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As you will be aware, The Coronavirus (COVID-19): Scotland’s Strategic Framework was published on 23 October 2020.

This document, which has been the foundation of the Government’s response since that date, set out our strategic approach to suppress the virus to the lowest possible level and keep it there, while we strive to return to a more normal life for as many people as possible.

To best tackle the virus, and protect people, we have moved to a strategic approach to outbreak management based on five levels of protection.

While it is important to always retain some flexibility, this, I feel, has provided a more transparent and easily understood framework for managing outbreaks and allow rapid but proportionate responses to be taken – locally or nationally – using a range of measures and options.

A levels approach has also allowed us to respond on a national basis if required, but also to avoid a 'one size fits all' approach if it is not, as has been demonstrated in response to generally better infection rates in many of Scotland’s islands areas. It will mean that one part of the country with low rates of infection does not have to live with the level of protective measures designed to suppress the virus in areas with much higher rates, although recent outbreaks in Barra and Shetland have demonstrated that circumstances can change remarkably in a short space of time, so ongoing vigilance is essential.

The assessment of what level of protection should be applied to each local authority is, as you will be aware, informed by five key indicators: number of positive COVID-19 cases per hundred thousand people over the last week; percentage of positive tests; forecast for new cases in the weeks ahead; capacity of local hospitals; and capacity of local intensive care facilities. The latter has proved to be significant in the context of islands in the Clyde, such as Arran and Cumbrae, that depend upon mainland health care facilities in the Ayrshire and Arran Health Board area – facilities that have faced sustained pressure on in-patient beds in recent months.

All these factors are assessed alongside the advice and recommendations of local public health officials, National Incident Management Team, the Scottish Government’s chief clinical and policy advisors, and consideration of local circumstances, such as: specific COVID-19 outbreaks; travel and work patterns; and the extent to which health services are provided by neighbouring health boards. Final decisions are based on all of these factors.

There had been positive progress made in regards to indoor gatherings. On 8 December 2020, the First Minister stated that there would also be an easing of restrictions on gathering in homes for Level 1 islands communities which are not linked by road to the mainland.

Up to six people from a maximum of two households were allowed to meet in private homes in Level 1 island communities. Islands with road links to the mainland, however, were not be included in this relaxation.

However, the increased transmissibility of the new variant of COVID-19 presents us with new and greater challenges; case numbers are rising and more families are today grieving the loss of loved ones which is why we need to take action now to ensure that we slow the spread, to protect lives and ensure our NHS is not over whelmed.

As the First Minister announced in her statement to Parliament on 4 January 2021, in terms of hospital beds, NHS Ayrshire and Arran was at 96% of its Covid capacity.

By taking action now we have a chance of keeping this situation under control while the vaccination programme continues to makes progress and get case numbers back to very low levels again.

We must all take personal responsibility for stopping the spread of all variants of this disease which is why our message is that everyone currently in a level 4 area, which includes Arran, should Stay at Home. At the time of writing, the island areas currently in level 3 will remain there for now, although we will continue to monitor them very carefully.

For those islands in level 3, we maintain a core message that residents should not meet anyone who is not in their household indoors in their home or in others’ homes. However, individuals can go into another household to provide care and support for a vulnerable person. This can include providing emotional support for someone whose wellbeing is at risk, including for those who are isolated because of disability or a caring situation.

Similarly to the lockdown of March last year, a legal requirement to stay at home except for essential purposes came in to effect on 5 January for all level 4 areas. These additional protective measures should remain in place until at least the end of January, and we will keep these measures and the situation in islands authorities and communities under close review. The impact of current measures will be reviewed by the Scottish Government on 19 January 2021.

I refer the member to the answer to question S5W-34019 on 5 January 2021. 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

Throughout the COVID-19 pandemic local authorities and ELC providers have continued to work extremely hard to progress the expansion and ensure as many families as possible can benefit from increased hours of funded ELC ahead of the statutory implementation date.

Work has continued to secure the required workforce and to re-phase capital programmes as construction activity resumed after lockdown.

I can advise that local authorities are continuing to offer expanded hours where they can, and to progress expansion plans ahead of setting a new statutory date. 14 Local Authorities are already offering 1140 hours to all families; and 18 Local Authorities are offering at least 600 hours of funded ELC to all families, and 1140 to some or most families.

Of the 18 Local Authorities still to deliver full roll out of 1140 the following indicative dates have been shared with the Scottish Government, however councils may deliver before these dates. The indicative dates below are subject to change due to future changes in public health measures and/or Covid-19.

• Glasgow City Council is delivering an 1140 model but is unable to ensure universal provision due to current public health measures
• Orkney and Perth and Kinross are working towards full role out in January 2021
• West Dunbartonshire are working towards full role out in April 2021
• Aberdeen, Aberdeenshire, East Ayrshire, East Lothian, East Dunbartonshire, City of Edinburgh, Falkirk, Fife, Highland, North Ayrshire, Moray, Renfrewshire, South Lanarkshire and West Lothian are working towards full roll out in August 2021.

We have spent over £1M since 2014 to support implementation on the Heart Disease Improvement Plan. This has included funding to improve heart failure care; support the work of the Cardiac Rehabilitation Champion; deliver a refresh of the HEARTe online learning resources; work on atrial fibrillation, and participation in the National Cardiac Audit.

Treating and preventing heart disease is a national clinical priority for Scotland. We continue to implement our Heart Disease Improvement Plan 2014, which sets out the priorities and actions to deliver improved prevention, diagnosis treatment and care for people living with and affected by heart disease in Scotland.

Latest ISD statistics from January 2020 show that the mortality rate for coronary heart disease fell by 32.4% between 2009 and 2018. This decrease in mortality rates show that our strategy for tackling heart disease is delivering important improvements for patients. However, we are determined to continue improvements in this area, and to respond effectively to the challenges posed by the Covid-19 pandemic.

Therefore, discussions are already underway with National Advisory Committee on Heart Disease (NACHD) regarding a successor plan to the 2014 Heart Disease Improvement Plan. We aim to publish a successor plan to 2014 Heart Disease Improvement Plan next year.

Treating and preventing heart disease is a national clinical priority for Scotland. We continue to implement our Heart Disease Improvement Plan 2014, which sets out the priorities and actions to deliver improved prevention, diagnosis treatment and care for people living with and affected by heart disease in Scotland.

Latest ISD statistics from January 2020 show that the mortality rate for coronary heart disease fell by 32.4% between 2009 and 2018. This decrease in mortality rates show that our strategy for tackling heart disease is delivering important improvements for patients. However, we are determined to continue improvements in this area, and to respond effectively to the challenges posed by the Covid-19 pandemic.

Therefore, discussions are already underway with National Advisory Committee on Heart Disease (NACHD) regarding a successor plan to the 2014 Heart Disease Improvement Plan. We aim to publish a successor plan to 2014 Heart Disease Improvement Plan next year.

Supporting the resurgence of a vibrant public transport network will be a vital step in the COVID recovery. While physical distancing remains in place capacity will continue to be restricted, and the higher Tiers of the Strategic Framework discourage unnecessary use of public transport. Once the pandemic has passed, encouraging a return to public transport will be a key component of the economic recovery, and a key way to help achieve climate change targets. Over the coming months we will be exploring a range of options for the future of all modes of public transport.