Chamber and committees

I refer the member to the answer to question S5W-30230 on 8 July 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 Scottish Government cannot comment on individual cases but in general terms NHS Scotland does not pay for or subsidise private health care arranged independently by a patient. This matter was discussed in the Chamber on 25 June 2020 in response to oral question S5O-04436, the full transcript can be found here: http://www.parliament.scot/parliamentarybusiness/report.aspx?r=12720&i=115044 .

Key workers are those in posts which ensure essential services can be delivered and cover tasks within the local community which support the vulnerable and aid community. We cannot designate whole workforces or entire groups of staff as key workers and there is no national list of who is considered to be a key worker.

Decisions around eligibility for key worker childcare are being taken locally, in line with guidance published on the Scottish Government website. Both parents are required to be key workers before being able to access childcare and in general, councils have not been making critical childcare available to families where one parent is a key worker but the other is not. We recognise that this is causing difficulties for key worker families. Such families can access informal care, although where possible this should be the same person, such as a non-vulnerable relative or friend, a nanny or babysitter. From 15 th July, subject to scientific evidence, there will be the full reopening of early years provision, including educational provision, childminders and local areas will also be resourcing additional activities.

More information on the advice and guidance in relation to key workers and the closure of schools can be found here:

http://www.gov.scot/publications/coronavirus-guide-schools-early-learning-closures/pages/key-workers/

Estimated numbers of people affected by the pause to bowel screening were published when the pause to the programme was announced on 30 March. The figures, which are based on the most recent information available to Information Services Division at the time of the pause, indicate that 248,177 people may have had a faecal immunochemical test (FIT) delayed as a result of the pause to the bowel screening programme over the past three months.

The resumption of screening services is taking place safely, carefully and in a series of stages, as part of the remobilisation of the NHS in Scotland. Bowel screening colonoscopies are now resuming in all Boards, including for bowel screening participants who returned a positive FIT test before or during the pause.

Local boards will be provided with numerical FIT values, to help them prioritise bowel screening participants alongside symptomatic patients.

During the pause to the screening programmes we have continued to emphasise that anyone who is concerned about any signs or symptoms of cancer should not wait for their next screening test and should seek medical advice.

Estimated numbers of people affected by the pause to breast screening were published when the pause to the programme was announced on 30 March. The figures, which are based on the most recent information available to Information Services Division at the time of the pause, indicate that 46,596 people may have had their breast screening appointment delayed as a result of the pause to the breast screening programme over the past three months.

The resumption of screening services is taking place safely, carefully and in a series of stages, as part of the remobilisation of the NHS in Scotland. The breast screening service is currently assisting acute services to prioritise high-risk familial clinics and post-treatment surveillance screening, while preparing for the resumption of the national programme.

In the meantime, it is absolutely vital for those in between screening appointments or awaiting a rescheduled appointment to be aware of any symptoms or signs of the conditions screened for. Anyone having these symptoms should contact their GP practice.

Estimated numbers affected by the pause to the screening programmes are based on the most recent information available to Information Services Division at the time of the pause. This indicates the following numbers of people may have had their appointment delayed in the three month period since the programmes were paused on 30 March:

• 248,177 bowel screening participants.
• 46,596 breast screening participants.
• 101,963 cervical screening participants.

The cancer screening programmes that were paused on 30 March (breast, bowel and cervical) are now beginning to restart – safely, carefully and in a series of stages.

The Scottish Government were concerned to read the findings of this tragic incident. NHS Lothian have accepted the findings of the Fatal Accident Inquiry and have confirmed that a number of actions have taken place since 2014 to improve the number of staff incorporated within ward establishment figures. Firstly, the Royal Edinburgh Hospital was given an uplift in budget of £3 million which allowed it to review establishment levels. In addition, when the new Royal Edinburgh Building was built, it allowed for an improved number of nursing staff per bed ratio.

NHS Lothian has produced a draft action plan in response to the FAI which includes implementation of the standards within Healthcare Improvement Scotland’s (HIS) "From Observation to Intervention" 2019 guidance. This is being taken to the NHS Lothian Health Care Governance Committee for discussion on 24 th July 2020.

On December 16 2019, the Scottish Government published the first Integrated National Health and Social Care Workforce Plan in the UK. Developed in partnership with COSLA, the Integrated Plan sets out how health and social care services will meet growing demand to ensure the right numbers of staff, with the right skills, across health and social care services. Covid-19 has led to widespread disruption to Health Boards' models of service delivery and we are carefully considering the Integrated Plan to ensure its content and associated guidance are, going forward, reflective of the full range of current and developing planning requirements on Boards and the changing circumstances regarding Covid-19.

In addition, implementation of the Health and Care (Staffing) (Scotland) Act, which is the first multi-disciplinary workload and workforce planning legislation in the UK, will support the wider workforce planning process by enabling a rigorous evidence based approach to staffing decisions. Health Boards have also been supported in planning their nurse staffing in response to the pandemic by the development of a professional judgement decision making template, including for mental health.

The Scottish Government will also shortly reconvene the National Mental Health Quality and Safety Board. This Board will be considering all issues that impact upon the quality and delivery of safe and effective services, including inpatient and community settings.

The Scottish Government continues to participate in the four nations approach to the procurement of tests and, subject to clinical recommendations and the availability/approval of an effective antibody test, can draw-down an allocation of the UK procured COVID-19 antibody tests for use in Scotland.

The exact information requested is not available centrally. Public Health Scotland collect social care information directly from Health and Social Care Partnerships; however, it is not possible to identify from this if social care packages have been withdrawn or the reason why a package may have been withdrawn or reduced.

It is possible to estimate the number of people receiving home care services each month and how many hours of home care were received. Table 1 provides this information for January to March 2018. Information for 2018-19 is not yet available.

Table 1. Number of people receiving home care 1 services and total number of hours 2,3,4 of home care by month and Health and Social Care Partnership 2,3,4 , January to March 2018

Our national expert body, Health Protection Scotland (HPS), jointly with the Department of Health and Social Care, Public Health Wales, Public Health Agency Northern Ireland, Public Health England (PHE) and NHS England published updated PPE guidance in relation to COVID-19 on Thursday 2 April (updated 12 June). The guidance is available here .

The guidance outlines what type of PPE frontline health and social care workers should be wearing in different settings and scenarios, including where a two-metre social distance is not possible. The guidance contains tables which clearly explain the PPE required for different common clinical and care scenarios. The first table relates to acute hospitals and the second and third are for primary care, outpatient and community care, ambulance staff, paramedics, first responders and pharmacy.

Given the recognised sustained community transmission of COVID-19, the guidance importantly includes detailed advice (table 4) around risk assessing use of PPE, including aprons, gowns, Fluid-Resistant Surgical Masks and eye protection, in a range of different clinical and care scenarios, including where a two-metre social distance is not possible.

Additionally, on 23 June recommendations on the wider use of face masks by staff within residential healthcare settings, such as acute adult (including mental health) and community hospitals and care homes for the elderly where staff are unable to physically distance were announced. The guidance recommends that staff working in a clinical area of an acute adult or community hospital, or in an care home for the elderly should wear a face mask at all times throughout their shift. Additional advice was also announced on the requirement for visitors to wear face coverings when attending adult hospitals or care homes for the elderly.