Coronavirus (COVID-19) Highest Risk (formerly Shielding) List end: equality and fairer Scotland impact assessment

2. Policy Background

2.1 At the beginning of the COVID-19 pandemic, the four Chief Medical Officers across the UK agreed a range of treatments and health conditions^[1] which they believed, at that point based on the available evidence at the time, would place people at higher risk of severe illness or death if they caught the virus. In March 2020, people who were identified as being most likely to be at highest risk were advised to 'shield' or stay indoors and added to a Shielding List. This shielding period lasted until 31 July 2020. The Scottish Government, with partners, provided emergency support during this period, including access to food and medicines, and communicated advice and support through letters from the Chief Medical Officer (CMO), online guidance and via a text messaging service.

2.2 From October 2020, the CMO provided additional advice about daily interactions such as working, shopping, transport and social contacts, aligned to the five protection levels introduced by the first Strategic Framework.

2.3 In January 2021, when Scotland went back into lockdown, everyone on the Shielding List who could not work from home was advised not to go into the workplace or use public transport until this lockdown was lifted on 26 April 2021.

2.4 In July 2021, we changed the name of the Shielding List to the Highest Risk List (HRL) to reflect the fact that it was extremely unlikely we would ask people to shield again. People on the HRL were advised that they could follow the same advice as the rest of the population, unless advised otherwise by their GP or clinician. This has been the advice to this group since that time.

2.5 Although people have not been advised to shield since July 2020, we know from user research^[2] and a more recent survey by Public Health Scotland (PHS) of people on the HRL^[3] that although seven in ten (71%) respondents reported they are less afraid of COVID-19 infection since they have been fully vaccinated, 81% agreed with the statement that they still make decisions that are mainly driven by fear of COVID-19 infection and 36% still try to minimise all physical contact with other households.

2.6 At its peak, over 184,000 people were on the Highest Risk List (HRL). As of 4 April 2022, there were 176,292 people on the Highest Risk List, around 3.2% of the population. (The composition of the Highest Risk List as of 4 April 2022 is set out in Appendix 1.)

2.7 This decision has been based upon clinical evidence and discussions with external stakeholders in Scotland. It has sought to use existing and emerging information and evidence and analysis, as part and parcel of the decision making process.

2.8 There has been discussion and dialogue with a group of medical experts (the Clinical Advisory Group for Scotland, or CLAGS, led by Dr John Harden) which has shaped this decision. In addition Scottish Government has also sought the views of other external organisations where possible these have included organisations representing disabled people, older people, women, minority ethnic people, etc. In spring 2021 we also actively sought to encourage people with these protected characteristics to join the group of people who were willing to participate in user research , and collected equality data. Our 'research participant list', increased in this period from 3,758 people to 6,429.

2.9 The Scottish Government has considered the evidence gathered and the inputs provided, both in implementation of the HRL and in the ending of the HRL. This in turn will help in the consideration of the existing and potential impacts – negative and positive – that this decision might have on each of the protected characteristics. It is recognised that the equality duty is not just about negating or mitigating negative impacts, as we also have a positive duty to promote equality. Therefore it should be recognised that mitigating actions do not stand alone and form part of that wider consideration of the duty.

2.10 Specifically, this EQIA assesses any impacts of applying a proposed new or revised policy or practice against the needs relevant to a public authority's duty to meet the public sector equality duty.

2.11 The needs are to:

• Eliminate discrimination, harassment and victimisation
• Advance equality of opportunity
• Foster good relations