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The Scottish Government follows the Joint Committee on Vaccination and Immunisation (JCVI) Guidance in the planning of vaccine delivery. This evidence based guidance advises that the single greatest risk of mortality from COVID-19 is increasing age, and that the risk increases exponentially with age. Additionally the committee considers frontline health and social care workers who provide direct care to vulnerable people a high priority for vaccination.

The JCVI priority list represents 90% of the preventable mortality from COVID-19 in Scotland and throughout the delivery of the vaccination programme we will be guided by the clinical expertise of the JCVI, the MHRA, and our own senior clinical advisers.

At this stage in the vaccination programme every vaccine given to one of these groups would be one less vaccine to an at-risk individual.

To save lives it is essential that vaccinations are given to the first priority groups as set by the JCVI, these being residents in a care home for older adults and their carers, people over the age of 80, and frontline health and social care workers.

Prioritisation by sector is not being considered for the following reasons;

• Criticality of service is not an indication for priority vaccination because clinical risk is the overriding concern. This is influenced most greatly by age, not occupation.
• Currently there is no sectoral prioritisation of any workers other than frontline health and social care workers. This is because we don’t know enough about if the vaccine prevents spread, but it does reduce the harm to those most at risk should they catch the virus.

Our plans will remain flexible and we will continue to adjust these based on the guidance provided by JCVI.

Garden centres can open in any area designated at protection level 3 or below and are presently open on some Scottish islands, including Shetland and Orkney. For all areas in protection level 4, garden centres are closed but are able to operate a permitted collection service and fulfil on-line orders.

I have recently met with the Horticultural Trade Association (HTA) to discuss the impacts restrictions are having on this area. The HTA has provided us with their safe operating protocol and have briefed us with valuable information which we are taking into consideration when making our decisions.

From 5 April it is our hope and expectation that the stay at home restriction will be lifted. Also in this phase, we will begin the re-opening of retail. This will start with an extension of the definition of essential retail and the removal of restrictions on click-and collect.

We hope to move back to a levels system from the last week in April with a phased but significant re-opening of the economy, including non-essential retail, hospitality and services like gyms and hairdressers.

We will set-out in Mid-March the indicators that will guide our decisions on levels as well as on any revision to the content of each level and the order in which we expect those parts of the economy that have been restricted could start reopening from the last week of April.

The Scottish Government engages regularly with both SEPA and local authorities on a wide range of issues, including flood defences, to ensure that Scotland is resilient to the challenges of flooding and other climate pressures.

As required by the process set out in the Flood Risk Management (Scotland) Act 2009, SEPA and local authorities are currently reviewing and updating the Flood Risk Management Strategies and Plans for the 2022-28 cycle and these will be published for consultation later this year. The updated Strategies will contain proposals for new flood defences and are required to be submitted to Scottish Ministers for approval before they are published.

In July 2020, we published the Rail Services Decarbonisation Plan, an action plan to decarbonise Scotland’s railways by 2035. The Plan focusses on decarbonising transport through the achievement of modal shift for both passengers and for freight.

In addition to this, our recently published Strategic Transport Projects Review 2 (STPR2) (Phase 1) confirms the action being taken to decarbonise the Borders railway.

This will include the removal of diesel-powered units through the introduction of Battery Electric Multiple Unit (BEMU) train services, via partial electrification, with the potential for full electrification of the line and move to full-electric (EMU) services in the future.

Further detail on STPR2 can be found via:- Strategic Transport Projects Review 2

We are progressing all 68 actions included in our action plan, and are reporting on the actions on a quarterly basis. As of the end of December 2020, 5 of the actions are complete. We will continue to build on these 5 actions and progress the remaining actions to their completion.

The National Cancer Recovery Group (NCRG) meets fortnightly and oversees the progress of the action plan. They provide strategic end to end oversight of cancer services, oversees national data and modelling work in relation to cancer recovery and advises on patient and public communications.

Rainfall and river levels data are available to SEPA internally in support of their flood forecasting service but at the moment cannot be exported automatically to the web pages to share with the public as a result of the cyber-attack. SEPA recognises the importance of the river levels service and has prioritised work to restore the link between its network and website. The web pages are expected to be restored by 5 March.

In the event that someone is unable to leave their home for a cervical screening appointment, their NHS Board can use a multidisciplinary team to take the necessary steps to allow someone to have their sample taken. This will be done on a case by case basis depending on the needs of the individual.

The UK National Screening Committee (NSC) has not yet recommended that self-sampling should be incorporated into the cervical screening programme. It continues to gather and evaluate the evidence on this matter, and it is not possible to say when this will be complete. However, Scotland is playing an active part in supporting this work, and will also begin taking the necessary steps to ensure that we can roll it out as soon as possible once a recommendation is made. At all times, ensuring patient safety will remain key, and we will not act until we are assured it is safe to do so.

A pilot is currently being carried out by NHS Dumfries and Galloway which involves sending all screening participants aged 25-64 years of age who have never attended for cervical screening or who have defaulted on their most recent appointment a self-sampling kit. Findings from this pilot will inform our work going forward.

Plans in early 2020 to establish a Working Group to lead a wider project to contribute to this evidence base had to be postponed due to the Covid-19 pandemic. However, these plans are now progressing, and the working group convened for the first time in February 2021. Their remit will be to develop a work programme that will ensure a range of evidence on different self-sampling use cases can be gathered and evaluated, and to understand what changes will be needed to the current programme to allow widespread roll-out in the future.

In initial sample taking training, NHS Education for Scotland (NES) provide information for sample takers to address the potential issues in assisting disabled people at their cervical screening appointment, along with many other groups where there may be barriers to screening. Further advice for sample takers is also set out in national guidance.

The Scottish Government has also made funding available through its Inequality Fund to Health Boards to allow them to tackle inequalities in access to screening. In addition to the £5 million we have made available over the last 5 years, we will be exploring how best to use this funding over the coming years to increase its reach and impact.

The Scottish Government monitors and considers all available evidence and recommendations from the UK National Screening Committee (UK NSC), an independent expert advisory group, which informs decisions taken across the UK on screening programmes. It is the primary objective of the Scottish Screening Committee to consider the advice and recommendations of the UK NSC and report to the Scottish Government on any such recommendations.