Chamber and committees

The number of staff working in NHS Grampian has increased by 20.7 per cent since Sept 2006, to over 13,520 Whole Time Equivalent (WTE). This includes a 6.9 per cent increase in numbers of Qualified Nurses and Midwives, which have risen to 4,099.1 WTE.

NHSScotland Boards are required to have the correct staff in place to meet the needs of the service and ensure high quality patient care. They have fully delegated powers in relation to employment issues. The Scottish Government works closely with Boards to support their efforts in staff recruitment. The creation of posts and filling of individual vacancies will depend on the service needs of each Board, taking account of national and local priorities.

We are investing £11 million in new recruitment activity and in the creation of a National Centre for Workforce Supply. The Centre will offer NHS Boards expert advice on labour market intelligence and coordinate recruitment campaigns, providing vital additional support to health board recruitment teams.

We are also taking forward a comprehensive programme to support recovery and build further capacity. The programme will include measures to increase international recruitment, retain staff and attract more returners to the service. The Scottish Government will continue to work with partners to explore options and opportunities that allow us to best support our registered staff.

The Scottish Government regularly reviews performance data from the Scottish Ambulance Service which includes data on response times across the country.

This information is normally reviewed weekly, however, given the current pressures being experienced we are receiving twice daily sit reps from the Service on performance.

Like all areas of Scotland, and indeed throughout the UK, we are aware that some patients are experiencing delays in response times from the ambulance service. This is why we have already taken significant action both prior to and since the pandemic to input measures to ensure our Ambulance service has the full resources and range of support in place to deliver services.

We announced an additional package of support for the Service, backed by an additional £20 million of investment, which will help increase capacity and improve response times and staff wellbeing, including assistance from over 100 military personnel.

We have also previously taken action to help with the situation, including an additional investment of £20m as part of the £1bn NHS Recovery Plan. This investment comes from continued involvement with the SAS Demand and Capacity programme which this Government has been involved in since its inception in 2019. It will deliver almost 300 additional Ambulance Service staff by April 2022.

This breaks down as 69 staff in the North of Scotland, 139 in West of Scotland and 88 in the East of Scotland. The additional staff are a mixture of paramedics, newly qualified paramedics (NQPs) and technicians. Extra ambulances and vehicles will also be introduced over the coming months, including two in Edinburgh.

Each Health Board operates their own escalation policy for the management of inpatient capacity that includes well established processes with locally agreed trigger points for maintaining a safe service and ensuring patient safety.

Health Boards across the country are operating under significant pressure due to the direct and indirect consequences of the pandemic, which has been the biggest challenge the NHS has faced in its 73 year existence.

The Scottish Government is in daily contact with all Health Boards to monitor the pressures in the system and continues to support improvement work to minimise delays for patients no matter where they are in the system.

Our Detect Cancer Early (DCE) Programme is aimed at increasing early diagnosis rates of Scotland’s most common cancers while reducing health inequalities. DCE launched a new overarching campaign – Survivors - in September 2018 to reduce fear of cancer and empower people to act early if they notice any possible signs of cancer.

An interactive symptom-checker tool has been developed on DCE’s website (getcheckedearly.org) to help raise awareness of key symptoms, including those associated with leukaemia (fatigue, weight loss, recurrent infections). The NHS Recovery Plan, published 25 August 2021, commits a further £20 million investment to the DCE Programme, which will include additional public awareness campaigns.

A clinical refresh of the Scottish Referral Guidelines for Suspected Cancer ( Scottish referral guidelines for suspected cancer - gov.scot (www.gov.scot) )has been completed, with revised guidelines published in January 2019. The Guidelines support primary care clinicians in ensuring those with symptoms suspicious of cancer are put on the right pathway at the right time. The Scottish Government continues to support Cancer Research UK’s Clinical Engagement Team to raise awareness of symptoms and best referral practice for all cancer types across NHS Scotland.

Scotland’s first three Early Cancer Diagnostic Centres (ECDC) are live, providing primary care with a new referral pathway for patients with non-specific symptoms i.e. fatigue, nausea, weight loss – this can often include patients with Haematological cancers.

