Promising signs that public efforts and sacrifices are beginning to pay off
By Health Secretary Jeane Freeman
Today is international workers memorial day and, across Scotland, many people observed a minute’s silence to honour the health and social care staff who have tragically died during this pandemic.
A number of our colleagues in Scotland have lost their lives to Covid-19. My thoughts and those of members across the chamber are with their families and loved ones.
In the past 24 hours, 70 deaths have been registered of patients who were confirmed as having Covid-19, taking the total number of deaths in Scotland under that measurement to 1,332.
As always, it is important to remember that behind each of those numbers is the loss of people who were loved and are now much missed. I offer my sincere condolences to their families and friends.
Notwithstanding all of that, we are starting to see promising signs that the efforts and sacrifices that the overwhelming majority of people across Scotland have made are having an impact.
In recent days, the number of patients in hospital with confirmed or suspected Covid-19 has been broadly stable, and there has been a decline in the number of people with Covid-19 in intensive care units. We should not read too much into all that yet—these are early days—but those trends are welcome and we are cautiously hopeful about them.
As of today, 50 per cent of adult care homes have reported an outbreak of suspected Covid-19. Last week, I set out a series of additional steps to support those who live and work in our care homes. Those steps increase the clinical support that is focused on preventing Covid-19 infection and transmission in care homes.
Our national health service directors of public health are providing enhanced clinical leadership and have contacted every care home in Scotland. They are assessing how each home is managing infection control, staffing, training, physical distancing and testing.
We have provided a direct delivery of personal protective equipment to care homes and have worked with local partners to significantly improve the operation of local PPE hubs.
Although in the private and public sectors the supply of PPE is primarily the responsibility of care home providers, we will continue to provide top-up and emergency provision to ensure that staff have what they need and that they and the residents have that protection.
Work is also under way to ensure that all Covid-19 patients who are being discharged from hospital provide two negative tests before discharge and that all new admissions to care homes and all residents who are symptomatic should be tested. Those new admissions should be isolated for 14 days.
Social care and care home staff continue to be priority key workers for testing. I have written to all care homes to remind them of that and to ask them to make sure that, as employers, they follow through where that testing is required.
As members know, we also have more than 21,000 returning health and social care staff alongside student nurses, student midwives, allied health professionals and newly graduated doctors, who are all willing to apply their skills and experience to the collective effort.
Many of them are able to work in the care and primary care settings. As of today, 185 applicants have been matched into roles in care homes and care-at-home services, and a further 218 are ready and available. In the coming weeks, I expect the number of matches to increase rapidly.
As well as those who work in care homes to protect our most vulnerable people, many carers—paid and unpaid—support people to stay in their own homes, and they, too, must be protected. Therefore, we have extended the provision of PPE to personal assistants and unpaid carers.
From the start of this week, the local PPE hubs for the registered social care sector are receiving enhanced supplies and support, so that they can distribute to the whole of the social care sector where normal supply routes have failed. We have published advice for unpaid carers on the appropriate use of PPE and how to access it, and we will shortly publish equivalent guidance for personal assistants.
I have asked the national carer organisations and local carers centres to discuss with carers their needs, and, when they need PPE, to help us direct them to their local hub.
We will ensure that hub locations are clearly signposted on the Scottish Government’s website and that health and social care partnerships are working with local carers centres to make it clear how individuals can get the necessary personal protective equipment.
Throughout this difficult time, it is critical that social care support is maintained, to ensure the safety, dignity and human rights of people who already receive that support. I reached agreement some weeks ago with the Convention of Scottish Local Authorities that, in addition to providing the funding that is directed towards social care in the 2020-21 budget, we will meet additional costs that are incurred because of the impact of the pandemic.
That agreement was reached specifically to ensure that existing and new demand and need could be met. Alongside that, the additional returning staff whom I mentioned a moment ago are also available for deployment to those services, to ensure staffing resilience.
So, it is not acceptable to me that care packages are being cut—in some instances, by 100 per cent. I expect people to follow the steps that I have already taken. If more needs to be done to ensure that existing packages are not cut and that new demand is met, I hope that colleagues in the sector know that my door is always open and that I expect them to come to me with those additional requirements.
I now turn to testing. By 22 April, 17,800 health and social care staff and symptomatic members of their households had been tested. Twenty-one per cent of those tested were social care staff. By the end of April, all 14 health boards should have local testing capacity. We are on track for testing capacity to reach at least 3,500 tests available per day by the end of this month, having made steady progress from the start of the pandemic, at which point capacity was 350 tests per day from two laboratories.
We also continue to work with the United Kingdom Government on its testing programme, which is expanding both capacity and access in Scotland.
Four UK Government drive-through testing facilities are already operational, with a fifth due to open in Perth this Thursday. Five mobile testing units, manned by Army personnel, are going live in Scotland this week, and it is anticipated that a further eight units will be live in Scotland within the next week or two.
The increased capacity in our own NHS laboratories and through our participation in the four-nation testing exercise has ensured that we are able to expand the areas and the groups that are being tested.
Thus we have increased availability to key workers beyond the health and social care sector, using the categories that we outlined before, and we have today also extended testing to all people aged 70 years and above who are admitted to a hospital setting. Access to the UK four-nation exercise is controlled through the queueing system and digital portal managed by the UK Government.
The pandemic has required fundamental change to how healthcare and care are accessed and delivered. That has involved a significant reorientation of resources and the incredible support and efforts of local leaders, planners and clinicians—in fact, of the entire workforce.
The work has included preparing to quadruple the number of ICU beds and ensuring that there is sufficient hospital bed capacity; significant increases in digital access to health services, with around 60 per cent of general practices now using NHS near me, and the number of weekly digital consultations increasing from around 300 to over 9,000; the reshaping of primary care to support Covid-19 hubs with 24/7 access; shielding almost 150,000 clinically vulnerable people and focusing multidisciplinary teams to work on anticipatory care planning with them; and expanding mental health support by moving towards a 24/7 NHS 24 mental health hub and digital therapies.
It is clear that, in line with our framework for decision making, which was published last week, we need to achieve a careful balance in managing our healthcare capacity, including our commitment to continue to treat emergency, urgent and maternity cases.
Therefore, we will continue to work closely with health boards and our partners to ensure that there are robust plans in place to safeguard local resilience and responsiveness while considering how and when we can increase the business-as-usual work of our NHS.
The incredible level of compliance with social restrictions that we have seen shows a clear willingness on the part of the people of Scotland to think beyond individual health to population health. As we introduce the test, trace and isolate measures that are required, we will need that focus on population health to continue.
In concluding, I will update you on research proposals for Covid-19 that were launched on 25 March. One hundred and thirty-nine proposals were received from across Scotland’s universities and research institutes, and, following an independent expert review process, 55 projects have been selected for funding. That has resulted in a pan-Scotland portfolio of research, with 15 different institutions leading on projects.
In summary, the outcome of the call is a programme of projects that meet the aim of establishing a broad Scottish programme of high-quality research on Covid-19 that will be delivered rapidly and that will inform policy and clinical practice in responding to the pandemic.
I continue to be grateful for the tremendous resilience of our health and social care staff, our key workers and, most important, people all across Scotland. Together, we are making progress, we are suppressing the virus, we are saving lives and we are showing that we can continue to rise to the challenges of this pandemic.
- As ever, the ever useless, unobtainable Cllr Jonathan McColl, chair of the SNP administration on West Dunbartonshire Council, was not available to comment to The Democrat on the Health Secretary’s update to the Scottish Parliament.