Chamber and committees

The Programme for Government 2019-20 included a commitment to begin work to pilot self-sampling for cervical screening at a national level. Although the work to establish a pilot in Scotland was paused due to the escalation of COVID-19, it will be resumed and prioritised following the restart of the screening programmes.

At this stage the UK National Screening Committee (UK NSC) has not approved self-sampling for use in a national screening programme, and this work will require further study in pilots and research projects before it can be introduced safely into the cervical cancer screening programme.

The decision to pause the cervical screening programme was taken with the advice of the Chief Medical Officer and follows careful consideration of all of the risks involved.

While there are risks to individuals through delayed diagnosis of cervical cancer, the majority of people participating in national population screening programmes are well and do not have early disease. These risks needed to be weighed up in the context of the pressures on the NHS in Scotland presented by Covid-19 and the need to prevent the further spread of coronavirus.

We continue to advise the public that it is important for those in between screening appointments or awaiting a rescheduled appointment to be aware of any symptoms or signs of the conditions screened for. More information on cervical cancer symptoms can be found on the NHS inform website, which can be accessed at the following link, https://www.nhsinform.scot/healthy-living/screening/cervical/cervical-screening-smear-test . Anyone having these symptoms should contact their GP practice immediately.

The Scottish Government announced a structured pause of the cervical screening programme on 30 March 2020. Work is underway to prepare for the resumption of all of the national cancer screening programmes as part of the remobilisation of our NHS and in line with the routemap out of lockdown. We envisage that the cervical screening programme will start with the prioritised recommencement of non-routine screening and women who had been invited for screening prior to the pause being announced. Arrangements will also be put in place to ensure that no one need miss their screening appointment as a result of the pause.

The Scientific Advisory Group for Emergencies (SAGE) met and advised all Governments in the UK via a COBR(M) meeting to enter lockdown on the 23 March 2020. There was no recommendation to enter lockdown earlier.

The Scottish Government Covid-19 Advisory Group held its inaugural meeting on
‎ 26 March 2020, three days after lockdown was announced.

Advice from SAGE is not routinely published, however minutes and papers from SAGE and the Scottish Government Covid-19 Advisory Group which are published can be found on the UK Government website and the Scottish Government website .

I refer the Member to the answer to his previous question S5W-29552 on 15 June 2020 . All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx

The health and wellbeing of individuals, communities and the economy is the priority of the Scottish Government. All employers in Scotland should follow the existing Scottish guidance, support workers to follow health protection advice and have a statutory duty to ensure that workers’ health and safety is protected. This includes undertaking risk assessments of their work activity, assessing the risk from Covid-19 spread in the workplace, and putting in place appropriate mitigating measures.

As part of risk assessments companies should explore with trade union or workforce representatives how to respond should anyone develop symptoms while at work, including whether it is possible to identify any particular parts of the workplace the individual may have accessed or equipment used while symptomatic. This should include consideration of how best to monitor health of all individuals in a workplace.

Test and Protect is Scotland’s approach to implementing the 'test, trace, isolate, support' strategy. It is a public health measure designed to break chains of transmission of Coronavirus (COVID-19) in the community. The NHS will test people who have symptoms, trace people who may have become infected by spending time in close contact with someone who tests positive, and then support those close contacts to self-isolate. Test and Protect Guidance for Employers is available on the Scottish Government website.

The health and wellbeing of individuals, communities and the economy is the priority of the Scottish Government. The Scottish Government has produced Business and Physical Distancing Guidance to help businesses and their employees to follow health protection advice. It is clear that employers have a statutory duty to ensure that workers’ health and safety is protected. This includes undertaking risk assessments of their work activity, assessing the risk from Covid-19 spread in the workplace, and putting in place appropriate mitigating measures.

Where companies and their workforce do not have access to the skills to undertake risk assessments in-house they should together explore external support options to put in place appropriate mitigation measures, for example through their trade association, health and safety consultancies or trade union health and safety representatives.

We understand that some sectors may not have a significant level of trade union membership in all areas. Where this is the case, employers should engage with workforce representatives in the way that they would engage with trade union representatives. There is HSE guidance available on worker involvement at: https://www.hse.gov.uk/involvement/ .

We are working closely with the key regulatory bodies; the Health and Safety Executive, Local Authorities and the Police, to ensure a joined up approach to the enforcement and monitoring of workplace public health measures. We have issued a joint statement that sets how these bodies will work together to ensure workplaces operate safely and in compliance with regulations, this is available at: https://www.gov.scot/publications/coronavirus-covid-19-safer-work-places-statement/ .

The Scottish Government will continue to monitor the information available on the number of deaths of black and minority ethnic (BAME) people as a consequence of COVID-19.

On 4 May, National Records of Scotland released a technical note describing the ethnicity data, and its limitations, held on COVID-19 deaths

https://www.nrscotland.gov.uk/files/statistics/covid19/ethnicity-deceased-covid-19-may20.pdf

• Ethnicity data is missing for nine per cent (203 records) of the 2,272 COVID-19 deaths recorded up to Sunday 26th April.
• 2,046 deaths (90%) were of people whose ethnic group was registered as White
• Registered deaths where a Black, Asian or minority ethnic group (BAME) was provided accounted for 1% of deaths (23 people).

NRS are currently testing whether ethnicity data from the 2011 Census can be used to improve the quality of the death registration data. If this is successful, NRS will carry out analysis which will aim to answer the question of whether there is a variation in the relative risk of mortality related to COVID-19 by ethnicity.

On 20 May, Public Health Scotland (PHS) published preliminary analysis which appears to show that there is not a higher level of Covid-19 cases than would be expected, given the size of our black, Asian and minority ethnic population. However, the data is very limited and additional analysis will need done as more data becomes available.

As set out in a paper from 10 March 2020, the Scottish Government was clear that if a point of sustained community transmission for COVID-19 was reached, we would rely less on contact tracing and focus instead on providing the best care to those who had developed the disease, on delaying and reducing the spread and protecting those who are most vulnerable: https://www.gov.scot/publications/coronavirus-how-contact-tracing-works/

On the advice of senior clinicians and public health experts, Scotland's testing capacity was initially prioritised where it would have the greatest effect; for the seriously ill and to allow key workers to return to work. Testing capacity has increased significantly and testing is now available to anyone age 5 and over with symptoms.