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The Scottish Government welcome the Audit Scotland report, and we are pleased that it recognised the swift actions of Scotland’s public sector partners to respond to the significant and unprecedented challenges presented by Covid-19. The Scottish Government agrees with Audit Scotland that we need to learn from this pandemic and bring that learning both into planning for future pandemics, and into our long term procurement strategy. This work is already underway. Officials are working across the public sector including with the NHS to learn the lessons and take them into future PPE procurement.

To address environmental concerns surrounding PPE, the Scottish Government has funded a Small Business Research Initiative £310,000, with Transport Scotland providing additional funding, to assess and evaluate prospective reusable PPE solutions and technologies to assist in decontaminating PPE. This initiative, led by NHS Tayside on behalf of the Scottish Government, supports companies to develop more environmentally-friendly PPE by providing funding to enable them to undertake vital research and development of their prospective solutions.

The Scottish Government has also established a PPE Innovation Working Group with partners across Scotland. The purpose of this Group is to oversee the implementation of positive changes to the provision of clinical PPE in Scotland. As part of this work, the Group will consider potential work streams and opportunities which surround the environmental impact of PPE and how manufacturers with innovative PPE solutions can better collaborate with NHS Scotland in the future.

If an individual has specific concerns arising from the results of a test they have taken, including related to their immunological response following vaccination, they should consult their primary clinician, who can determine whether further investigation is necessary.

The results of serology (antibody) tests, while indicative, may not be definitive. The value of antibody tests is currently limited to answering the question of whether someone has had COVID-19 before and providing data and a greater understanding on the spread of the virus. An antibody test cannot tell you if you’re immune to COVID-19 or whether you can or cannot spread the virus to other people.

Some individuals may not develop a serologically detectable antibody response to vaccination. Additionally, vaccination does not have an immediate protective effect, but takes up to 3 weeks to produce an antibody response. This is particularly true for elderly, immunocompromised, or infirm people.

In addition to the individual level of protection against severe disease or hospitalisation afforded by vaccination, an additional benefit of the vaccination programme is to assist in developing widespread community immunity and thereby reduce the force of transmission and viral reproduction rate, controlling the prevalence of COVID-19. The inoculation of a large proportion of the population will help to provide a degree of passive protection in the community for those who may develop a weaker immune response, although further research into the impact on transmission is underway. The majority of those inoculated with two doses of vaccine develop a high level of protection.

Further research is being conducted on the effect of the vaccination programme on transmission both in relation to current and new variants of concern. Until we know more, it is essential that everyone continues to follow public health guidance and the COVID-19 protection level rules which apply in their Local Authority area.

Scotland’s daily PCR test capacity is over 66,000 per day. This is made up of a combination of the aggregate capacity of all testing sites/facilities and distribution/collection services where individuals can get a test, and laboratory capacity to process the samples taken.

As set out in our updated Testing Strategy, published on 22 June, testing is key to quickly identifying and isolating positive cases to break chains of transmission within a community. The testing system is designed to be completely flexible so neither sampling nor laboratory capacity is allocated to a specific local authority area. We work with Public Health Scotland to provide local decision makers with insights and data to target tests where they are most needed. We are also helping to maximise existing testing interventions at the request of local incident management teams (IMT). Local authorities’ testing response will vary as their approaches will be targeted to meet the needs of their communities.

Details of the daily number of tests carried out and number of positive cases in the Glasgow area are available from the Public Health Scotland dashboard.

The Scottish Government has remained engaged with the aviation sector throughout the pandemic and will continue to do so, including on testing of international travellers.

Travellers returning from green and amber list countries must use the NHS tests, which can be booked through the UK Government’s booking portal for international travel. These kits are home test PCR kits provided by NHS Test & Trace. The cost of the kits is set by the UK Government and the process managed through its contract with the travel management company, so our ability to reduce costs unilaterally is limited.

Currently, we are not using private test providers for international travellers arriving into Scotland from green and amber list countries due to concerns about the speed and reliability of the flow of data from private companies. We are having on-going discussion with the UK government on any issues with using private test providers and any risks attached to this. We are keen to understand fully the key performance indicators (KPIs) that have been recently set for these companies and the process should these not be met.

The Scottish Government holds monthly performance meetings with all NHS Boards, including NHS Grampian. Their last meeting was earlier this month.

Officials also hold weekly cancer performance meetings to monitor the Board’s progress with regards to cancer services.

Recovering the NHS is our immediate focus, and this is why we have committed to publishing an NHS Recovery Plan within the first 100 days.

As part of this, we are investing over £330 million in a network of National Treatment Centres, one of which will be located in NHS Grampian. This will provide additional capacity for elective care.

