Chamber and committees

I will need to check. I am not sure whether my colleagues know exactly when that money was given to the third sector organisations. However, we worked with those organisations, made it clear that the money was coming as part of the money that health boards could not spend, and asked whether they were confident that they would be able to meet the criteria for it. That is why, as you will see, the amounts are, in some cases, relatively small and, in some cases, larger. The organisations are building on existing programmes. However, the fundamental point is that we have given a guarantee to health boards and others that the £10 million will be available over the next few years.

That is a really good question. We have learned a lot from the vaccine programme; we have had to really understand where uptake has been lower and what we can do to respond to that—for example, by putting mobile clinics in areas of higher deprivation, and in mosques, gurdwaras and temples. We have to take the learning from the vaccine programme and make sure that it goes right across the various parts of health and social care. The UK-level survey data indicated that what John Mason said is absolutely right, which is that prevalence of self-reported long Covid is greatest among people who are aged 35 to 69 years, who are female, who live in more deprived areas and who work in social care. That goes back to Jackie Baillie’s point, as well.

We know that the data exists, and I guarantee to John Mason that what we are doing in health and social care is often focused on areas where there are issues of accessibility and lower take-up. That is something that we have learned very well from the vaccination programme, so we are making sure that it is embedded right across our health and social care approaches.

We have to do our best to use the data that we have. For example, the World Health Organization commissioned a study—which a certain John Mason will know about—that showed that the vaccination programme saved well over 20,000 lives in Scotland. Given the recent autumn and winter booster vaccination programme, I am certain that that number has gone up. We need to rely on data and evidence and try to counter some of the misinformation. I am afraid that there are some people whom we will almost never be able to convince, but we can convince the vast majority, and that work will continue to rely on the strong evidence base for the vaccination programme.

We should also use as many different people as possible in society to get the message out. People might not trust politicians—shock, horror!—but we should make sure that we empower clinicians, as well as the people who have benefited from the vaccine, to speak about the benefits. Of course, all of us should make sure that we speak about the benefits of the vaccine and vaccination programme, as well.

We should be able to get those figures to you. Forgive me—I do not have them at my fingertips, right now. If I am able to give them, I will be happy to share them with you, convener, for sharing with the rest of the committee. I think that that should be possible but, if you do not mind, I will take that off the table and see what we can provide.

Thank you very much, convener, and good morning to you and to committee members.

I want to start exactly as you did, convener, and offer my condolences to people who lost loved ones over the course of the pandemic and who are continuing to do so. I would also reflect, as we will in the course of this conversation, that many who first contracted Covid suffer to this day from its long-term debilitating effects.

I am grateful for the opportunity to appear before the committee to discuss the impacts of long Covid and to provide information on the steps that we are taking to support the health and wellbeing of people with the condition. As committee members know, long Covid is a term that encapsulates a wide range of more than 200 different symptoms, which vary highly between people.

At present, the underlying causes are poorly understood. What is well understood, however, is that for the adults, children and young people most severely affected, the symptoms are having a significant impact on everything from their physical and mental health through to their education and employment. Indeed, I have heard as much myself in my meetings with people with long Covid and from those in our national health service who support them. For those who are severely affected, life can be extremely challenging.

Around the world, science has begun the work of trying to find not just an explanation but treatments for long Covid. That science is still in its early stages, and proven, safe, evidence-based treatments are still in their infancy. Scotland is contributing to that worldwide research effort and, in the meantime, we are taking steps to test new ways to support people. We know that, as we evolve our understanding of the disease, the current lack of effective treatments can, understandably, contribute to distress, and we understand the need for supportive care that recognises the challenges faced by people who are living with those symptoms.

At the moment, the clinical guidance recommends the provision of treatment for people’s specific symptoms, where possible, or a rehabilitative approach to help people manage the impacts of their symptoms on their day-to-day lives. That care and that support are being provided through the full range of services delivered across our NHS. People can access general practitioner assessment in a setting close to their home, and GPs can then make referrals to community rehabilitation services or secondary care pathways such as respiratory care or cardiology, where appropriate. Those individual services are best placed to investigate and support people who have as a result of long Covid symptoms that might require support.

