Chamber and committees

The Scottish Government has committed to introducing a National Care Service before the end of the current Parliament. We have consulted on proposals for the National Care Service to develop and manage a National Commissioning and Procurement Structure of Standards and Processes for ethical commissioning and procuring of social care services and supports.

We propose that these standards will set principles to inform decision making, including in respect of financial transparency and commercial viability across the whole of the care home sector.

The Scottish Government recognises the importance of the portability of care and care packages if people move from one local authority area to another. To support this, a new Self-directed Support Framework of Standards was published in March 2021. This includes a commitment to consistency of practice, and states that Local Authorities should work collaboratively to ensure that people can move from one Local Authority area to another while retaining a level of provision sufficient to meet their agreed outcomes. The Scottish Government is continuing to work with Local Authorities to ensure the effective implementation of the Standards and to continue to improve the implementation of Self-directed Support.

The Scottish Government is committed to implementing the key recommendations of the Independent Review of Adult Social Care, including the establishment of a National Care Service (NCS). The consultation on the NCS, undertaken in 2021, set out proposals to ensure that there is not a postcode lottery and to support the portability of care. Proposals in respect of the development of the NCS will be brought forward during the lifetime of this parliament.

We have considered carefully whether people need to continue to be on the Highest Risk List. A significant body of evidence has been reviewed by clinical advisers related to the impact of vaccination for the approximately 176,000 people who have, for the most part, been on Scotland’s Highest Risk List since the start of the pandemic when we initially asked people to shield.

Based on the strong evidence that the risk of hospitalisation or death from Covid has significantly reduced for the majority of people on the Highest Risk List as a result of vaccination, alongside effective new treatments now being made available to people who will benefit most, we have decided to stand down the Highest Risk List from 31 May 2022. The Chief Medical Officer (CMO) will write to everyone on the Highest Risk List to advise them of this, along with a summary of the evidence that informed this decision and information about further, ongoing guidance and support.

The CMO wrote to everyone on the Highest Risk List on 4 March and indicated that we were undertaking a review of the Highest Risk List in light of the evidence that has emerged over the past two years. This intention was also set out in the update to the Strategic Framework in February.

Since July 2021, the CMO has advised people on the Highest Risk List to follow the same guidance and take the same precautionary measures as the rest of the population, unless advised otherwise by their GP or clinician who will understand their health condition and individual circumstances best.

The CMO also said in his letter that we will share the evidence that we have used to make those decisions and we are publishing a summary of the clinical evidence today. You can read the full publication at the following link https://www.gov.scot/isbn/9781802017311 which will go live at 10:00. We are aware that a core of immuno-suppressed people are unable to mount a full immune response due to their condition and/or treatment. We will publish separate advice for this group. We are working with Public Health Scotland and have put an identification process in place to be able to rapidly generate an accurate and current list of individuals for vaccine prioritisation and covid treatments, and to provide additional advice in the event of any escalated threat level to those who may need it.

We are also aware from our own and Public Health Scotland research with people on the Highest Risk List of ongoing wider negative impacts, particularly in terms of mental health, and issues of isolation, for some people on the Highest Risk List. We know that some people will continue to be more cautious or anxious about what this change means for them, or need more time to reconnect with people, or to restart the things they were doing before the pandemic. To help support these people, we have funded the British Red Cross to extend their Connecting with You Service to support people to rebuild their confidence and lives. We are also engaging with partners across all sectors to find ways to support people who may need more help to adapt, and will continue to provide guidance on protecting ourselves and others, including promoting the Distance Aware Scheme.

This is a positive step as there is no longer a need for the vast majority of people who have been on the Highest Risk List to consider themselves at any significantly higher risk. Our hope is that this will enable them to adapt to living with COVID and enjoy a better quality of life.

The Scottish Government's approach to healthcare has for a number years prioritised a preventative approach, recognising the wide range of benefits this can provide. This has been supported by broader initiatives that take a whole-system approach, for example through Scotland's world-leading approach to ill-health prevention policies on reducing smoking and alcohol consumption.

A preventative approach will underpin the National Care Service (NCS), which the Scottish Government is committed to introducing by the end of this Parliament to end the postcode lottery of care provision, ensuring quality, fairness and consistency of provision that meets individuals’ needs, regardless of where they live in Scotland.

