Chamber and committees

The reopening of dental services in Scotland presents a number of specific challenges which the Chief Dental Officer and officials continue to strive to address in collaboration with NHS colleagues. At the present time the position of the Scottish Government remains the same as that when answering the question from Neil Bibby MSP of 21 May (SW5-29259) viz.:

“On 2 June 2020 the Cabinet Secretary for Health & Sport made a statement to the Scottish Parliament concerning the on-going delivery of NHS services as part of the Scottish Government’s response to the COVID-19 pandemic. In this statement she indicated that work is being undertaken with dental teams to prepare for a phased introduction of dental services over the course of this month.

“The Chief Dental Officer for Scotland wrote to all dental contractors providing NHS dental services on 20 May with details of the remobilisation plan which is now to be implemented as circumstances permit.

“Remobilisation of NHS dental practices is an extremely complex process. We need to be mindful of the oral health needs of patients balanced against the wider situation with COVID-19, and the essential requirement that we reduce the risk of community transmission and protect both patients and dental teams. When making the decision on reopening dental practices in Scotland we will take into consideration the added risk of aerosol generating procedures on COVID-19 transmission and the availability of appropriate PPE.”

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

In all our decisions on the phasing of changes to restrictions, we have to be conscious of the need to avoid the rapid spread of the virus and the NHS being overwhelmed. We appreciate that the current physical distancing measures are difficult, particularly for those who have been unable to see family, friends and partners. We will not keep them in place any longer than is necessary.

At each review stage, we are drawing on scientific evidence to inform which restrictions, if any, we are able to ease, and to shape the associated guidance. We hope that in Phase 2 we will be able to relax rules to allow people to meet with another household indoors, with appropriate guidance being issued and followed on physical distancing and hygiene measures to contain the spread of the virus. We are looking at the issue of couples who live apart in particular to see if we can provide some guidance that allows people to live their lives sensibly, but also in a way that is as safe as possible.

Until then, there remains a risk of the virus rapidly spreading and overwhelming our NHS if physical distancing is not observed. For that reason, the advice remains where possible to stay at home and to maintain a 2 metre distance when meeting members of another household outdoors. We will continue to monitor the situation and will advise when it is safe to relax restrictions further.

On the 7 May 2020, in a joint letter from the Cabinet Secretary for Finance, Kate Forbes MSP and myself to the Chancellor, we noted that the Job Retention Scheme is a lifeline for employers and employees, but highlighted that the scaling back of the scheme should be done in a carefully considered way that reflects the economic priorities of each of the four nations, and the different sectors of their economies.

Further, I wrote to the Chancellor on the 26 May 2020 to seek assurances that the extension of support to employers in each of the four nations, who have to comply with any differences in public health guidance that may be in place, would not change between now and the end of October.

The Job Retention Scheme has been an essential part of our collective response so far and the Scottish Government welcome the extension of the scheme. We also welcome the flexibility for employers to start work on a part time basis while still being supported through the scheme.

In addition, we are pleased that the scheme will enable employers to bring back their furloughed employees for any amount of time and any shift pattern. This will help employers to better ensure they are meeting the needs of their business and provide flexibility to employees particularly those with caring responsibilities and children.

The Scottish Government is seeking assurance that those accessing the scheme will not be impacted by the different approaches that Scottish Ministers might take to UK Ministers on workplace guidance. We do not have powers to create a separate Scottish furlough scheme – but there might be a different set of public health priorities or issues that our Ministers need to manage compared to the rest of the UK.

The Scottish Government does not centrally collect information or data relating to the use of Do Not Attempt Cardiovascular Resuscitation (DNACPR) forms in hospitals.

As with all other clinical treatments, decisions about CPR should be based on the individual clinical circumstances and wishes of the patient and recorded appropriately. This is done in hard copy on a DNACPR form, the existence of which is then recorded on an individual’s Key Information Summary. Such information is only shared for the purposes of direct care and is therefore not centrally collected.

The target to have a total testing capacity of 15,000 by the end of May has been achieved. There is active weekday NHS lab capacity for over 6,500 tests a day (and weekend capacity of 5,350 tests a day). In addition, there is currently capacity for 10,000 tests a day from the Glasgow Lighthouse Laboratory, which analyses samples taken from regional testing centres, mobile testing units and community testing. The combination of the NHS and Lighthouse Lab capacity provides overall normal weekday capacity of over 16,500.

Health Protection Scotland (HPS) are assessing a number of antibody tests in order to identify which will work best in Scotland. HPS, supported by the Inverness reference laboratory, commenced antibody prevalence testing on 6 May as part of enhanced surveillance testing and good progress is being made.

Through the work of the Health Protection Scotland surveillance team, a range of random samples from the general public are being collected to inform our understanding of the prevalence of Covid-19. This testing is for surveillance purposes.

The Scottish Government published ‘ Strategic Framework for Reopening of Schools and ELC Provision’ alongside Scotland’s Route Map on 21 May.

This puts in place a framework to ensure that children and families can access safe, high quality ELC and childcare services as early as it is safe to do so.

The Strategic Framework will support both Local Authorities and private and third sector providers to identify the capacity available within their settings, and if necessary to prioritise access to that capacity.

The full reopening of childcare services is not scheduled to begin until Phase Three of the Route Map. At this point all childcare providers will be able to reopen their services subject to public health measures.

The Critical Childcare and ELC work stream of the Education Recovery Group, in collaboration with the newly-established sector working group, will now lead the development of a suite of clear operating guidance, supported by public health advice. This will ensure that sector specific issues relevant to reopening across the early learning and childcare and out of school care sectors are addressed in guidance ahead of reopening. Guidance was issued to the childminding and fully outdoor childcare sectors on 1 June, ahead of the reopening of this part of the sector.

Parent Club Scotland has also created an extensive digital hub to provide evidence based advice for parents and carers around coronavirus, which is regularly updated with information, advice and resources for parents. This includes a new Frequently Asked Questions section which covers for example when providers will reopen and safety issues.

The Scottish Government is maintaining a cautious approach to changing lockdown measures as outlined in the Route Map and each step taken is based on scientific evidence that it is safe to do so. The Framework for Decision Making makes clear that we are putting equality and human rights at the heart of our response to Covid-19.

We know that the measures currently in place to lower the transmission of the virus can themselves cause a wide range of harms. For children who are missing early learning and childcare, these may be wide ranging.

Our first priority is, of course, for the safety of staff, parents and children who access early learning and childcare settings. While Phase One of the Route Map allows for a limited reopening of childminding and fully outdoor childcare services, this is conditional upon the scientific and medical advice confirming that the reopening of these settings can be done in a manner that is consistent with wider efforts to control the reproduction rate and protects all those accessing these services. Settings must also have in place a comprehensive implementation of complementary public health measures, including adhering to ‘test, trace, isolate and support’ practices, the use of appropriate personal protective equipment and a range of other enhanced hygiene measures. These measures are set out in detail in section five of the ‘ Strategic Framework for Reopening of Schools and ELC Provision’ and in addition to this comprehensive guidance was issued to the childminding and fully outdoor childcare sectors on 1 June, ahead of reopening.

The full reopening of childcare services is not scheduled to begin until Phase Three of the Route Map. At this point all childcare providers will be able to reopen their services subject to public health measures. Further guidance will be issued to support that on 15 June.

Public Health Scotland issues shielding letters on behalf of the NHS Boards.

The following table provides information on the number of individuals who have been sent shielding letters by area of residence.

Letters are sent as people who should shield are identified.

Number of individuals sent Shielding letters by area of residence (as at 26th May 2020)