Chamber and committees

I have a final question. Ahead of getting into winter, do you feel that we will be able to reduce the numbers or the waiting times from the current data? Are you optimistic about the winter ahead?

If Donna Bell had been on this panel, she would say that there are real challenges with maintaining heating in care homes.

On long-term, sustainable solutions, I know that NHS Orkney has solar panels on its hospital. Is that being planned for other hospital estates, such as those in Dumfries and Galloway or in Grampian?

I have a final question on the procurement of personal protective equipment. My point is basically that we should shop local. Is NHS Scotland procuring our PPE from Scottish companies where possible? I know that one company in Dumfries, Alpha Solway, was making 80 per cent of face masks. That reduces costs and emissions compared to purchasing from China, for example. Of course, there is an added cost in preparing for winter in stockpiling or procuring masks. I would be interested to hear a wee bit about that.

We are planning for the winter but are we projecting an increase in Covid cases? I was part of a team giving Covid vaccines last winter and I agree with Sandesh Gulhane that we need to encourage folk to take up vaccines, whether they are for Covid, flu, pneumococcal disease or whatever.

However, I am also thinking about other things, such as wearing masks. Instead of face coverings, should we be encouraging folk to be wearing FFP2 masks, which require fit testing, rather than surgical masks? I am concerned about what happens when we head into the winter and we are indoors again with the windows closed. I know that healthcare professionals are fed up with wearing masks already, but how do we find a balance to support everybody to reduce the risk of the spread of Covid?

It is sometimes difficult to see whether there is going to be light at the end of the tunnel. Should we just accept that the levels of attendance are high right now and that that situation will continue all through winter? Part of getting people out of hospital involves working with our social care teams, and that will include falls assessments and prevention and the other things that we can do to support people to get back to their own homes. What about the pressure on demand and the resulting impact on everyone across the service? Are there any other mitigating measures that you think could be implemented in that respect?

I have a quick question. We are planning for winter. How do we avoid admissions for people with asthma, chronic obstructive pulmonary disease or diabetes, for instance? Telemedicine is working, as is telemonitoring for folk who have COPD so that they have a plan. What work is being done to prevent folk who have asthma or COPD from coming into hospitals during winter?

I asked the previous witnesses about the challenges that we are experiencing in accident and emergency. Knowing how to move people through the system—whether you bring them into A and E and discharge them if possible or move them into acute beds—is a complicated matter, and given what the previous panel said, I am interested in hearing what this panel thinks is driving the increased delays in A and E services.

Good morning, everybody. A and E discharges and the four-hour waiting time target are all over the news all the time. I know that looking at what causes those breaches in the four-hour target, and the on-going issue about delayed discharges or the whole throughput, is complicated.

John Burns just described what actions are being taken. I am interested to hear about what specifically causes the delays in A and E treatment—what causes that four-hour target to be breached? It is not the case that people are just sitting on a trolley waiting for somebody to see them; they are still getting some care at that time, whether it is blood pressure assessment, vital signs or waiting for an X-ray or whatever. It is not that people are just sitting there doing nothing. I am interested in what causes the delays and what further specific action we can take to reduce them.

Last week, we had a chamber debate about out-of-hours GP services and I quoted some percentages in relation to out-of-hours care reducing the number of hospital admissions, so that approach has been quite successful. I know that there are challenges around staffing out-of-hours services in some places in Scotland, but those have been a good way of reducing hospital admissions. Is that correct?

Since we got our papers last week, I have been doing a bit of reading about the NHS estate and sustainability, and how the NHS can achieve net zero by 2040.

I am interested in what the panel thinks about 20 million miles per annum being saved during the pandemic through the implementation of NHS Near Me. That shows that mileage reduction can be achieved—it is a hefty figure. When calculated as CO₂ emissions saved, it is in the billions of milligrams.

Another issue relates to remote virtual clinics and using telemedicine so that, for example, blood pressure readings can be obtained remotely and then analysed by a GP, who can see the results without seeing the patient.

How do we marry up the technologies? How do we get the biggest bang for our buck in saving emissions in our NHS estate? I will go to Professor Bell first, as he is in front of me.