The UK Government announced that the UK would participate in the COVAX initiative in September 2020.

COVAX is a World Health Organisation (WHO) initiative to ensure that poorer countries have equitable access to COVID-19 tests, treatments and vaccines.

The initiative is designed to support the research, development and manufacturing of COVID-19 vaccines and negotiate their pricing.

On 8 June, UNICEF sent an open letter to G7 countries, urging them to donate 20% of their vaccines doses to COVAX by August.

To date the UK has committed over £500m to the Covax initiative, the UK has also announced it will donate at least 100 million surplus coronavirus vaccine doses within the next year, including 5 million beginning in the coming weeks.

In September 2020, the Scottish Government began a review of its approach to international development, and in December marked £2M of its International Development Fund (IDF) to support partner countries’ COVID-19 responses.

The online vaccine booking portal closed on 11 June.

The online portal was part of the Scottish Government’s measures to widen the accessibility of vaccine appointments, and was extended for another week, on top of the original three week window. 40% of the young people aged 18-29 who were still to be vaccinated, self-registered on our online portal.

Those who did not register online, are being scheduled for an appointment on the system, and letters are coming out over this week and next. However, to give advanced sight of appointments online, we are launching an appointment checker on NHS Inform to help people view their pending appointments. This will help those people, like students, who may have moved away from their registered GP term time address. This will also help them view their offered appointment earlier and chose to reschedule to fit with their work and life.

The National Vaccination Scheduling System (NVSS) has successfully appointed millions of Scottish citizens while achieving exceptionally high uptake rates this demonstrates a massive success for a system built from scratch in the space of 8 weeks.

Our intention has always been to evolve and continually enhance the NVSS. As the programme has engaged with younger cohorts it has become evident a digital first online booking approach would be beneficial. The programme team are in the process of designing an online booking system for the autumn/winter Flu vaccinations.

Travellers arriving into Scotland from green and amber list countries must use the NHS tests, which can be booked through the UK Government’s booking portal for international travel. These kits are home test PCR kits provided by NHS Test & Trace.

Travellers arriving into England from green and amber list countries are allowed to book private sector tests.

To date, there are concerns with the flow of data from private sector providers into Public Health England/Public Health Scotland to help with contact tracing and to identify Variants of Concern (VoCs). The UK Government has recently introduced key performance indicators (KPIs) for private providers to meet and is increasing the requirements on such providers to try to address these problems in England.

There are risks associated with the use of private sector tests. In particular, there have been concerns with the data flow from private laboratories into relevant contact tracing systems on either side of the border. There have been examples of it taking 30 days for positive test results to be transferred, making it impossible for contact tracing to be undertaken to interrupt chains of transmission.

We are currently exploring options to allow the use of private sector tests, provided this can be done safely and we can be assured that there aren’t any issues with the flow of data from the testing provider to Public Health Scotland regarding test results, as well as the need for positive test results to be analysed for evidence of any variants of concern. No decision has been made yet on this, however this is under review.

The Scottish Government does not hold a breakdown of the requested figures by local authority area. The annual figures are shown in the following table:

All of our decision making in the approach to responding to Covid-19 is guided by the latest scientific evidence from the Scientific Advisory Group for Emergencies (SAGE) , advice from Health Protection Scotland and our Chief Medical Officer. The Joint Committee on Vaccination and Immunisation (JCVI) provides advice on immunisation to all UK Health Departments, including on the efficacy and safety of vaccines.

Decisions to prioritise one population group over another are not taken lightly, nor are they straightforward. That is why our prioritisation decisions have been, and will continue to be, guided by the independent expert advice from the JCVI.

It is also worth noting that this is the case with many other vaccines. People are not routinely offered a choice of the type of vaccines in other vaccine programmes in Scotland. The Scottish Government currently has no plans to introduce an option for receiving either Covid-19 vaccine, beyond a clinical recommendation.

Following the statements by the Medicines and Healthcare products Regulatory Agency (MHRA) and the Joint Committee on Vaccination and Immunisation (JCVI) we want to stress that the evidence shows that, overall, the benefits of the Oxford/AstraZeneca vaccine outweigh the risks and it continues to be a safe and effective vaccine.

However, the Scottish Government will follow the JCVI recommendation to offer alternative vaccines to adults under 40 without underlying health conditions.

The JCVI and MHRA continue to monitor this carefully and are in regular contact with other regulators.

JCVI recommendations are set out in the Green Book, available at COVID-19 Greenbook chapter 14a (publishing.service.gov.uk)

GPs may make a recommendation for their patients to receive a specific vaccination if they believe there is a clinical need.

If the JCVI recommend a specific vaccination for any specific group we will of course take up this advice immediately.