Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, February 9, 2021

Official Report 816KB pdf

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Urgent Question

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Covid-19 Vaccination Centres (Delays)

To ask the Scottish Government what the causes were of the reported delays at vaccination centres in Fife and Tayside on 8 February, and what is being done to ensure that they are not repeated.

Let me start by apologising to all those who were affected by the problems in the NHS Fife vaccine clinics yesterday. The issue, which was specific and restricted to Fife, as I understand it, was the result of an information technology issue with the ServiceNow national scheduling system, which resulted in the overbooking of appointments. This morning, I have written to Fife’s MSPs and MPs, apologising, explaining in detail and setting out the action that is under way for those affected.

Urgent work is under way by NHS National Services Scotland to resolve the issue. A permanent fix to the system will be in place by the end of the week; in advance of that, standard operating procedures have been revised to ensure that the issue is not repeated.

NHS Fife is making alternative arrangements to ensure that appointments booked for today and tomorrow can still go ahead. All those with an appointment for today and tomorrow will be vaccinated, with NHS Fife increasing capacity at five of its clinics. The Scottish Ambulance Service is providing additional vaccinators and mobile units, where required. For later appointments that are affected, people will receive a letter tomorrow, rescheduling their appointment. All those who could not be vaccinated yesterday will be called directly.

In NHS Tayside, I understand that throughput was slower than anticipated at the Caird hall clinic due to weather conditions and associated staff and patient attendance, and on-site training. That is being addressed by deploying additional vaccinators and support staff to the clinic.

Despite the difficulties, which were experienced most acutely by those who were waiting to be vaccinated, Fife vaccinated 5,006 individuals yesterday, contributing to the 61,299 people across Scotland who were vaccinated yesterday, which took us to a vaccination level of 99.97 per cent of care home residents, 96 per cent of people aged 80 or over and 75 per cent of people aged 75 to 79 in the community.

I thank the health secretary for that genuine apology, but I was disappointed that the First Minister said earlier that nothing was wrong with the vaccination programme. It is wholly unacceptable for people over the age of 70, many of whom have not been out of the house for months, to be left waiting in sub-zero conditions for hours on end. Some waited for four hours for an injection that should have taken minutes. A lady collapsed in Lochgelly. Another, who was just out of hospital with breast cancer, was told to wait for two and a half hours. Why was the problem discovered only when people turned up for their appointment? Why were those 7,000 double-bookings not spotted manually in advance?

There were not 7,000 double-bookings. I am very happy to ensure that Mr Rennie and any other interested colleagues have exactly the right number.

As I said, the situation was not acceptable. I am not sure what more Mr Rennie wants me to say about that. NHS Fife has acted to resolve the problem for those who turned up and did not get vaccinated, and for those who would have been affected today, tomorrow and later in the week had it not been identified.

In essence, what happened, as I understand it—I am no IT guru by any stretch of anybody’s imagination—was that, as NHS Fife transferred from local booking arrangements to the national booking portal, there was an issue with the data transfer that was not spotted until the clinics took place.

NHS National Services Scotland, which is our national system service, NHS Fife and the Government are looking at two things right now. They are looking at fixing that so that it does not happen again but, in order to fix it so that it does not happen again, they need to understand why it happened in the first place and why it was not flagged up by the system before people got to the clinics. As they resolve those two matters, I am very happy to ensure that Mr Rennie and other interested colleagues have that explanation. However, I cannot give more detail until those bodies resolve the problem by understanding exactly what the problem was.

It was the health secretary’s letter this morning that referred to the 7,000 bookings. What I need to understand is how we can be sure, if we still do not fully understand what the problem was, that it will not be repeated tomorrow or the day after. If we move other boards to the centralised system, how do we know that what has happened will not happen to them as well? What lessons have been learned from the events at the Caird hall in Dundee? What advice does the health secretary have for the over-70s in Fife who have no letter, because the helpline is currently not helping them?

The point that I am trying to make is that the way in which we will ensure that the system is fixed is by understanding exactly what the problem was and why it was not flagged up at the point when it happened as opposed to later, when people were turning up for appointments. Work on that is under way in order not only to fix the system but to ensure that, where problems arise, there are additional flags in the system.

Other boards are already on the ServiceNow platform, and they have been for some time. NHS Fife is one of the late transitioners to it. In fact, all our mainland health boards will be on it by the end of this week. The reason for that is that we need that national booking system in the same way that we need the national vaccine management tool. It allows us to look ahead nationally at the planned bookings against the known supply so that we can manage the two much better. Having everyone on the ServiceNow platform is the right thing to do. The majority of boards are already on it, and the problem has not arisen before.

I think that I have answered Mr Rennie’s question in full, but if I have missed something, he should let me know, please.

Six other members wish to ask a question. We will see whether we get through them all.

I think that we can all agree that what happened in Fife yesterday was completely unacceptable. What my constituents want now is assurances that it will not happen again, and they need clear information about how what happened will be resolved and how those who are waiting for appointments who were overbooked this week will get their new appointments. Why has a decision been taken to send appointments in the mail, as we know that there have been delays in the mail? People who are expecting appointments at the end of the week need to know about them soon—why have they not been telephoned? Will the cabinet secretary clarify why NHS Fife has mentioned five sites but the letter that she sent us this morning mentions eight sites and refers to one particular site for the weekend? It would be helpful for MSPs to know what site will be impacted over the weekend.

I apologise to Ms Baker—I missed some of the questions at the end. We will check the Official Report and ensure that I answer them.

