Coronavirus (COVID-19) update: Health Secretary Statement to Parliament 28 April 2020

Thank you very much Presiding Officer, and thank you for the opportunity to update the chamber on several key areas around our response to COVID-19, and to say something about our future planning.

Today is International Workers’ Memorial Day, and across Scotland many people observed a minute’s silence to particularly honour health and social care staff who have tragically died during this pandemic. A number of our own colleagues in Scotland have lost their life to COVID-19 and my thoughts, and I know those of members across the chamber, are with their families and loved ones.

In the last 24 hours, 70 deaths have been registered of patients who have been confirmed as having COVID-19 – and that takes the total number of deaths in Scotland, under that measurement, to 1,332.

As always, it is so important to remember that behind each one of those numbers is the loss of someone loved and now much missed and I offer my sincere condolences to their families and friends.

Presiding Officer, notwithstanding all of that, we are starting to see some promising signs that the efforts and the sacrifices that the overwhelming majority of people across Scotland have made are having an impact.

The number of patients in hospital with confirmed or suspected COVID-19 has been broadly stable in recent days, and the number of people in ICU with COVID-19 has shown signs of decline.

We should not read too much into all of this yet - these are early days - but these trends are both welcome and cautiously hopeful.

As of today, 50% of adult care homes have reported an outbreak of suspected COVID-19. Last week I set out a series of additional steps to support those who live and work in our care homes.

These steps increase the clinical support focussed on preventing COVID-19 infection and transmission in care homes. Our NHS Directors of Public Health are now providing enhanced clinical leadership and have contacted every care home in Scotland. They are assessing how each home is managing infection control, staffing, training, physical distancing and testing.

We have provided a direct delivery of PPE to care homes and have worked with local partners to significantly improve the operation of local PPE hubs. Whilst the supply of PPE is primarily the responsibility of care home providers in both the private and the public sector, we will continue to provide both top up and emergency provision to ensure staff have what they need and they and the residents have that protection.

Work is also underway to ensure that all COVID-19 patients being discharged from hospital should provide two negative tests before discharge, and that all new admissions to care homes, and all residents who are symptomatic should be tested and those new admissions should be isolated for 14 days.

Social Care and care home staff continue to be priority key workers for testing and I have written to all care homes reminding them of this and asking them to make sure that as employers they follow through where this testing is required.

As members know we also have over 21,000 returning health and social care staff alongside student nurses, student midwives, AHPs and newly graduated doctors, all willing to apply their skills and experience to the collective effort. Many of them are able to work in both the care and the primary care setting. And, as of today, 185 applicants have been matched into roles in care homes and care at home services, and a further 218 are ready and available. I expect the number of matches to increase rapidly in the coming weeks.

As well as those working in care homes to protect our most vulnerable people, I know there are many carers – both paid and unpaid – who are supporting people to stay in their own homes and they, too, must be protected. So we have extended the provision of PPE to Personal Assistants and unpaid carers.

From the start of this week, the local PPE Hubs for the registered social care sector are receiving enhanced supplies and support so that they can distribute to the whole of the social care sector where normal supply routes have failed.

We have published advice for unpaid carers on the appropriate use of PPE and how to access it, and will be publishing equivalent guidance for Personal Assistants shortly.

I have asked the National Carer Organisations and local carers’ centres to discuss with carers their needs, and help us with directing them to their local Hub where they need PPE.

We will ensure Hub locations are clearly signposted on the Scottish Government website and Health and Social Care Partnerships are working with local carers’ centres to make clear how individuals can get the necessary Personal Protective Equipment.

Throughout this difficult time, it is critical that social care support is maintained to ensure the safety, dignity and human rights of people who already receive that support.

In addition to the funding directed towards social care from the 2020-21 budget, I reached agreement some weeks ago with COSLA that we would meet additional costs incurred because of the impact of the pandemic. That agreement was specifically reached to ensure that both existing and new demand and need could be met. Alongside this, those additional returning staff I mentioned a moment ago are also available for deployment to these services to ensure staffing resilience.

So it is not acceptable to me that care packages are cut – in some instances by 100%. I expect the steps I have already taken to be used and if there is more that needs to be done to ensure existing packages are not cut and new demand is met, then I hope that colleagues in the sector know that my door is always open and I expect them to come to me with those additional requirements.

I want to turn now to testing. By 22 April, 17,800 health and social care staff, or symptomatic household members, had been tested. 21 per cent of those tested were social care staff.

By the end of April, all 14 Health Boards should have local testing capacity. In terms of testing capacity, we are on track to reach at least 3,500 tests available per day by the end of this month, making steady progress from the start of this pandemic, where capacity was 350 tests per day, from two labs.

We also continue to work with the UK Government on its testing programme, which is expanding both capacity and access in Scotland.

Four UK Government drive-through testing facilities are already operational, with a fifth due to open in Perth this Thursday.

Five mobile testing units manned by army personnel are going live in Scotland this week, and it is anticipated that a further eight units will be live in Scotland within the next week or two.  

This increased capacity in our own NHS labs and through that participation in the four nation testing exercise has ensured that we are able to expand the areas and the groups whoa re being tested. So we have increased availability to key workers beyond the Health and Social Care sector using the categories that we have outlined before, and have today also increased testing to all 70-year-old and over admissions to a hospital setting.

In terms of access to the UK four nation exercise, this is controlled through the queueing system managed by the UK Government and through their digital portal.

I want to touch on now on two other issues before I conclude: research and ongoing changes to healthcare delivery.

The pandemic has required fundamental change to how health and care is accessed and delivered. This has involved a significant reorientation of resources, and the incredible support and efforts of local leaders, planners, clinicians – in fact the entire workforce. The work has included:

• preparing to quadruple ICU beds and ensuring there is sufficient hospital bed capacity
• significant increases in digital access for health services – with around 60% of GPs now using “Near Me”, and weekly digital consultations increasing from around 300 to over 9,000
• the reshaping of primary care to support COVID-19 hubs with 24/7 access
• shielding almost 150,000 clinically vulnerable people and focusing multi-disciplinary teams working on anticipatory care planning with them
• and expanding mental health support by moving towards a 24/7 NHS24 mental health hub and digital therapies

What is clear is that, in line with our framework for decision making that was published last week, we need to achieve a careful balance in managing our healthcare capacity going forward including our commitment to continue to treat emergency, urgent and maternity cases. 

So we will continue to work closely with Health Boards and their partners to ensure there are robust plans in place to safeguard local resilience and responsiveness, whilst we also consider how and when we can increase the business as usual work of our NHS.

The incredible levels of compliance with social restrictions that we’ve seen show a clear willingness on the part of the people of Scotland to think beyond individual health to population health. As we move to introduce the test, trace and isolate measures required, we will need that focus on population health to continue.

Finally, I want to update you on research proposals for COVID-19 that we launched on 25 March.

139 proposals were received from across Scotland’s Universities and Research Institutes.

Following an independent expert review process, 55 projects have been selected for funding.

This has resulted in a Pan-Scotland portfolio of research, with 15 different institutions leading on projects.

In summary, the outcome of the call is a programme of projects meeting the aim of establishing a broad Scottish programme of high quality research on COVID-19 that will be delivered rapidly and inform policy and clinical practice in responding to the pandemic.

Presiding Officer, I continue to be grateful for the tremendous resilience of our health and social care staff, our key workers, and most importantly people all across Scotland.

Together, we are making progress, we are suppressing the virus, we are saving lives and we are showing that we can continue to rise to the challenges of this pandemic.

Thank you.