Chamber and committees

People who are on the shielding list have been sent a letter today confirming that the shielding period will continue until at least the end of July and that support which is in place will remain in place for at least that period. The letter contains updated advice to enable outdoor exercise provided strict physical distancing is followed. This advice is in place from 18 June, subject to infection rates in Scotland remaining at a sufficiently low level. The updated advice, along with the future steps on shielding are available here: https://www.gov.scot/isbn/9781839608100

Evidence from the progress of the COVID-19 pandemic highlights that there is a risk of the virus spreading where people are grouped together in enclosed spaces, like hospitals.

The NHS has been alive to this risk and has taken steps to minimise risks of transmission. These steps have included strict adherence to Infection Prevention and Control (IPC) guidance, the wide use of appropriate PPE, frequent hand washing, decontamination of the care environment and physical distancing between staff, where this is possible. Efforts have been made in particular to establish and enforce separation between COVID-19 and non-COVID-19 areas of hospitals, and the direction of patients to different routes has been adapted to take account of developing evidence in relation to symptoms.

Visits to patients have also been restricted to those that are considered essential. These include a birth partner during childbirth; to a person receiving end-of-life care; to support someone with a mental health issue such as dementia, a disability or autism where not being present would cause the patient to be distressed; and, to accompany a child in hospital. Visiting times are managed to ensure social distancing and prevent accumulation of visitors in the ward, and visitors must adhere to strict hand and respiratory hygiene.

Work also continues to enhance the effectiveness of action taken to minimise risks of hospital transmission. A sub group of the Chief Medical Officer’s COVID-19 Advisory Group is examining domestic and international evidence to consider new steps that might be taken. The Government expects to make an announcement shortly about the additional circumstances in which health care workers might be tested for the virus. Consideration is also being given to how to enhance measures to limit transmission in non-clinical areas of hospitals. The group is also developing recommendations in relation to wider patient admission screening.These efforts will be of particular importance as the NHS seeks to both continue suppressing the virus but also begin to re-commence elective surgery and other activity that was paused as priority was given to ensuring sufficient capacity existed to cope with patients suffering from COVID-19.

Where outbreaks have occurred steps are taken quickly to seek to determine the source of transmission and to curtail it, and management of incidents can often involve the temporary closure of wards, or part of a ward. Infection prevention and control has been and remains a priority for NHS Scotland, in all settings.

NHS Boards have been reporting incidents that have involved COVID-19 appearing outside the dedicated ward areas. Reports of incidents first arose in mid-March (from 18 March) and increased in line with the trend of the community outbreak. Reports of incidents have been declining since the beginning of May.

In the period up to 3 June, Health Boards reported to Health Protection Scotland (HPS) a total of 125 incidents involving COVID-19 cases outside the COVID-19 wards. Of these incidents, 120 are now classified as closed. Incidents are classified as closed by Health Boards when there is no evidence of continuing transmission taking into account possible contacts and the incubation period of the virus. Some incidents are also closed where there are sufficient isolation facilities or where COVID-19 positive patients are transferred to COVID-19 wards.

These reports constitute incidents of suspected transmission in hospitals. Because of the varying incubation period of COVID-19 it will have been the case that some patients admitted have not presented with symptoms on admission but will have already acquired the virus in the community.

In these unprecedented circumstances we expect Alcohol and Drug Partnerships to do all they can to keep the people who rely on their services as safe as is possible.

Options for online and phone support for people in recovery have been developed during the current pandemic. Fellowship and SMART recovery meetings are being offered online. Many ADPs are reporting locally-based recovery support provision through WhatsApp, phone and online groups.

Scotland’s Interim Chief Medical Officer Dr Gregor Smith and I wrote to health boards and Integration Joint Boards on 16 April to ensure the need for continuation of care for this vulnerable group of people is prioritised.

