Chamber and committees

The Scottish Government encourages anyone planning to visit a Scottish Island to test for coronavirus prior to travel, this includes any Ministers, staff or agency employees who are traveling to the islands. Scottish Government staff are not routinely travelling for work purposes and continue to work from home wherever possible.

Pre-departure testing for travel to the Scottish Islands is a voluntary scheme, however, everyone is encouraged to participate in order to reduce the risk of inadvertently carrying coronavirus into one of the island communities. Information on travel, including to the Scottish islands, is set out in the COVID-19 Framework for Decision Making – Scotland’s route map through and out of the crisis, which is available at www.gov.scot/coronavirus .

Following clinical advice, and in agreement with stakeholders, we will not be running a sepsis awareness campaign while the COVID-19 public awareness campaign continues.

We are aiming to re-start the annual sepsis public awareness campaign in 2022. In the meantime we are in discussion with sepsis charities around how we can support them in other ways to raise awareness of sepsis.

Data on diagnosis of sepsis by age, gender and location can be found at:

https://publichealthscotland.scot/publications/acute-hospital-activity-and-nhs-beds-information-annual/acute-hospital-activity-and-nhs-beds-information-annual-annual-year-ending-31-march-2020/ .

At present the Scottish Government has no plans to publish data on people affected by sepsis, broken down by ethnicity.

Our strategy is for all health records to be held electronically. The majority of people’s medical records are already digitised, following significant investment in GP IT systems in primary care and full implementation of the TrakCare patient management system in secondary care. We recognise, however, that paper-based records still exist within the service, particularly within individual clinical specialties, and that there remain a number of older records that have not been fully scanned or digitised. Health Boards continue to work through these challenges. Our forthcoming refreshed Digital Health & Care Strategy will set out further ambitions for greater patient access to their medical information.

The information requested is not held centrally by the Scottish Government.

Information relating to the number of women aged (a) 50 and over and (b) under 50 currently waiting for diagnostic tests to confirm either (i) primary or (ii) secondary breast cancer would be held by individual Health Boards.

The 2021-22 Scottish Budget provides £1.1 billion for investment in general medical services, in addition to £11.6 billion for our frontline NHS Boards.

General medical services includes general practice investment and a wider range of additional and linked services in the community, including pharmacy, mental health nursing, dental and ophthalmic.

Thank you for submitting the series of parliamentary questions in relation to NHS Forth Valley, with a specific focus on the External Review around Culture in the Emergency Department, Forth Valley Royal Hospital. I have responded to each of the questions in this one response.

Firstly, you asked about the number of people that were directed away from the A&E department at Forth Valley Royal Hospital without a correct clinical assessment during 2020 and from 1 January to 30 June 2021, we do not collate that level of data therefore I am unable to provide a response on this.

Regarding the findings of the External Review around Culture in the Emergency Department, this was an independent report commissioned by NHS Forth Valley and we are pleased that the Board took swift action after serious allegations were made by staff representatives.

The Scottish Government has noted the findings of the independent review and welcome that the Board has accepted the recommendations. We meet regularly with all Boards, including Forth Valley, and we will support the Board in taking forward these recommendations, seeking assurance that these are fully implemented.

We are also committed to supporting staff within the Board. All staff in our NHS must have the confidence to raise any concerns they have about patient care and not suffer any repercussions for doing so. The NHS Scotland Whistleblowing Policy requires boards to have an impartial, confidential contact that all staff can access to raise concerns should they feel that they cannot raise these concerns with their line manager or senior management.

In addition the confidential, Independent National Whistleblowing Officer (INWO) advice line provides information, support and signposting for those raising whistleblowing concerns, including former staff - the number of this service is 0800 008 6112. The INWO, which came into force in April 2021 and is the first of its kind in the UK, provides a mechanism for external review of how a Health Board, primary care or independent provider has handled a whistleblowing case.

Furthermore, staff working in health and social care can access support services available through the national wellbeing hub this can be accessed via www.promis.scot or by calling 0800 111 419. Both the INWO and wellbeing hub are available to current and former members of staff.

You have raised a number of issues including communication with patients in case of any subsequent legal or civil action. The decision on whether or not an action for damages is time-barred is a matter for the courts to determine. If there is any doubt as to when the limitation period should start to run, a court could hear arguments about when the pursuer became aware of his or her entitlement to pursue a claim, as part of the court’s application of the date of knowledge test.

The Scottish government and NHS Scotland have a shared vision for an open and learning culture and we want to learn when there has been dissatisfaction or harm and encourage organisations to identify improvements. Safety is at the heart of everything we do in NHS Scotland and it is vital to building a culture, which allows all frontline professionals time and safe spaces to learn, without fear of censure.

As part of our commitment to transparency, improving standards and learning lessons when something goes wrong, we have introduced a Statutory Organisational Duty of Candour. This makes it a legal requirement for all care providers, including Health Boards, to review certain types of adverse events, meet personally with those affected, and to publish an annual report to support openness and learning.

