Chamber and committees

John Swinney; The Scottish Government’s approach to using testing alongside other measures to suppress COVID-19 outbreaks is set out in Scotland’s Strategic Framework, published on 23 October and available at https://www.gov.scot/publications/covid-19-scotlands-strategic-framework/ . This approach is informed by the clinical and scientific review of our testing strategy, also published on 23 October and available at https://www.gov.scot/news/clinical-and-scientific-review-of-testing/ .

Testing is available to anyone who has symptoms of COVID-19, including school children and the education workforce. Testing is also available for asymptomatic staff in schools and early learning settings who are concerned they have been exposed to the risk of infection. In addition, Public Health Scotland have recently commenced recruitment of a sample of school staff who will undertake antibody tests as part of the enhanced Covid-19 surveillance being carried out within schools.

The Scottish Intensive Care Society Audit Group (SICSAG) is part of the Scottish National Audit Programme (SNAP) within Public Health Scotland (PHS) and has the aim to improve the quality of care delivered to critical care patients in Scotland by monitoring and comparing activities and outcomes across Scottish critical care units.

The SICSAG database held within PHS focusses on patient information, and, therefore, this resource does not include data which would allow the monitoring of the number of empty beds within each unit. We do not therefore have the information to answer the PQ.

As part of the COVID response, NHS Boards worked to put in place the surge capacity to double and triple ICU capacity should it have been required.

In their June 2020 report, SICSAG said that the baseline capacity for the most complex level of ICU care (level 3 care) was exceeded from 31 March 2020 to 24 April 2020. This activity peaked at 46% above baseline on 09 April 2020.

URL: https://beta.isdscotland.org/find-publications-and-data/population-health/covid-19/scottish-intensive-care-society-audit-group-report-on-covid-19/3-june-2020/

The Scottish Ambulance Service always make decisions on requirement to convey patients to Hospital on an individual and clinical basis.

Whilst receiving no direct advice from the Scottish Government, SAS implemented a specific protocol on 3rd April 2020 commonly used during a pandemic to help understand the clinical acuity of patients presenting with Covid-19 symptoms in order for SAS to respond appropriately.

Following a standard methodology of structure questions, this protocol helps to identify priority symptoms and assess levels of clinical risk to support decision making.

The Scottish Ambulance Service does not have a ratings score system.

The decision to admit patients to hospital is made by either the Emergency Department or Primary Care, not the ambulance service.

In terms of categorisation of calls, these have not changed during 2020.

The information, covering the first 6 months of the pandemic, is published by National Records of Scotland (NRS) in their monthly 'Deaths involving coronavirus (COVID-19) in Scotland' reports. The latest report was published on 14th October.

https://www.nrscotland.gov.uk/files//statistics/covid19/covid-deaths-report-week-41.pdf

It showed that from week 12 to week 37 (mid-March to mid-September) there were 2,258 excess deaths in care homes (37% above average), 3,458 excess deaths at home or in non-institutional settings (47% above average) and whilst after an early peak, hospital deaths fell below average levels in week 19 (4th – 10th May) and are now 686 (5%) below average levels for the period covering weeks 12-37.

Table 1 gives the total number of episodes of care of patients aged 65 and over to ICU and combined units in Scotland for the past 6 years. The data includes both elective and emergency episodes of care. The level of elective and emergency demand on hospitals during the spring was affected by COVID-19 and as such care needs to be taken when comparing trends.

There has been no variance from normal clinical practice in decision making around any aspect of ICU care for COVID-19.

The data is related to ICUs and combined units, excluding specialist cardiovascular and neurological ICUs. The number of episodes does not account for the length of stay which will vary for different types of patients.

Table 1. Number of episodes of care for patients aged 65 and over to ICU and combined units in Scotland (2015-2020)

Since the start of the pandemic our priority has been to save lives and we have always placed the upholding of human rights at the heart of our approach.

COVID-19 presents an unprecedented public health challenge and the actions we have taken in responding to that challenge have been, and continue to be, carefully monitored to ensure that they are fully compliant with the European Convention on Human Rights (ECHR) and with the wider international human rights obligations.

However, we recognise the challenges faced by many older people during the pandemic and have worked hard to ensure they are supported. We have provided a range of support including the national helpline and the £350 million funding package to support communities affected by the pandemic.

We are committed to continuous improvement in the diagnosis, care, treatment and support of people living with respiratory conditions, which is why we set out in our Programme for Government a Respiratory Care Action Plan to deliver these key priorities.

As we continue to develop our understanding of the impact the virus has had on the health of the people of Scotland, including those that have developed long-term respiratory problems as a result of contracting the virus, the Respiratory Care Action Plan will play a key role in responding to the implications and consequences for many aspects of respiratory care going forward, including pulmonary rehabilitation.

We have also developed and published the ‘Framework for supporting people through Recovery and Rehabilitation during and after the COVID-19 Pandemic’. This is now in its implementation stage and its priorities will link to future work to support people living with a respiratory condition. The Framework can be found at the following link: https://www.gov.scot/publications/framework-supporting-people-through-recovery-rehabilitation-during-covid-19-pandemic/ .

Under sections 15 and 87 of the Police and Fire Reform (Scotland) Act 2012, Scottish Ministers must approve the deployment of Scottish Police Officers when they are delivering training overseas.

Any future work with the Sri Lankan Police Service is a matter for the Chief Constable of Police Scotland. Police Scotland has not delivered training specifically for Sri Lanka’s Special Task Force.