honest about the scale of the challenge that we collectively face. It is therefore critical that we reform our services as national circumstances evolve. We are committed to maintaining a health and social care system that is resilient and adaptable.

I think that I can say on behalf of the entire Parliament that we all owe the health and social care workforce a huge debt of gratitude. There can be no recovery without continued investment in our workforce. The NHS recovery plan commits to growing our workforce. We have invested in our staff through fair pay, increased training and upskilling opportunities, and widening access to career opportunities.

By April this year, we had recruited more than 1,000 additional healthcare support staff and almost 200 registered nurses from overseas to help to address the unprecedented challenges that our services face. Staffing levels have increased by more than 2,800 permanent whole-time-equivalent roles in the past year. That builds on our strong track record of delivering 10 consecutive years of growth. There are almost 25,000 additional more whole-time-equivalent staff working in NHS Scotland than there were a decade ago. Indeed, staffing in NHS Scotland remains at historically high levels.

General practice is the bedrock of the NHS, and I recognise the pressures that our practices face. To that end, we have expanded community multidisciplinary teams across the country. We have recruited more than 3,220 primary care multidisciplinary team members and increased funding for those teams to £170 million this year, which will be the minimum funding position for future years. That helps patients to access a range of expert advice from a wider team of healthcare professionals who work alongside and support GPs and practice teams. Furthermore, we are making good progress on increasing the number of GPs by 800 by the end of 2027.

Progress on the recovery and reform of planned care in the past year has been impacted by the need to respond to various waves of Covid-19. Despite that, we continue to make progress. Statistics that have come out just today show that 21,218 operations were performed in August, which is a 19 per cent increase on the month before and the highest monthly total since the pandemic began.

Over the past 18 months, we have opened the NHS Golden Jubilee eye centre; procured Carrick Glen clinic in NHS Ayrshire and Arran, which will become the Ayr national treatment centre; opened a mobile operating theatre to enable almost 350 elective surgeries for patients in Orkney and Shetland; and opened a urology hub at Forth Valley royal hospital. In addition, significant progress has been made on the national treatment centre programme. The Fife and Forth Valley national treatment centres are planned to open in early 2023, followed by the centre in Highland and then by the Golden Jubilee phase 2. Work to recruit staff for those facilities is very much under way.

We are committed to reducing long waits. The longer somebody has to wait for an operation, the greater the chance of deterioration and deconditioning. Public Health Scotland data shows that, by the end of August this year, 75 per cent of out-patient specialties had zero or fewer than 10 patients waiting more than two years, and 10 out of 14 territorial health boards had five patients or fewer waiting more than two years.

Between June and August of this year, significant progress was made in several specialisms to eradicate long out-patient waits, including reductions of 48 per cent in general surgery waits, 74 per cent in plastic surgery waits and 96 per cent in cardiology waits. I thank all NHS staff for their phenomenal work to tackle those long waits. Of course, the continued theme of the statement is that there is still work to do.

On urgent care, accident and emergency performance is not where I or the Government would want it to be. Too many people are waiting far too long for urgent care and treatment. Our A and E departments are working under significant pressure and, as with health services across the rest of the UK, the pandemic continues to seriously affect services. We are determined to improve and stabilise performance through working very closely with boards on measures to reduce pressures on our acute sites. However, as winter arrives, those pressures will undoubtedly have a detrimental impact on already stretched services. We will do what we can to mitigate the worst effects of those.

This update on recovery of the NHS is, by its nature, a snapshot of a larger, longer and more complex picture. Over the course of this parliamentary session, we will invest more than £70 billion in delivery of health and social care services. This NHS recovery update demonstrates a clear plan to support health and social care.

I was interested to note that the recent plan for patients that was announced by the UK Secretary of State for Health and Social Care very much resembles work that is already being done in NHS Scotland. Our recovery plan, which was first published in August last year, includes a commitment to increasing NHS capacity by at least 10 per cent as quickly as possible in order to help to address backlogs. It committed to scaling up use of technology and use of NHS Near Me. In the same plan is a commitment to ensuring that all Scotland’s general practices have support from pharmacy and nursing practices.

