Chamber and committees

Emerging data suggests that some individuals with suppressed immune systems may not mount a full immune response to COVID-19 vaccination.

The multi-centred OCTAVE study led by colleagues from Glasgow University published their preliminary findings with widespread media coverage. The study funded by the UK Research and Innovation (UKRI) Medical Research Council (MRC) was designed to evaluate the immune responses following COVID-19 vaccination in patients with immune-mediated inflammatory diseases including inflammatory arthritis and Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) (an auto-immune disease affecting small blood vessels) who have received Rituximab treatment, along with a host of other conditions with various degrees of immunosuppression.

Initial findings suggest that in total about 40% of those across the patient groups studied produced a low antibody response to two doses of COVID-19 vaccine, and the proportion varied depending on the nature of the immune impairment.

The OCTAVE group presented their findings to the Joint Committee on Vaccination and Immunisation (JCVI) and the Committee took into account these findings to make their recommendation on a third primary dose of COVID-19 vaccine for severely immunocompromised people.

A second study called OCTAVE DUO, led by the same researchers and also funded by UKRI, is examining whether a third dose will give a stronger immune response in people with impaired immune systems.

Information about these studies is available at: Vaccine responses in patients with impaired immune systems – UKRI

New study tests third jab for people with weakened immune systems – UKRI

The COVID pandemic has inevitably affected A&E attendance and the pressure is being felt across the UK. Our NHS staff have faced unprecedented pressures over recent weeks as they work tirelessly and consistently to respond to the pandemic whilst continuing to provide vital treatment and optimal patient care. We are in daily contact with every Board, including NHS Forth Valley, and are monitoring the situation closely.

The significant pressures currently presenting in Health Boards, including NHS Forth Valley, are primarily as a result of reduced capacity due to infection control, staffing pressures as a result of self-isolation and annual leave, and an increase in attendances to A&E by those who are much sicker and require higher levels of care.

In July, NHS Forth Valley received their share of the additional £12 million in funding for Boards to support non-COVID emergency care by increasing staffing resource, recruitment is underway.

We are in daily contact with NHS Forth Valley and continue to support improvement work with the Board and the Health & Social Care Partnerships to minimise delays for patients no matter where they are in the system.

The Scottish Government and Public Health Scotland do not currently hold data on the number of people eligible for a Covid-19 vaccine who are unable to receive one due to needle phobia.

As every individual case is different, all those who suffer from needle phobia should initially seek support from their GP, clinician or local health board so that adjustments can be made to accommodate their specific needs. Their local medical team will be more aware of their specific requirements. The staff delivering the vaccines are skilled and experienced, and will be used to dealing with more nervous patients, some of whom have phobias.

Phobias are not covered under the current version of the vaccination certification policy, and are therefore not considered a valid exemption.

Health Boards throughout Scotland are asked to record any wastage on an online waste recording tool. However in providing some context to the Member there are a number of limitations; it is not mandatory for GP Practices to use the recording tool and most GP Practices do not record waste on the online reporting tool. The vaccine tool was launched in late January; some but not all Boards chose to record wastage from the beginning of the programme (entering data retrospectively)

The total number of vaccine doses recorded as expired since the start of the programme under the reason code ‘expired shelf life’ is 23,312 doses (11,700 Moderna, 5696 Pfizer and 5,917 AZ) however as above, this is not comprehensive.

In terms of stock that will go out of date by 30 September 2021, there is ongoing work to minimise any wastage including sites only drawing down stock where there is certainty that it will be used before expiry.

Given the scale of the COVID-19 vaccination programme, some vaccine wastage has been unavoidable for a variety of reasons. Wastage has remained well below the 5% planning assumption throughout, however, we continue to work with Health Boards to ensure wastage is at a minimum, and maximise the availability of vaccines to the people of Scotland.

Weekly updates on the number of vaccine doses allocated and delivered to Scotland are published at Coronavirus (COVID-19): daily data for Scotland - gov.scot (www.gov.scot) – see COVID-19 Vaccine supply data in the Vaccination section.

As announced in our Programme for Government, we are investing £10 billion in health infrastructure over the next decade, to renew and replace health facilities across Scotland. The Scottish Government provide NHS Boards with over £140 million of capital funding each to invest in maintaining their existing estate and replacing and upgrading equipment. Over the next five years, as detailed in the Infrastructure Investment Plan published in February 2021, we will double our annual funding for maintenance, so that in total £1 billion will be invested in enhancing or refurbishing existing facilities, and updating and modernising key equipment.

