Coronavirus (COVID-19): Children and Families Collective Leadership Group minutes - 20 August 2020

Attendees and apologies

Chair: Karen Reid

Meeting participants

Members:

• Association of Directors of Education in Scotland (ADES) - apologies from Douglas Hutchison
• Care Inspectorate - Andrew Gillies (deputy for Helen Happer), apologies from Peter Macleod
• CELCIS, University of Strathclyde -  Joanna McMeeking (deputy for Claire Burns)
• Children’s Hearings Scotland (CHS) - Elliot Jackson
• Children in Scotland - Jackie Brock
• Child Protection Committees Scotland - Alan Small
• Coalition of Care and support Providers in Scotland (CCPS) - apologies from Annie Gunner Logan
• COSLA - Laura Caven, apologies from Eddie Follan
• Disabled Children and Young People Advisory Group (DCYPAG) - apologies from Jim Carle
• Education Scotland - Janine McCullogh (deputy for Laura-Ann Currie)
• The Promise - Thomas Carlton, apologies from Fiona Duncan and Fi McFarlane
• Inspiring Children’s Futures, University of Strathclyde - Jennifer Davidson
• NHS Chief Executives - Angela Wallace
• Police Scotland - apologies from Sam McCluskey
• Public Health Scotland - Debby Wason
• Scottish Children’s Reporter Administration (SCRA) - Neil Hunter
• Scottish Government - Michael Chalmers, Iona Colvin, Laura Meikle, Ann Holmes, Kate Smith, apologies from Hugh McAloon
• SOLACE - Grace Vickers
• Scottish Social Services Council - Phillip Gillespie
• Social Work Scotland - Alison Gordon

Additional meeting participants:

• Jason Leitch, SG National Clinical Director
• Kerry McKenzie, Public Health Scotland
• Eileen Scott, Public Health Scotland
• Diane Stockton, Public Health Scotland
• Lorna Watson, co-chair of Directors of Public Health Children and Young People Special Interest Group
• Leadership Group secretariat: Anne-Marie Conlong and Chris Lindores
• Innes Fyfe, SG Interim Deputy Director for Improving Health and Wellbeing, C and F Directorate
• Bill Scott-Watson, SG Acting Deputy Director, Care, Protection and Justice Division, C and F Directorate
• Bill Alexander, SG Deputy Chief Social Work Adviser

Items and actions

Note of the last meeting and updates on actions [paper 12/01]

Members agreed the note, including the amendments suggested by Laura Meikle.

Update on future pandemic scenarios

Jason Leitch presented a state of the nation and state of the world review, followed by questions and discussion. A summary of the key points from his presentation are noted below.  

There are four key harms, from:

• COVID itself
• stopping services
• social harms – lockdown, no school
• economic harm – this is a public health issue

WHO have declared a Global Public Health Emergency- have done this 6 times and do not do it lightly. COVID is clearly the most significant outbreak since the Spanish Flu. We do not know what is happening in some countries so the figures are probably gross under- estimates. The virus is not under control. Rates were slowing in Europe but we are now seeing signs of re-acceleration. 

We have no drugs and no prevention. The only treatment we have available is population restrictions. These are the only things that can be done for a virus with this scale of deaths. We needed a blunt tool because we didn’t know enough about the virus. 

Now that we know more, we can begin to gradually re-open but there is ongoing balancing required of what can and cannot re-open. The second wave of the 1918 Spanish Flu Pandemic killed many more than the first- principally over the Winter. This is not the best comparison but it is the closest we have.  That is why we are worried about a second wave, whilst recognising the need for the economy to re- open. 

Questions and discussion

Is it still appropriate to prioritise lifting restrictions for CYP to protect their mental health, wellbeing, etc.?  

The science globally shows that children and young adults get a very mild case of COVID (in developed countries), so the issue is not them catching it. It is a droplet-spread virus, so mild cases with milder symptoms such as little or no coughing are less likely to spread it. It is not about age itself being protective.  Transmission is still complex. A gradient of transmission risk as you age and as you get symptoms. Opening schools is a massive step but if we keep the virus at a low level across the country, we are safe. If infection rates increase across the country then we are less safe.

Is there anything that can be shared on thinking and modelling on second wave? 

The Public Health community is currently worried about outbreaks due to reopening across the country, but longer term, being indoors more with cold weather, possible evolution of the virus (thankfully, no sign at the moment), more central heating, less ventilation is not good. Vaccine scientists are better resourced than ever and may have a short-term vaccine ready for vulnerable people over winter, with a longer term vaccine available by spring/summer.

Any thoughts on the success of Test and Protect?

There have been suggestions that the outbreak in Grampian shows Test and Protect doesn’t work but actually it’s the opposite as it’s been contained within 2-3 weeks. ‘Shoe leather’ contact tracing, i.e. individually contacting everyone by phone, is working and more successful than just sending one text message to each contact.

How do we make sure that the disadvantages (pre-COVID and caused by COVID) don’t become hard- wired into the country? 

All effective measures (population restriction measures such as Lockdown) widen inequalities and health inequalities, therefore, when we come out of restrictions, we have to try and redress the balance. Appropriate allocation of resources is important, as is the return of face-to-face support services, such as Alcoholics Anonymous, Narcotics Anonymous and the opening of Citizens Advice.  There are also opportunities, it is not all doom and gloom, e.g. mosques cooking meals for 1000s of people, sports clubs doing community visiting. There has been an increase of community spirit and engagement that we need to harness. 

The harms from pausing and adapting services; what is the impact on CYP health? 

Every 3 weeks, we publish our assessment of the harms against the Route Map. We make judgements on the harms- this is an attempt, pretty uniquely apart from New Zealand to assess everything that we are doing. Assessments on children’s services are part of this. We also need to keep capacity within services for COVID.
    
Action:

• Jason Leitch potentially to return to the LG once data and intelligence coming out from re- opening of schools

Public health responses to the impact of COVID-19

Slides were circulated in advance of the meeting and Debby Wason, Kerry McKenzie and Eileen Scott took the Group through these. 

Questions and discussion

Very concerning about families not being able to access services that they needed. What can we do about that?

We have set up a lessons learned session for 17th September- useful for this. What type of issues were stopping parents from seeking help?  

Parents said they perceived services as shut or couldn’t negotiate systems for getting in touch. Sending letters about services being open and giving a number to call has been important. Going forward, we could maybe ask parents about what would work best for them if we need to go into lockdown again. PHS are commissioning a survey on how things like Near Me have worked for pregnant women. In domestic abuse situations, women can’t speak over the phone and need face to face contact. Based on what we know now about transmission, we could institute some face to face for 27 to 30 month health visitor review. 

Actions:

• Karen and Grace to raise lack of uptake for 27-30 month health visitor review with COGs
• Michael will also check with relevant SG colleagues on 27-30 month health review issue
• Laura to include some material on this presentation in the elected members bulletin

AOB

The Chair informed members of the following:

Michael Chalmers has returned to his post as Director for Children & Families and he will be taking over LG co-chair duties from Iona. Iona will continue to attend LG as Chief Social Work Adviser. A huge thank you to Iona on behalf of the Group. 

An update on the National Family Support Resource was sent yesterday – relevant third sector partners will receive the first version of the resource for feedback, with live testing of the tool with families week commencing 31 August.

The next meeting on 3 September will include agenda items on:

• disabled CYP
• support and wellbeing for children’s services workforce

The following meeting on 17 September will be dedicated to lessons learned from first lockdown & forward planning for next phases of COVID.

No further business from members.

Action:

• members to e-mail suggested agenda items to: Covid19CandF@gov.scot