Chamber and committees

We have engaged with mental health leads at each of the NHS Boards and they have provided the following information. There are twelve new mental health assessment centres, which have been established in response to the COVID-19 outbreak. All centres but two became operational between the middle of March and early April 2020. The target operating date for the final two is 30 April 2020. All centres are in significant population centres. All operate seven days per week and all but three operate 24 hours a day. All are staffed with current clinical mental health staff, with bank staff supplementing in a few cases. Boards in more rural areas are monitoring demand and putting in place appropriate measures to minimise mental health presentations in emergency departments, where possible.

From Monday 27 April, the local personal protective equipment (PPE) Hubs for the registered social care sector started to receive enhanced supplies and support so that they can expand their supplies to unpaid carers and others.

The Scottish Government has published advice for unpaid carers who visit or live with a friend or family member to provide help with personal care such as washing or dressing. The advice details the situations in which unpaid carers may require PPE:

www.gov.scot/publications/coronavirus-covid-19-advice-for-unpaid-carers-providing-personal-care .

We are working with NHS National Services for Scotland, local authorities and carer centres across Scotland, to ensure unpaid carers who require PPE to undertake their caring role safely, can access it easily if their normal supply routes are not available.

Carers should contact their local carers centre to find out about arrangements for accessing supplies in their area. If their local carers centre is unavailable, carers can call the Social Care PPE Support Centre on 0300 303 3020 for advice on who to speak to.

We are also working with the national carer organisations to ensure carers have access to the right information on PPE.

As Lord Advocate, I remain constitutionally responsible for the investigation of sudden, unexpected and unexplained deaths in Scotland throughout the current COVID-19 Pandemic. With one adjustment, the requirement to report sudden, unexpected and unexplained deaths to the Crown Office and Procurator Fiscal Service (COPFS) remains unchanged at this time; and such deaths continue to be reported to COPFS.

That adjustment is, as I advised Parliament on 26 March, set out in a joint letter which was issued on 24 March 2020 from the Chief Medical Officer, COPFS, Police Scotland and the Registrar General to professionals in Scotland on the processes to be followed for providing a Medical Certificate of Cause of Death (MCCD, or Form 11) during the COVID-19 Pandemic. This letter informed medical professionals that COVID-19 or presumed COVID-19 deaths do not require to be reported to COPFS, unless there is some other substantive reason for reporting the death. This approach reflects that taken in relation to previous significant outbreaks of infectious disease and reduces the demands being placed on medical professionals at this time.

If there is some other substantive reason for reporting the death of a person with COVID-19 or presumed COVID-19 disease to COPFS, then it continues to require to be reported to COPFS. Equally, other sudden, unexpected and unexplained deaths require to be reported in the usual way. The level of investigation in each case will depend on the circumstances, and may include testing for COVID-19 and post mortem examination as appropriate.

The numbers of sudden, unexpected and unexplained deaths being reported to COPFS during the COVID-19 pandemic is, at present, similar to the numbers being reported in previous months. COPFS officials are monitoring the situations closely.

The Scottish Government has spoken with Health Boards to understand the impact of COVID-19 and how people can access care and support for chronic pain. Like most NHS services, specialist pain clinics have been postponed where the multi-disciplinary specialist workforce has been re-deployed to provide critical care. Where possible alternatives to face-to-face consultations are being offered, these include telephone or Near Me video appointments with clinical psychologists and specialist physiotherapists in non-pharmacological strategies. There are also a number of third sector organisations with expertise in specific conditions that can provide telephone or online support for pain management. We have published an information leaflet to signpost people to resources available at https://www.gov.scot/publications/coronavirus-covid-19-tailored-advice-for-those-who-live-with-specific-medical-conditions/ .

In terms of decisions about altering lockdown restrictions that will in turn inform wider decisions such as re-establishing outpatient clinics, all four UK governments recently agreed to extend the current lockdown rules for at least a further three weeks. Therefore while resources continue to be focused on the immediate care of those affected by COVID-19, all activities associated with the Waiting Times Improvement Plan have been paused.