The Scottish Government recognises that change cannot wait until the NCS is in place, and we have established a number of programmes across the Health and Social Care portfolio which will further embed a preventative approach. The Preventative and Proactive Care programme will help develop preventative healthcare models, and will support the delivery of many of the recommendations made in the Independent Review of Adult Social Care, which highlighted the need for a greater preventative approach. A range of pathfinders are being considered to test potential models in various settings.

The Place and Wellbeing Programme has a primary focus on preventative local action in partnership with communities and how we – as the system – can support that. This will bolster local cross-sector partnerships with evidence, data, intelligence and the right policy context and funding so they can together address the root causes of health inequalities in their area. We are also working to better integrate community-led Third Sector provision of health improvement activity within local health and social delivery across Scotland. This will make it easier for individuals to reach preventative and early intervention support in their community.

A fundamental shift in how the NHS and the NCS contribute to community wealth will widen access to fair work in the sector with accelerated routes into these jobs for those furthest from the job market. Alongside actions to enable partnership working and local leadership, the Scottish Government will support health and social care providers to be active anchor institutions and build wealth in their community. This will mitigate against some of the drivers of poor health and health inequalities, such as unemployment.

Court operational matters, including the system for jury service, fall within the remit of the independent Scottish Courts and Tribunals Service (SCTS).

I understand SCTS is setting up a working group to consider the remaining recommendations from the 2018 Enabling Jury Service report, available at https://www.scotcourts.gov.uk/about-the-scottish-court-service/reports-data/enabling-jury-service . This matter will be included and the Scottish Government will work with SCTS and justice partners to consider any legislative requirements flowing from that consideration.

I refer the member to the answer to question S6W-07911 on 26 April 2022. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at: https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

We recognise the need for urgent action to address our twin nature and climate crises. That is why we are not waiting until the introduction of the Natural Environment Bill to take action. We have already committed to invest £65 in our Nature Restoration Fund over the course of this Parliament and £250 restoring our peatland over this decade. We will soon be consulting on our new Biodiversity Strategy where we will set out our ambitious vision for a nature rich Scotland. We remain committed to introducing a Natural Environment Bill in year 3 which will include nature targets to help tackle the biodiversity and climate crises.

We recognise that the high-level ambitions we have to tackle the twin nature and climate crises need to be supported with adequate funding. This is why we have already committed to invest an additional £500 million in the natural economy over the course of this Parliament. This includes £250 million on peatland restoration over the current decade, £65 Million on the new Nature Restoration Fund over the course of this Parliament, and £100 million to increase forestry planting,

‎ £30 million to expand Scotland's national forests, and £20 million to increase nursery stocks. The Resource Spending Review will reflect these priorities.

We have written to the Comhairle setting out our view on the issues raised by Tighean Innse Gall and continued delivery of home insulation schemes in the Western Isles. The Scottish Government has proposed practical solutions and remains open to receiving proposals from the council that aim to further strengthen the local supply chain. This year we will allocate £64 million in funding to local councils to support local delivery of Area Based Schemes.

Help and support for fuel poor households continues to be available through our national Warmer Homes Scotland service. Warmer Homes Scotland has installed insulation measures in 17 homes in the Western Isles since last September. Likewise there is a range of cashback and loans available to householders, as well as advice and information, through our Home Energy Scotland helpline.

In line with the Test and Protect Transition Plan, testing changed on Scotland on 18 April.

Thanks to vaccination coverage and new Covid treatments, most people no longer need to test when they don’t have COVID-19 symptoms. Lateral flow device (LFD) tests are now being used in a targeted way to support clinical care and protect high risk settings.

Up until the end of April 2022, LFD tests can be ordered online or by phoning 119 for:

• anyone eligible for Covid treatments,
• an unpaid carer,
• anyone visiting a hospital or care home,
• a contact of a positive case and are fully vaccinated, or,
• a positive case who is self-isolating and are eligible to end self-isolation early (take an LFD test from day 6 as advised in guidance for ending self-isolation early).

From the 1 May LFD tests can be ordered online or by phoning 119 for:

• anyone eligible for Covid treatments,
• an unpaid carer, or
• anyone visiting a hospital or care home,

PCR testing for those with symptoms remains available until the Test and Protect transition period ends on 30 April.