Digital consultations have played an important role in allowing people to continue to access appointments during Covid-19 with nearly 17,000 consultations being held each week across Health and Care services. Feedback on using our Near Me video consulting service remains extremely high and in mobilisation plans we have now asked for Health Boards to maintain and build upon this. We would expect a video consultation to take place whenever it is clinically appropriate to do so.

To support its wider uptake and awareness of the service, we are currently in the middle of a public engagement exercise to ensure that we gather feedback on areas where the service is particularly beneficial or where it may not be appropriate for such a consultation and we will use this feedback to adjust our approach to scale up once we have collated the information. The survey can be found here - https://www.nearme.scot/views .

The exact information requested is not available centrally. Public Health Scotland collect social care information directly from Health and Social Care Partnerships; however, it is not possible to identify from this if social care packages have been withdrawn or the reason why a package may have been withdrawn or reduced.

It is possible to estimate the number of people receiving home care services each month and how many hours of home care were received. Table 1 provides this information for January to March 2018. Information for 2018-19 is not yet available.

Table 1. Number of people receiving home care 1 services and total number of hours 2,3,4 of home care by month and Health and Social Care Partnership 2,3,4 , January to March 2018

The information is not held centrally. Data on the number of people admitted to hospitals from care homes is not recorded systematically in the data submissions from NHS Boards to Public Health Scotland (PHS). PHS have analysed and linked a suite of their management information data sources in order to identify people admitted to hospitals from care homes. This analysis was unable to produce reliable answers.

PHS will now work with NHS National Services Scotland, local Health and Social Care authorities (NHS Boards and IJBs) and the Care Inspectorate to improve national information so that these types of questions; as well as ones in relation to patients discharged from hospital to care homes; can be answered in future.

The Scottish Government has been working with partners to explore options for transparent masks and face coverings. Currently, there are no commercially available transparent masks that are certified for use in clinical settings. However, £50,000 of funding from the Scottish Enterprise’s Pivotal Enterprise Resilience Fund (PERF) was recently awarded to an Edinburgh based company to expand its production of face coverings to include coverings with transparent panes, which enable lip-reading. This company is also being supported by the National Manufacturing Institute for Scotland (NMIS) to upgrade these face coverings to type IIR masks suitable for use in clinical settings.

The Scottish Government is aware that when face coverings and face masks are worn there may be additional challenges for those who are deaf or have hearing loss, as well as others with different communication needs. Guidance is being continually updated as to when face masks and face coverings should be use in health and social care settings. The latest guidance on the extended use of face masks recommends that staff working in clinical areas of an adult acute, community hospital or care home for the elderly should wear a medical face mask at all times. However the guidance also stipulates that where necessary and when safe to do so, staff can lower or remove their mask to allow for lip-reading, but must maintain 2m physical distancing. Where physical distancing is not possible, other communication methods should be used.

On 11th June 2020 the Association of Medical Research Charities (AMRC) published on their website an article entitled COVID-19: The risk to AMRC charities.

https://www.amrc.org.uk/covid-19-the-risk-to-amrc-charities .

The published AMRC figures do not distinguish between cancer and other medical research charities.

On 30 th March Cancer Research UK released a press release that referred to an estimated 25 percent drop in fundraising income in FY 2020-21

https://www.cancerresearchuk.org/about-us/cancer-news/press-release/2020-03-30-cancer-research-uk-estimates-25-per-cent-drop-in-fundraising-income-due-to-coronavirus?_ga=2.60513902.2117832912.1593763662-1469902633.1572445696

The impacts of COVID-19 on medical research are being considered by the UK Office for the Strategic Coordination of Health Research Board, which includes representation from the AMRC and the Scottish Government’s Chief Scientist Office through the Chief Scientist for Health as well as from the other UK Health Departments, and UK research councils.

The UK Government has announced on 27 June that, from this autumn, UK universities will be able to access a series of UK Government grants and long-term, low interest loans covering up to 80% of each institution’s income losses caused by a decline in international students, up to the value of non-publicly funded research activity in that university. In addition, around £280 million UK Government funding will be made available to universities and research organisations for costed extensions of UK Research and Innovation and National Academy research projects impacted by the pandemic.

We welcome the recent announcement by the UK Government which builds on the Scottish Government’s commitment last month to provide an additional £75 million to ensure our universities can protect their world-leading research against the financial impact of COVID-19. However, we are concerned about the emphasis on loans in the UK Government’s stabilisation package, as not all universities will be in a position to take advantage of those. We will work with the UK Government not only to agree how this package will be implemented in Scotland, but also to address the long term sustainability of our sector to ensure it plays a key role in Scotland’s economic and social recovery.