I have already said that what happened was unacceptable, and I am not sure what more I can say about that. Steps have been taken to identify what the problem is, to resolve it, to ensure that it does not happen again and to address issues that relate to those who are booked today and tomorrow to ensure that they are vaccinated and are not turned away and kept waiting; those who could not be vaccinated yesterday, who will get a phone call to book them in; and those who might have been affected on Thursday, Friday and into the weekend, for whom alternative arrangements will be put in place.

Notwithstanding the ServiceNow problem, NHS Fife has acted to try to resolve that problem with our help and that of the Scottish Ambulance Service.

I do not want to diminish for one second the upset, difficulty and concern experienced yesterday by people who turned up to be vaccinated, waited in the cold, and were not, in the end, vaccinated. That will have been a very distressing experience.

To everyone else, I say that, in a national programme that is vaccinating 4.5 million people, that is now going faster than those elsewhere in the UK and for which we are creating an infrastructure as we go, there will be glitches and problems. We need to fix those, we need to apologise for them and we need to ensure that they do not happen again. However, we must not use those glitches and problems to undermine the success of the entire programme, which is proving itself right now.

I agree that we are seeing the roll-out of a programme the likes of which we have not seen in our lifetimes, and I commend all those who are doing their bit. However, it remains the case that many of my constituents had a grim day yesterday, queuing outside for the Covid vaccine in the freezing cold at the Lochgelly centre, and then not getting it. A lot of people were not impressed with that, even if we are collectively impressed with the programme.

The key thing now is to focus on there being absolute clarity in the information that the individuals who were affected yesterday, and any more who might be affected this week as a result, get about what will happen now. The cabinet secretary has said twice what is to happen, so NHS Fife should now make that clear to the people who are affected, because it is not—I assure members—clear to them. A phone call might, in the circumstances, be more appropriate than people having to wait for a letter that might, given the post and the weather, be a wee bit delayed.

I therefore make a plea to the cabinet secretary. Those people simply want clarification about the position, and I am sure that NHS Fife could provide that quickly.

I am grateful to Ms Ewing for her constructive and helpful suggestion. When we are finished here, in the chamber, I will go and make sure that that happens.

Yesterday’s queues followed a winter flu vaccination programme in NHS Fife that was described at the time as “shambolic”. Why has Fife been particularly affected by problems with vaccine roll-out? The cabinet secretary said earlier that NHS Fife was “a late transitioner” to the national booking service—[Inaudible.]

I am sorry, Mr Ruskell, but we missed the question. Could you repeat it?

Yes. The question is about the cabinet secretary’s comment that NHS Fife transitioned late to the national booking system. Why does Fife seem to be falling behind when it comes to flu and coronavirus vaccinations?

NHS Fife was a late transitioner, but it was not the only one, so it is not fair to say that Fife alone is “falling behind”. The NHS has made long-standing use of ServiceNow for other provision. A number of boards transitioned to the national booking system early on during the vaccination programme, and the final boards to do so, of which NHS Fife is one, will be transitioning this week. That is partly because boards wanted to be able to make local arrangements for early delivery but knew that my overall objective was that all would go on the national platform, for all the good reasons that I have already outlined. NHS Fife is one of the last to go on to the service; it is not alone. Other boards are joining it this week, and, by the end of the week, all our mainland boards should be on the national service platform.

Many elderly people who are housebound should have received their vaccination but still have not. They are feeling abandoned and forgotten, according to some general practitioners. Does the Government accept that that is a significant failing of vaccination roll-out? What is being done to remedy the situation?

Mr Cameron keeps looking for significant failings, but that is not one. I have asked all boards to update me on where they are on the matter. It is, rightly, general practices and primary care that will vaccinate people who are housebound. They are working their way round those people and are making considerable progress. I have no doubt that they will complete that as quickly as possible.

I believe that most people want the vaccination programme to succeed; I certainly do. However, when the over-80s were being done in Fife—which we should remember is a particularly rural area—they got their jag at their local health centre or GP surgery. That worked wonderfully. Why shift it for the over-70s? The reason—[Inaudible.]—cabinet secretary is that the cost is far cheaper if people go to the hub. However, over-70s might end up waiting in the freezing cold, as they did yesterday. I am also told that the choice of venues is not great and that there is a lack of social distancing and sanitisation. Those people still have to get their second jag, so will the cabinet secretary agree to look at the matter again and treat the over-70s in the same excellent way as the over-80s were treated, so that they can be vaccinated in a safe environment?

I am grateful to Mr Rowley for his questions and have no doubt about the sincerity of his hope that the national vaccination programme will succeed. He and I share that hope.

The shift was, and is, not at all about cost. I have no reason to doubt Mr Rowley, so I will investigate urgently whether the clinics have in place sufficient protection measures in terms of physical distancing and sanitisation. If they do not, I will make sure that that is resolved.

In many of our boards, 75 to 79-year-olds have been vaccinated through GP clinics. I undertake to look again at whether NHS Fife could do that. However, it then becomes a question about pace. If we do it through individual GP practices, excellent though they are, the speed with which they can vaccinate numbers of people at the same time as maintaining standard GP services, which we want them to do, is slower than when people go to clinics—even small ones.

Members should remember that we are, because of the protection level that it brings, trying to vaccinate the largest possible number of people as quickly as we can, as supplies allow. There is a balance to be struck between the safe and right way to do something and the quickest way to do it. I repeat that the decision is absolutely not about cost. I will look again at whether something can be done in relation to second doses—we will talk with NHS Fife and other boards—but we must also remember that the balance has to be struck between moving as quickly as we can, as supplies allow, and making vaccination as local and accessible as possible. The two do not always sit neatly together.

I apologise to Neil Findlay, but we have to move on to the next item of business. There will be a short pause before we do so.