Those are just a few of the policies that are already being delivered in Scotland that have subsequently been announced by the UK Government. We will continue to work tirelessly to deliver the ambitions that are set out in the recovery plan, and we will provide the next progress update in a year’s time.

Winter will come between then and now, of course. To help us to mitigate the challenges that winter will undoubtedly bring, we are investing £600 million in total to support services over what we expect to be an extremely challenging season. We know that if Covid transmission rises in our community there will be significant impacts on our health and social care services. That is why our winter vaccination programme is very much under way. More than 2 million people in Scotland will be offered Covid-19 and flu vaccines by the holiday season. That will help to protect the public and relieve pressure on the NHS.

We have been working for several months with NHS Scotland chief executives, directors of planning and executive leads for resilience to plan for the significant pressures that we fully expect this winter to bring. “Scottish Government Winter Resilience Overview 2022-23”, which was published today and contains priorities that have been agreed with our partners in the Convention of Scottish Local Authorities, builds on our response to last winter and involves Government at national and local levels, with delivery partners across the system.

We are working with the British Medical Association and the Royal College of General Practitioners to increase accessibility to primary care and to ensure that appointments can be made with the most appropriate person—whether that be a general practitioner, a physiotherapist, a pharmacist or another appropriate member of the multidisciplinary team—to help people throughout the course of this winter.

This winter, we want to see improved call waiting times at NHS 24 and improved patient outcomes. We will be using a suite of tools, including the NHS 24 app, to support people throughout Scotland.

Our winter resilience overview focuses on recruitment, retention and the wellbeing of our health and social care workforce, with the aim of expanding and supporting our workforce over the course of the winter period. To boost our NHS workforce, which has already grown by almost 9 per cent since December 2019, we are making £8 million available this winter to support boards in recruiting up to 750 additional nurses, midwives and allied health professionals from overseas. In addition, NHS boards have identified that they will recruit an additional 250 band 4s across the system over the coming months. That investment, which allows for the significant recruitment of 1,000 additional staff over the course of the winter, will be a welcome boost to our workforce in health boards throughout the country.

The offer of paid part-time work to health and social care students and additional measures that are designed to support opportunities for volunteering across the NHS are also contained in our plan.

As well as recruitment, we are supporting the retention of our existing workforce through new retire and return guidelines, and by devolving powers to NHS boards to utilise local flexibilities within NHS pension arrangements. Some £200 million of the £528 million that has been allocated to health and social care partnerships for winter pressures funding has been set aside to increase the hourly rate of pay for people who work in social care to £10.50.

We are investing £45 million in the Scottish Ambulance Service to support recruitment and service development this year. That includes plans for winter.

We have managed to avoid 45,000 hospital bed days this year through expanding our virtual capacity, and we will continue to invest in hospital at home.

Presiding Officer, the coming months will be another test for our health and social care system and its incredible workforce. I wish that I could stand here and tell you and all members that we will be able to mitigate every challenge that this winter will throw at us, but recovery is a process, and I have always been up front in saying that the recovery journey that we are on will take years—not weeks or a few months.

I hope that our winter plan has set out the measures that we will take to bolster the workforce and reduce demand by treating people at home, or as close to home as possible, during this difficult period.

I wish to end where I started, by thanking our incredible NHS and social care staff for all their unbelievable efforts across the course of this pandemic. There can be no recovery if we do not take care of people’s wellbeing, which is this Government’s top priority.

The cabinet secretary will now take questions on the issues that were raised in his statement. I intend to allow about 20 minutes for that, after which we will need to move on to the next item of business. I ask members who wish to ask a question to press their request-to-speak buttons now or as soon as possible, if they have not already done so.

All members in the chamber pay tribute to the outstanding work of health and social care workers across Scotland, but the reality is that they have been badly let down by the Scottish National Party-Green Government.

The NHS recovery plan was published more than a year ago, but things have gone from bad to worse. Only today, we heard that August’s A and E waiting times were the worst on record across every category. There are already reports of ambulances stacking up outside emergency departments, often for hours, including at Aberdeen royal infirmary in my region, and that is well before the winter months arrive.

