Chamber and committees

The Scottish Government continues to closely monitor all emerging evidence on the effectiveness of COVID-19 treatments and their clinical effectiveness. The Medicines and Healthcare products Regulatory Agency (MHRA) is now assessing Paxlovid’s safety and effectiveness, and I cautiously welcome analysis of the final clinical trial results from Pfizer (which are yet to be published or verified) which show that Paxlovid cuts the risk of hospitalisation or death by approximately 89% in high risk, non-hospitalised adult patients with mild-to-moderate COVID-19. If approved by the MHRA, this will represent another significant pharmaceutical option in our response to COVID-19.

On 20th October, the UK Government announced that 250,000 treatment courses of Paxlovid had been ordered, pending regulatory approval. On 22nd December, the UK Government announced that a further 2.5 million treatment courses had been ordered as part of efforts to reduce the impact of COVID-19 and the Omicron variant across the UK. If authorised by the MHRA, the intention is to initially deploy antivirals such as Paxlovid to individuals through a UK-wide national study, funded by the National Institute for Health Research (NIHR). The University of Oxford has been selected to lead the study . This will enable collection of additional data to address limitations in the company-sponsored trials, for example the effectiveness of the treatments in vaccinated patients, as participants in the company trials were unvaccinated.

Funding provided by the Scottish Government (Chief Scientist Office) for research falls into three broad areas of activity, i.e. research studies, capacity building and supporting infrastructure.

The specific amounts provided by condition are set out below although it should be noted that research studies (funded by non-commercial and third sector organisations) would also have benefited from the provision of service support costs and other generic resources which are not routinely recorded by condition.

Research Grants

The Chief Scientist Office supports response mode grant committees and a small catalytic grants scheme (2016-19). The committees which comprise independent experts as well as public representatives consider applications across broad research remits to address health and care challenges in Scotland. Applications are subject to independent expert peer-review with funding recommendations made by the committees. It should be noted that (1) funding rounds were significantly impacted in 2020 due to the COVID-19 pandemic which saw a significant research response and (2) for 2021 to date only one of the two funding rounds has been completed.

We have not made a direct assessment of the impact of the Covid-19 pandemic on the detection of atrial fibrillation. However, we regularly assess statistics on Covid-19’s impact on cardiovascular services more widely to inform our work.

Public Health Scotland Statistics on COVID-19’s impact on the health care system including cardiovascular procedures can be found at:

https://scotland.shinyapps.io/phs-covid-wider-impact/

To address the wider impacts of the pandemic our NHS Recovery Plan, backed by over £1bn of investment, sets out our plans for health and care over the next five years. Through the plan we will take forward our aim of increasing NHS capacity by at least 10% as quickly as possible to address the backlog of care and meet the ongoing healthcare needs for people across the country.

I can confirm that the project remains on budget. There is no change to the estimated total project cost of £49.5m at Q4 2018 prices, of which the construction contract value is £18m, as reported in the Infrastructure Investment Plan updates.

Construction cost updates for the project are published on the Scottish Government website every 6 months via the Major Capital Projects update.

NHS Greater Glasgow and Clyde has carried out a case note review in regards to the care of Andrew Slorance.

NHS Lothian have subsequently been commissioned to undertake an independent external peer review into the care of Andrew Slorance, which will be facilitated by 7 clinicians and published once key individuals have been informed.

The 2022-23 Scottish Budget delivers record funding of £18 billion for the health portfolio to support our vital health and care services, including those services that are supporting the needs of people living with long COVID, chronic fatigue syndromes and chronic pain.

We have published ‘Scotland's long COVID service’, which sets out our approach and 16 commitments to improve care and support for people with long COVID in Scotland.

In addition, our £10million ‘long COVID Support Fund’ will provide NHS Boards with additional resource to respond in a flexible and tailored manner to the needs of people with long COVID.

In light of the final National Institute for Health and Care Excellence (NICE) guidelines for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS being published, we are pleased to confirm that a formal stakeholder consultation project will begin in early 2022. The main focus of this is to work collaboratively with key stakeholders towards implementing the recommendations within these guidelines, in Scotland.

