Chamber and committees

Targeted clinical guidance has been issued to support decision making in a range of areas including clinical prioritisation. This includes:

• Clinical and patient guidance disseminated to clinical and oncology teams on the 30 April which has been kept under constant review.
• The Framework for Recovery of Cancer Surgery to assist NHS Scotland prioritise those most in need of cancer treatment.
• Clinical guidance has been published on q(FIT) testing to specifically support decision making for those colorectal cancer symptoms.
• Published Re-mobilise, Recover, Re-design: The Framework for NHS Scotland on 31st May to support clinical decision making as NHS Boards begin to restart paused services. This Framework sets out how NHS Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of services while maintaining COVID-19 capacity, resilience and providing appropriate support for social care.

Throughout the pandemic we have been clear that urgent, emergency, Maternity and Cancer services should continue to be available and that the NHS is open for those who require medical attention.

The Data requested by the member is not held centrally by the Scottish Government.

Whilst the majority of cancer treatments have continued throughout this pandemic, some patient’s treatment plans may have changed to minimise their individual risk. Those that require changes will always be done on a clinical basis and will be in discussion with the patient and clinical team.

It has been made clear that vital cancer services should remain where clinically agreed during the Covid-19 pandemic, this includes the use of private hospitals to treat these NHS patients. By utilising the private sector capacity we are able to provide a COVID free environment for urgent cancer procedures. The Golden Jubilee is also supporting the treatment of urgent cancer patients.

On 11th June 2020 the Association of Medical Research Charities (AMRC) published on their website an article entitled COVID-19: The risk to AMRC charities.

https://www.amrc.org.uk/covid-19-the-risk-to-amrc-charities .

The published AMRC figures do not distinguish between cancer and other medical research charities.

On 30 th March Cancer Research UK released a press release that referred to an estimated 25 percent drop in fundraising income in FY 2020-21

https://www.cancerresearchuk.org/about-us/cancer-news/press-release/2020-03-30-cancer-research-uk-estimates-25-per-cent-drop-in-fundraising-income-due-to-coronavirus?_ga=2.60513902.2117832912.1593763662-1469902633.1572445696

The impacts of COVID-19 on medical research are being considered by the UK Office for the Strategic Coordination of Health Research Board, which includes representation from the AMRC and the Scottish Government’s Chief Scientist Office through the Chief Scientist for Health as well as from the other UK Health Departments, and UK research councils.

The UK Government has announced on 27 June that, from this autumn, UK universities will be able to access a series of UK Government grants and long-term, low interest loans covering up to 80% of each institution’s income losses caused by a decline in international students, up to the value of non-publicly funded research activity in that university. In addition, around £280 million UK Government funding will be made available to universities and research organisations for costed extensions of UK Research and Innovation and National Academy research projects impacted by the pandemic.

We welcome the recent announcement by the UK Government which builds on the Scottish Government’s commitment last month to provide an additional £75 million to ensure our universities can protect their world-leading research against the financial impact of COVID-19. However, we are concerned about the emphasis on loans in the UK Government’s stabilisation package, as not all universities will be in a position to take advantage of those. We will work with the UK Government not only to agree how this package will be implemented in Scotland, but also to address the long term sustainability of our sector to ensure it plays a key role in Scotland’s economic and social recovery.

The Covid-19 Clinical Guidance Cell has been established by the Chief Medical Officer to rapidly develop and revise guidance on clinical management of COVID-19 for the NHS.

The purpose of the Clinical Guidance Cell is to rapidly prepare guidance for the health and care system in Scotland on the clinical management of COVID-19.

Membership is drawn from key organisations and professional communities across Scotland who have a direct interest. This includes the Scottish Academy of Medical Royal Colleges and Faculties and Health Protection Scotland.

The Scottish Government is also advised by the COVID-19 Advisory Group, which was established to address the need for additional scientific analysis of the impact of COVID-19 in Scotland, based on regularly updated advice and modelling from the UK Scientific Advisory Group for Emergencies (SAGE), and other emerging scientific evidence.

The group is chaired by Professor Andrew Morris, Professor of Medicine at the University of Edinburgh, supported by vice chair, Professor David Crossman, Dean of Medicine at the University of St Andrews and Chief Scientist (Health) at the Scottish Government. Members are public health experts, clinicians and academics spanning the disciplines of epidemiology, virology, public health, behavioural sciences, global health, medicine and statistical modelling. Full details of the group’s membership are available on the Scottish Government’s website at https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/

As part of the Scottish Government response to the COVID-19 pandemic, on 25 th March 2020 the Chief Scientist Office (CSO) launched a call for rapid research in COVID-19. The call attracted 139 individual research project proposals. CSO convened an independent expert panel to review the applications. This panel, which met virtually on 21 April 2020 to consider the applications, comprised 35 expert members from the medical and wider health and social care research sectors and 3 lay members and was co-chaired by Professor Eleanor Davies from the Univeristy of Glasgow and Professor Shaun Treweek from the Univeristy of Aberdeen.