Consideration for people who do not have digital access has been built into our vaccination programme from the start. Communication has gone out via non-digital channels and we have also undertaken a door-to-door paper leaflet drop with important information on vaccines. COVID-19 vaccine leaflets are available in audio, BSL, easy read and large print as well as other languages.

Those who do not have online access can call the COVID-19 National Helpline on 0800 030 8013. The helpline allows people to check and, where required, reschedule appointments. All information and services on NHS Inform are available via this phone line. We encourage people to double check their GP holds correct address details, to make sure that any appointment letter reaches them.

For those who are eligible for flu and/or COVID-19 booster vaccines, we have ensured that:

• Those aged 70 and over or those who are clinically extremely vulnerable will receive a vaccine invitation by post or may be contacted by their GP.
• Letters will be sent to those aged 60-69 years of age inviting them for vaccination from late October.
• When the online booking portal becomes available for those in stage 2, people who do not have access to digital booking will also be able to book their vaccinations via the COVID-19 National Helpline.

Our forthcoming national marketing campaigns for both flu and COVID-19 booster will direct people towards both the online booking system as well as the phone line so no one should be left out.

Informed consent is integral to the vaccination programme, and we have developed detailed information for young people and their parents or carers to allow them to make informed decisions on vaccination. Vaccinators are fully trained and have materials to support discussions on informed consent at appointments.

Further information on consent for children and young people can be found on NHS Inform: Vaccinating 12 to 15 year olds | NHS inform .

A new leaflet from Public Health Scotland will be circulated and is available to view online at: COVID-19 vaccine information for young people in English (healthscotland.com) .

Whilst we strongly encourage those eligible to receive coronavirus vaccination to do so, the decision is one of personal choice and the Scottish Government has no plans to introduce mandatory vaccination.

We are working with NHS Scotland Health Boards to put in place delivery models for the 2021-22 seasonal flu vaccination programme to suit local circumstances, whilst maintaining a COVID-19 safe environment and maximising efficiency.

If someone is unable to attend for their flu vaccination, they can rearrange their appointment to a more convenient time or location on line at Rearrange your flu vaccine appointment | The flu vaccine (nhsinform.scot). If invited by their GP practice or local Health Board, they should rearrange their appointment with them directly. If cancelling the appointment, the Flu Vaccination Helpline on 0800 030 8013 can assist with this.

The Case Record Review is underway. Introductory interviews with the participants are close to completion. More than half of the participants have received an ‘information gathering’ form from the Administrator. Following return of this form, Clinco, a commissioned contractor involved in the retrieval of patient records, will request the appropriate case records from Health Boards. This process is already underway for a number of participants.

As is standard practice, data sharing agreements are required for the release of medical records. Agreements are in place already for a number of Health Boards and it is expected that agreements will be in place in relation to all relevant Boards shortly.

Health Board Accountable Officers have been kept abreast of developments with the Case Record Review through the Short Life Working Group on mesh complications.

NHS National Procurement has confirmed that arrangements have been made to make Ronapreve available in Scottish Hospitals.

Commissioning guidance was issued to Health Boards on 17 September, and work is ongoing to ensure that Ronapreve can be administered as quickly as possible where clinically appropriate.

We have worked closely with a range of delivery and partner organisations to prepare, plan and respond to a range of issues and risks which may impact on NHS services. Planners and officials are using a range of modelling and intelligence to minimise potential impact of COP26 and to help protect NHS services across our communities.

Our planning has also used the experience and learning from previous large-scale events in Scotland, the UK and internationally including previous UN COP summits .

The Scottish Government publishes a weekly Research Findings which models the COVID-19 epidemic in Scotland. The Research Findings includes a section which estimates infections, as well as hospital and ICU bed demand from COVID-19. This gives an assessment of the impact of COVID-19 on the NHS in the next few weeks. This will provide information in the run up to COP26 and after the event has taken place.

The publications can be found on the Scottish Government website at the following link:

https://www.gov.scot/collections/coronavirus-covid-19-modelling-the-epidemic/