I also wrote a letter with the Chief Pharmaceutical Officer and the Chair of the Drug Death Taskforce, which issued on 12 May to all Directors of Pharmacy and Community Pharmacy Scotland to emphasise the importance of the continued delivery of Opioid Substitution Therapy (OST) during the current period.

I announced on 1 May , a package of 3 measures to provide new support and treatment for those affected by drug use during the COVID-19 pandemic:

• £1.9 million to support people in prison on prescribed Opiate Substitution Treatment (OST) to switch to a new longer-acting form called Buvidal;
• £150,000 for residential rehab to people leaving prison to support their recovery and reduce pressure on local services.
• Widening the availability of overdose reversal drug naloxone.

Test and Protect, Scotland's approach to implementing the test, trace, isolate, support strategy, will launch nationwide on Thursday 28 May following successful pilots in NHS Fife, NHS Highland and NHS Lanarkshire. The Scottish Government will this afternoon provide additional information on how people can self-isolate effectively if they are asked to do so by the NHS as part of Test and Protect, alongside guidance for employers. The guidance will be available on www.gov.scot/coronavirus-covid-19/ .

As a result of coronavirus and advice relating to physical distancing, the scientific trial of electrofishing for razor clams was suspended until 30 April 2020. I am not in a position to recommence the trial at this stage as all Marine Scotland survey programmes are suspended.

I am therefore extending the suspension of the trial until 15 June 2020, in line with current Marine Scotland Science survey suspension, and will review the situation then.

The domestic fishing licences of the vessels engaged in the trial remain valid should the fishers wish to seek alternative fishing opportunities.

I am leading national work on support or the health and wellbeing of the health and social care workforce at this time.

In relation to work being carried out (a) nationally:

I have written to NHS Chief Executives, Local Authority Executives and Integration Joint Board (IJB) Chief Officers about the importance of support for the wellbeing of the workforce and has highlighted key messages and approaches.

A programme of work is in progress to ensure that a range of wellbeing and practical support is in place for health and social care staff, covering guidance for staff, accommodation, catering, rest space and access to mental health support. This activity complements and builds on the work already underway across the health and social care landscape, including the further £3.8 million that is being provided to begin to increase the capacity of NHS 24’s Mental Health Hub and Breathing Space service, alongside increased access to digital therapies.

NHS Education for Scotland (NES) is taking forward development of national resources, training models and systems of practice support for local delivery to promote and address staff wellbeing arising from the Covid-19 response. The intention is to provide a ‘ladder’ of support spanning early intervention (Psychological First Aid) to complex care. This should help with prevention, early intervention and treatment of stress, anxiety, burn out depression and post-traumatic stress disorder (PTSD).

The Scottish Government will continue to explore opportunities to build on the good work underway to respond to the emerging needs of the health and social care workforce.

In relation to work being carried out (b) by each NHS Board:

All Boards have developed responses to support their staff in response to the Covid-19 outbreak. These responses include staff wellbeing ‘hubs’ and services, staff helplines and phone services, staff wellbeing champions, links with Occupational Health and Chaplaincy services, wellbeing and mental health guidance and digital offerings in relation to staff mental health and wellbeing.

South of Scotland Enterprise will take up its legal powers and begin its work with businesses and communities across the south on 1 April 2020 as planned.

There has been some speculation around a potential delay to the launch date as a result of legislation laid before the Scottish Parliament on 20 March 2020. The legislation laid before parliament effects a technical amendment only relating to the transfer of property and liabilities from Scottish Enterprise to South of Scotland Enterprise.

This is simply an administrative adjustment to the date that properties and liabilities will legally transfer between the two enterprise bodies, without impacting the operational activities of either body. Plans for the establishment of SOSE on 1 st April are well advanced, and the agency will open on schedule next week as planned.

The work of our enterprise agencies is even more critical in light of COVID19 impacts on our economy, and SOSE is already preparing to play its part in supporting economic recovery in the south when it assumes operational responsibilities and legal powers.