Coronavirus (COVID-19): phase 3 measures - equality and fairer Scotland impact assessment

3. Summary of Impacts from Phase 3 Measures

This section summarises the key findings from the templates published in the Annex. Please refer to the Annex for further detail and references.

Protections

All of the Phase 3 changes on our Route Map out of lockdown required strong compliance with ongoing rules and advice. The general protections (FACTS: face coverings; avoid crowded places; clean hands and surfaces; stay two metres distant and isolate with symptoms) follow measures recommended by the World Health Organisation to increase public safety and reduce transmission of the virus. All of these protections were in place for Phases 1 and 2 but in Phase 3 the mandatory requirement to wear face coverings was extended to cover more enclosed spaces. In addition to shops and public transport, face coverings were required in enclosed public spaces including places of worship, indoor funeral services and in communal areas in schools with further requirements from 16 October to wear face coverings in communal areas of workplaces.

It was recognised that the wearing of face coverings may not be appropriate for everyone, including disabled people with particular impairments or health conditions. In recognition, exemptions were set out for the young (under five years of age), for those people for whom a face covering is inappropriate for health reasons, for situations when persons are taking sustenance or medication, or for other justifiable reasons, e.g. in a protected environment such as a driver’s cab or in response to passengers who request information. The Regulations, therefore, exempts the wearing of face coverings for disabled people for whom it is not appropriate or where there are justifiable reasons e.g. where individuals may have a hearing impairment or lip read. In recognition that people who were exempt could face challenge or even abuse for not wearing face coverings in public spaces an exemption card was subsequently made available^[14].

Seeing Family and Friends

During Phase 2 and Phase 3, a significant easing in the ability for family and friends to get together was initially allowed. Children under 12 were allowed to mix outdoors without physical distancing, while young people aged 12 – 17 were allowed to meet other households outdoors^[15], without a limit on the number of households that they could meet in a day. Further measures also increased the ability of people to meet indoors with up to two other households being able to meet inside (eight people in total) and up to four other households outside (15 people in total); this also included overnight stays. Finally, non-cohabiting partners, and any children under 18 in their households, were allowed to form extended households enabling them to meet without physical distancing.

While still representing a restriction compared with the pre-COVID-19 situation, allowing outdoors and indoors meetings helped children and young people who were most at risk of loneliness to return to peer support, as well as increasing their wellbeing from outdoor activity. It also benefited their carers, who tend to be women, as children could regain friendships and social support outside of the home. While older and some disabled people may have benefited less from the outdoors measures, they should have benefited from the limited indoor meeting quota, meaning that grandparents could have seen grandchildren. Older people and disabled people could see family and friends, as well as obtain additional support and informal care at home more easily. In addition, lone parents, who are primarily women, may have been able to obtain additional emotional and practical support. Restrictions remained in place though and as the evidence tables in the Annex show some minority ethnic groups, where larger household sizes are more common, may have continued to be disadvantaged by the measures.

This measure was amended on 10 September due to an increasing prevalence of the virus. The change was to allow up to six people from up to two households to meet socially. This applied in all locations, for example at home, in hospitality or outdoors in a park or garden. Limited exemptions applied including gatherings related to care or child-care and organised children’s activities. Children under 12 were not counted in the total number of people in a household.

These restrictions will have been disappointing for many people, especially the reduction in the number of people who could meet outdoors. However, allowing two households to meet indoors or outdoors meant that some care and support could be maintained benefitting parents, particularly lone parents, and grandparents who could continue to care for children, as well as older people and disabled people whose family and friends could provide support and informal care at home more easily. However, the restrictions of two households and six people will have been challenging, especially for minority ethnic groups, where larger household sizes are more common. Initially children were allowed to participate in organised sport but not meet informally which would have disadvantaged low income families who could not afford the cost to participate in organised activities. This rule was subsequently changed to allow children to meet informally.