The Scottish Government have asked NHS Lothian to submit a Full Business Case for the new Eye Pavilion following our approval of their Outline Business Case. It is for NHS Lothian to manage their local budget and determine where their maintenance budget is directed, but we would expect them to maintain a safe and compliant facility, until the new eye hospital opens.

Scottish Government were advised of Mr Alexander’s death by NHS Ayrshire & Arran on 16 February 2021. At that time, the Board also confirmed that a review was ongoing to determine Reporting of Injuries, Diseases and Dangerous Occurrence Regulations (RIDDOR) reportable status. They further advised that the Health and Safety Executive had been advised by telephone of the death of a member of staff and that NHS Ayrshire & Arran would submit a RIDDOR notification if the internal review indicated this requirement.

Scottish Government has since been advised that in accordance with Health and Safety Executive COVID-19 RIDDOR guidance, Mr Alexander’s death was not, and has not, been formally reported to the Health and Safety Executive as it did not meet the requirements for reporting under RIDDOR.

The Scottish Government is grateful to everyone who has volunteered for COVID-19 vaccine trials in Scotland. The clinical trials participants have made an important contribution in tackling the coronavirus pandemic.

The Scottish Government are committed to ensuring that these participants are not disadvantaged. Work is ongoing to ensure that vaccine status is correctly presented on the coronavirus vaccine database.

An interim letter was sent to study investigators to send on to participants, including those in the Valneva study, on 15 July advising how they can provide vaccination status. An updated letter is currently being prepared and will be sent out in the coming weeks.

The digital application to record the COVID-19 vaccine will be available from 30 September. Clinical trial participants who have received a licenced product and are un-blinded will be able to access the application. Other clinical trial participants will not have access to the application at this time. However, other measures are in place to provide proof of vaccination.

This includes a letter of support and subsequently participants will receive a hard copy Record of Vaccination which contains security features and 1-D barcode. This Record of Vaccination can be used across the UK. In due course, this will be replaced by a QR Record of Vaccination with a QR code.

Participants should receive a record of vaccination status and do not have to do anything. If they have not received it or have lost it, they should contact their Principal Investigator.

General advice is on the NHS Inform pages at https://www.nhsinform.scot/covid-19-vaccine/after-your-vaccine/get-a-record-of-your-coronavirus-covid-19-vaccination-status and https://www.nhsinform.scot/clinicaltrialparticipants .

The Scottish Government does not hold information on the newborn hearing test and newborn infant physical examination. These would need to be requested from health boards directly.

The following table shows the number of babies screened using the bloodspot test in the newborn screening programme between January 2019 and July 2021.

It is important to note that the data provided below is management information and has not been subject to the necessary quality checks carried out for an official publication.

As part of the NHS Scotland response to coronavirus (COVID-19), an Innovation Workstream has been created to manage the evaluation of antibody and swab (PCR) tests. This workstream is led by NHS NSS and clinical scientists from NHS Health Boards, and is designed to take advantage of rapid innovations within testing, while at the same time avoiding duplication of effort between Health Boards.

As part of this workstream, antibody tests being used within Scotland are validated by NHS Scotland. The evaluation reports for the antibody assays which have currently been validated and are in use are publicly available, and can be found on NHS Scotland’s Health Innovation Assessment Portal . These evaluation reports show the high sensitivity and specificity of antibody tests approved for use within Scotland.

Scotland is also part of the UK National Testing Programme, participating in UK-wide antibody studies such as the Post Positive PCR Antibody Testing Initiative, where antibody tests have been validated by the UK Government. These validation reports are publicly available, and can be found on the UK Government website .

The Scottish Government expects everyone to be treated with consideration, dignity and respect when accessing and using NHS services. NHS staff will make every effort to ensure that the privacy and dignity of all patients are maintained in Scottish hospitals.

All patients should routinely be cared for in wards or bays which are for single sex occupancy. The Scottish Government provided guidelines and recommendations on the elimination of mixed sex accommodation in 1999 and 2000. Further guidance and direction regarding the provision of clinically appropriate single room accommodation in all planned new buildings and major refurbishments was provided in 2008 and 2010.