The system is not just stretched, it is overstretched. Few people, apart from SNP members, will be reassured by the cabinet secretary’s statement, so I will put three questions to him. First, his statement mentions improved call waiting times for NHS 24. Given that, in June, one patient waited two hours, eight minutes and 15 seconds to be answered by an operator, can the cabinet secretary tell us how that will be achieved and what he considers to be an acceptable waiting time?

Secondly, there is no mention in the statement of NHS dentistry, which is at breaking point. Does the cabinet secretary realise the catastrophic impact that his funding cuts will have on the dentistry sector?

Finally, the statement mentions growing the NHS workforce through recruitment, but there is almost nothing about retention. Nursing vacancies are up by as much as 25 per cent compared with last year. Therefore, what is the Scottish Government doing to improve retention of NHS workers?

Before I call the cabinet secretary, I advise members that there is a lot of interest in asking questions, so questions will have to be more succinct or keep to time—so, too, will the responses.

Taking that cue, I am happy to follow up with members if they feel that anything is missing from any of the answers that I give.

In relation to the overall deterioration of certain aspects of care that is provided, Tess White is right to mention that A and E figures are not where we want them to be. The monthly figures that came out for August in Scotland showed that 66.1 per cent of patients were seen within four hours. In England, that figure was 55.8 per cent, so we continue to be the best performing. I accept that that is cold comfort to people who are waiting for far too long. I give that information to provide the important context that health services across the UK—in fact, many health services across the world—face the same problem.

The example that Tess White gave of a patient waiting for as long as she outlined is simply not good enough. I expect that to be the exception—in fact, I know it to be the exception, because we know what median call waiting times are. We will support that through additional recruitment. I was pleased to be at the Dundee NHS 24 hub, where an exceptional workforce has been recruited to bolster NHS 24’s capability and capacity. I can write to Tess White with more detail on what we are planning to do with NHS 24.

Additional funding for dentistry is covered in our plan. In my statement, I was able only to give a small snapshot of our overall plans for dentistry. We will continue to make bridging payments between now and the end of the financial year. Those payments will be 20 per cent on top of the fees that are currently paid and will then go to 10 per cent. Again, I can write to Tess White in more detail about the significant impact that those payments have had on increasing NHS dental examinations in the most recent quarter, which I am very pleased about.

The member is absolutely right that retention must be a key plank of our plan. I will make three points on retention. First, if she looks at the detail of the plan—I outlined some of this in my statement—she will see that we will invest in the wellbeing of the workforce, as that helps with retention.

Secondly, we have allowed there to be some flexibility around pensions, which the BMA has been calling for to help with medical staff. We will devolve to boards powers related to the recycling of employers’ contribution scheme. I think that other members have called for that.

Thirdly—again, I am happy to provide Tess White with more detail about this offline—we are making changes to the retire and return policy. That is a direct result of a meeting attended by the Royal College of Nursing at which a number of members, including Craig Hoy, Jackie Baillie and Alex Cole-Hamilton, told us that there had to be a better retire and return policy. We have implemented that.

I thank the cabinet secretary for advance sight of his statement, and I associate myself with his remarks about thanking our NHS staff.

In the 500 days for which the cabinet secretary has been charge, things have got worse. There is little recognition of the scope of the challenge in the new plan. Nurses are being balloted for strike action, and there are 7,500 vacancies across the NHS, which is a staggering increase of 169 per cent since the Scottish National Party came to power. Staff tell me that patients are at risk because wards are short staffed—in some wards, there is one nurse to 30 patients. In addition, as many as 50 per cent of junior doctors are thinking of leaving.

Given that staff are the backbone of our NHS, that amounts to a catastrophe on the cabinet secretary’s watch. What action will he take? How many more nurses and doctors can we expect to have for this winter?

All the medical experts, including the RCN, the BMA and the Royal College of Emergency Medicine, have been telling the cabinet secretary time and time again that he should invest in tackling delayed discharge to deal with the long wait at A and E, but, under his watch, we have lost 740,000 bed days.