With increasing infection rates linked to socialising, particularly in homes, from 25 September households were no longer permitted to visit another household indoors. However, building on earlier learning there were exceptions; those who had formed an extended household were allowed to continue to mix allowing support for non co-habiting couples, lone parents, grandparents and grandchildren, older people and disabled people needing informal care and support. The provision of essential care also remained an exception.

In addition only two households with a maximum of six people were able to meet outdoors socially. Again building on earlier learning, separate rules were established for children and younger people to support physical and mental health and reduce loneliness. Under 12s did not count towards the maximum number of households or number of people who can meet outdoors. Under 12s also did not have to physically distance, which was a positive for many children and their families. A maximum of six 12 to 17 year olds were able to meet outdoors socially, with no household limit, but with physical distancing. This enabled teenagers to maintain social contact and emotional support from peers.

These measures still represented significant restrictions on society; a fact which was fully understood and regrettable but the increased public health risks of larger household groupings meeting were such that the limit of six people and the restriction on household mixing was deemed necessary to suppress the virus.

Getting Around

Phase 3 removed any restrictions on travel in Scotland if acting in line with all other guidance which supported the Route Map. Public transport also continued to scale up to full services. However, capacity continued to be reduced compared to normal service provision with geographical differences in services depending on local circumstances. Vehicle instruction resumed, including motorcycle and driving lessons.

During lockdown, and early phases of release, public transport had been limited to essential only use and perceived as a high risk environment for catching and spreading the virus. The Transport Scotland Public Attitudes Survey on COVID-19 had shown a consistently high level of concern about using public transport due to the risk of transmission of the virus.^[16] The easing of restrictions on travel was likely to raise anxiety as people looked to use public transport again.

The distance to be observed on public transport was reduced from two metres to one metre, once appropriate mitigations were in place, but physical distancing remained in place in Phase 3 and public transport capacity continued to be constrained. Those with lower car ownership levels (women, disabled people, older people, minority ethnic communities, and those on lower incomes) were reliant on public transport to access health services, education, employment, and other services / activities and were therefore more likely to be negatively impacted by this restricted capacity. These are also the groups most unlikely to be able to work from home or to work flexible hours to avoid commuter congestion (e.g. the hours tend to be set in some retail shops).

The consultation process undertaken to develop the National Islands Plan confirmed that travel for island communities is also more difficult. This is due to a number of barriers including the need to use boats and planes to travel off island, physical distancing requirements that further limit these services and the general higher costs associated with these modes of transport. Additionally, the lack of infrastructure for walking and cycling routes further limit people’s ability to travel.^[17] Some of these issues may also affect people living in remote rural mainland communities.

Transport Scotland developed a Transport Transition Plan^[18] to keep the public safe when travelling during the COVID-19 pandemic. The plan informed passengers about when and how to safely access public transport and supported the management of travel demand. This reinforced broader messages on physical distancing, staying local and discouraging unnecessary travel, sustaining behavioural changes, encouraging active travel options and staggering journeys to avoid peak times. It informed passengers and road users of busy areas and times in order to encourage alternative choices. The Plan is informed by detailed impact assessments and stakeholder engagement and aims to mitigate some of the issues of reduced capacity and fear of being able to observe physical distancing measures. This is a particular issue for disabled people and some older people.

With the resumption of motorcycle lessons on 22 July, guidance was published to enable the safe return to work of motorcycle instructors. This was drafted with support and comments from Scottish Government, Transport Scotland, Driver and Vehicle Standards Agency (DVSA) and industry trade bodies. Due to instructors and learners having to sit within close proximity, thus impacting their ability to physically distance. Driving lessons did not resume at the same time. Driving Lessons resumed on 24 August, with vehicle guidance updated to include a separate page on the safe return for driving instructors. As before, this update was drafted alongside support from Scottish Government, Transport Scotland, DVSA and industry trade bodies. Testing, including theory testing, is reserved to the UK Government and managed by DVSA. DVSA ensures that arrangements are in place to deliver theory testing in a safe manner.

