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

6. Mental Health and Wellbeing and ongoing information, advice and support

6.1 With regard to mitigating any mental health and wellbeing concerns of those on the highest risk list with protected characteristics and/or from disadvantaged socio-economic groups associated with the removal of the HRL, we will continue to provide evidence and reassurance.

6.2 The Chief Medical Officer has written to everyone on the Highest Risk List to:

• explain the decision to end the Highest Risk List
• set out the identification process the NHS will retain to quickly identify people who should be prioritised for vaccination, treatments and, if the threat level increases, for additional protective advice
• ask them to follow the same advice in relation to COVID-19 as the rest of the population, unless advised otherwise by their GP or clinician.

6.3 Two different versions of the Chief Medical Officer letter have been issued, one version to those on the Highest Risk List who are no longer considered to be Highest Risk, and a separate version to those on the Highest Risk List who may still be considered at higher risk as a result of being unable to mount a full immune response due to their health condition and/or treatment, which will give any final advice needed.

6.4 Letters are available to be translated into any format and language needed. On each occasion, we produce 60 different variants of the letters, translated into 'Easy Read', large print, BSL, alongside several languages such as Urdu, Cantonese and Mandarin^[63]. All direct communications with individuals on the HRL have been made available in these different formats throughout the pandemic.

6.5 We carried out user testing on letters/messages around the ending of the HRL with people on the List (aiming to be as representative and include protected characteristics as possible with small sample numbers for qualitative work) to ensure they were understood and accessible.

6.6 We have published an evidence review^[64] to show how the vaccination programme has made a significant difference. GPs, clinicians and third sector organisations which support people with the range of conditions which have put them on the HRL will be able to use the Review to underpin discussions about risk with individual patients and people they support.

6.7 The evidence review and the letter from the CMO should help to address any clinical concerns of people on the Highest Risk List, with protected characteristics for example disabilities and/or from disadvantaged socio-economic groups, to understand they are no longer at highest risk and can get back to a more normal way of life.

6.8 As before the pandemic, people who are immunosuppressed or immunocompromised can get advice from their GP or clinician on how best to protect themselves, including reminding family and friends not to visit or come into close contact with them if they're unwell.

6.9 We have published two sets of guidance around the ending of the HRL. The first guidance is specifically for people who remain at higher risk because of suppressed immune system, and includes information on vaccination, testing and treatments as well as mental health support^[65]. The second guidance is for people who are on Scotland's Highest Risk List but who are no longer considered to be at higher risk that the general population^[66].

6.10 We have carried out engagement with various medical charity stakeholders to ensure they are fully briefed and able to respond to questions and concerns from people they represent in relation to the ending of the HRL. Details of stakeholders who we have engaged with can be found in Annex 2.

6.11 We are also exploring with delivery partners in local authorities and health and social care partnerships what more we can do to support people who have been on the HRL to recover and reconnect with people and things they were doing before the pandemic. Third sector partners are also crucial in providing support, exemplified by the British Red Cross Connecting with You Service. Funded through the Social Isolation and Loneliness Fund, this service is open to anyone experiencing issues with loneliness but has been targeted at those on the HRL to provide one-to-one support to remake those connections.

6.12 We have and will continue to provide advice about daily life including shopping and going to work and have encouraged employers to consider the needs of those on the HRL as they implement flexible and hybrid working. We have developed workplace guidance specifically for people at highest risk, including support to get back to working, at mygov.scot/covid-highest-risk/work. In addition to safety at work advice, this highlights services and support to help people return to work or re-skill and find new work.