Does the cabinet secretary not understand that he could lose the confidence of the medical profession in the face of a long and difficult winter ahead? Does he not agree that he will have failed if the measures that he has outlined today do not reduce delayed discharge, do not tackle A and E waiting times and do not stop staff leaving?

Jackie Baillie does a disservice to the health service if she does not recognise some of the recovery that has been made by our incredibly hard-working NHS staff. For example, I have mentioned that statistics came out today that show that planned operations increased from July to August by 19 per cent to the highest level since the pandemic.

Of course, things are challenging. I do not think that anybody can deny that—I am certainly not denying that. I am saying, as I have said many times in the chamber, that performance on urgent care is not where we need it to be. The member is absolutely right that the position on delayed discharge is nowhere near where we want it to be. That is not through a lack of effort. I am happy to provide detail to Jackie Baillie on the conversations that we have had with health and social care partnerships up and down the country around how we resolve some of that.

However, we know that a number of factors, including external factors that are not within this Government’s control, have made staffing in care homes and for care at home more difficult. Brexit is one example of that; the very difficult recruitment market is another example. However, we are working day and night to try to resolve some of those issues.

I will now pick up some of Jackie Baillie’s direct questions. On nurses being balloted for strike action, that gives me great concern. I have been speaking to the RCN, Unison and other trade unions regularly. We are looking to get back round the table with them this month to recommence those discussions and negotiations, and to give them an improved pay offer, because they had a very strong mandate from their members to reject the previous pay offer that we put to them.

On staff recruitment, I would have hoped that Jackie Baillie would have listened to what I said in my statement; I also hope that she will read what is in the plan. Staff recruitment is a clear central plank of our plan. I am not sure why she is shaking her head—the plan says that we will recruit 750 overseas nurses, midwives and allied health professionals. If she wants a breakdown of how many of those will be nurses, midwives and AHPs, I would be happy to give that detail offline. On top of that, there will be an extra 250 band 4 posts as well. Will there still be vacancies? Of course there will, and we will do our best to reduce those.

The member should be left in no doubt at all that staffing levels are historically high under this Government—in fact, they are 6 per cent up since the onset of the pandemic. That includes our gaining an additional 550 qualified nurses and midwives since we published the recovery plan. [Humza Yousaf has corrected this contribution. See end of report.]

I have referenced delayed discharge already. It is crucial that we continue to invest in the hospital at home service, because the out-patient parenteral antimicrobial therapy—OPAT—pathway has managed to save 45,000 bed days in the past year alone.

We are almost halfway through our time and we have just finished questions from the front-bench spokespeople. I will protect back benchers’ opportunity to ask questions, so I will prolong the session ever so slightly, but that is not an invitation to extend questions and responses.

Duly noted, Presiding Officer.

Patient flow through hospitals is always important, but it will be particularly so through the winter months. What steps are being taken to ensure effective system flow, particularly in health boards that cover large rural areas?

In short, there have been really good discussions, particularly with some of our health boards that cover rural areas, about what we can do to bolster the hospital at home service. Although flow is absolutely a problem, the more people we can treat closer to home, the better—it is better for patients who often have to travel long distances to get to acute sites to be treated at home or as close to home as possible. Our hospital at home teams, particularly those in rural health boards, are working hard to ensure that a good service is being provided. I saw a good example of the hospital at home service in the Western Isles, as that very remote island community was able to deliver the service very effectively.

We will also continue to invest in staff in rural health boards. We expect a proportion of the staffing that I referenced in my answer to Jackie Baillie to go to rural health boards, and we want to incentivise particular staff cohorts to work in those health boards. That will help to keep people out of hospital.

On helping with flow through hospital, I assure Gillian Martin that the work that we are doing in relation to delayed discharge has a focus on health boards that cover rural, remote and island communities.

Across the country, lack of access to cottage hospitals is undermining the recovery, including in my Galloway and West Dumfries constituency. Cottage hospitals are vital in tackling the endemic problem of delayed discharge, which has a knock-on impact throughout the whole healthcare system, particularly in A and E departments.

In my area, three hospitals have, in effect, been mothballed since early 2020.

Question, please.

