Chamber and committees

As of 25 January, our wastage estimate so far is 1.82%. That is well below our planning assumption of 5%, which accounts for worst case scenarios and is in line with global best practice.

There are currently no accounts blocked by the Scottish Government’s primary Twitter and Facebook pages.

The Scottish Government does not have a duty to assess its compliance with the Equality Act 2010 as a whole. This legislation is largely reserved. However, the Scottish Government does assess its compliance with the Public Sector Equality Duty by adhering to the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012, which Scottish Ministers introduced to supplement the Public Sector Equality Duty. The Scottish specific duties aim to improve implementation of the Public Sector Equality Duty through a number of mechanisms. These include requiring public authorities, including the Scottish Government, to report on the progress being made to advance equality both in policy and in the treatment of their own employees every two years and publish equality outcomes every four years. The most recent report was published in 2019 and the next report is required by regulation to be published no later than 30 April 2021.

The duties also ensure the Scottish Government assesses it compliance with the Public Sector Equality Duty by obliging the Scottish Government to undertake and publish equality impact assessments of its policies. For example, the published document “Equality and Fairer Scotland Impact Assessment: Evidence gathered for Scotland’s Route Map through and out of the Crisis” sets out the evidence gathered in relation to the actual or likely impacts of the proposed activities on different groups, based on protected characteristics and socio-economic disadvantage, as well as describing a range of activities that were put in place to mitigate negative impacts or promote positive impacts and advance equality or good relations.

The published document Equality and Fairer Scotland Impact Assessment: Evidence gathered for Scotland’s Route Map through and out of the Crisis sets out the evidence we have gathered in relation to the actual or likely impacts of the proposed activities on different groups, based on protected characteristics and socio-economic disadvantage, as well as describing a range of activities that we have put in place to mitigate negative impacts or promote positive impacts and advance equality or good relations.

Information on ministerial engagements is routinely published on the Scottish Government website at: http://www.gov.scot/About/People/14944/Events-Engagements .

On 3 December 2020 a representative of Charlotte Street Partners attended a ministerial meeting with chairs, non-executive directors and directors of Scottish companies and organisations. This will appear in the ministerial engagement report in due course.

The Scottish Government will continue to engage with external organisations where that is necessary in pursuit of Scottish Ministerial responsibilities and the public interest. Such engagements will routinely appear in the ministerial engagement report.

We are not aware of any NHS board using an age-based frailty score system as a triage tool during pandemic.

On 25 July, Scottish Government published on updated Clinical Advice that aims to support clinicians with decision making throughout this COVID-19 pandemic. It includes guidance on use of the clinical frailty score.

The Clinical Advice does not make any recommendations to clinicians about changing the way that they make decisions. Clinicians continue to make decisions as they always have, using their clinical judgement, the best scientific evidence, abiding by their legal and ethical obligations and ensuring they facilitate shared decision making by patients.

The guidance makes it clear that even where it is appropriate to use the CFS, it should not be used in isolation to direct clinical decision making. Factors such as age, frailty or the existence of co-morbidities should only be considered when included as part of a non-discriminatory personalised assessment which will assess a patient’s overall potential to benefit from interventions such as critical care admission, alongside their ability to return to a quality of life that is acceptable to them.

The guidance also makes it clear that it is vital that no clinical decisions are made on the basis of any characteristic(s) of a patient, such as age, disability or the presence of existing health conditions or impairments that are not clinically relevant to the potential benefits of a course of treatment.

Care Home Residents: The most recently available official statistics from Public Health Scotland show there were 35,630 care home residents in all adult care home types as at 31st March 2019. Most, 32,445 are in Older People Care Homes, and of those, 30,914 are long-stay residents ( Care Home Census for Adults in Scotland 27 October 2020 - Data & intelligence from PHS (isdscotland.org) ).

More recent estimates from the management information system, TURAS Care Management System, covering all but a small number of adult care homes, estimate around 30,000 care home residents in long-stay Older People Care Homes, as published in the Vaccine Deployment Plan ( COVID-19+vaccine+deployment+plan+14+January+2021.pdf (www.gov.scot) ).

Care Home Staff:

The most recently available official statistics from the Scottish Social Services Council show there were 53,080 care home staff (headcount) and 41,090 Whole Time Equivalents (WTE) in all adult care home types as at 31st December 2019. This includes long-stay, short-stay and respite care homes and non-clinical ancillary staff ( Scottish Social Service Sector: Report on 2019 Workforce Data | Scottish Social Services Workforce Data (sssc.uk.com) ).

More recent estimates from the TURAS Care Management System estimate around 45,000 care home staff in long-stay Older People Care Homes, as published in the Vaccine Deployment Plan.

As of 23rd December Public Health Scotland are publishing weekly vaccination statistics on their website. As further vaccination data becomes available, PHS will consider expanding their reporting in line with this.

I refer the member to the answer to question S5W-32758 on‎ 3 December 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 .

I would also make the member aware that following the evidence session, the Public Petitions Committee wrote to both myself and the Chief Medical Officer. Our responses are published online at: PE01517: Polypropylene Mesh Medical Devices - Getting Involved : Scottish Parliament .

Following the publication of the Public Health Scotland report Discharges from NHSScotland hospitals to care homes ( https://beta.isdscotland.org/find-publications-and-data/population-health/covid-19/discharges-from-nhsscotland-hospitals-to-care-homes/ ) the data management team within PHS are working to improve the recording of the 'discharge to' field within hospital discharge records. This will include all discharge destinations, including discharges to hospices.

The Scottish Government DNACPR guidance makes clear that we expect clinicians to discuss treatment options openly and honestly with patients and their families (where appropriate) to help ensure that they get the care that is right for them. This should ideally take place before an event occurs so as to avoid causing distress to the individual and their family.

Our DNACPR guidance also emphasises that where it is clear in advance that CPR would not be successful it is essential that the information that CPR cannot be offered is clearly and sensitively shared with patients or power of attorney (and their loved ones if the patient wishes to do so), unless it is judged that the conversation would cause physical or psychological harm to the individual. This discussion is then recorded on a DNACPR form and included in the individual’s care notes.

When a disagreement with the family or patient occurs around CPR, a second opinion should be offered.