This data is not routinely collected on death certificates. However, the Scottish Government are working with National Records of Scotland and the Scottish Learning Disability Observatory to ascertain whether the data from death certificates can be linked to the census data to give an indication of deaths related to COVID for people with learning disabilities and autistic people.

The supply of medicines is a matter reserved to the UK Government.

The Scottish Government works with the Department of Health and Social Care, the UK and Scottish Medicines Supply Response Groups (MSRG), Community Pharmacy Scotland and its members and NHS Boards to minimise the impact of supply issues across Scotland.

In September 2019, the Scottish Government, in collaboration with the MSRG (Scotland), introduced a new process to alert community pharmacists, Health Boards and other healthcare professionals about medicine supply shortages.

We are currently aware of a shortage of atracunium, a muscle relaxant used in anaesthesia: an alternative neuromuscular blocking agent, rocuronium, can be used in line with guidance from the Royal Collage of Anaesthetists (RCoA) and the Faculty of Intensive Care Medicine (FICM). The supply of critical care medicines will continue to be closely monitored and managed.

The requested information is not collected or held by the Scottish Government.

Information on (a) how many and (b) what proportion of anaesthetists in each NHS board have been absent from work due to suspected or confirmed COVID-19 is not centrally held by ISD or NES.

The info on Covid absence is published daily and can be found on the following link:

https://www.gov.scot/publications/trends-in-number-of-people-in-hospital-with-confirmed-or-suspected-covid-19/

See ‘Trends in daily COVID-19 data’ – Table 6.

Information on how many (a) anaesthetists and (b) other NHS staff have been redeployed since the start of the COVID-19 outbreak is not held centrally by ISD or NES.

National Boards have been asked to consider where they can return any clinical staff to clinical roles in territorial boards.

The daily and cumulative number of suspected COVID-19 cases in adult care homes is published on the Scottish Government website:

https://www.gov.scot/publications/coronavirus-covid-19-daily-data-for-scotland/ .

The following information is also available:

• Number/ proportion of adult care homes which have lodged at least one notification for suspected COVID-19 to the Care Inspectorate.
• Number of adult care homes which have reported more than one case of suspected COVID-19.
• Number/ percentage of adult care homes which have a current outbreak of suspected COVID-19. This is a care home where at least one care home resident has exhibited symptoms during the last 14 days.

Every Wednesday National Records of Scotland (NRS) publish a weekly report on deaths involving coronavirus (COVID-19) in Scotland. This includes a breakdown of deaths by location, including care homes.

The latest update can be found here: https://www.nrscotland.gov.uk/covid19stats

R is a measure of the average number of people that would be infected by one individual with COVID-19. If R is 2, then two people would be infected by one person on average. It is calculated through modelling of the path of the virus in Scotland. The epidemiological progression in the Scottish Government model is simulated using the publicly available Imperial College COVID-19 model as used for UK level modelling. This uses data on cases and deaths published on the Scottish Government website: https://www.gov.scot/publications/trends-in-number-of-people-in-hospital-with-confirmed-or-suspected-covid-19/ .

Health Protection Scotland is responsible for the community surveillance testing programme which is currently underway. This informs the Scottish Government’s response to Covid-19. The Scottish Government is working with Health Protection Scotland on the dissemination of results once they become available.

A range of improvements and changes were made to local and national influenza pandemic preparedness arrangements since the multi-agency exercise Silver Swan in 2015 and up to January 2020. These are reflected in documents relevant to a pandemic response which have been updated during that period, including:

- Local and regional pandemic response plans which have been kept under review and updated at various points since 2015

- The NHS Standards for Organisational Resilience were published in 2016 and reviewed in 2018

- Guidance on dealing with mass fatalities in Scotland was revised in 2017

- Good Practice Guidance For Setting Up And Managing Body Storage Facilities was issued in 2017

- Guidance on death certification during a pandemic was revised in 2017

- The Scottish Risk Assessment was issued in 2018

- National pandemic response and guidance documentation for health and social care was updated and issued for consultation in 2019.

- Pandemic Influenza Guidance for Infection Prevention and Control was updated in 2019

- Pandemic Influenza Communications Guidance was issued to stakeholders in Scotland in 2019

A point was raised through Exercise Silver Swan regarding assumptions on whether deliveries to NHS Boards would be to central locations or a wider range of delivery points. NHS National Services Scotland core approach to pandemic distribution has remained the same since 2015, in that it is based on delivery to single or multiple points depending on the size and infrastructure of the individual NHS Board.

During the exercise event there was a point raised around modelling allocations to Boards during a pandemic; specifically whether these would be based on proportionate population based allocations or other approaches. NHS National Services Scotland have continued to base their approach on initial allocations to Boards largely based on population size. Subsequent allocations are based on the individual needs of the Board.