Kirkcudbright, Newton Stewart and Castle Douglas hospitals have a capacity of more than 36 beds. What action will the cabinet secretary take to reopen those hospitals or to provide new fit-for-purpose facilities to provide the services, including palliative and step-down care, that cottage hospitals effectively delivered in the past, in order to reduce pressure?

Finlay Carson asks an important question. I hope that he appreciates—I think that he does—that really difficult decisions were made during the pandemic, as we needed staff in acute sites that were exceptionally busy.

He, other members and local health boards are right to push me on whether cottage hospitals could be reopened to tackle, for example, delayed discharge by transferring patients from acute settings to facilities that provide step-down care. Our challenge in that regard is staffing, but I will look at the issue. In the context of Dumfries and Galloway, I will look at the three cottage hospitals that Finlay Carson mentioned. I promise him that the possibility of reopening cottage hospitals is being explored in our plans.

Individuals who are unable to heat their homes and unable to have food at regular times will be susceptible to greater illness, which will place greater strain on health and social care services over winter. What additional impact will the increase in the cost of living have on demand for NHS and social care services over winter?

I can be brief because my views on that are well known. The cost crisis is, in my view, a public health crisis. As part of our winter planning, we are planning for the eventuality of the cost crisis worsening and for the impact that that will have on public health.

I appeal to the chancellor not to take his hatchet to our public services—as he is threatening to do in order to mitigate the impacts of his economic mismanagement—because that would have a devastating impact on already very stretched budgets.

I assure David Torrance that the cost crisis and its impacts are very much factored into our winter planning.

Last week, it was reported that several patients have suffered cardiac arrests in the past month while waiting to be seen in the A and E department at the Queen Elizabeth university hospital. Tragically, two of those cardiac arrests were fatal and followed significant delays in triage.

That followed reports last week that winter surge beds are already almost at capacity, with John-Paul Loughrey, the vice-chair of RCEM Scotland, stating that the NHS urgently needs extra resources to cope.

It is only October and our NHS is on life support. What is the cabinet secretary going to do? When will he bring forward a detailed plan that provides A and E departments with sufficient staffing, capacity and resources to deal with already overstretching demand in relation to not only delayed discharge but triage?

I invite Paul O’Kane to look at the plans that have been published: the recovery plan update and the winter resilience plan. Of course, staffing is a key plank of those, and I hope that that will help.

In relation to triaging and the cases that the member references, I will not comment on individual cases, other than to express my deepest sympathy to people and their families who have been affected by long waits. The member will not get an argument from me about the fact that there are really detrimental impacts on people who have to wait for elective surgery or for urgent treatment.

I guarantee that my focus, and the Government’s focus, is on doing everything possible to bolster our NHS through this difficult winter. In A and E, the key to that will have to be trying to create capacity, which is why we will do everything in our power to reduce delayed discharges. At the front door, we will do our best to reduce demand, which is why we have the investment that I detailed in the hospital at home service and in social care and so on, which will be important to that end.

Throughout the pandemic, our NHS and social care staff have shown extraordinary commitment and have worked under immense pressure to support people. Now, those same staff face increased living costs and energy prices. What steps are being taken to support employees in the NHS and social care during the winter months?

That is a really important point. The member will know that our NHS agenda for change staff are the best paid anywhere in the United Kingdom, and we want to maintain that position. As the member knows, we are in the midst of pay negotiations, but I have every intention of maintaining our position of having the best-paid NHS staff, because, ultimately, that will make a difference in dealing with the cost crisis, which is affecting them.

Wellbeing initiatives will also be important. We have done a significant amount on wellbeing. The measures go from what would be described as relatively minor but well appreciated interventions, such as providing hot food and drinks on busy wards, right through to interventions that are seen as more significant, such as making available psychological therapies and counselling for staff. We will continue that work as well.

Ultimately, of course, the significant economic levers on the cost crisis lie with the UK Government. If the members of that Government can stop fighting with one another, get round the table and, I hope, introduce a package that deals with the cost crisis, that would benefit NHS and social care workers up and down the country.