Schools, Childcare and other Educational Settings

The closure of schools, regulated childcare provision, colleges, community learning, and universities had an impact across the population, particularly for children and young people. It also negatively impacted on parents and carers, particularly women, who were more likely to have been managing caring responsibilities, home schooling, and paid work during that period.

The provision of critical childcare for those children and families who most needed support with childcare mitigated the impacts for some, but not for all.

As we moved into Phase 3, all childcare providers were able to open from 15 July if they wished. Following updated guidance, which came into effect on 10 August, we anticipated that the majority of childcare providers would have been able to open, subject to public health measures.

Increased accessibility to childcare provision will have had a particularly positive impact on those who were disproportionately affected by closures: children for whom home is not a safe or stable environment and for those where childcare provides resources and experiences that are not available at home. Additionally, women generally carry out the majority of caring responsibilities (census data shows nine out of 10 lone parent households are headed by women), so would have been positively impacted by the re-opening of childcare options.

In the context of the COVID-19 virus, without age appropriate mitigations, increased access to childcare could have a disproportionately negative health impact on certain groups. For example, if exposure is greater for those who share a particular protected characteristic (e.g. women, who make up the majority of the Early Learning and Childcare (ELC) and teaching workforces) or where exposure has a greater risk to some groups compared to others (e.g. those from some minority ethnic groups who may have a higher risk of severity of COVID-19 and families with household members in the ‘shielding’ category).

As we moved into Phase 3, schools opened on a full-time basis from the start of the academic year. School is shown to be vitally important to a child’s development, wellbeing and right to education, and being back in school will help address the wider impacts of the virus on the health and wellbeing and educational attainment of our children and young people. Children and young people were able to benefit from face-to-face learning and increased support networks, particularly those with additional support needs, and those in the Gaelic medium education sector who missed out on immersive language learning throughout lockdown. The overall impact of this approach is also expected to be positive for parents and carers who will be benefiting from regular childcare during school hours, enabling them to return to previous working patterns.

It is recognised that individuals will have had different experiences during school closures and that some groups may have been disproportionately negatively impacted. Since lockdown began officials and ministers have been engaging with the COVID-19 Education Recovery Group^[19] as well as wider stakeholders, representing the views of parents, staff, children and young people, and groups with protected characteristics. This engagement has influenced policy development and has supported decisions to create the policies outlined in the Annex.

Contingency plans remained in place in terms of blended learning, where pupils split their time between learning in school and learning at home. However, they will only be used if scientific advice determines that they are required at a local or national level.

In the context of further and higher education, the Scottish Government wanted to minimise the disruption to learning and ensure that all students were supported to complete their studies or transition into work. This is crucial in the economic response to COVID-19 and to reduce socio-economic disadvantage. For example, college provision plays a central role in providing opportunities for many of Scotland’s school leavers and young people to help offset rising youth unemployment.

From 22 July, colleges and universities were able to begin a phased return to campus with a blended model of remote learning and limited on campus learning where this is a priority. Community Learning and Development (CLD) activity, including adult learning, resumed in line with guidance. Face-to-face outdoor youth work resumed from 13 July along with, in colleges, time-sensitive mandatory or regulated skills assessments that were essential to the completion of Modern Apprenticeship qualifications or to comply with a legal obligation. Indoor face to face youth work also resumed on 31 August.

A blended approach to remote and on-campus learning presents different risks and challenges. Practical subjects, which tend to be taken more often by socio-economically disadvantaged young people, such as construction, care and social care support, are more likely to be disrupted by remote learning and continued physical distancing. Online learning and teaching is also dependent on staff and students being able to access the internet, which may be a particular issue for older people, people living in remote rural communities, and those facing socio-economic disadvantage.

