Chamber and committees

The Seasonal Flu Immunisation Programme helps to protect the most vulnerable and alleviate pressure on the NHS. This is more important than ever this year, in light of the COVID-19 pandemic.

Those most at risk from the seasonal flu, who are already eligible to receive the vaccine are:

• Those aged 65 and over,
• Those who have an underlying health condition,
• Pregnant women,
• Health care workers,
• Young and unpaid carers,
• children aged 2-5 (not yet at school), and
• primary school pupils.

This year the Scottish Government expanded free eligibility for the seasonal flu vaccine to include:

• social care workers who provide direct personal care;
• household members of individuals who are shielding; and
• all those aged 60-64 (who are not already eligible) and with the intention to further expand to 59-55.

With the expansion some occupations, such as health and social care workers are entitled to the free seasonal flu vaccine, this is because they come into contact with a higher proportion of people who are vulnerable to the seasonal flu. Given the COVID-19 pandemic, there is pressure on the global supply of seasonal flu vaccine and those at the greatest clinical risk must continue to be prioritised. Therefore school staff who are at higher risk from flu will already be eligible to receive their flu vaccination and will be contacted by their Health Board letting them know where they will receive the vaccine and how to book their appointment.

The Scottish Government does not hold information in this form.

The Perinatal and Infant Mental Health Programme Board provides strategic leadership of a £50m investment in perinatal and infant mental health. Within this, services directly towards infants aged 0 to 3 years are being developed across Scotland. Over £800,000 has been invested in infant mental health this financial year.

NHS Boards draw funding for Child and Adolescent Mental Health Services (CAMHS) from the overall health and social care funds allocated to them by the Scottish Government. Boards work with the Integration Joint Boards in their area and other partners to ensure funding decisions reflect local and national priorities for the delivery of person-centred, safe and effective mental health services.

Detail on mental health spending and the NHS budget is made available each year as part of the annual NHS Costs Book publication and the Scottish Budget, this includes CAMHS expenditure data by NHS Board. I refer the member to the answer to question S5W-26493, which details this expenditure from 2011 until 2019. The 2019-20 data is expected to be published on 19 January 2021. However, CAMHS expenditure data is not available broken down by age.

The new five level framework for COVID 19 allows for rapid but proportionate response on both a local and national basis using a transparent range of measures and options. https://www.gov.scot/publications/covid-19-scotlands-strategic-framework/ A summary of this publication is available in BSL, Mandarin, Gaelic, Arabic, and Polish, as well as Easy Read and audio versions .

We encourage people to adapt this advice to make it right for them. It is a personal decision how to balance the benefits of protection with quality of life. To do this in practice, people told us they needed information about infection rates in local communities, level of risk specific to their health conditions, and how to manage risks on a day to day basis.

We are therefore providing information, advice and tools to enable and empower those who are clinically most at risk to make decisions about their day to day interactions and activities including:

• Data on neighbourhood infection levels
• Advice on specific clinical conditions
• Information on high and low risk activities
• Workplace risk assessments
• Information on how to shop and undertake other activities safely

Various methods used to make as many people as possible aware of the guidance and support available to them.

• The Scot.gov website contains the most up to date information and is highlighted in written communication from the Chief Medical Officer to those on the shielding list. Information is regularly.

• The Public Health Scotland website also provides a detailed cases by local neighbourhood map of areas that allow people to check in on the number of cases in their area.

• People are directed to the website and other support by means of television and radio adverts. We also suggest that people watch the daily briefings of the First Minister to keep up to date with developments

• We ask that people keep checking the Scottish Government website at https://www.gov.scot/publications/covid-shielding/ and https://www.gov.scot/publications/coronavirus-covid-19-what-you-can-and-cannot-do/pages/healthcare/ for the most up to date information.
• People can call the national helpline on 0800 111 4000. The helpline is open Monday to Friday, from 9am to 5pm.

• National mailings, sent via Royal Mail, are sent in one format but we signpost additional languages/formats which are available within it. As part of this information a QR code was supplied to make for easier access to these formats

• For example, several areas of key information and guidance are available in an accessible format for the visually impaired.

• We are also working with stakeholders to signpost and disseminate this information within their communities, to ensure that individuals with language or communication requirements are aware that there is guidance available in a format they can access.

From the outset of the pandemic maternity and neonatal care has been recognised as an essential acute, integrated and community service, providing both scheduled and unscheduled care. Midwives, obstetricians and the wider maternity and neonatal workforce have continued to provide care for pregnant women, babies and families throughout the pandemic.

To support professionals, the Scottish Government issued guidance to Health Boards and Social Care Partnerships for delivery of Maternity, Neonatal and Health Visiting Services throughout the COVID-19 pandemic, which set out the minimum standard of care expected, relevant to the local protection level, and to maintain services for women and families.

