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Key workers are those in posts which ensure essential services can be delivered and cover tasks within the local community which support the vulnerable and aid community. We cannot designate whole workforces or entire groups of staff as key workers and there is no national list of who is considered to be a key worker.

Decisions around eligibility for key worker childcare are being taken locally, in line with guidance published on the Scottish Government website. Both parents are required to be key workers before being able to access childcare and in general, councils have not been making critical childcare available to families where one parent is a key worker but the other is not. We recognise that this is causing difficulties for key worker families. Such families can access informal care, although where possible this should be the same person, such as a non-vulnerable relative or friend, a nanny or babysitter. From 15 th July, subject to scientific evidence, there will be the full reopening of early years provision, including educational provision, childminders and local areas will also be resourcing additional activities.

More information on the advice and guidance in relation to key workers and the closure of schools can be found here:

http://www.gov.scot/publications/coronavirus-guide-schools-early-learning-closures/pages/key-workers/

Estimated numbers of people affected by the pause to breast screening were published when the pause to the programme was announced on 30 March. The figures, which are based on the most recent information available to Information Services Division at the time of the pause, indicate that 46,596 people may have had their breast screening appointment delayed as a result of the pause to the breast screening programme over the past three months.

The resumption of screening services is taking place safely, carefully and in a series of stages, as part of the remobilisation of the NHS in Scotland. The breast screening service is currently assisting acute services to prioritise high-risk familial clinics and post-treatment surveillance screening, while preparing for the resumption of the national programme.

In the meantime, it is absolutely vital for those in between screening appointments or awaiting a rescheduled appointment to be aware of any symptoms or signs of the conditions screened for. Anyone having these symptoms should contact their GP practice.

I refer the member to the answer to question S5W-30230 on 8 July 2020. 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

The Scottish Government were concerned to read the findings of this tragic incident. NHS Lothian have accepted the findings of the Fatal Accident Inquiry and have confirmed that a number of actions have taken place since 2014 to improve the number of staff incorporated within ward establishment figures. Firstly, the Royal Edinburgh Hospital was given an uplift in budget of £3 million which allowed it to review establishment levels. In addition, when the new Royal Edinburgh Building was built, it allowed for an improved number of nursing staff per bed ratio.

NHS Lothian has produced a draft action plan in response to the FAI which includes implementation of the standards within Healthcare Improvement Scotland’s (HIS) "From Observation to Intervention" 2019 guidance. This is being taken to the NHS Lothian Health Care Governance Committee for discussion on 24 th July 2020.

On December 16 2019, the Scottish Government published the first Integrated National Health and Social Care Workforce Plan in the UK. Developed in partnership with COSLA, the Integrated Plan sets out how health and social care services will meet growing demand to ensure the right numbers of staff, with the right skills, across health and social care services. Covid-19 has led to widespread disruption to Health Boards' models of service delivery and we are carefully considering the Integrated Plan to ensure its content and associated guidance are, going forward, reflective of the full range of current and developing planning requirements on Boards and the changing circumstances regarding Covid-19.

In addition, implementation of the Health and Care (Staffing) (Scotland) Act, which is the first multi-disciplinary workload and workforce planning legislation in the UK, will support the wider workforce planning process by enabling a rigorous evidence based approach to staffing decisions. Health Boards have also been supported in planning their nurse staffing in response to the pandemic by the development of a professional judgement decision making template, including for mental health.

The Scottish Government will also shortly reconvene the National Mental Health Quality and Safety Board. This Board will be considering all issues that impact upon the quality and delivery of safe and effective services, including inpatient and community settings.

Staff and carer wellbeing was highlighted as one of eight key objectives for safe and effective mobilisation across health and social care in “Re-mobilise, Recover, Re-design: the framework for NHS Scotland”, which was published on 31 May 2020.

The Scottish Government is working closely with partners across the health and social care sector, including NHS Boards, Health and Social Care Partnerships and local employers, to ensure a range of psychological and wellbeing support is in place for the workforce as normal services are remobilised.

A range of support is available at the national level, including through the National Wellbeing Hub (www.promis.scot), which continues to be widely used by the workforce. We are exploring with partners how best to respond to those who may need more specialist support and care over the coming months.

Test and Protect programme is run by NHS Scotland using NHS staff and resources. Spend on private contractors by Scottish Government to support delivery of the programme is to date limited to support for marketing campaigns, contact centre telephony, data analytics and modelling, and systems development. Detail of spend to date is set out in the following table. A minimum threshold of £10,000 has been applied. Spend on governance support has been excluded as it does not relate to programme delivery. Further expenditure on private contractors may have been incurred by NHS territorial health boards. This information is not held centrally.

Digital consultations have played an important role in allowing people to continue to access appointments during Covid-19 with nearly 17,000 consultations being held each week across Health and Care services. Feedback on using our Near Me video consulting service remains extremely high and in mobilisation plans we have now asked for Health Boards to maintain and build upon this. We would expect a video consultation to take place whenever it is clinically appropriate to do so.

To support its wider uptake and awareness of the service, we are currently in the middle of a public engagement exercise to ensure that we gather feedback on areas where the service is particularly beneficial or where it may not be appropriate for such a consultation and we will use this feedback to adjust our approach to scale up once we have collated the information. The survey can be found here - https://www.nearme.scot/views .

A safe and effective COVID-19 vaccination is dependent on success in at least one of over 170 vaccine trials underway worldwide in terms of both development and manufacture. When a vaccination might be available, and considerations about delivery and prioritisation, will depend in part on which vaccine candidates are successful.

While there is no guarantee of success in any of the trials, it is prudent that we plan on the basis of a vaccine becoming available. In Scotland we already deliver nearly 2 million doses of vaccine routinely every year and we have a comprehensive vaccine delivery infrastructure in place. We are currently working to upscale this in order to deliver a COVID-19 vaccine in the event that a safe and effective vaccine does become available.

Prioritisation and eligibility decisions will be founded on clinical evidence and advice.

I refer the member to the answer to question S5W-27044 on 3 February 2020. This confirmed that routine health data records hernia operations, bladder operations, etc., using prosthetic implants, not those specifically using mesh implants. Furthermore, NHS Information Services Division (ISD) confirmed that reported complications or problems following surgery cannot accurately be established from routine health data because readmissions are recorded according to the symptom reported, not the underlying cause.

All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: https://www.parliament.scot/parliamentarybusiness/28877.aspx .

There is currently insufficient clinical evidence to conclude that people who have recovered from COVID-19 are protected from either a second infection or from infecting others.

Until such evidence exists the main public health benefits are for research purposes or in the clinical management of patients. The World Health Organisation and SAGE have warned there are potentially negative impacts on public health if individuals assume immunity from a positive result and adapt their behaviour in a way which could increase the risk of continued transmission.

On this basis, the CMO advised health boards on 23 rd June 2020 not to offer on-demand antibody testing. This applies equally to care or NHS staff.

Our approach is being kept under ongoing review. If clinical evidence around immunity changes we will swiftly roll out a national antibody testing programme in order to realise the potential health, social and economic benefits this would offer, and are preparing now for that prospect.