We have engaged closely with universities, colleges, CLD stakeholders, trade unions, student representatives, the Scottish Funding Council (SFC), Skills Development Scotland, and other sector organisations throughout the COVID-19 crisis to understand its impact and develop our response. This included preparing guidance^[20] to support the safe and phased return of colleges, universities and Community Learning and Development. The guidance set out the latest health and safety and public health advice, including on physical distancing; it also set out the need to take into account individual health circumstances and protected characteristics.

Working and Running a Business

In Phase 3, remote working remained the default position for those who were able to do so. People working from home are contributing to the public health effort by reducing footfall and making it safer for workers who cannot work from home. Homeworking guidance has been published to aid employers in developing their homeworking polices.^[21]

In Phase 3, work started to prepare non-essential indoor office workplaces to begin to open, once relevant guidance is agreed, including contact centres with physical distancing measures in place. This will only take place when the virus is supressed enough to allow offices to open safely. Physical distance measures will reduce the capacity of offices but at the appropriate time staff will be able to return safely to workplaces where these were closed and on-site presence is required. Health factors must be considered in any phasing of who returns to work, with employees only expected to return when new safe working environment measures have been implemented. Workplace Guidance has been made available to help employers and employees assess their individual risks and ensure workplaces are safe.^[22] This guidance considers age, sex, ethnicity and various health conditions as part of its risk score.

There are a range of equality impacts both for workers working from home and those returning to offices for essential purposes. Disabled people may find it more challenging to attend work and undertake physical distancing if they are required to return for essential purposes but this will be dependent on their impairment or mental or physical health condition, as well as access to suitable transport. There may also be challenges for parents and carers in finding suitable child care opportunities for younger children such as breakfast and after school clubs. For home workers the problems for parents and carers (mainly women) of juggling childcare and work outside of the school day could remain; as well as problems with the lack of space or suitable facilities (e.g. socio-economically disadvantaged people living in small or overcrowded accommodation or people in rural or remote areas with limited broadband). All workers may find that working from home increases loneliness and decreases mental wellbeing but this may be particularly challenging for men or women living alone or disabled people with a past history of mental health illness.

Guidance also encourages employers to ensure that the organisational culture is inclusive, with the aim that every employee should feel that they are working within or returning to a supportive, caring and safe environment. The pandemic has had an unequal impact across the workforce, as different employee groups, and individuals, will have been affected in diverse ways according to factors such as their job role, and demographic / personal circumstances. Lessons learnt from outbreak situations in Scotland highlights there is a risk of victimisation of those infected, suspected, or more at risk to the worst effects of COVID-19. Therefore, it is important that organisations foster a fair and inclusive working environment that does not tolerate discrimination.

Shopping, Eating and Drinking Out

Phase 3 included the substantial easing of indoor operations including non-essential shops in shopping centres; indoor hospitality; as well as hairdressers, barbers and personal retail services, such as beauticians. This will have had positive financial impacts for businesses and for workers in these sectors, as well as positive impacts for people who are consoled by a return towards aspects of normal life. Young people, women and socio-economically disadvantaged people are more likely to work in retail, personal retail, and the hospitality industry and will likely feel the benefit of this.

However, the risk of COVID-19 infection and transmission in the community also increased the negative impact on people more susceptible to severe illness and the negative impact on community confidence in welcoming visitors. Busier streets and town centres, one way shopping systems, potential queuing or a lack of observance of physical distancing may all have raised anxiety for some older people or disabled people, or deterred some from going out if they are unable to stand for long periods. Likewise many workers responsible for hygiene and sanitation in shops, as well as personal retail services and customer facing staff, may have had specific anxieties about returning to work due to the risk of infection and transmission within their households if they are at higher risk. This depends on individuals but could include older, disabled, and minority ethnic people.

