Chamber and committees

Under the leadership of Public Health Scotland (PHS), the long COVID Strategic Network has developed a theory of change and logframe which form the basis of a comprehensive framework to evaluate long COVID services. Both the theory of change and logframe were developed in close consultation with representatives across the Network, including people with lived experience of long COVID, clinicians, researchers, service planners, local boards, PHS and Scottish Government officials.

The theory of change provides the context around what the Network is aiming to achieve, while the logframe is the complementary tool enabling the tracking of milestone indicators linked to process, outputs, and outcomes. For example, indicators include those linked to the implementation of long COVID service pathways, generation of research and evidence, and the development of an education and training strategy.

In addition, patient related experience and patient outcome measures will be recorded through NHS Boards’ use of the C-19 YRS digital screening tool. The provision of heath data through this tool will be of vital importance in understanding the provision and effectiveness of long COVID services. Where possible, the data will be disaggregated by age, gender, ethnicity, and deprivation quintile. This will support understanding of any inequitable variation in service provision, experience and outcomes which may need to be addressed through service changes.

A data and intelligence group has been established to oversee reporting against the monitoring and evaluation framework. This will allow the Network to have an informed understanding of overall progress of its support to the provision of long COID services.

I refer the member to the answer to question S6W-21155 on‎ 22 September 2023. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

11 out of 14 territorial NHS Scotland Boards have long COVID pathways in operation. The following table outlines anticipated commencement date of the remainder, where applicable.

In our response to the Scottish Mental Health Law Review we committed to establish a Mental Health and Capacity Reform Programme to further enhance and protect human rights within legislation, policy and practice. This includes a commitment to enhance carers’ rights and role in practice through further developing and promoting carer awareness training for staff working with people with mental or intellectual disability across health and social care settings, by 2026.

These actions will also be set out in the Mental Health and Wellbeing Workforce Action Plan, which will be published in Autumn 2023.

We have funded NHS Education for Scotland (NES) to develop three training modules for the health and social care workforce, including those working with mental or intellectual disability across health and social care settings, to help them to identify, include and support unpaid carers. We expect those to be launched by the end of 2023.

Rather than permanent monitoring, which is the common approach for water companies in England, Scottish Water worked with SEPA to carry out a comprehensive Scotland-wide environmental study programme to assess and model the impacts of its assets on water quality. The programme was undertaken during the 2015 to 2021 investment period with an investment of £40m. These studies supported identification and prioritisation of River Basin Management Planning objectives, which were published at the end of 2021.

The computer models Scottish Water developed allow it to understand when CSOs will spill, under what rainfall conditions and the impact those spills will have on the environment. Instead of taking the approach of English water companies, targeted monitoring is being put in place to support the information already obtained from the models and to support operational performance. The Scottish Government is supportive of this evidence based and proportionate approach by Scottish Water. We also support their decision to invest inn widening monitoring by installing 1,000 new spill monitors by the end of 2024 with an investment of up to £70m.

Scottish Water’s Improving Urban Waters Routemap commits it to publishing near real-time spill data for all monitored CSOs by December 2024. The data collected by the 1000 new monitors will support SEPA’s and Scottish Water work to prioritise investment where it will most benefit our environment and communities. Continued investment by Scottish Water contributes towards Scotland’s water quality being at its highest level ever, with 87% of the water environment rated as good or better, up from 82% six years ago. Scotland’s River Basin Management Plan sets out objectives, including those for Scottish Water, aiming to improve water quality to 92% of the water environment to be in good or better condition by 2027.

I wrote to NHS National Services Scotland on 16 June 2023 to request that an evaluation of post COVID services (including long COVID clinics) in comparison to pathways in Scotland was added to the long COVID Strategic Network’s workplan for 2023-24. Consequently, the Strategic Network has contracted the University of Leeds to support the initial evaluation of long COVID services in Scotland.

The University of Leeds is currently the only institution in the UK evaluating long COVID services under the LOCOMOTION study, which includes NHS Highland as a pilot site. The University of Leeds also collaborates with ELAROS which has produced the C19-YRS digital tool which has been procured for use within NHS Scotland to monitor long COVID services. This partnership will also enable Scotland to benefit from the lessons already being learned from NHS England’s long COVID services.

As part of the evaluation, the University of Leeds will provide an: analysis of demand and capacity within Scotland’s long COVID services; analysis of longer-term outcomes for long COVID patients assessed within NHS Health Board services; and where possible, compare differences in service models.

All NHS Scotland Boards are providing support for children and young people with long COVID.

Assessment and initial investigation is being provided by local primary care teams, who can give advice and guidance about the management of symptoms and any potential treatment options for these in the first instance. Primary care clinicians can refer to occupational therapy and physiotherapy for further support where appropriate. In cases where referral to secondary care is required, children and young people may be referred to general paediatric services for investigation and management.

The information requested is not held centrally by the Scottish Government.

The National Child and Adolescent Mental Health Services (CAMHS) Specification (published in February 2020) and the National Neurodevelopmental Specification for Children and Young People: Principles and Standards of Care (published in September 2021), set out the levels of service that children, young people and families can expect across Scotland.

This includes nationally agreed referral criteria, a first engagement appointment for all those that meet the criteria, and personalised and meaningful signposting for all those that do not require treatment .

The National Specification for the delivery of Psychological Therapies and Interventions is also due to be published this month and will set out what patients can expect following a referral, and detail the whole system approach including early intervention options that services should offer.

As outlined in our response of 16 June 2023 to the COVID-19 Recovery Committee report on long COVID, I wrote to NHS National Services Scotland on 16 June 2023 to request implementation of a range of actions to support internal and external communication regarding activities being undertaken by the long COVID Strategic Network. NHS National Services Scotland has confirmed that these actions are in progress, and include the identification of an appropriate web solution to share priorities, key outputs, and meeting minutes.

The Scottish Government is represented on the Strategic Oversight Board of the long COVID Strategic Network. The Strategic Oversight Board provides oversight of the workplan and programme outcomes of the Strategic Network.

NHS Inform is Scotland’s national health information service. Its aim is to provide the people of Scotland with accurate and relevant information to help them make informed decisions about their own health and the health of the people they care for.

NHS Inform has a dedicated long COVID microsite for people with ongoing symptoms after Coronavirus, setting out key information and sources of support for people impacted by long COVID.

This information is publicly accessible at www.nhsinform.scot/long-covid and comes in a variety of different languages and accessible formats to provide clear and accessible guidance to people living with long COVID on managing their symptoms.