Part of that includes an organisational emphasis on staff support and training to ensure effective implementation of the organisational duty of candour. Staff must feel that they have the necessary skills and confidence if they are to be meaningfully involved in the delivery of the procedure and they are supported after an incident occurs. Being candid promotes accountability for safer systems, better engages staff in improvement efforts, and engenders greater trust in patients and service users.

The Scottish Government is clear that there should be robust site management in place across NHS Boards at all times, including access to senior decision makers, with operational overview of all emergency activity. Through our unscheduled care programme we continue to work closely with Boards, including NHS Forth Valley, with a specific focus on supporting the implementation of a series of improvements, including the workforce model in emergency departments, for example staffing levels, systems and processes as well as a nursing workforce review.

In terms of redirection, the Scottish Government policy is that patients may be referred to another service or provided with self-care advice once assessed by an appropriate clinician and deemed not to require emergency care. We are aware that during peak times of the pandemic some Boards had to take necessary measures to keep patients and staff safe by redirecting people following triage at the front door. We would expect any Board utilising this approach do so based on risk assessment.

During the summer months NHS Forth Valley, supported by the national programme for unscheduled care, have been working to explore the option of a care navigation area at the front-door to safely direct people to the onsite Minor Injury Unit and Urgent Care Centre if these areas are appropriately medically staffed.

In addition, the Scottish Government unscheduled care programme commissioned a Short Life Working Group, with representation including clinicians and managerial staff, during this year to review existing Redirection and Signposting Guidance to support Boards to implement best practice and ensure a consistent, coherent and safe approach to the right care in the right place. A key aim is to ensure people can be seen at services which better meet their healthcare requirements avoiding unnecessary exposure to a hospital environment. This will be published in September.

We regularly engage with people who are at highest risk from COVID-19 through surveys, in-depth interviews and testing communications. Earlier this year we spoke directly to people at highest risk who have returned to the workplace as restrictions eased, to understand their challenges and what guidance and support may be needed when restrictions ease. Most recently, we launched a survey about the move to level 0 and beyond which asks how people are feeling about those changes. The results will be published late summer.

Three Disabled People’s Organisations (Inclusion Scotland, Disability Equality Scotland and Glasgow Disability Alliance) were consulted on the easing of restrictions.

Throughout the pandemic we have been engaging with both carers and carer organisations to ensure unpaid carers have the advice they need to help protect themselves and their loved ones during the COVID-19 outbreak.

The Scottish Government acts on the basis of the latest guidance issued by the Joint Committee on Vaccination and Immunisation (JCVI), which considers all available evidence for the most appropriate vaccinations policy approach in the UK. Current JCVI advice remains that the single greatest risk of mortality and severe disease from COVID-19 is increasing age and COVID-19 risk increases exponentially with age.

Those registered as clinically extremely vulnerable (CEV) on the GP system are already included in group 4 of phase 1 of the JCVI priority list. Solid organ transplant recipients are deemed CEV and have been previously included on the Shielded Patient List. A hospital clinician or GP can also add a patient to the list, based on their clinical judgement, because they consider them to be at very high risk of serious illness from COVID-19.

All patients on the CEV list will also fall into the broader disease categories outlined in table 3 of the Green Book, Chapter 14a, but are in priority group 4 because of more recent treatment, more advanced condition or co-morbidities. Other patients in the same clinical risk group, but not on the CEV list at the time group 4 is called, are within priority group 6, or with their appropriate age cohort. Further information is available here: COVID-19: the green book, chapter 14a - GOV.UK (www.gov.uk)

On 30 June the JCVI published interim advice on adult COVID-19 booster vaccinations. The interim advice is to begin offering COVID-19 booster vaccines in September 2021, in a two-stage programme alongside the annual flu vaccination programme.

The JCVI will consider additional scientific data as it becomes available over the next few months ahead of formulating final advice. Accordingly, we shall consider the final advice issued on this matter and any adjustments JCVI may or may not recommend in light of additional scientific data it is presently considering, as this becomes available over the next few months.

The Serum Institute of India (SII) manufactures both Vaxzevria and Covishield, both branded vaccines are exactly the same COVID-19 AstraZeneca vaccine. All SII-made doses approved by the Medicines & Healthcare products Regulatory Agency (MHRA) and administered in the UK were those branded as the ’COVID-19 vaccine AstraZeneca’ which is now known commercially as ‘Vaxzeria’. The MHRA has not approved doses branded as ‘Covishield’ and none were in administered in the UK.

All AstraZeneca vaccines given in the UK are the same product and appear on the NHS Vaccination status letter as Vaxzevria. The European Medicines Agency has authorised this vaccine and we are confident travel will not be affected.

Individuals can access the batch number of the vaccine they received in Scotland via a Subject Access Request from their GP.