Retail sector guidance^[23] was published and regularly reviewed. The guidance advises retailers to undertake a risk assessment prior to opening to determine necessary actions and adjustments. An operational guide for retailers is provided with the guidance to aid retailers in conducting their assessments. This operational guide can be arranged in an alternative guidance format, such a braille, or community language on request. Scottish Government is working with a Minister-led Retail Guidance Sub-group comprising of trade unions, leadership bodies and regulators to collaboratively develop and review the guidance and tackle challenges.

The evidence gathered alongside ongoing dialogue with stakeholders will help to inform thinking as to how the proposals may need to be adjusted to remove barriers or disadvantages for particular equality groups, or people in poverty, to better advance equality or to foster good relations.

All shops in Phase 3 required the mandatory wearing of face coverings to reduce the health risks posed by the virus. Negative impacts have been noted for some groups - for example, disabled people, including people with sight or hearing loss - who may find that face coverings create new communication barriers; older people with advancing dementia or Alzheimer’s may also struggle to understand or accept the requirement. Legislation allows for face coverings not to be worn in certain circumstances - such as where a person cannot put on, wear or remove a face covering because of any physical or mental illness or impairment, or without severe distress, or where it would hinder communication with a person who has communication difficulties due to the mask.

As of 9 October additional restrictions were brought in to try to contain the virus which again closed parts of hospitality provision. Licensed premises in the central belt (the protected area) were required to close and to stop selling food or drink for consumption on their premises. Unlicensed premises (e.g. cafes) in the central belt (the protected area) were only allowed to open from 6am to 6pm. Hospitality premises outside the central belt were required to close indoor areas from 6pm to 6am and outdoor areas from 10pm to 6am. There were some exceptions to these requirements, for example, for marriages and civil partnerships and funerals. For five health boards all pubs and restaurants selling alcohol were closed. This will have heightened the issues noted above for businesses and people working in these sectors.

Sport, Culture and Leisure Activities

Phase 3 included the opening of a range of sport, culture and leisure activities under varying timescales. Museums, galleries, monuments, libraries, various other visitor attractions, cinemas (including drive-ins and venues screening films), fun-fairs, amusement arcades, and bingo halls were opened with physical distancing and other measures (e.g. ticketing in advance). Live events indoors and outdoors were due to open at a later stage in Phase 3 but had not opened when the Strategic Management Framework came into effect.

The opening of activities will have had benefits for people who normally use these services, as well as for people who work in them, who will see a boost to their household income. This will be different depending on the activity. For example, the opening of libraries will be positive for older people, young people and children, lone parents, disabled people, and the socio-economically disadvantaged. All of these groups tend to make greater use of libraries and library resources including access to the internet and e-readers. However, local authorities were tasked with opening libraries in a phased manner as they responded to safety and hygiene measures as appropriate to their local circumstances. Access to facilities may therefore vary for different people and different places depending on local arrangements.

Increased use of facilities will have increased jobs and household income. However it also slightly increases the risks of community virus transmission which may impact more on people working in public facing roles.

In terms of sport, organised outdoor contact sports, play and physical activity resumed for children and young people under 18 (subject to guidance) on 13 July. This earlier easing recognised the positive impacts of physical activity on the health and wellbeing of children and young people, allowing them to enjoy their summer holiday and providing carers - especially those working from home - with some respite.

Non-professional organised adult outdoor contact sports were permitted to resume from 24 August, subject to sports governing bodies agreed guidance with sportscotland. Indoor leisure facilities, including gyms and swimming pools, were able to reopen from 31 August. Children under 12 were able to play contact sports in these facilities from this date, with those aged 12 and over only permitted to undertake non-contact sport and physical activity.

Indoor contact sports for those aged 12 has not recommenced. For young people and adults, the delay to this resuming will have been disappointing for those who regularly participate in indoor contact sport (young people). It may also have had negative financial impacts on related clubs, businesses and employees who work in the sector.

