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The COVID pandemic has inevitably affected A&E attendance and the pressure is being felt across the UK. While Scotland continues to have the best performing A&E in the whole of the UK, our NHS staff are facing unprecedented pressures as they work tirelessly and consistently to respond to the pandemic whilst continuing to provide vital treatment and optimal patient care.

Demand on NHS Highland services has been, and continues to be challenged. This is largely due to limited bed capacity due to staffing pressures, and an increase in attendances to A&E by those who are much sicker and require higher levels of care.

We are in daily contact with NHS Highland and continue to support improvement work within the Board and the Health & Social Care Partnerships to minimise delays for patients no matter where they are in the system. We also invested an additional £12 million in the summer to support improvements, NHS Highland has used its allocation to increase capacity in community hospitals.

Additionally, to help alleviate pressures across the whole system we announced a substantial new investment of over £300 million in hospital and community care to support the NHS and social care system over winter. The new funding will support a range of measures to maximise capacity in hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care, helping to improve waiting times for people attending A&E.

All pandemic PPE procurement undertaken by public sector organisations has been conducted in line with the relevant public procurement legislation and policy. In addition, direct awards have taken place using procedures outlined in Regulation 33 within the Public Contract (Scotland) Regulation 2015.

Information on contracts awarded by the Scottish Government for PPE was included in the answers to PQs S6W-02211 and S6W-02212 on 28 September 2021.

Information on contracts let by other national public sector organisations is a matter for those bodies.

The Procurement (Scotland) Regulations require all public bodies to publish an award notice for all regulated procurements no later than thirty days after the award of the contract. These can be found on the Public Contracts Scotland website: www.publiccontractsscotland.gov.uk

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/chamber-and-committees/written-questions-and-answers

We recognise the extreme pressure facing the Scottish Ambulance Service due to the Covid-19 pandemic, and our thanks go out to the paramedics, technicians and wider ambulance staff for the continued work they are doing in exceptionally challenging circumstances.

Last month, the Scottish Government announced an additional package of support for the Scottish Ambulance Service, backed by an additional £20 million, which will help increase capacity and improve response times and staff wellbeing.

On 7 September 2021, the Scottish Government published the 2021/22 Programme for Government which confirmed that the Scottish Government will start work on a detailed prospectus for an independent Scotland. The Scottish Government is now determining how this work will proceed and the resourcing it requires, as we do for delivering all commitments in the Programme for Government. It is the role of the civil service to support delivery across the full range of Government commitments.

The number of staff working in NHS Grampian has increased by 20.7 per cent since Sept 2006, to over 13,520 Whole Time Equivalent (WTE). This includes a 6.9 per cent increase in numbers of Qualified Nurses and Midwives, which have risen to 4,099.1 WTE.

NHSScotland Boards are required to have the correct staff in place to meet the needs of the service and ensure high quality patient care. They have fully delegated powers in relation to employment issues. The Scottish Government works closely with Boards to support their efforts in staff recruitment. The creation of posts and filling of individual vacancies will depend on the service needs of each Board, taking account of national and local priorities.

We are investing £11 million in new recruitment activity and in the creation of a National Centre for Workforce Supply. The Centre will offer NHS Boards expert advice on labour market intelligence and coordinate recruitment campaigns, providing vital additional support to health board recruitment teams.

We are also taking forward a comprehensive programme to support recovery and build further capacity. The programme will include measures to increase international recruitment, retain staff and attract more returners to the service. The Scottish Government will continue to work with partners to explore options and opportunities that allow us to best support our registered staff.

The Vaccination Transformation Programme (VTP) is funded via the Primary Care Improvement Fund, which began in 2018 and will have provided £250 million to health boards up to the end of financial year 2022. The extended flu programme and COVID-19 vaccination programme (including boosters) are outside the scope of this fund, however work to deliver these programmes has helped to build Health Board capacity to vaccinate and complete the VTP.

The Scottish Government recognises vaccines approved for use in the UK regardless of where they were administered to determine whether a person has completed their primary dose or whether they require additional doses to be fully vaccinated.

Those who have been vaccinated out-with the Common Travel Area (CTA) should obtain proof of their vaccination status from the country they received their vaccination. For domestic certification purposes, we will accept proof of vaccination from across the UK and Crown Dependencies as well as from members of the EU Digital Covid Certificate Scheme.

For those who have proof of vaccination status from out with the CTA and the EU, domestic certification rules for international visitors will align with current border rules. Visitors from international countries out-with the CTA and EU scheme will require to provide the same proof of vaccination status that is accepted for entry to the UK.

Those who have received a final dose of a UK approved vaccine in Canada at least 14 days before travel are currently recognised as fully vaccinated and can use their proof of vaccination for domestic certification purposes. More information on this can be found at: Coronavirus (COVID-19): international travel and managed isolation (quarantine) - gov.scot (www.gov.scot) .

We are working with NHS Scotland Health Boards to put in place delivery models for the 2021-22 seasonal flu vaccination programme to suit local circumstances, whilst maintaining a COVID-19 safe environment and maximising efficiency.

If someone is unable to attend for their flu vaccination, they can rearrange their appointment to a more convenient time or location on line at Rearrange your flu vaccine appointment | The flu vaccine (nhsinform.scot). If invited by their GP practice or local Health Board, they should rearrange their appointment with them directly. If cancelling the appointment, the Flu Vaccination Helpline on 0800 030 8013 can assist with this.

The Case Record Review is underway. Introductory interviews with the participants are close to completion. More than half of the participants have received an ‘information gathering’ form from the Administrator. Following return of this form, Clinco, a commissioned contractor involved in the retrieval of patient records, will request the appropriate case records from Health Boards. This process is already underway for a number of participants.

As is standard practice, data sharing agreements are required for the release of medical records. Agreements are in place already for a number of Health Boards and it is expected that agreements will be in place in relation to all relevant Boards shortly.

Health Board Accountable Officers have been kept abreast of developments with the Case Record Review through the Short Life Working Group on mesh complications.

NHS National Procurement has confirmed that arrangements have been made to make Ronapreve available in Scottish Hospitals.

Commissioning guidance was issued to Health Boards on 17 September, and work is ongoing to ensure that Ronapreve can be administered as quickly as possible where clinically appropriate.

The requested information is not centrally held. NHS Education for Scotland publish annual data on joiners/leavers, but this information is not available by reason or destination.

Information on joiners/leavers by staff group for each financial year can be found on the following link:

https://turasdata.nes.nhs.scot/media/tnvdmmwd/turnover_m2021_updated.xlsx