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The Scottish Government continues to participate in the four nations approach to the procurement of tests and, subject to clinical recommendations and the availability/approval of an effective antibody test, can draw-down an allocation of the UK procured COVID-19 antibody tests for use in Scotland.

Urgent and emergency care has been maintained throughout this pandemic to ensure those with life threatening conditions were and continue to be seen as a matter of priority.

Through the Re-mobilise, Recover, Re-design: The Framework for NHS Scotland , Health Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of some paused services whilst continuing to protect emergency, urgent, Cancer and maternity care. Health Boards will plan to resume services while maintaining COVID-19 capacity and resilience and providing appropriate support for social care, and also protecting the safety of all patients and staff. Health Boards are taking a careful and considered approach to this, balancing the treatment of COVID-19 patients with the all potential impacts of longer waiting times, including assessing the impact of this on excess death rates.

Our national expert body, Health Protection Scotland (HPS), jointly with the Department of Health and Social Care, Public Health Wales, Public Health Agency Northern Ireland, Public Health England (PHE) and NHS England published updated PPE guidance in relation to COVID-19 on Thursday 2 April (updated 12 June). The guidance is available here .

The guidance outlines what type of PPE frontline health and social care workers should be wearing in different settings and scenarios, including where a two-metre social distance is not possible. The guidance contains tables which clearly explain the PPE required for different common clinical and care scenarios. The first table relates to acute hospitals and the second and third are for primary care, outpatient and community care, ambulance staff, paramedics, first responders and pharmacy.

Given the recognised sustained community transmission of COVID-19, the guidance importantly includes detailed advice (table 4) around risk assessing use of PPE, including aprons, gowns, Fluid-Resistant Surgical Masks and eye protection, in a range of different clinical and care scenarios, including where a two-metre social distance is not possible.

Additionally, on 23 June recommendations on the wider use of face masks by staff within residential healthcare settings, such as acute adult (including mental health) and community hospitals and care homes for the elderly where staff are unable to physically distance were announced. The guidance recommends that staff working in a clinical area of an acute adult or community hospital, or in an care home for the elderly should wear a face mask at all times throughout their shift. Additional advice was also announced on the requirement for visitors to wear face coverings when attending adult hospitals or care homes for the elderly.

Patient safety will be at the forefront of NHS Boards plans as they restart previously paused services, and a number of different steps to mitigate the impact that two-metre physical distance are being put in place. This includes extended working days including evenings and weekends to provide more clinics and see more patients.

The Golden Jubilee providing national support to territorial Health Boards in specialties such as Ophthalmology and Orthopaedics, and continue to support with Cancer surgery.

The Private Sector is supporting NHS Boards by providing a COVID free environment for urgent and Cancer surgery. This provides a safe environment for both staff and patients.

In addition, in order to increase access to diagnostic testing, NHS Boards will be deploying six mobile MRI scanners and three CT scanners, across Scotland. This will enable Boards to ensure patients have appropriate access to diagnostic services while also ensuring physical distancing measures and PPE requirements are followed.

We are also exploring options for further pathways for the NHS Louisa Jordan with the possibility that the facilities can be used to provide outpatient appointments and access to diagnostics testing.

The Scottish Government has been working with partners to explore options for transparent masks and face coverings. Currently, there are no commercially available transparent masks that are certified for use in clinical settings. However, £50,000 of funding from the Scottish Enterprise’s Pivotal Enterprise Resilience Fund (PERF) was recently awarded to an Edinburgh based company to expand its production of face coverings to include coverings with transparent panes, which enable lip-reading. This company is also being supported by the National Manufacturing Institute for Scotland (NMIS) to upgrade these face coverings to type IIR masks suitable for use in clinical settings.

The Scottish Government is aware that when face coverings and face masks are worn there may be additional challenges for those who are deaf or have hearing loss, as well as others with different communication needs. Guidance is being continually updated as to when face masks and face coverings should be use in health and social care settings. The latest guidance on the extended use of face masks recommends that staff working in clinical areas of an adult acute, community hospital or care home for the elderly should wear a medical face mask at all times. However the guidance also stipulates that where necessary and when safe to do so, staff can lower or remove their mask to allow for lip-reading, but must maintain 2m physical distancing. Where physical distancing is not possible, other communication methods should be used.

The information is not held centrally. Data on the number of people admitted to hospitals from care homes is not recorded systematically in the data submissions from NHS Boards to Public Health Scotland (PHS). PHS have analysed and linked a suite of their management information data sources in order to identify people admitted to hospitals from care homes. This analysis was unable to produce reliable answers.

PHS will now work with NHS National Services Scotland, local Health and Social Care authorities (NHS Boards and IJBs) and the Care Inspectorate to improve national information so that these types of questions; as well as ones in relation to patients discharged from hospital to care homes; can be answered in future.

Scotland’s testing capacity fluctuates on a daily basis and for this reason, and given daily fluctuation in NHS capacity, it is not possible to give a definitive figure for the proportion of testing capacity that comes from UK regional testing facilities.

We are working hard to ensure we maximise use of our daily capacity, as we expect the number of daily tests to increase as we roll out Test and Protect. NHS lab capacity is currently around 10,000 tests a day and around 8,000 at the weekend, and is supported by non-NHS labs including: University of Edinburgh, University of Aberdeen, and the Scottish National Blood Transfusion Service.

In addition to this, we have further capacity through the Lighthouse Laboratory in Glasgow (run by the UK government), which has capacity to process approximately 20,000 tests a day. The Glasgow Lighthouse Laboratory may however process tests taken from across the UK.

As part of our activity we have worked with public and third sector partners to understand language and accessibility requirements, and have worked collaboratively to translate and distribute key coronavirus information. This has involved:

1. Digital marketing activity has been developed and undertaken to target those whose digital footprint highlights they are from a BAME community.

2. Scottish Government has been leading the coordination of translations of NHS Inform coronavirus content with NHS 24, NHS Greater Glasgow and Clyde, and NHS Lothian on a weekly basis from March to June. Content is translated into 12 different languages and formats.

3. Key promotional posters have been translated into various languages. For example, Household Isolation posters were translated into Polish, Mandarin, Arabic, BSL, Audio MP3, Easy Read, Kurdish, Sorani, Cantonese, Tigrinya, Vietnamese.

4. The two national door drops distributed by SG have been made available in a variety of language and accessible formats.

Scottish Government Policy teams are also working with relevant stakeholder and community groups to increase awareness of these resources and how to access them.

We do not collect data relating to learning disabilities of people receiving testing. Consent would have to be provided by the individual to allow collection of this data.

I have asked all stakeholders, including NHS Unions and NHS Scotland employers, to work in partnership to examine options for arriving at pay settlements for both the immediate and longer term. Stakeholders will work together to agree a timetable for this. In addition, and in consultation with a wide range of partners across the health and social care sector, we are taking forward a raft of measures designed to provide support to staff at this difficult time. Information on these can be found at our National Wellbeing Hub - www.promis.scot