From the outset of the pandemic we have provided clear, evidence based information for pregnant women and new parents both online in Ready Steady Baby, via Parent Club, and through information leaflets. In addition we have delivered a free-to-access online antenatal education package, and pushed forward a new home monitoring initiative and rapidly up scaled the of use of ‘Near Me’ technology in maternity and newborn services, all of which have enabled care to be delivered as close to home as possible and minimised the need for hospital attendance. We have also ensured continued provision of high quality infant feeding support to new mums.

COVID-19 transmission is taking place in the community and – as is the case with any infectious disease – transmission is more likely where people are in closed settings, including within hospitals. As a result, we are seeing a rise of definite hospital onset cases.

Health Boards, supported by expert advice from the COVID-19 Nosocomial Review Group (CNRG) established by the Scottish Government in May, are implementing a range of measures to minimise the risk of coronavirus transmission in hospitals. Based on the latest infection prevention and control guidance from National Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, these measures include:

- the appropriate use of PPE,

- extended use of face masks and coverings

- physical distancing,

- outbreak management,

- risk assessed patient care pathways to help guide the implementation of measures for safe and effective care, and

- staff and patient testing

Since the outbreak of the pandemic, we have and continue to work hard to ensure IPC measures in hospital and other care settings are robust.

Since 1 November dentists have been permitted to offer the full range of NHS care in surgeries. With the resumption, dentists providing NHS care are required to submit claims for items of treatment undertaken to National Services Scotland. This information will be used to monitor the impact on current service provision.

The diagnosis of oral cancer is monitored through hospital data. The patient pathway for oral cancer was maintained throughout the pandemic. Despite a reduction in dental services on account of the COVID-19 outbreak ensuring that people have access to cancer services has always remained a priority. Dental practices have continued to triage patients during the pandemic and, in accordance with the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidelines, refer patients with symptoms of oral cancer for urgent assessment.

The Scottish Government supports the World Health Organizations strategy to accelerate the elimination of Cervical Cancer.

On 17 November 2020, two Scottish Government buildings, St Andrews House and Victoria Quay, were lit up in support of this cause.

We will continue to take steps towards achieving the strategy’s aims, with uptake of our HPV vaccination programme already high, it achieves 85.4% for both doses, and exceeds 90% for the first dose by the end of S3 in secondary schools. A recent study in the BMJ showed that the levels of cancer-causing HPV in Scotland had dropped by almost 90% in young women, demonstrating the significant and continued benefits of our vaccination programme.

Additionally, in March we introduced HPV testing as our primary test for cervical cancer – the test is offered to all women aged 25-64.

Safety of staff in schools is paramount. Teachers are entitled to feel safe at work and we expect schools and local authorities to make sure appropriate arrangements are in place for them.

Our latest guidance on reducing coronavirus (COVID-19) risks in schools, published on 30 th October, says schools and local authorities should follow the Royal College of Obstetricians and Gynaecologists advice to try to keep the risk of exposure as low as is practically possible to pregnant women, particularly in the third trimester. Normal pregnancy risk assessments should also be undertaken, and appropriate attention paid to mental health and wellbeing.

We are working with local authorities to keep implementation of the guidance under review, and where there is a need to take further action, we will work with staff, trade unions and local authorities to do so.

The NHS Louisa Jordan was established to help ensure NHS Scotland had extra capacity to treat patients during the COVID-19 pandemic and stood ready to do so since 20 April 2020. Building the NHS Louisa Jordan was a precautionary action and I was always clear that I hoped it would never be needed to treat a COVID patient. The NHS Louisa Jordan has not been required to treat COVID-19 patients because of efforts made to suppress the virus. If required, the hospital continues to remain ready to accept COVID-19 patients at a few days’ notice.

The Scottish Government recognises the impact that COVID-19 has had on people living with cerebral palsy and we recognise the importance of a consistent approach being taken forward in the community to support people with the management of their condition, including cerebral palsy across Scotland accessing the right support and services.

The pandemic has clearly impacted on the NHS but we are resuming services as quickly and safely as possible. NHS Boards have mobilised their activity including protecting critical neurological services and establishing mechanisms to support their local population including the use of telephone and video consultations to minimise face to face contact unless absolutely necessary.

The Scottish Centre of Technology for the Communication Impaired (SCTCI) is one way the services have adapted, SCTCI delivers an Augmentative and Alternative Communication (AAC) tertiary service across 11 NHS Boards, which includes NHS Greater Glasgow & Clyde service have continued to operate their open referral system throughout the pandemic and have adapted their service delivery methods to ensure compliance with national and local restrictions while continuing to establish and maintain contact with those who need support.

We are already taking action to support those experiencing the longer physical and mental health impacts of COVID-19 – with our NHS delivering care tailored to the individual needs of people experiencing ongoing effects.

Work is underway to establish the National Advisory Board for Rehabilitation to implement the Framework for Supporting People through Recovery and Rehabilitation during and after the COVID-19 Pandemic . The Framework is aligned to the Re-mobilise, Recover, Re-design: the framework for NHS Scotland , and puts in place clear principles, priorities and objectives to support planning to meet increasing demand and to provide high quality person-centred rehabilitation in different settings.