Chamber and committees

The Scottish Government does not hold the information requested. Information on the discharge destination of delayed patients was published for the first time as part of Public Health Scotland's April Delayed Discharge census. However, details on specific homes patients were discharges to does is not collected.

The Scottish Government's testing strategy has from the outset been informed by the best available evidence for Scotland as advised by senior clinicians and public health experts. The First Minister announced on 18 May 2020 that the eligibility for testing was being widened so that everyone in Scotland aged 5 or over who has symptoms can now access testing.

Tests provide a point in time assessment of whether someone has the infection when the test was taken. It cannot indicate whether someone is incubating the disease, and therefore may go on to develop it after a test is undertaken. Current evidence suggests that widespread asymptomatic testing may be of limited utility in the wider population, and should be prioritised in contexts of high risk and complex community settings, such as care homes.

Scottish Government policy is consistent with the recommendations of the World Health Organisation that all suspected cases be tested for COVID-19 according to WHO case definitions and that, faced with community transmission over large areas of the country, prioritisation will be required to assure the highest public health impact of reducing transmission using available resources. The guidance is available here: https://apps.who.int/iris/bitstream/handle/10665/331509/WHO-COVID-19-lab_testing-2020.1-eng.pdf

We have moved to a more proactive method of deployment, so that mobile testing units support testing in priority areas, in particular in care homes and where there is an outbreak situation. Priority will be given to those areas with the greatest need in the first instance.

On 10 April 2020 the Scottish Government's Chief Medical Officer, BMA and RCGP wrote to GP practices to provide advice and support on having anticipatory care planning conversations and to make clear that there is no requirement for health professionals to have a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) discussion as part of this conversation, unless the patient wishes to discuss it or clinician feels strongly it is necessary to raise in conversation for the patient’s wellbeing.

Additionally, on 17 April 2020, a further joint letter from the Scottish Government’s Chief Medical Officer, BMA and RCGPs was sent to GPs to reinforce this message and set out how they could effectively support care homes during this difficult time.

From 27 May, the Care Inspectorate began reporting on deaths in care homes, as provided for under schedule 1, part 9 of the Coronavirus (Scotland) (No2) Act 2020.

In the week ending 31 May 2020, 213 care homes notified the Care Inspectorate of 289 deaths. This included a total of 76 suspected or confirmed cases attributable to Covid-19 across 44 services. Of those 44 services, 21 had at least one grade of weak or adequate at their last inspection.

No portfolio budgets are being cut in the Summer Budget Revision and all reprioritisation amounts within portfolios are set out in the detailed tables within the budget revision document. All funds are being redeployed to support the industries and infrastructure necessary to support the Scottish Economy.

All of the £255m reprioritisation amounts relate to areas where services have experienced reduced demand over the lockdown period and so funds have been redeployed to service providers to best support the Scottish Covid-19 response.

For example, £105m that was originally earmarked for domestic efficiency loans will now be used to provide funding for SME housebuilders with liquidity issues as a result of the temporary closure of housebuilding sites.

I am in no doubt that significant budget challenges lie ahead and work is underway to ensure that Scottish Government resources are targeted at stimulating a safe, swift and sustainable recovery for our public services and our economy.

Contractors delivering capital investment and maintenance programmes for Scottish Water operate under contracts that use the recognised New Engineering Contracts published by the Institution of Civil Engineers. These contracts include provisions relating to costs when unforeseen events occur. The shutdown as a result of COVID-19 is such an event.

During the COVID-19 crisis, contractors have made use of the UK Coronavirus Job Retention Scheme where their employees have been unable to work which has mitigated the cost to Scottish Water during the COVID-19 shutdown. Scottish Water is currently working with its supply chain to establish and ensure only properly due monies are paid in line with the aforementioned contracts and taking account of the Job Retention Scheme. It will take some time to complete assessments as the supply chain staff return from furlough but an early view is a cost of £9-15 million in total for the months of April and May. These costs will be subject to a full commercial audit and scrutiny when they are fully presented.

The Scottish Government recognises the importance of New Lanark as one of Scotland’s six World Heritage Sites, and we are committed to doing everything we can to ensure it can continue to thrive.

My officials attended two online meetings on Friday 29 th May, hosted by Aileen Campbell MSP as the local Clydesdale constituency MSP, to discuss its situation including concerns surrounding the recent potential redundancy announcements, and its financial situation. We have offered the Scottish Government’s full support to work alongside the Trust and other partners to address these issues including consideration of specific short-term funding needs.

Historic Environment Scotland (HES), our lead public body for the historic environment, and Scottish Enterprise are also supporting the New Lanark Trust to conduct a strategic review of its business operations which is designed to ensure the long-term viability and sustainability of this important asset.

The 2014 Future of Residential Care for Older People in Scotland report made a number of important recommendations to help shape the future of the care home sector in Scotland. The Residential Care Task Force Implementation Group was established to take forward the report recommendations. Whilst many of the recommendations made were taken forward and were implemented relatively quickly, there were some longer term recommendations which required considerable development, planning and potentially funding. At the time the Taskforce anticipated that the integration of health and social care would open up opportunities for the care home sector to be developed through strategic commissioning based on local need, with an increase in intermediate care in care homes and at home, alongside a greater provision of extra-care housing as an alternative to care homes. In this context a number of significant recommendations, including the development of strategic commissioning plans, were made which are now being implemented by our Health and Social Care Partnerships (HSCPs). Some of the most significant recommendations were around support for the workforce, in particular with the implementation of the real living wage for all social care workers. As a result of this work, the Scottish Government has since October 2016 provided resources to enable all social care workers to be paid the real living wage for day time hours and that this was later extended to overnight support. However work to address the workforce challenges doesn’t end there. The Scottish Government has committed to working with national and local partners to take forward the recommendations set out in the Fair Work Convention’s Social Care Sector 2019 report to improve fair work practices for the workforce. Having reflected on progress within the care home sector five years on from the residential care taskforce report, the Scottish Government launched the adult social care reform programme last year along with COSLA. As part of that programme, the Scottish Government had started, prior to the COVID-19 outbreak, to look at ways to improve care home sustainability. While the current focus needs to be on supporting the care home sector through the COVID-19 crisis, it will be important to reflect on the lessons learned during this pandemic and identify what that means for the future of care home provision.

These data were published by National Record of Scotland on 3 June. Up to 17 May, there were 1,623 deaths where confirmed or suspected COVID-19 was mentioned on the death certificate either as the underlying cause or as a contributory cause. A further 154 care homes residents died in hospital with a confirmed or suspected COVID-19.