Chamber and committees

Clinical advice on admitting people with suspected or confirmed COVID-19 to hospital is included in a range of clinical guidance that has been published on the Scottish Government website - https://www.gov.scot/publications/coronavirus-covid-19-clinical-advice/ .

Information on all admissions to care homes is not held centrally; data on how many people have been admitted to local authority care homes will instead be held by each local authority.

We are not aware of any evidence from worldwide literature that we are aware of that suggest that air conditioning systems spread COVID-19, however we recognise that our understanding of COVID-19 continues to grow and expand and we will continue to review new evidence as it becomes available.

Air conditioning and ventilation systems in hospitals are designed and operated to reduce the spread of airborne infection of many types. The guidance followed across the NHS is published on the Health Facilities Scotland web site:

http://www.hfs.scot.nhs.uk/publications/1475762746-
SHTM%2003-01%20V2%20Part%20A.pdf.

I refer the member to the answer to question S5W-29453 on 10 June 2020. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx .

We have published the ‘Re-mobilise, Recover, Re-design, The Framework for NHS Scotland’ that sets out how Health Boards will follow national and local clinical advice to safely and incrementally prioritise the resumption of services paused during the current public health emergency. This is in the context of maintaining COVID-19 capacity and resilience, where many of the specialist pain workforce was re-deployed to, and providing appropriate support for social care.

As part of this, the Interim Chief Medical Officer and National Clinical Director have provided an outline of services that could be prioritised including:

• cancer services, especially referrals and postponed treatments
• expanding treatments for non-cancer urgent inpatients and outpatients
• outpatient therapies where delay will increase the risk to patients, such as management of macular degeneration, paediatrics and respiratory services
• mental health support
• treatment room services such as blood monitoring and B12 injections

The above is in line with the Faculty of Pain Medicine guidance of 15 May, which refers to a letter issued by NHS England advising the initial focus should be on urgent and time critical work.

Our approach is driven by clinical priorities, as well as what matters to people’s quality of life. We are therefore engaging with Health Boards and stakeholders to stimulate a national discussion to inform local and regional planning to resume hospital pain management services as quickly and as safely as possible, and to evolve the Scottish Chronic Pain Service Model to improve access to care and support for pain management in the community.

There have been 441 retired medics who have expressed an interest in returning to support the NHS as a doctor during the COVID-19 outbreak through the Accelerated Recruitment Portal.

This information is based on self-declarations and may be subject to revision as formal pre-employment checks are carried out.

This figure does not include retired medics who may have expressed their interest directly with an NHS Board, as these figures are not held centrally. This also does not include retired medics who expressed an interest in non patient clinical roles.

Prior to the action it took last month to seeking an Emergency Cancellation Order the Care Inspectorate inspected Home Farm Care Home in April 2019, November 2019 and January 2020. Following these inspections, requirements were made on the service and steps were taken to support and monitor improvement through multi-disciplinary processes.

There has been no change to the guidance on the use of Do Not Attempt Cardiopulmonary (DNACPR) forms during the Covid 19 outbreak. As such, the Scottish Government has not sought legal advice on the existing DNACPR guidance during the Covid 19 outbreak.

In 2016, the DNACPR policy was reviewed to reflect feedback and changes in the national good practice guidance which remains current (Decisions Relating to Cardiopulmonary Resuscitation - guidance from the British Medical Association, Royal College of Nursing and the Resuscitation Council ( UK) - 2016). This policy also takes into account relevant legal changes resulting from case law and therefore specialist legal advice was provided as part of the formation of the policy.

There has been no change to the guidance on the use of Do Not Attempt Cardiopulmonary (DNACPR) forms during the Covid 19 outbreak. As such, the Scottish Government has not formally consulted with professional representational organisations on the existing DNACPR guidance during the Covid 19 outbreak.

The Scottish Government continues to work closely with a wide variety of professional groups and organisations in responding to the challenges posed by the Covid 19 outbreak.

On the 10 April, the Chief Medical Officer, Chair of the Scottish General Practitioners Committee of the BMA and Chair of the Royal College of General Practitioners (RCGP) wrote to GPs to provide advice and support on having anticipatory care planning conversations and to make clear that there is no requirement for health professionals to have a DNACPR discussion as part of this conversation, unless the patient wishes to discuss it or clinician feels strongly it is necessary to raise in conversation for the patient’s wellbeing. On the 17 April, a further joint letter from the Scottish Government’s Chief Medical Officer, BMA and RCGP was sent to GPs to reinforce the advice already provided.