Chamber and committees

The Chief Medical Officer wrote to those people considered most at risk from COVID-19 on 26 March. The letter provided information and support on shielding themselves from Covid-19 and how they could access the care and treatment they might need. The letter also explained that their GP practice would contact them to discuss how best to ensure they still receive the medical care appropriate to them during this period.

As part of these discussions, the GP may ask about their health and care wishes to ensure that they are recorded should they become unwell with COVID-19. These conversations are known as Anticipatory Care Planning (ACP) and GPs and other health professionals are supported to have them in a sensitive manner. This discussion might also include conversation about Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions if raised by the person or their GP deems it necessary.

To support GPs in having these discussions in a way that is compassionate and respectful, on 10 April we issued a letter to GP practices to provide advice and support on having anticipatory care planning conversations. The letter makes clear that there is no requirement for health professionals to have a DNACPR discussion as part of this conversation, unless the patient wishes to discuss it or clinician feels strongly it is necessary to raise in conversation for the patient’s wellbeing.

Additionally, on 17 April, a further joint letter from the Scottish Government’s Chief Medical Office, BMA and RCGPs was sent to GPs to reinforce this message and set out how they could effectively support care homes during this difficult time.

To raise public awareness and support people to have these conversations we have added information about anticipatory care planning in the context of COVID-19 to the NHS Inform website. This includes a link to a video providing information and support about what to consider with those closest to you before having an ACP conversation with your GP or other health professional.

The Scottish Government continues to consider public feedback and work with stakeholders to consider how we can best promote awareness of anticipatory care planning and support people and those closest to them to have those conversations.

The Scottish Government set a target to have the daily lab capacity for 3500 tests by the end of April 2020. Maximum NHS testing capacity as of 1 May was 4,350 tests a day and has increased since that date.

 The Scottish Government does not routinely publish advice to Ministers of this kind. The remit, membership and minutes of the Scottish Government COVID-19 Advisory Group, which considers the scientific and technical concepts and processes that are key to understanding the evolving COVID-19 situation and potential impacts in Scotland, can be found at the following link.

https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/

The Scottish Government proactively publishes details of all Ministerial meetings. This information can be found at the following link https://www.gov.scot/collections/ministerial-engagements-travel-and-gifts/ .

The operation of the statutory framework for lobbying is a matter for the Scottish Parliament.

Daily trends in COVID-19 data, including number of tests are available here: https://www.gov.scot/publications/trends-in-number-of-people-in-hospital-with-confirmed-or-suspected-covid-19/

The Scottish Government has no plans to publish this information.

The hospital is currently undergoing construction work to address the issues identified in both NSS reports I published in 2019.

Please find attached links to both National Service Scotland Reports:

Phase 1 – https://www.gov.scot/publications/nhs-national-services-scotland-review-water-ventilation-drainage-plumbing-systems-nhs-lothian-royal-hospital-children-young-people-department-clinical-neurosciences/

Phase 2 – https://www.gov.scot/publications/nhs-lothian-royal-hospital-children-young-people-department-clinical-neurosciences-review-fire-systems-electrical-systems-medical-gas-installations/

The Scottish Government does not routinely publish advice to Ministers of this kind.

Reducing delayed discharge is a long standing objective given the clinical benefit to patients. Following the Covid-19 outbreak the Scottish Government commenced the collection of daily delayed discharge management information from Health and Social Care Partnerships. Since recording began on 4 March over 1,000 patients whose discharge was delayed were discharged from hospital to a community setting, a 63% reduction (as at 30 April 2020).

This information does not include destination on discharge. However, based on data collected by Public Health Scotland for the February Delayed Discharge census returns suggests that around 71% of delayed discharges return to their own home, and 29% are admitted to a care home. Local information from Health and Social Care Partnerships suggests this trend has continued through the current crisis, albeit there may be some people who move temporarily to care homes before returning home.

Figures for calendar month February 2020 are shown in Table 1.

Table 1. Number of discharges following a period of delay where the delay reason was awaiting completion of care arrangements or place availability 1 ; Calendar month February 2020