The outcome of the review was that 56 research projects were funded, led by 15 different research institutions from across Scotland. The work funded through this call involves researchers from the medical and wider health and social care research sector. This includes research to:

• Better understand the effects of COVID-19 infection in order to inform treatment and management of disease

• Develop and test new diagnostics and therapeutics

• Investigate novel disease surveillance approaches

• Inform interventions to prevent transmission of infection

• Support the resilience and mental health of frontline health and social care workers

• Understand the physical and mental health implications of social distancing and other restrictions and their impact on the general population and also a number of vulnerable groups

Details of the funded projects are available from the CSO website. https://www.cso.scot.nhs.uk/rapid-research-in-covid-19-programme/

We have been clear that throughout this pandemic, the NHS is there for those who need it. Our NHS is Open campaign was launched 24 April and we have seen a steady increase in the number of people presenting to their GP practice with symptoms that could be suspicious of cancer – now 86% pre COVID levels.

Our Clinical Director for Scotland, Jason Leitch also made a statement urging patients who have an appointment to attend hospital for these as it will have been deemed clinically safe to do so.

We are working hard to ensure vital and urgent care remains, including the use of private hospitals to treat these NHS patients. By utilising the private sector capacity we are able to provide a COVID free environment for urgent cancer procedures. The Golden Jubilee is also supporting the treatment of urgent cancer patients.

The Scottish Government convened the National COVID19 Cancer Treatment Response Group (CTRG) on 18 th March to form national clinical consensus in Scotland on changes to cancer treatment in response to the new risks associated with COVID-19 ensuring those most urgent cases were prioritised.

The group has produced clinical advice on an ongoing basis and throughout the pandemic the majority of cancer treatments have continued.

We have now established a National Cancer Recovery Group which has been established to offer national arbitration on overall clinical priorities. It will also oversee national data and modelling work in relation to cancer recovery and advise on patient and public communications.

Any cancer patient worried about symptoms should call their existing cancer treatment helpline or the national cancer treatment helpline. Individuals with serious or worrying signs or symptoms are encouraged to use the NHS as normal and contact their local GP practice.

Urgent and emergency care has been maintained throughout this pandemic to ensure those with life threatening conditions were and continue to be seen as a matter of priority.

Through the Re-mobilise, Recover, Re-design: The Framework for NHS Scotland , Health Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of some paused services whilst continuing to protect emergency, urgent, Cancer and maternity care. Health Boards will plan to resume services while maintaining COVID-19 capacity and resilience and providing appropriate support for social care, and also protecting the safety of all patients and staff. Health Boards are taking a careful and considered approach to this, balancing the treatment of COVID-19 patients with the all potential impacts of longer waiting times, including assessing the impact of this on excess death rates.

Data on patients recruited from NHS Scotland in each of the last 12 months into non-COVID-19 Trials in Scotland are set out below.

June 2019 1,678

July 2019 1,839

Aug 2019 1,725

Sept 2019 1,358

Oct 2019 1,647

Nov 2019 1,431

Dec 2019 991

Jan 2020 1,500

Feb 2020 1,293

Mar 2020 789

Apr 2020 34

May 2020 19

Notes

1. The data does not take account of patients recruited into other types of research.

2. The number of patients recruited in previous years and still involved in Clinical Trials is not captured by NHS Research Scotland.

3. The data has been provided by research teams working in NHS Scotland and may not be complete.

Patient safety will be at the forefront of NHS Boards plans as they restart previously paused services, and a number of different steps to mitigate the impact that two-metre physical distance are being put in place. This includes extended working days including evenings and weekends to provide more clinics and see more patients.

The Golden Jubilee providing national support to territorial Health Boards in specialties such as Ophthalmology and Orthopaedics, and continue to support with Cancer surgery.

The Private Sector is supporting NHS Boards by providing a COVID free environment for urgent and Cancer surgery. This provides a safe environment for both staff and patients.

In addition, in order to increase access to diagnostic testing, NHS Boards will be deploying six mobile MRI scanners and three CT scanners, across Scotland. This will enable Boards to ensure patients have appropriate access to diagnostic services while also ensuring physical distancing measures and PPE requirements are followed.

We are also exploring options for further pathways for the NHS Louisa Jordan with the possibility that the facilities can be used to provide outpatient appointments and access to diagnostics testing.

Every death from COVID-19 is a tragedy and the Scottish Government offers our condolences to every family that has been impacted, not least those of our frontline health and care staff.

We are working to fully understand the impact of COVID-19, taking into account individual risk factors which would make someone more vulnerable to COVID-19 such as age, ethnicity, underlying co-morbidities, where they live and the prevalence of the virus in their local area.