That said, I know that people’s experiences of accessing and navigating support can be challenging. There is certainly room for improvement—there will be no challenge to that premise from me. That is why we are committed to investing £10 million in a long Covid support fund and have made an initial £3 million available from the fund this year. Rather than mandate one specific model, we are supporting NHS boards to innovate and plan based on local needs and infrastructure. The long Covid support fund is targeted additional resource for NHS boards to increase the capacity of existing services, to develop them into more clearly defined pathways and to provide a more co-ordinated experience for those accessing support. We have heard time and again from long Covid sufferers that that is what is needed. The approaches being tested include looking at ways of achieving those outcomes through having a single point of access for assessment and co-ordinated support from services, including physiotherapy and occupational therapy.

Along with our support for the initiatives that are under way in boards, the Scottish Government has delivered a clinical guideline implementation support note to help GPs effectively assess and refer people with long Covid. We have a dedicated microsite on NHS Inform that contains key information and sources of support for people with long Covid; we have launched a marketing campaign to increase awareness of the condition; and we have allocated funding of £2.5 million for nine Scottish-led research projects to better understand it. As the committee knows, we have also established a national strategic network, which brings together people with lived experience, clinical experts and those working on local service responses.

Long Covid is undoubtedly a considerable challenge. There is still much to do and learn, and there are improvements to be made, but we have an opportunity for our healthcare system to adapt and learn based on the best evidence available.

I very much welcome the committee’s inquiry on the issue and the opportunity to discuss it and to take questions from members.

I agree. I wonder whether that is the same person from Aberdeenshire whom I met—I will not say their name. I heard about a very similar experience from a young person in Aberdeenshire who felt that their GP was dismissive. I have heard that experience from people not just in Aberdeenshire but in many other parts of the country.

That is why not only the National Institute for Health and Care Excellence guideline but the implementation support note, on which we can give the committee further detail in writing through the convener, if it wants that, give a level of detail on the referral pathways that are available, and why we have put so much work, through the strategic network, into the education tools that are available for GPs.

I highlight the written evidence that the Royal College of General Practitioners gave to the committee, in which it stated that it believes that primary care and GPs are the first port of call and are “best placed” to give a holistic assessment before onward referral. I agree with it.

I would be more than happy to provide more detail on that in writing, but that is why so much work has gone into assisting our GP colleagues, who are facing a number of challenges from the pandemic around where those referral pathways are.

We have the implementation support note and an education strategy to raise awareness of long Covid. NHS Education for Scotland also has its learning platform, and I suspect that members will know that it contains a video and webinar content on long Covid. There is a lot in that space, and we are working closely with our primary care and GP colleagues to make sure that they know about the pathways that are available.

No. The money was distributed before the letter was sent to you.

That is not quite what I said.

We would have to do a further assessment of long Covid services to answer that, but I accept entirely the premise that you cannot reprofile money from one area to another without that having an impact, particularly given that I had to reprofile £400 million of funding within the health and social care budget. That clearly had an impact, and it would be foolish, and I would be insulting your intelligence and the intelligence of other people listening and watching, if I said that that was not the case. I know that Jackie Baillie understands that those decisions were made because our budget was so badly impacted by peak inflation. At that point, that made the health and social care budget worth about £1.2 billion less.

We also wanted to ensure that we gave a fair pay deal to our NHS workers. I know that Jackie Baillie fully supports that. To do that, we had to reprofile. That is why I was very keen to ensure that, when we set the budget for 2023-24, we put that money back into primary care. However, it is absolutely the case that, when we reprofile that amount of money, although we try to do it in a way that has a minimal impact, it will, of course, have an impact.

That is exactly why the strategic network is so important—it has those dedicated workstreams and brings them all together at the national level. Where we are trying to improve services for adults and children, we make sure that there are no gaps between services for young people who are in that transitionary phase. As you would imagine, that issue presents itself in many other parts of the health and social care system, but it has not been raised with me specifically in relation to long Covid. However, I am happy to take that issue up with Long Covid Scotland and Long Covid Kids.