The Scottish Government procures sufficient vaccine to vaccinate all those who are invited to receive the seasonal flu vaccine, in line with uptake planning assumptions. For the adult flu programme, vaccines are procured nationally and as part of the contractual agreement, the Scottish Government receives an end of season credit for the unused vaccine, therefore would not constitute as wastage.

The HPV vaccine is procured centrally and the stock is managed through NHS Board Vaccine Holding Centres. The vaccines are procured in a manner that minimises wastage by placing orders regularly and only holding sufficient stock for programme requirements each month. Holding Centres work closely with school immunisation teams to ensure the correct amount of HPV vaccine is delivered to schools for each setting.

It is not possible for Public Health Scotland to give precise totals for people with those conditions. However, (a) cystic fibrosis, (b) severe asthma, (c) chronic obstructive pulmonary disease (COPD), (d) interstitial lung disease and e) sarcoidosis all fall into the broader “Respiratory” shielding category, which includes other conditions and totals 76,421 patients according to figures published by PHS

21-01-2021.

The Palliative Care Research Forum has been unable to meet in 2020 due to the challenges associated with the Covid -19 pandemic. The Scottish Government remains supportive of the Forum and will work with Forum leads over the coming months to learn from our experiences in the pandemic, and reflect on the role and work of the Forum going forward.

The Scottish Government remains committed to ensuring that people get the palliative and end of life care that is right for their unique circumstances.

Over the coming months, we will be working with key stakeholders to reflect on our experiences during the pandemic and focus on the lessons learned to inform any future palliative and end of life care service development work. Ministers will communicate any decisions regarding service development work to Parliament in due course.

Research work undertaken by the University of Edinburgh and Marie Curie in 2019 found that on average 69% of people had a KIS in place at time of death. The study reported that this was an encouraging improvement on previous years but that more work was needed.

For people to get the care that is right for them, it is important that medical professionals have early and sensitive conversations about their care wishes should the worst happen. That is why from the outset of the pandemic, we encouraged GPs to contact those registered with their practice who may be vulnerable and required to shield to help ensure that appropriate care planning was in place and recorded. Our guidance emphasised the importance of completing a KIS following such discussions to help ensure people get the care that is right for them.

We have also produced further resources and guidance on having Anticipatory Care Planning conversations which we believe will be helpful to GPs in having successful discussions with patients for whom this is appropriate, and allowing them to record the outcome in their KIS.

We want people to be able to receive high quality end of life care in the setting that is most comfortable for them. For most people this will be at home or in a homely setting.

However, there are significant challenges associated with gathering views from those who have had a loved one supported by palliative care services to support further improvement work. These include the difficulty in gathering a suitable sample size to make the findings useful for service improvement, the need to put in place support arrangements for those contacted, and most significantly the ethical requirement for the benefit of those findings to outweigh the distress caused by surveying the families of the recently deceased. This a particularly important consideration during the pandemic.

As part of our wider work to learn from experiences during the pandemic, we are working with Public Health Scotland and other key stakeholders to identify options on how best to establish a more coherent picture of the quality of end of life care, which can also be used for improving future service delivery.

This information is not collected centrally.

The Key Information Summary (KIS) is a collection of information, extracted from a patient’s general practice record, that may be helpful to attending medical professionals in providing treatment. As this information is stored via GP systems, it is not possible to centrally collect information in the manner described.

We want people to get the high quality palliative and end of life care and support that is right for them. For most people this will be at home or in a homely setting.

Due to the challenges associated with the pandemic, we are seeing more people being cared for in community and homely settings. That is why throughout this year we have provided additional resource to Integration Authorities to help ensure that those being cared for in community settings can get the care that is right for them.

Most recently, in November 2020, we published our Adult Social Care Winter Preparedness Plan which includes a focus on supporting people to get the care that is right for them when time becomes short. To support this work, we provided Integration Authorities with an additional £72 million to help ensure that those being cared for in the community, including those with palliative care needs, have access to the right services at the right time.

Scottish Government published updated care home visiting guidance on 17 th November and 14 th December which relates to adult care homes including younger adults where they are in an adult care home.

This builds on existing visiting guidance first published in August, which outlines recommendations for safely resuming visiting in a staged way, both by family and friends, as well as those providing spiritual, holistic and physical and mental care and aligned to Scotland’s Strategic Framework Levels.

For younger adults in other types of residential care settings for example supported accommodation, Health Protection Scotland guidance on COVID-19: Information and Guidance for Social, Community and Residential Care Settings applies (excluding Adult and Older People Care Home settings). Infection Prevention and Control Addendums have also been published for both Care Homes and Community Health and Care settings. The guidance can be found here:

1. https://www.hps.scot.nhs.uk/web-resources-container/covid-19-information-and-guidance-for-social-community-and-residential-care-settings/

2. National Infection Prevention and Control Manual: Home (scot.nhs.uk)

We are hugely grateful to the efforts of dedicated NHS staff as they continue to respond to the pandemic. On 30 November 2020, as a thank you for the outstanding efforts of NHS staff in these most challenging times, the First Minister announced a one-off pro-rata thank you payment.

I meet regularly with the Royal College of Nursing through their role in STAC Secretariat, most recently on the 30 December 2020, where all issues related to pay can be discussed. I remain absolutely committed to securing a pay settlement for 2021/22 that is fair, affordable, and sustainable and my officials are working with employers and staff side to agree an approach and timetable for securing a pay deal for NHS Agenda for Change staff in 2021/22.

Nurses in Scotland are the best paid in the UK. In 2020/21, nurses received a 2.95% pay rise as part of the current three-year NHS Agenda for Change pay deal, which has delivered a minimum 9% pay increase for most staff, and over 27% for some still moving up their pay scale. This is in excess of the 1.67% pay uplift for NHS England nurses.

The Scottish Government is doing everything it can to ensure we have sufficient numbers of staff on the ground who are well supported in these challenging times. Since September 2006, Qualified Nurses & Midwives (including Interns) have increased by 8.7%, or 3,564.5 WTE, from 41,026.2 WTE to 44,590.7 WTE. We continue to work with health boards to ensure that nurses receive the clinical professional support they require, and that psychological and wellbeing support is in place at both local and national levels. These measures include the National Wellbeing Hub and a National 24hr phone line for NHS and social care staff.