Inequalities in access to sport that were apparent pre-COVID-19 remain with children, young people and adults from more deprived areas less likely to participate in sport. SportEngland Covid Survey^[24] indicates that certain groups have found it more difficult to keep active, certainly during the early stages of the pandemic – including older people and those on low incomes, people self-isolating due to age or a health condition. There is also a concern that reopening facilities will have a further differential effect in terms of reticence by those groups who may feel more at risk (older people, those with long term health conditions, lower socio-economic status) who may initially be reluctant to return to such facilities and sports.

Organised sports are more likely to have participation costs that may act as a barrier to people who are financially struggling. Opening up sport could exacerbate these differences, especially given the current constraints on public transport. Sportscotland is encouraging further guidance on inclusive sport from sporting regulator bodies.

In general, national guidance has been developed to provide support to the sport and leisure sector to help them plan and prepare for the resumption of activity. In addition, sportscotland is supporting the Scottish governing bodies of sport and local partners to plan for the return of sport and to develop specific guidance for their sports. This has included facilitating scenario planning based on the Scottish Government Decision Making Framework and Route Map and a template with prompts to facilitate planning, including inclusivity, communicating with participants and ensuring that information on plans for restarting and safe opportunities within the parameters of physical distancing are followed. There is also an operational guide and checklist to sit alongside the guidance that we recommend operators follow to ensure that the health and safety of workers and participants is protected.

All holiday accommodation was permitted to reopen subject to a range of physical distancing rules and guidance. This allowed individuals and families to have a holiday break in Scotland, positively impacting on the wellbeing of visitors. Socio-economically disadvantaged people are less likely to take such breaks and will benefit less from this measure. Risks of transmission of the virus will be mitigated through adherence to the sector guidance which was published on 18 June, as well as through work to encourage the responsible and considerate behaviour of visitors. Some communities and residents (particularly those in tenements / flats with shared entrance-ways and remote communities) have expressed concern about the reopening of tourism and the attendant risk of increased visitors from other places and further virus transmission. The reopening may create local anxiety and concern, particularly among those who are at greater risk of severe illness (older people, some disabled people, and some minority ethnic people, who are more likely to live in flats).

The return of tourism helped businesses and workers in the sector start to earn income from the season. The tourism sector is a significant employer across Scotland employing 184,000 people, constituting 6.9% of Scottish employment.^[25] Relative to other sectors, tourism workers are disproportionately young, from ethnic minorities, non-UK nationals, low-skilled, low-paid or work part-time on temporary contracts. Women are slightly more likely than men to work in the industry. Reopening will not have addressed any of these structural issues but will provide some short term financial relief.

Community and Public Services

Crime victimisation varies across the population and therefore any changes in offending patterns as restrictions are eased may have a disproportionate impact on different groups. For example, racially aggravated crimes are the most commonly reported hate crime. There is no equivalent hate crime law for sexism or misogyny for women to use^[26], so these crimes are likely to not be reported, even though a disproportionate number of victims of certain crimes (e.g. stalking, domestic abuse, sexual offending) are women. The likelihood of experiencing crime is much higher for socio-economically disadvantaged people. Disabled people are more likely to be the victims of crime^[27] and also of requiring help with civil justice issues.

Phase 3 has seen the resumption of further solemn and summary cases in both Sheriff and High Courts. High Court trials restarted on 20 July in Edinburgh and 21 July in Glasgow in new formats designed to ensure a safe and secure process for all involved; in accordance with public health guidelines on physical distancing and hygiene. Remote jury centres based in cinema complexes are now being used as of 28 September. Further consideration has been given to the introduction of remote jury centres. As noted in the impact assessments for previous phases, COVID-19 has impacted key potential human rights and equality issues around delays to courts and tribunals and conditions within prisons. The relevant impact assessments have already been completed for underpinning emergency legislation and the Scottish Government is continuing to assess the impact of recovery actions as more details of options are developed.

