Coronavirus (COVID-19) digital health and care response: 2021 update

COVID-19 Digital Response

In March 2020, the Digital Health and Care Directorate undertook rapid prioritisation and engagement work.

Teams working across the Scottish Government Directorates worked with colleagues across the health and care, third and independent care sectors and industry, to develop and deploy solutions and to recycle learning into service delivery. These included:

• Test and Protect.
• Extending sampling centres.
• Public engagement and communication.
• Restriction of movement.
• Treatment.

The Scottish Government team has taken a lead on Information Governance, Cyber, and the People's Pathway. NHS National Services Scotland colleagues have taken a lead on the Clinical Authority and Technical Portfolios, and Public Health Scotland is leading on the Data Portfolio.

The benefits of this approach ensured key teams were actively involved in programme delivery and resources were shared by taking a more collaborative approach.

Products delivered by the using this approach are:

• National Vaccination Scheduling Service (NVSS).
• Albasoft and GPIT – played a key role in obtaining data out from GPIT systems into the NCDS.
• Cohort data for scheduling.
• Clinical Portal (Orion).
• Vaccination Management Tool (VMT) – developed by NES Digital.
• National Clinical Data Store (NCDS) – developed by NES Digital.

This section contains further information on the background of the following programmes:

• Test, Trace and Isolate – later referred to as Test & Protect.
• Check In Scotland.
• Proximity App.
• Symptom Checker App for NHS24.
• COVID-19 Vaccination Programme.

Test and Protect

There are a number of strands of work which contrite to this development. In April 2020, the Digital Health & Care Innovation Centre published a Rapid Review of Contact Tracing Methods for COVID-19 followed by Global Examples of COVID-19 Surveillance Technologies: Flash Report.

Wider collaboration on data flows and privacy by design took place. New models for enhanced engagement were adopted with the public and interested groups including:

• The Open Rights Group.
• The Scottish Privacy Forum.
• The Children's Parliament.
• Young Scot.

An example of the way in which Transparency information is being used is provided on the Test and Protect website.

Check In Scotland

The Check In Scotland App is another tool in NHS Scotland's Test and Protect Service. It is a digital support designed to help businesses, for example, entertainment, leisure or cultural venues, to collect information for contact tracing purposes. The service will allow people visiting participating locations to provide their contact details by scanning the official Test & Protect Check In Scotland QR code poster via their smartphone camera or by downloading the Check In Scotland app. The details collected are held in an encrypted data store for 21 days only.

Unless information is requested by public health officials as part of their contact tracing efforts, visitor data is automatically deleted thereafter.

Proximity App

In September 2020, the Protect Scotland App was launched as free to download. Within 24 hours the App had been downloaded 600,000 times and by Summer 2021, it had over 2 million downloads. The Protect Scotland App is an anonymous digital contact tracing tool that acts in addition to manual contact tracing and uses the same Public Health Scotland definition of a close proximity contact – 2 metres or less for 15 minutes or more. The App does not store an individual user's details or location. It uses encrypted, anonymised codes exchanged between smartphones to determine all close contacts.

Using a process to calculate individual risk of exposure based on two parameters or questions:

• Was the contact two metres or closer for a period of 15 minutes or more (which can be accumulated over a 24-hour period)?
• Was the contact during the infectious period of the person that tested positive (defined as 2 days before the onset of symptoms or, for those with no symptoms, 2 days before their test date)?

For more information about Protect Scotland select How it Works | Protect Scotland.

NHS24 Symptom Checker App

The Directorate team supported our partners at NHS24, who deliver the public-facing information and guidance in our national response to deliver a Symptom Checker App.

The content on the free to download App provides accessible, mobile and up-to-date information which is derived from NHS Inform.

COVID-19 Vaccination Programme

It is useful to set the context for this activity. Immunisation policy in Scotland is determined by Scottish Ministers and follows advice from the Joint Committee of Vaccination and Immunisation (JCVI) and other appropriate bodies.^[15] The JCVI advises the UK Government and the NHS in the four nations about all aspects of immunisation; and supports implementation of all immunisation programmes.

The complexity of the data flows and information systems used across boundaries between all NHS Scotland organisations and beyond (e.g., care homes, Social Security Agency, Armed Forces etc.) presents particular challenges to be managed when dealing with a response of this scale. The strategic planning and decisions have been translated into specific priorities and areas of work within the COVID-19 programmes, including Test & Protect, Vaccinations and Certifications.

A UK-wide Information Governance group, with four-nations collaboration, has been operating throughout this period to reach agreement on COVID-19 joint work required to ensure fair, secure and lawful sharing of data between devolved nations and the UK Government. The work has been focused on data-sharing required for testing and the Test, Trace and Isolate programme, Proximity Apps, Data Privacy, etc.

The role of the Flu Vaccines and COVID-19 Vaccinations Delivery Programme (FVCV) is to ensure the readiness of Scotland for the implementation of the flu vaccination programme and the delivery of a COVID-19 vaccination as per recommendations by the Joint Committee for Vaccinations and Immunisations (JCVI) and Scottish Government (SG). The FVCV Programme is made up of 9 core workstreams, one of which is Digital & Data (D&D).

The FVCV Digital & Data Delivery Board will retain a focus on planning across the workstream, to help ensure:

• Approval and sign-off of key items across the workstream to progress work.
• Coordination across the workstreams, four thematic portfolios –
  • Assurance
  • Technical
  • People Pathway
  • Data.
• Links into the main FVCV Programme are made and maintained.
• Products are identified, designed, and deployed in a coordinated and joined-up way.
• Live product enquiries will be coordinated through the Operational Board.
• Links and connections with the Operational Board are maintained.

Self-Registration Example

Whilst the majority of invitations to receive a vaccination have been delivered to citizens via letters, a small part of the roll out of the vaccination invitation has been the self-registration service offered to unpaid carers who may have the risk of transmission of the virus to the person or people for whom they provide care. In this model, unpaid carers access the self-registration services or use the national helpline. At registration, they are asked for their preference for contact. Registration is confirmed by receipt of an SMS text or email. The self-registration service for unpaid carers enabled around 200,000 people to identify themselves as carers. The unpaid carer self-registration service is an example of how technology across multiple platforms and organizations can be used to improve service delivery and citizen experience.