Chamber and committees

To ensure patients are seen in the most appropriate clinical environment for their healthcare need, we have set up a group made up of clinical and operational leaders to provide leadership to the redesign of urgent care.

The key elements of the programme will be in place by winter to provide safe access to care and manage more patients more effectively closer to their home based on COVID 19 learning. We will continue to monitor this and support ongoing work to further improve care over the next 18 months

We are working with Health Boards and NHS 24 to assess what additional capacity and resource is required to implement this new approach in time for winter.

I will provide further details to the Parliament after the October Recess.

I have asked Teresa Medhurst, Interim Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

COVID-19 testing is already available for all those living and working in prisons in Scotland presenting with symptoms.

Where an individual in custody displays symptoms of Covid-19, they are required to self-isolate and take a test. NHS Health Boards have tested those in custody who are showing signs of Covid-19 since 25 May 2020/ Early testing of those in custody who present as symptomatic ensures there is no unnecessary requirement to hold someone in isolation for a prolonged period.

In line with public health advice, any SPS staff member who displays symptoms of Covid-19 is also required to self-isolate and are advised to take a test. SPS staff access to testing was introduced in April 2020 and, as key workers, staff may be tested by local NHS Health Boards or they can access National Testing Centres through the key staff portal.

The Scottish Government is not planning to introduce regular testing of asymptomatic people in prisons. Taking the test when an individual has had no symptoms is often not helpful – it cannot exclude the possibility that the virus is present.

The COVID-19 tests we use in Scotland work by detecting evidence of the virus in a person’s nose or throat sample. These tests cannot tell us whether or not someone is incubating the disease, but only if the virus is present at the time when they are tested. This means that testing is a single point in time assessment of whether a person may be infectious but it cannot tell us whether a person is going to become ill in the future.

I have asked Teresa Medhurst, Interim Chief Executive of the Scottish Prison Service (SPS), to respond. Her response is as follows:

I can confirm that, as at 8 October, there have been 35 individuals who have tested positive for COVID-19. This has been across 8 establishments. Where the number is less than 10, this has been marked as

Recruitment data for Action 15 of the Mental Health Strategy 2017-27 is published on the Scottish Government website ( https://www.gov.scot/publications/mental-health-workers-quarterly-performance-reports/ ). The last publication provides data as of 1 January 2020. In response to Covid-19, quarterly reports were postponed. We are now assessing the position as of 1 July 2020 and will publish that information shortly.

We have been deliberately seeking to build winter capacity as we know demand will increase as people come forward with COVID-like symptoms over the winter months, in addition to the temporary demand increases such as those we’ve seen from local outbreaks and schools and universities returning.

We have continued to build our own NHS capacity throughout this pandemic and additional hubs will rapidly increase our lab capacity, allowing us to migrate testing to the NHS system and away from the UK Lighthouse network.

We have also been taking forward plans to expand existing capacity by:

• Deploying additional mobile testing units

•Increasing the number of tests that can be carried out at regional testing centres

•Utilising additional NHS testing capacity, for example by activating additional drive-through facilities

Furthermore, on 28 August the First Minister announced plans to create 22 walk through test centres across the country, with 11 being operational by the end of October and the rest over winter.

However, testing is only one effective intervention that we are using to manage the virus and it remains vital that people continue to follow physical distancing advice and practice good hand and cough hygiene not just for their own safety but in order to protect others.

The Minister for Children and Young People and I wrote to Health and Social Care Partnerships, Chief Social Work Officers, care providers and others on 3 August 2020 advising that guidance on dedicated residential respite and day care services would be issued as soon as possible. The letter also advised that in the interim, such services can reopen subject to being adapted and risk assessed in line with existing guidance; and in agreement with local Health Protection teams and the Care Inspectorate. The letter is published on the Scottish Government website at:

https://www.gov.scot/publications/coronavirus-covid-19-letter-to-health-and-social-care-partnerships/

Guidance to support the safe re-opening and delivery of building-based day services for adults was published on 31 August 2020 on the Scottish Government website at:

https://www.gov.scot/publications/coronavirus-covid-19-guidance-on-adult-social-care-building-based-day-services/

The Minister for Children and Young People and I wrote again on 23 September 2020 to confirm the guidance to enable safe reopening of stand-alone residential respite for adults and children. The letter is published on the Scottish Government website at:

https://www.gov.scot/publications/coronavirus-covid-19-residential-respite-services---letter-from-the-cabinet-secretary-for-health-and-sport-and-the-minister-for-children-and-young-people-2/ .

This information is not held by the Scottish Government. It may be available on request from health boards.

The InHealthcare platform has been procured to deliver an interim remote monitoring solution aimed at Covid-19 patients and to aid response and recovery mobilisation plans within Scotland. Immediate additional focus areas have been identified in collaboration with local Board strategic and clinical leads and linked to Scottish Government key priorities including Covid-19 symptom monitoring, Heart Failure, Asthma, COPD and Pre-operative assessment.

We acknowledge there may be further targeted care pathways which could be supported by the platform, including pulmonary rehabilitation, and we are engaging with national and local clinicians and strategic leads to assess potential additional services on a case-by-case basis.

The SPCB is committed to providing a safe and positive working environment for Members and staff.  The SPCB recognises that this can be put at risk by individuals who misuse alcohol, drugs or substances to such an extent that that it affects their health, work performance, behaviour or relationships at work. The SPCB is committed to ensuring a working environment which is free from this risk.

Under its published policies, the SPCB makes a distinction between individuals with an alcohol, drugs or substance misuse problem and misconduct involving alcohol, drugs or substances.  These policies apply to SPCB staff and Members’ staff.  The SPCB considers dependency on alcohol, drugs and substances to be a health problem for which the individual requires specialist treatment and support. 

As such the SPCB, through its occupational health partners, provides impartial information, advice and support to individuals experiencing difficulties.  This includes arranging specialist counselling, assessment or referral to another agency.  Individuals can also seek support through the Employee Assistance Programme.  This Programme provides a network of counsellors who are available to offer continuing support to those who have more complex issues.

The SPCB recognises that it is also the responsibility of the individual to accept this help and assistance to improve their condition.