The significant impacts of delays to court business, in particular, are recognised. A criminal justice evidence base has being developed with stakeholders.^[28] The resumption of more summary and solemn cases in the criminal justice system will start to address these issues. However, while adjustments are being made, there may be further implications e.g. the use of remote hearings may make it more challenging for the court to identify participants that feel vulnerable, and put in place reasonable adjustments to ensure effective participation, and consideration will need to be given as to appropriateness in some types of cases. The Scottish Government and the Scottish Courts and Tribunals Service are working to ensure that early evaluation of new approaches is embedded in the recovery approach carried out to identify any emerging issues and to ensure appropriate mitigation.

Phase 3 eased restrictions allowing face to face youth work to take place. The objective of youth work is to effectively engage people in communities in learning activities to help mitigate the barriers being faced by social disadvantage. Youth work helps to mitigate effects of social isolation and improve mental health and wellbeing, improving opportunities for young people to progress and make informed decisions which positively affect their future. Survey data suggests that it may be younger people who are at greatest risk of loneliness during the pandemic^[29] so this easing of restrictions will be welcomed.

There has also been easing of restrictions for a range of support groups and services which support our most at risk people and communities. At the height of lockdown, the focus was on addressing risk and high priority situations. The relaxation of restrictions on support groups and services has enabled support and contact with a wider range of issue based work whether it is drug or alcohol problems, domestic abuse or for at risk children and families needing support, including those whose needs have been negatively impacted during the crisis. This takes place as part of co-ordinated arrangements between partner agencies, building on the relationships that people already have with services. It is founded on a continuing hybrid model of direct and indirect contact, but services recognise and take account of people who may have been excluded because they have not had access to online and telephone approaches.

Gathering and Occasions

Phase 3 allowed for the reopening of Places of Worship for congregational services, communal prayer and contemplation with physical distancing and limited numbers. This easing of restrictions enabled more individuals to exercise their religious rights within a place of worship. However, not all services and faith based practices have resumed and some restrictions will remain on higher risk activities, such as singing. Additionally, numbers have been limited and two metre physical distancing must continue to be maintained. This may continue to have a negative impact on faiths that have larger catchment areas for an individual place of worship, which ordinarily has a high capacity, such as Muslim and Sikh communities. As of 8 August, face coverings must be worn by all those attending a place of worship, with the exception of the individual leading an act of worship (subject to additional mitigations). This is to minimise interference to the spiritual connection between the congregation and the person leading an act of worship.

Given the negative impacts of closures of Places of Worship on faith communities, the date for re-opening of places of worship was brought forward to 15 July. This decision was taken following discussion with faith communities and working with them to ensure that appropriate mitigations are in place, and guided in particular by evolving scientific and health advice on transmission risks. The economic impact to places of worship has been severe. They are likely to face further costs in relation to the re-configuration of places of worship and implementing hygiene / physical distancing changes.

Phase 3 allowed for the easing of some restrictions on attendance at funerals, marriage ceremonies, civil partnership registrations with physical distancing remaining in place. In all previous phases, funerals were permitted to take place but attendance was limited to close family. Twenty mourners were permitted to attend each funeral from the beginning of Phase 3, with this figure being regularly reviewed.

As part of Phase 3 of Scotland’s framework for easing restrictions in lockdown, it is possible for marriages and civil partnerships to take place indoors as well as outdoors. The easing of restrictions for marriages and civil partnerships enables more individuals to exercise their right to marry and will reduce the impact on those groups most affected by the previous restrictions, including religious and belief organisations. However, there continues to be a limit of 20 on the number of people attending and the guidance should be followed by people planning to get married or form a civil partnership in Scotland, those responsible for venues that may host such events, and the celebrants who conduct them.^[30] From 28 September, where a ceremony or registration is taking place in a private dwelling, the persons participating should include no more than six people, being the couple, the registrar or celebrant, the witnesses and, if required, an interpreter. Ceremonies and registrations should only take place in private dwellings if it is not possible for them to take place in a public place, for example, if a party to the marriage or civil partnership is seriously ill.