Targeted clinical guidance has been issued to support decision making in a range of areas including clinical prioritisation. This includes:

• Clinical and patient guidance disseminated to clinical and oncology teams on the 30 April which has been kept under constant review.
• The Framework for Recovery of Cancer Surgery to assist NHS Scotland prioritise those most in need of cancer treatment.
• Clinical guidance has been published on q(FIT) testing to specifically support decision making for those colorectal cancer symptoms.
• Published Re-mobilise, Recover, Re-design: The Framework for NHS Scotland on 31st May to support clinical decision making as NHS Boards begin to restart paused services. This Framework sets out how NHS Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of services while maintaining COVID-19 capacity, resilience and providing appropriate support for social care.

Throughout the pandemic we have been clear that urgent, emergency, Maternity and Cancer services should continue to be available and that the NHS is open for those who require medical attention.

We have been clear that throughout this pandemic, the NHS is there for those who need it. Our NHS is Open campaign was launched 24 April and we have seen a steady increase in the number of people presenting to their GP practice with symptoms that could be suspicious of cancer – now 86% pre COVID levels.

Our Clinical Director for Scotland, Jason Leitch also made a statement urging patients who have an appointment to attend hospital for these as it will have been deemed clinically safe to do so.

We are working hard to ensure vital and urgent care remains, including the use of private hospitals to treat these NHS patients. By utilising the private sector capacity we are able to provide a COVID free environment for urgent cancer procedures. The Golden Jubilee is also supporting the treatment of urgent cancer patients.

The Data requested by the member is not held centrally by the Scottish Government.

Whilst the majority of cancer treatments have continued throughout this pandemic, some patient’s treatment plans may have changed to minimise their individual risk. Those that require changes will always be done on a clinical basis and will be in discussion with the patient and clinical team.

It has been made clear that vital cancer services should remain where clinically agreed during the Covid-19 pandemic, this includes the use of private hospitals to treat these NHS patients. By utilising the private sector capacity we are able to provide a COVID free environment for urgent cancer procedures. The Golden Jubilee is also supporting the treatment of urgent cancer patients.

The Covid-19 Clinical Guidance Cell has been established by the Chief Medical Officer to rapidly develop and revise guidance on clinical management of COVID-19 for the NHS.

The purpose of the Clinical Guidance Cell is to rapidly prepare guidance for the health and care system in Scotland on the clinical management of COVID-19.

Membership is drawn from key organisations and professional communities across Scotland who have a direct interest. This includes the Scottish Academy of Medical Royal Colleges and Faculties and Health Protection Scotland.

The Scottish Government is also advised by the COVID-19 Advisory Group, which was established to address the need for additional scientific analysis of the impact of COVID-19 in Scotland, based on regularly updated advice and modelling from the UK Scientific Advisory Group for Emergencies (SAGE), and other emerging scientific evidence.

The group is chaired by Professor Andrew Morris, Professor of Medicine at the University of Edinburgh, supported by vice chair, Professor David Crossman, Dean of Medicine at the University of St Andrews and Chief Scientist (Health) at the Scottish Government. Members are public health experts, clinicians and academics spanning the disciplines of epidemiology, virology, public health, behavioural sciences, global health, medicine and statistical modelling. Full details of the group’s membership are available on the Scottish Government’s website at https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/

As part of the Scottish Government response to the COVID-19 pandemic, on 25 th March 2020 the Chief Scientist Office (CSO) launched a call for rapid research in COVID-19. The call attracted 139 individual research project proposals. CSO convened an independent expert panel to review the applications. This panel, which met virtually on 21 April 2020 to consider the applications, comprised 35 expert members from the medical and wider health and social care research sectors and 3 lay members and was co-chaired by Professor Eleanor Davies from the Univeristy of Glasgow and Professor Shaun Treweek from the Univeristy of Aberdeen.

The outcome of the review was that 56 research projects were funded, led by 15 different research institutions from across Scotland. The work funded through this call involves researchers from the medical and wider health and social care research sector. This includes research to:

• Better understand the effects of COVID-19 infection in order to inform treatment and management of disease

• Develop and test new diagnostics and therapeutics

• Investigate novel disease surveillance approaches

• Inform interventions to prevent transmission of infection

• Support the resilience and mental health of frontline health and social care workers

• Understand the physical and mental health implications of social distancing and other restrictions and their impact on the general population and also a number of vulnerable groups

Details of the funded projects are available from the CSO website. https://www.cso.scot.nhs.uk/rapid-research-in-covid-19-programme/

The Scottish Government does not hold this data however vital cancer services have remained throughout the COVID-19 pandemic where clinically agreed. We have been clear that throughout this pandemic, the NHS is there for those who need it most.

To ensure patients are seen based on their clinical priority Health Boards clinical teams have weekly Multi-disciplinary team meetings where patients are reviewed based on clinical risks and individual treatment requirements.

To support Health Boards in treating these urgent cancer patients capacity has also been identified within the Private Sector and the Golden Jubilee National Hospital providing a safe environment for both patients and staff.