Chamber and committees

The Scottish Government welcomes the collaborative efforts of Scotland’s medical schools, Health Boards, NHS Education for Scotland (NES) and the General Medical Council, to make it possible for all final year medical students to graduate earlier than usual and, if they wish, to apply for Interim Foundation posts in our health service. Each University is expediting graduation without jeopardising the extent to which these students will be prepared for frontline service.

NES will work with Health Boards and our medical schools to ensure a comprehensive induction period, effective supervision and pastoral support is in place so that these newly graduated medical students are supported through this time. Those volunteering for interim Foundation doctor posts will be fully supervised by their clinical teams who will appropriately manage patient contact, and each postholder will know the extent of their role, and have named contacts to provide additional support and mentoring until 31 July 2020 when many are expected to transition into their planned Foundation Year 1 posts.

Given there is no vaccine or reliable treatment available, a series of social distancing measures have been introduced as these are the most effective way of delaying the spread of the virus, reducing the impact on health and social care services and therefore saving lives.

To reduce demand on acute hospitals we are working with Health Boards and partners to scale back non-urgent elective procedures and reduce the number of patients delayed in hospital waiting on their next stage of care.

We are encouraging the public to access the most appropriate service during the COVID-19 outbreak, and only attend A&E if their illness is immediate or life threatening.  As a result of these efforts, A&E attendances in the latest published week were 58.8% below recent seasonal average.

We have rolled out a new community pathway of local Hubs and Assessment Centres for individuals with deteriorating COVID-19 symptoms. This will ensure that individuals get the right help at the right time, from the right people at the right place. By triaging efficiently we will ensure that only those that need to go to hospital are admitted.

Additionally, if followed, the advice given to the public by the Scottish Government to stay at home will minimise the spread of COVID 19 and reduce the demand on the health service and minimise hospital admissions.

Of the £70 million Food Fund, £60 million will be directed at structured public sector responses. This includes the initial £30 million being made available to local authorities to support households who may experience barriers in accessing food and up to £30 million to deliver nationally co-ordinated support for those clinically at high risk from the coronavirus.

£10 million will support community-based infrastructure, with around £5 million committed to date to organisations including FareShare and Food Train.

This investment will be complimented by the Wellbeing Fund, which is being supplemented with an initial £1 million from the Food Fund to support local community food responses, and the Supporting Communities Fund. Further information for organisations seeking to access this support can be found on the SCVO Coronavirus Third Sector Information Hub: https://scvo.org.uk/support/coronavirus/funding/for-organisations/scottish-government .

We have been engaged in detailed discussions with supermarkets since the end of March about prioritising deliveries during the COVID-19 outbreak, to support all those at the highest clinical risk from COVID-19 to self-isolate, or ‘shield’. People at the highest clinical risk are those who have received a letter from the Chief Medical Officer asking them to stringently self-isolate for at least 12 weeks. From 9 April, people in this group have been able to request that their details are passed to supermarkets so that they can be offered priority delivery slots from week commencing 13 April.

This new priority supermarket delivery offer is in addition to the national contract already established with Brakes and Bidfood, which has been delivering food and household items to thousands of ‘shielding’ people across Scotland since 3 April.

There are many people who are not in the clinical high-risk ‘shielded’ group, but are otherwise at risk, and we are working to ensure that support can be provided to these groups. This will include continued dialogue with retailers to see what further action may be possible in relation to supporting vulnerable groups , and we are also aware that some supermarkets are offering priority delivery slots for older people. There is, however, unprecedented demand for online supermarket deliveries, which far exceeds the capacity which is available, and so we are working to ensure other support is available.

The Scottish Government understands the importance of protecting the funeral sector from the risk of infectious transmission of COVID-19 via contact with the deceased.

We advise that, taking account of the latest evidence­ based health guidance, organisations should ensure that their key frontline workers are appropriately equipped and, where there is a real need for PPE, the first option should be to endeavour to utilise and develop their existing supply chains and networks.

To oversee the effective implementation of additional deaths planning for COVID-19 in Scotland, a national group has been established, which includes Funeral Director representatives, and is linked to the Scottish Government PPE Group working hard to address PPE supplies across all sectors.

We have been working very closely with stakeholders from across the funeral industry to ensure they have access to the most up to date information relevant to them, including guidance from Health Protection Scotland, and information from the Royal College of Pathologists which outlines the PPE required for care of the deceased during the COVID-19 pandemic based upon the official advice.

In addition to this, we published guidance for funeral directors and burial and cremation authorities , which includes the use of appropriate PPE for infection control, on 13 April to further help these organisations manage their services during the current pandemic.

I refer the member to the answer to question S5W-28076 on 15 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.

NHS Boards have been asked to repurpose 3,000 acute staffed beds for COVID-19 patients within the existing base of just over 13,000 acute staffed beds. Boards have already trebled ICU capacity and are now working to quadruple ICU capacity.

We continue to explore with Boards, as part of their mobilisation planning, how to further maximise bed capacity. In addition to this, we are seeking to augment capacity through the use of the private sector and we recently set up the NHS Louisa Jordan in Glasgow to create capacity for an initial 300 extra hospital beds, with the ability to expand to over 1,000 if required.

The Community testing part of the enhanced surveillance is being adjusted to work with the new community pathway – community hubs and community assessment centres. Surveillance testing will now either be carried out at home or at the community hubs rather than GP practices and at this stage only involves testing of those who are symptomatic.

A sample will be taken of individuals with mild to moderate symptoms triaged at the telephone community hubs. People will self-swab on receipt of a testing kit. Logistics being discussed with NHS Boards around delivery and return of the self-sampling kit.

A further sample by a HCW will be taken of individuals triaged in person at community assessment centres, provided they are not being sent on to hospital.

This will be a total maximum of 1000 samples weekly spread across the country geographically.