The easing of restrictions on funerals and marriages will be beneficial across the protected characteristic groups. People who may have been in a shielding group were strongly advised not to attend public places until 10 September when new guidance came out.^[31] Although some shielders may still be unable or unwilling to attend their Places of Worship for the purpose of worship or to attend marriages or funerals if they do not have sufficient support or still fear catching the virus.

Health and Social Care

In line with the NHS remobilisation plan Remobilise, Recover, Redesign: The framework for NHS Scotland, Phase 3 saw a further expansion of a range of services including screening services, GP practice services, optometry, dentistry, physiotherapy and podiatry, antenatal and postnatal, and district nursing services.^[32] These services had remained open for essential or emergency care but Phase 3 has seen an expansion of services, but in some cases routine care was not normally allowed.

Social care support and assisting people to live independently goes far beyond ‘care visits’ to encompass a wide range of support including community facilities, access to activities, help with shopping, involvement in local groups and interests. All of these aspects of social care help people in leading full and independent lives as valued members of our society. Social care support has wide relevance to both carers and people being cared for, and also has relevance across the different themes. For example, issues around provision of informal care has been discussed under ‘Seeing Family and Friends; while problems in accessing shopping has been discussed in ‘Shopping, Eating and Drinking Out’.

Equality groups impacted by both health and social care support measures will depend on the nature of the service. For example, the restart of breast and cervical cancer screening will positively impact on women whereas other screening, such as Abdominal Aortic Aneurysm, tends to be more beneficial for men; the restart of ante and postnatal services will benefit pregnant women, and women who have just given birth and their partners, whereas podiatry tends to benefit older people and some disabled people.

Details are provided in the Annex but more generally, there are a number of areas where there are common issues:

Communications are essential to alert the population to changes in services and there was recognition that different formats may be needed to be appropriate for protected characteristics and particularly those of race, age and disability. For example, a Communications Action Plan was developed for the further expansion of the screening programmes, led by Public Health Scotland. This included a focus on providing reassurance that it is safe to attend screening appointments when they restarted, and include channels to communicate with a range of equality group audiences. Printed inserts are posted out with screening invitation letters to explain the changes that have taken place in the light of COVID-19 – these were made available in Polish, Arabic, Simplified and Traditional Chinese, BSL, audio and Easy Read. Translated versions of all new and updated materials were also available and promoted through social media channels.

During earlier phases many healthcare services moved to an online platform. This continued in Phase 3 with many digital services supplementing more traditional services. For many these services will be welcome, preventing unnecessary travel, removing anxiety around catching the virus, increasing capacity and opening up broader opportunities for consultation. However, digital exclusion was an important factor for some with older people, disabled people, remote and rural residents, and people from socio-economically disadvantaged backgrounds less likely to have access to the devices or internet (data) to engage with services through this means. Increased opening of medical practices may make it easier for people who would prefer face to face services to communicating remotely.

The changes required to practice premises and ways of working to ensure safety, including continuing to maintain a 2 metre distance, when possible, will continue to reduce the number of patients that practices can safely see face-to-face, compared to pre-COVID-19 levels; this may continue to restrict access for those seeking care.

Older people and disabled people tend to have a wider range of health issues, make greater use of the health and social care support services and are also more likely to be digitally excluded. They were likely to be impacted by a lack of access to routine and normal services and may also be anxious about attending appointments due to the increased risk of severe illness from the virus.

The inability to take a family member or friend for support to appointments is likely to have negatively impacted on many people but particularly those who needed help communicating. Phase 3 allowed some easing, for example, women were allowed to identify one designated visitor to accompany them to scans / antenatal / postnatal appointments. In addition to the birth partner, women could also choose to have one additional person attending the birth and can have their birth partner and one designated visitor visit in antenatal and postnatal wards.