Chamber and committees

Digital consultations have played an important role in allowing people to continue to access appointments during Covid-19 with nearly 17,000 consultations being held each week across Health and Care services. Feedback on using our Near Me video consulting service remains extremely high and in mobilisation plans we have now asked for Health Boards to maintain and build upon this. We would expect a video consultation to take place whenever it is clinically appropriate to do so.

To support its wider uptake and awareness of the service, we are currently in the middle of a public engagement exercise to ensure that we gather feedback on areas where the service is particularly beneficial or where it may not be appropriate for such a consultation and we will use this feedback to adjust our approach to scale up once we have collated the information. The survey can be found here - https://www.nearme.scot/views .

The exact information requested is not available centrally. Public Health Scotland collect social care information directly from Health and Social Care Partnerships; however, it is not possible to identify from this if social care packages have been withdrawn or the reason why a package may have been withdrawn or reduced.

It is possible to estimate the number of people receiving home care services each month and how many hours of home care were received. Table 1 provides this information for January to March 2018. Information for 2018-19 is not yet available.

Table 1. Number of people receiving home care 1 services and total number of hours 2,3,4 of home care by month and Health and Social Care Partnership 2,3,4 , January to March 2018

The Covid-19 Clinical Guidance Cell has been established by the Chief Medical Officer to rapidly develop and revise guidance on clinical management of COVID-19 for the NHS.

The purpose of the Clinical Guidance Cell is to rapidly prepare guidance for the health and care system in Scotland on the clinical management of COVID-19.

Membership is drawn from key organisations and professional communities across Scotland who have a direct interest. This includes the Scottish Academy of Medical Royal Colleges and Faculties and Health Protection Scotland.

The Scottish Government is also advised by the COVID-19 Advisory Group, which was established to address the need for additional scientific analysis of the impact of COVID-19 in Scotland, based on regularly updated advice and modelling from the UK Scientific Advisory Group for Emergencies (SAGE), and other emerging scientific evidence.

The group is chaired by Professor Andrew Morris, Professor of Medicine at the University of Edinburgh, supported by vice chair, Professor David Crossman, Dean of Medicine at the University of St Andrews and Chief Scientist (Health) at the Scottish Government. Members are public health experts, clinicians and academics spanning the disciplines of epidemiology, virology, public health, behavioural sciences, global health, medicine and statistical modelling. Full details of the group’s membership are available on the Scottish Government’s website at https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/

As part of the Scottish Government response to the COVID-19 pandemic, on 25 th March 2020 the Chief Scientist Office (CSO) launched a call for rapid research in COVID-19. The call attracted 139 individual research project proposals. CSO convened an independent expert panel to review the applications. This panel, which met virtually on 21 April 2020 to consider the applications, comprised 35 expert members from the medical and wider health and social care research sectors and 3 lay members and was co-chaired by Professor Eleanor Davies from the Univeristy of Glasgow and Professor Shaun Treweek from the Univeristy of Aberdeen.

The outcome of the review was that 56 research projects were funded, led by 15 different research institutions from across Scotland. The work funded through this call involves researchers from the medical and wider health and social care research sector. This includes research to:

• Better understand the effects of COVID-19 infection in order to inform treatment and management of disease

• Develop and test new diagnostics and therapeutics

• Investigate novel disease surveillance approaches

• Inform interventions to prevent transmission of infection

• Support the resilience and mental health of frontline health and social care workers

• Understand the physical and mental health implications of social distancing and other restrictions and their impact on the general population and also a number of vulnerable groups

Details of the funded projects are available from the CSO website. https://www.cso.scot.nhs.uk/rapid-research-in-covid-19-programme/

We have been clear that throughout this pandemic, the NHS is there for those who need it. Our NHS is Open campaign was launched 24 April and we have seen a steady increase in the number of people presenting to their GP practice with symptoms that could be suspicious of cancer – now 86% pre COVID levels.

Our Clinical Director for Scotland, Jason Leitch also made a statement urging patients who have an appointment to attend hospital for these as it will have been deemed clinically safe to do so.

We are working hard to ensure vital and urgent care remains, including the use of private hospitals to treat these NHS patients. By utilising the private sector capacity we are able to provide a COVID free environment for urgent cancer procedures. The Golden Jubilee is also supporting the treatment of urgent cancer patients.

On 11th June 2020 the Association of Medical Research Charities (AMRC) published on their website an article entitled COVID-19: The risk to AMRC charities.

https://www.amrc.org.uk/covid-19-the-risk-to-amrc-charities .

The published AMRC figures do not distinguish between cancer and other medical research charities.