At such a time when the lockdown rules are amended, and Health Boards review decisions about the availability and design of services, we will support Health Boards to improve waiting times. The provision and type of services offered, however, may be different depending on the clinical evidence available on the risks to people of receiving certain procedures if they have a high risk of severe illness from COVID-19. Clinicians will need to discuss this individually with people to take these risks into account when agreeing ongoing treatment plans.

The Scottish Government recognises how important it is that people are able to grieve the passing of a loved one. However, in order to protect the most vulnerable in society we need to respect social distancing.

Under the Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020 the following people are allowed attend a funeral service:

• members of the deceased’s household;
• close family members of the deceased; or
• if no-one in the above two categories is attending, a friend of the deceased.

There is no maximum number of attendees set out in the regulations. In line with wider public health advice though, families are advised that in-person attendance of funeral services should be kept to the minimum number of people possible and that social distancing should be complied with. These requirements are set out in detailed advice on NHS Inform about social distancing and self-isolation and Scottish Government guidance on funeral services .

Adherence to these regulations and wider NHS Inform advice on social distancing is important to help stop the spread of coronavirus (COVID-19) amongst communities.

In relation to parts a and b I refer the member to the answer to question S5W-28124 on 20 April 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 refer the member to the answer to question S5W-28124 on 20 April 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

The international standard for an appropriate pandemic response is to double ICU capacity. NHS Scotland has more than trebled its adult ICU capacity, from a base of 173 beds to a surge capacity of 585. These beds will be brought into use as needs dictate, on a daily basis. Given the scale of the current emergency, we have asked Health Boards to go further by preparing to quadruple the base ICU capacity; bringing the total number of adult beds to over 700.

This increase in ICU bed capacity includes increased staffing delivered through internal redeployment supported by education and training which is being locally provided to meet the needs of each Board. The Chief Nursing Officer issued guidance to all Boards to support the deployment of Nursing, AHP, Pharmacy and other staff in Critical Care.

There will be no changes to NHS laundry services until we have addressed the current Covid-19 situation.

The Scottish Infected Blood Support Scheme makes payments to individuals infected with HIV and/or Hepatitis C by infected NHS blood or blood products. The Scheme also makes payments to beneficiaries' spouses, civil partners, long-term cohabitees, or dependent children following their death. Where an infected person has died and had not previously received a lump sum payment from the Scheme or one of the former UK-wide schemes, the beneficiaries of their estate, which could include parents or adult child carers, can receive this lump sum payment.

The Scheme also provides support and assistance grants, which can be used by parents or adult child carers providing care to their infected relatives, for example to pay for a carer(s). These grants normally need to be applied for by the scheme beneficiary, although where the beneficiary does not have the capacity to apply themselves due to a particular disability or notifies the Scheme that they want a named person to be able to correspond with the Scheme for them then a relative or other trusted person can apply on their behalf.

Health Protection Scotland (HPS) has developed specific guidance for social or community care and residential settings on COVID-19 to support those working in the social care sector. It is based on the National Infection Prevention & Control Manual and includes advice on how to prevent the spread of all respiratory infections, including COVID-19, with social care setting-specific information and advice

There is a dedicated helpline for all registered social care providers – including those providing care and support to people in their homes – to call if they are working with people who have confirmed or suspected COVID-19 and have an urgent need for additional Personal Protective Equipment (PPE). We are asking social care providers to fully explore their business as usual procurement routes for PPE before they contact the centre, to ensure that the triage service can prioritise stock for critical cases.

The triage service is being facilitated by NHS National Services for Scotland (NHS NSS).

We are working quickly to roll out the triage arrangements more widely, including access for unpaid carers and personal assistants. The situation is developing rapidly, and we expect to confirm the new arrangements in the coming days.