We are continuing to work with Health Boards to ensure the remobilisation of appropriate pain management support as quickly and as safely as possible. As part of this we providing funding to enhance the capacity of pain management care through the Chronic Pain Winter Support Fund. We will shortly announce the outcome of this funding call. The projects we fund will boost the support available for people with chronic pain at the national and local level to help them maintain their health and wellbeing over the months ahead.

a) Since 2019 the Scottish Government has increased legal aid fees by 8% with a further 5% committed to in early 2022. This is a total rise of 13% set against a backdrop of difficult public finances and compares well to public sector pay increases. The 5% plus 5% increases are part of an over £20m package of support for legal aid providers, in the context of the COVID pandemic. This included a £9m grant fund, payments for which were completed in September 2021 and £1m for legal aid trainees over this and next year.

The legal aid Fund is demand-led and is not cash limited. The report of the Independent Review of Legal Aid, published in 2018, found that Scotland’s legal aid system benchmarked well against other countries. The report set a long-term vision for reform. The Scottish Government has committed to bring forward reforms, including a Legal Aid Reform Bill, during this parliament.

b) With reference to pay comparisons, legal aid providers are private firms. Salaries and terms and conditions are a matter for each business. However, we are committed to the future sustainability of the legal aid system. We continue to be open to discussion and to consider evidence of gaps in the workforce and supporting diversity in the profession. The levers to assist with recruitment which the Scottish Government has undertaken includes £1m of funding over this year and next to support the costs of employing trainee solicitors.

The Scottish Government announced in January 2020 that it intended to establish a licensing scheme for short-term lets using powers under the Civic Government (Scotland) Act 1982 and we have been engaging with local authorities on implementation of a licensing scheme since then. Local authorities have experience in licensing other activities under the 1982 Act and we made changes to our proposals in response to their views.

In setting timescales for establishing a licensing scheme, and for existing operators to have made an application, the Scottish Government has been mindful of striking a balance between giving local authorities and operators sufficient time to prepare, whilst moving quickly enough to address what remains a pressing issue for many residents and communities.

We will be working closely with local authorities, and other stakeholders on the working group, to review and update guidance and prepare for implementation.

The information is not held centrally. There is however, some information regarding patients diagnosed with Venous Thromboembolism available at the NHS National Services Scotland Discovery site: https://www.nssdiscovery.scot.nhs.uk/

Two sets of regulations amending the Health Protection (Coronavirus) (Requirements) (Scotland) Regulations 2021 were made today.

The Health Protection (Coronavirus) (Requirements) (Scotland) Amendment (No.6) Regulations 2021 amend the Health Protection (Coronavirus) (Requirements) (Scotland) Regulations 2021 (“the principal regulations”).

These Amendment Regulations introduce physical distancing requirements in hospitality and indoor leisure premises, requirements for table service and also introduce a capacity limit for live events. These regulations provide the following requirements;

• Physical distancing – a requirement to take measures to ensure, so far as reasonably practicable, that a distance of 1 metre is maintained between people in or waiting to enter hospitality and leisure premises and that only enough people are admitted to the premises to allow the 1 metre distance to be maintained.
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• Table service - a requirement for table service in premises where alcohol is sold for consumption on the premises, and that the customer must remain seated whilst consuming food and drink on the premises.
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• Capacity limit for live events - a requirement that live events held indoors and outdoors do not exceed capacity limits set in the regulations - 100 people at indoor standing events, 200 people at indoor seated events and 500 people at outdoor events (whether seated or standing).

The requirements in relation to capacity limits at live events will take effect at 5.00 a.m. on 26 December and the requirements in relation to physical distancing and table service will take effect at 5.00 a.m. on 27 December.

These regulations have been published at http://www.legislation.gov.uk/id/ssi/2021/496

The Health Protection (Coronavirus) (Requirements) (Scotland) Amendment (No.7) Regulations 2021 also amend the principal regulation and will take effect at 5.00 a.m. on 27 December 2021.

These Amendment Regulations have the effect of closing nightclubs, dance halls or discotheque premises from 5.00 a.m. on 27 December 2021. It would remain open to these businesses to operate the premises with distancing and table service, rather than as a nightclub, dance hall or discotheque.

These regulations have been published at http://www.legislation.gov.uk/id/ssi/2021/497