On 30 th March Cancer Research UK released a press release that referred to an estimated 25 percent drop in fundraising income in FY 2020-21

https://www.cancerresearchuk.org/about-us/cancer-news/press-release/2020-03-30-cancer-research-uk-estimates-25-per-cent-drop-in-fundraising-income-due-to-coronavirus?_ga=2.60513902.2117832912.1593763662-1469902633.1572445696

The impacts of COVID-19 on medical research are being considered by the UK Office for the Strategic Coordination of Health Research Board, which includes representation from the AMRC and the Scottish Government’s Chief Scientist Office through the Chief Scientist for Health as well as from the other UK Health Departments, and UK research councils.

The UK Government has announced on 27 June that, from this autumn, UK universities will be able to access a series of UK Government grants and long-term, low interest loans covering up to 80% of each institution’s income losses caused by a decline in international students, up to the value of non-publicly funded research activity in that university. In addition, around £280 million UK Government funding will be made available to universities and research organisations for costed extensions of UK Research and Innovation and National Academy research projects impacted by the pandemic.

We welcome the recent announcement by the UK Government which builds on the Scottish Government’s commitment last month to provide an additional £75 million to ensure our universities can protect their world-leading research against the financial impact of COVID-19. However, we are concerned about the emphasis on loans in the UK Government’s stabilisation package, as not all universities will be in a position to take advantage of those. We will work with the UK Government not only to agree how this package will be implemented in Scotland, but also to address the long term sustainability of our sector to ensure it plays a key role in Scotland’s economic and social recovery.

The Scottish Government convened the National COVID19 Cancer Treatment Response Group (CTRG) on 18 th March to form national clinical consensus in Scotland on changes to cancer treatment in response to the new risks associated with COVID-19 ensuring those most urgent cases were prioritised.

The group has produced clinical advice on an ongoing basis and throughout the pandemic the majority of cancer treatments have continued.

We have now established a National Cancer Recovery Group which has been established to offer national arbitration on overall clinical priorities. It will also oversee national data and modelling work in relation to cancer recovery and advise on patient and public communications.

Any cancer patient worried about symptoms should call their existing cancer treatment helpline or the national cancer treatment helpline. Individuals with serious or worrying signs or symptoms are encouraged to use the NHS as normal and contact their local GP practice.

Urgent and emergency care has been maintained throughout this pandemic to ensure those with life threatening conditions were and continue to be seen as a matter of priority.

Through the Re-mobilise, Recover, Re-design: The Framework for NHS Scotland , Health Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of some paused services whilst continuing to protect emergency, urgent, Cancer and maternity care. Health Boards will plan to resume services while maintaining COVID-19 capacity and resilience and providing appropriate support for social care, and also protecting the safety of all patients and staff. Health Boards are taking a careful and considered approach to this, balancing the treatment of COVID-19 patients with the all potential impacts of longer waiting times, including assessing the impact of this on excess death rates.

Data on patients recruited from NHS Scotland in each of the last 12 months into non-COVID-19 Trials in Scotland are set out below.

June 2019 1,678

July 2019 1,839

Aug 2019 1,725

Sept 2019 1,358

Oct 2019 1,647

Nov 2019 1,431

Dec 2019 991

Jan 2020 1,500

Feb 2020 1,293

Mar 2020 789

Apr 2020 34

May 2020 19

Notes

1. The data does not take account of patients recruited into other types of research.

2. The number of patients recruited in previous years and still involved in Clinical Trials is not captured by NHS Research Scotland.

3. The data has been provided by research teams working in NHS Scotland and may not be complete.

The information is not held centrally. Data on the number of people admitted to hospitals from care homes is not recorded systematically in the data submissions from NHS Boards to Public Health Scotland (PHS). PHS have analysed and linked a suite of their management information data sources in order to identify people admitted to hospitals from care homes. This analysis was unable to produce reliable answers.

PHS will now work with NHS National Services Scotland, local Health and Social Care authorities (NHS Boards and IJBs) and the Care Inspectorate to improve national information so that these types of questions; as well as ones in relation to patients discharged from hospital to care homes; can be answered in future.

Staff and carer wellbeing was highlighted as one of eight key objectives for safe and effective mobilisation across health and social care in “Re-mobilise, Recover, Re-design: the framework for NHS Scotland”, which was published on 31 May 2020.

The Scottish Government is working closely with partners across the health and social care sector, including NHS Boards, Health and Social Care Partnerships and local employers, to ensure a range of psychological and wellbeing support is in place for the workforce as normal services are remobilised.

A range of support is available at the national level, including through the National Wellbeing Hub (www.promis.scot), which continues to be widely used by the workforce. We are exploring with partners how best to respond to those who may need more specialist support and care over the coming months.