It is astonishing to me that it was a full 10 minutes before the cabinet secretary acknowledged that there is any kind of problem in the NHS. Much of the problem relates to staffing—that has been staring his Government in the face for years. Last week, a whistleblower told me that the Edinburgh royal infirmary operates routinely with 80 fewer nurses than it needs on every single shift. Just moments ago, the British Medical Association released research showing that half of junior doctors are thinking of leaving the profession altogether—they are demoralised, undervalued and exhausted. Will the cabinet secretary take this opportunity to offer health and care workers, whom he rightly thanks, a profound apology for the Government’s failures?

In my conversations with health and social care workers, I give them a commitment and promise that the Government is singularly focused on trying to improve their wellbeing so that they can care for the people whom we represent. That is what I will do, and it is what I am focused on, which is why we have historically high levels of staffing and the best-paid staff anywhere in the UK.

If Alex Cole-Hamilton actually has any solutions, he should please come forward with them. All that he said was a diatribe against the Government, which will not help NHS staff on the ground.

I note from the cabinet secretary’s statement that students are being employed part-time to add capacity. Although I recognise that that is vital experience, what structures are being put in place to support such students and to ensure that they are not overworked or put under undue pressure that may affect their studies?

That is a very good question. There are, of course, limits on how much students can work, so that it does not impact on their studies. During the really difficult periods in the early days of the pandemic—of course, those difficult periods continue to this day—there was the ability to utilise students, particularly during December and January, when there was a natural lull and break from intense study. We are exploring whether we could do something similar again. I thank in advance the students to whom we are able to offer placements, because they will be of great help and they always show great enthusiasm in helping out on the front line. There are safeguards in place to protect them, so that their studies are not unduly affected.

We have three more members who need to ask a question, so the questions will have to be brief and the answers briefer.

Vaccination remains our best line of defence, and I am aware that Covid boosters are now being offered to priority groups and that everyone who is eligible can safely receive that vaccination and the flu vaccination at the same appointment. Can the minister provide an update on the roll-out of the winter vaccination programme and an assurance that there are adequate vaccines to meet demand?

I can be brief in saying that the roll-out is well under way. It is going exceptionally well and we are tracking above our modelled expectation for this time of the programme. The roll-out is going fantastically well, the uptake is exceptionally high and the co-administration rate for flu and Covid-19 is well above 90 per cent. As much as we are focused on Covid, clinicians tell me that they expect a resurgence of flu this winter in the same way that has been seen in the southern hemisphere. Statistics and the latest data around how many vaccinations we have administered will be published later this week, which I think will be the same for other UK nations.

The cabinet secretary’s centralising projects such as vaccination centres are causing more problems than they are solving by taking staff from community hospitals to centres more than 40 miles from the patients they were previously helping. With Insch and Aboyne community hospitals now closed, when will the cabinet secretary admit that his winter resilience and Covid recovery plan not only fails to mention rural Scotland but fails to offer it any flexibility at all?

It is astonishing that the member has criticised the Covid vaccination programme. Scotland has led the way in first, second and third doses of the vaccination. Not only that, but at one point during a previous winter vaccination programme it was one of the fastest and most successful vaccination programmes in the entire world, yet he is not able to congratulate the fantastic staff on the efforts that they have made.

There are local flexibilities. Local communities can, for example, request GPs to be involved in their programme. That decision is then discussed and made in conjunction with officials in the Scottish Government. If Alexander Burnett has particular concerns, he is more than welcome to approach me and I am more than happy to try to be as flexible as possible. However, so far, from the data that I have seen—which, as I said to Natalie Don, will be published shortly—the winter vaccination programme is going extremely well.

Covid-19 remains a threat to public health this winter. Can the cabinet secretary reiterate what action is being taken to mitigate the risk of increased levels of Covid infection over the winter months?

As briefly as possible, cabinet secretary.

I can be brief by saying that the number 1 action that we can take, collectively as a society as well as in Government, is to make sure that people are being vaccinated. As I say, the vaccination programme is well under way. We will continue to work with Public Health Scotland to reiterate public health guidance, as well. I remind people that the pandemic is not over—the virus has not gone away—so, if you are able to have cognisance of, be aware of and implement that strong public health guidance, you can help yourself and the people around you.

That concludes the statement.