As set out in our strategic framework for the pandemic published on 23 October, our plans to develop the testing element of Test and Protect in the next three months are focussed on building capacity within NHS Scotland and deploying expansions in UK Government testing capacity and capability to its maximum effect in Scotland.

These increases in capacity will primarily be required to meet demand from people with symptoms of Covid, both those infected with Covid, and those with colds or flu, or other illness with similar symptoms and for clinical patient care. As testing capacity builds and in line with clinical and public health priorities identified though the review of our testing strategy, we will also extend routine weekly testing of asymptomatic groups in a way which focusses on protecting those most vulnerable to the most harm, including those at highest risk of mortality.

Further details on the Framework can be found here:

https://www.gov.scot/publications/covid-19-scotlands-strategic-framework/

Regular testing of this type sits alongside other measures such as strong emphasis on symptomatic individuals immediately self-isolating and arranging testing, use of appropriate PPE, physical distancing, environmental optimisation and decontamination and good social hygiene.

The Clinical and Professional Advisory Group (CPAG)is co-chaired by the National Clinical Advisor on Ageing and Health, Chief Medical Officer Directorate, and the Depute Chief Nursing Officer, Chief Nursing Officer Directorate in the Scottish Government.

Group membership includes clinical advisers with expertise in gerontology, nursing, general practice, academia, public health, and representatives from RCPE, RCN, RCPSG. Professional representatives include care home providers, social work, Care Inspectorate, SSSC, Scottish Care and third sector organisations.

The CMO and CNO commissioners have agreed with CPAG chairs an extension of remit to all adult social care and are currently reviewing membership to ensure alignment.

The Clinical and Professional Advisory Group is a multi-disciplinary group of care home providers, clinicians, nursing, GP, social work and social care, scrutiny and third sector representatives which considers and advises on issues during the pandemic. Meeting weekly, all members including workforce representatives have the opportunity to shape the agenda and to inform guidance to the sector, including on visiting. Infection Prevention and Control and visiting focussed sub-groups also include the care home workforce.

The CPAG co-chair and representatives regularly attend a workforce surgery call/ webinars to discuss visiting and clinical and professional practice with Scottish Care members and will continue to engage in a range of ways with the sector.

In the latest reporting week (19 - 25 October) 39,461 care home staff were tested, comprising 5,421 staff in homes with confirmed covid , and 34,101 staff in homes with no cases of confirmed covid . This data is published weekly.

NHS Boards are continuing to closely monitor all cancer referrals, including prostate, to ensure that capacity supports demand and patients can move through their pathway as safely and quickly as possible. Throughout the pandemic urgent cancer care has been prioritised supported by clinical guidance.

To support improvement for overall Cancer services a Recovery Plan is being developed with patients experience at the core and will be published in November. This plan will have an operational focus on diagnosis and treatment in cancer services.

The plan will focus on reducing the inequalities exacerbated by the pandemic and ensure patients are receiving treatment equally across Scotland using a Once for Scotland Approach.

The following table includes all eligible referrals on the 62 day cancer pathway for Urology for each quarter. It should be noted that this data cannot be broken down to specific prostate referrals.

Guidance on organised activities for children was updated on 5 October to allow that when all children in a group are less than 12 months old, and other health and safety criteria are met, groups will now allow up to ten adults to be present at one time.

Complete information on (a) self-referrals and (b) and referrals by each NHS board for residential rehabilitation services is not held centrally.

Information on referrals by Health Boards is not collected centrally. However, data collected for Public Health Scotland’s quarterly, published Drug and Alcohol Treatment Waiting Times reports includes the number of alcohol and drugs residential rehabilitation treatments provided by Health Board area - broken down by “Self-referral” and “Other referral” numbers. This data is sourced from regular reports provided by Alcohol and Drug Partnerships. Information on the number of residential rehabilitation treatments provided by each Health Board area for the last 5 financial years is set out in the following table.

Table 1 – Residential Rehabilitation referrals, for drug and alcohol clients, or clients with a combination of the two, by Health Board of Treatment and Referral Type.

Our Alcohol Framework set out a commitment to engaging in a national social marketing campaign to increase public awareness of the UK Chief Medical Officers’ low-risk drinking guidelines.

We delivered the ‘Count 14’ marketing campaign over two phases, for three weeks in March 2019 and for six weeks through January and February 2020. Count 14 aims to increase awareness of the weekly 14 unit low-risk guidelines and to break down what 14 units means in terms of specific alcoholic drinks.

The campaign included TV, radio, print and digital advertising as well a roadshow in local supermarkets and a range of partnerships. We will publish the results of the campaign in early course.

We are considering how best to build upon our Count 14 campaign in order to further increase awareness and knowledge of safe drinking limits.

The Scottish Government has provided support to vulnerable people in various ways during the Covid-19 lockdown period, and recognises it is just as important now that we continue to make sure support is available and accessible to those that need it.

We have commissioned Public Health Scotland to provide analysis of alcohol sales data for the first six months of 2020 which will provide quantitative consumption data covering the lockdown period. This will help to inform us about the impact of Covid-19 on alcohol and also the potential impact on alcohol treatment services going forward.

During the pandemic, the Scottish Government has worked with a number of organisations addressing alcohol and drug harms. We have provided additional funding of £166,000 to fund activities such as the purchase of equipment to keep people in recovery connected, and increased the hours of our national helpline and webchat facilities. The Scottish Recovery Consortium has issued guidance to enable recovery groups to meet face-to-face where on-line meetings are not possible. I and the Interim Chief Medical Officer, Dr Gregor Smith, wrote to health boards and Integration Authorities on 16 April to ensure the need for continuation of care is prioritised for those with alcohol problems. Additional funding has been made available through NHS Mobilisation Plans to ensure support services remain open and accessible where possible.

Early on in the pandemic, we announced an expansion of the Distress Brief Intervention (DBI) pilot programme, supported by an additional investment of over £1m. In our recent Programme for Government we committed to extend the DBI programme across Scotland, for a transitional period to 2024, at which point we expect it to be fully embedded by boards. We have provided an additional £2.1 million to expand the NHS 24 Mental Health Hub, and £0.5m to expand the capacity of the Breathing Space helpline and web support service for people experiencing low mood, depression or anxiety. In April, we also launched our Clear Your Head campaign, which provides practical advice on how to stay active, keep connected with friends and family, and create healthy routines to help us get through these times.