Chamber and committees

We are undertaking work across our health and social care settings to assess our preparedness for Winter. As part of this we are working with Boards and delivery partners to ensure that we are as prepared as we can be for the months ahead in the context of Covid-19 and other winter risks such as winter flu, winter pressures on Emergency Departments and restarting elective care.

The immediate focus of work is planning for the implications of a resurgence of Covid-19. The impact of Covid-19 is unlikely to fall evenly and so will be felt harder in some parts of the country than others. Our collective response will need to factor in strong mutual aid arrangements and logistics support to ensure there are safe levels of staffing throughout the system to manage winter pressures. A Health & Social Care Winter Planning team will work with Boards and delivery partners to assess winter preparedness.

On staffing capacity, we are working closely with Health Boards and at a national level to understand any concerns about staffing levels and explore effective mitigations. We continue to support the effective deployment of staff, including the use of temporary and emergency staffing through the National Health and Social Care Covid-19 Accelerated Recruitment Portal. The Portal was launched in March 2020, to allow returning health care professionals to come forward and support our health and social care services at this time of national emergency. We are prepared to make further use of the Portal to mitigate future staffing demand from NHS Boards.

Regarding staff absence, we have collected, monitored and published data on NHS and care home staff absences since the outbreak of this pandemic. Data is continually collated from NHS Boards and the Care Inspectorate on the number and rate of absences associated with Covid-19.

For the week to 20 October 2020, a daily average of 1.6% of the NHS workforce were recorded absent for reasons related to Covid-19. The rate of NHS Covid-19 related absence has remained below 2% since late July and below 4% since early May.

For the week to 20 October 2020, a daily average of 2.3% of the care home workforce were recorded absent for reasons related to Covid-19. The rate of Covid-19 related absences in care homes has remained at or below 2.5% since early August and below 4% since late June.

We will continue to pay close attention to staff absence data in the coming months.

In the latest reporting week (19 - 25 October) 39,461 care home staff were tested, comprising 5,421 staff in homes with confirmed covid , and 34,101 staff in homes with no cases of confirmed covid . This data is published weekly.

The following table includes all eligible referrals on the 62 day cancer pathway for Urology for each quarter. It should be noted that this data cannot be broken down to specific prostate referrals.

NHS Boards are continuing to closely monitor all cancer referrals, including prostate, to ensure that capacity supports demand and patients can move through their pathway as safely and quickly as possible. Throughout the pandemic urgent cancer care has been prioritised supported by clinical guidance.

To support improvement for overall Cancer services a Recovery Plan is being developed with patients experience at the core and will be published in November. This plan will have an operational focus on diagnosis and treatment in cancer services.

The plan will focus on reducing the inequalities exacerbated by the pandemic and ensure patients are receiving treatment equally across Scotland using a Once for Scotland Approach.

The Scottish Government has provided support to vulnerable people in various ways during the Covid-19 lockdown period, and recognises it is just as important now that we continue to make sure support is available and accessible to those that need it.

We have commissioned Public Health Scotland to provide analysis of alcohol sales data for the first six months of 2020 which will provide quantitative consumption data covering the lockdown period. This will help to inform us about the impact of Covid-19 on alcohol and also the potential impact on alcohol treatment services going forward.

During the pandemic, the Scottish Government has worked with a number of organisations addressing alcohol and drug harms. We have provided additional funding of £166,000 to fund activities such as the purchase of equipment to keep people in recovery connected, and increased the hours of our national helpline and webchat facilities. The Scottish Recovery Consortium has issued guidance to enable recovery groups to meet face-to-face where on-line meetings are not possible. I and the Interim Chief Medical Officer, Dr Gregor Smith, wrote to health boards and Integration Authorities on 16 April to ensure the need for continuation of care is prioritised for those with alcohol problems. Additional funding has been made available through NHS Mobilisation Plans to ensure support services remain open and accessible where possible.

Early on in the pandemic, we announced an expansion of the Distress Brief Intervention (DBI) pilot programme, supported by an additional investment of over £1m. In our recent Programme for Government we committed to extend the DBI programme across Scotland, for a transitional period to 2024, at which point we expect it to be fully embedded by boards. We have provided an additional £2.1 million to expand the NHS 24 Mental Health Hub, and £0.5m to expand the capacity of the Breathing Space helpline and web support service for people experiencing low mood, depression or anxiety. In April, we also launched our Clear Your Head campaign, which provides practical advice on how to stay active, keep connected with friends and family, and create healthy routines to help us get through these times.

Complete information on (a) self-referrals and (b) and referrals by each NHS board for residential rehabilitation services is not held centrally.

Information on referrals by Health Boards is not collected centrally. However, data collected for Public Health Scotland’s quarterly, published Drug and Alcohol Treatment Waiting Times reports includes the number of alcohol and drugs residential rehabilitation treatments provided by Health Board area - broken down by “Self-referral” and “Other referral” numbers. This data is sourced from regular reports provided by Alcohol and Drug Partnerships. Information on the number of residential rehabilitation treatments provided by each Health Board area for the last 5 financial years is set out in the following table.

Table 1 – Residential Rehabilitation referrals, for drug and alcohol clients, or clients with a combination of the two, by Health Board of Treatment and Referral Type.

Our Alcohol Framework set out a commitment to engaging in a national social marketing campaign to increase public awareness of the UK Chief Medical Officers’ low-risk drinking guidelines.

We delivered the ‘Count 14’ marketing campaign over two phases, for three weeks in March 2019 and for six weeks through January and February 2020. Count 14 aims to increase awareness of the weekly 14 unit low-risk guidelines and to break down what 14 units means in terms of specific alcoholic drinks.

The campaign included TV, radio, print and digital advertising as well a roadshow in local supermarkets and a range of partnerships. We will publish the results of the campaign in early course.

We are considering how best to build upon our Count 14 campaign in order to further increase awareness and knowledge of safe drinking limits.

Our budget commits a further £20 million to reduce the harm caused by drugs. This means the total Scottish Government spend on drugs and alcohol in 2020-21 will be up to £95.3 million.

Decisions on configuration of local services, including residential rehabilitation, as well as the level of resource, funding allocated and referral to them are made locally by Alcohol and Drugs Partnerships.

We have established a working group to consider the provision of residential rehabilitation services and make recommendations for strengthening referral pathways, capacity planning and developing models of good practice for funding and delivery.

Guidance on organised activities for children was updated on 5 October to allow that when all children in a group are less than 12 months old, and other health and safety criteria are met, groups will now allow up to ten adults to be present at one time.

Factors such as background sound that may lead to raised voices or cause people to lean-in close to others to be heard are a risk factor in the transmission of coronavirus. This is recognised by a wide body of publicly available scientific evidence in relation to the role of aerosols in the transmission of viruses. The current position of no background sound, including low level music and audio from television, is a measured and cautious approach to reduce risk. It is being kept under review and government has engaged with industry experts to consider how guidance can be developed to allow low level background sound to be managed safely when transmission rates are back to a manageable level.