The Scottish Government must focus on transforming health and social care services to address the growing cost of the NHS and its recovery from Covid-19.
Improving the NHS will be very difficult against the competing demands of the pandemic and an increasing number of other policy initiatives, including plans for a National Care Service.
The health service in Scotland is on an emergency footing and remains under severe pressure. There is a growing backlog of patients waiting much longer for treatment because of the response needed to Covid-19. That has made workforce planning and delivering on ambitious recruitment plans all the more important. But the Scottish Government has historically struggled to recruit enough people with the right skills.
The NHS’s ability to plan remains hindered by a lack of robust and reliable data, including workforce, primary care, community, social care, and health inequalities data.
Meanwhile the pandemic has increased the fiscal pressures on the NHS, which remains financially unsustainable. This is despite the Scottish Government allocating £2.9 billion for pandemic-related costs in 2020/21 and committing more funding in 2021/22 and beyond.
Stephen Boyle, Auditor General for Scotland, said: “Reforming the NHS is key to the Scottish Government’s pandemic recovery plan and needs to remain a priority. Putting Covid costs to one side, health spending is rising every year, meaning less money for other public services.
“There’s now a clear opportunity to do things differently by building on the innovation and collaboration we’ve seen across the NHS in the last few years.
“For that to happen, our leaders must take the public with them and involve them in the shift from care being delivered in hospitals to much closer to people’s homes. But better-informed policy decisions and services won’t be possible without better collection and use of data.”
Public Health Scotland (PHS) has published an analysis of the latest available data on alcohol sales and harms in Scotland during the COVID-19 pandemic. This provides a picture of how the pandemic and its related restrictions may have impacted on alcohol sales, alcohol-related hospital stays and alcohol-specific deaths.
Presenting data on alcohol sales up to 8 May 2021, and previously published data on hospital stays up to 31 March 2021 and deaths up to 31 December 2020, the report shows that while rates of hospital stay related to alcohol fell, rates of alcohol-specific death increased. This was driven by an increase in deaths in men and those aged 45 to 64 years, groups that experienced the highest rates of deaths caused by alcohol prior to the pandemic.
This is despite total alcohol sales (litres of pure alcohol per adult) being 9% lower in 2020 than the 2017-19 annual average, and 16% lower in 2021 (January–May) than the average for January–May 2017-19. While sales of alcohol through supermarkets and shops (off-trade) increased during the pandemic, sales through pubs, clubs and restaurants (on-trade) decreased substantially due to the restrictions imposed because of the pandemic.
This, combined with other evidence of how alcohol consumption may have changed during the pandemic, suggests that drinking at hazardous and harmful levels may have increased for some groups who potentially experienced higher rates of mortality as a consequence.
Lucie Giles, Public Health Intelligence Principal at Public Health Scotland said:“The data show that the number of people accessing hospital with an alcohol-related diagnosis fell during the pandemic, particularly at times when restrictions were at their most stringent.
“We saw the greatest reductions amongst men and those aged 45 years and over and it was in these same groups that we saw increases in deaths caused by alcohol. This was despite average alcohol consumption for the population falling, a change driven by a reduction in sales of alcohol through pubs and clubs.
“Despite the reduction in sales overall the data indicate that population level consumption of alcohol was still above recommended levels. Between March 2020 and May 2021, 17 units (171 ml) of pure alcohol have been sold per adult each week on average, 16 (162 ml) of which have been from off-trade premises. This represents enough alcohol to put every adult in Scotland over the Chief Medical Officer’s low-risk weekly drinking guideline of 14 units.
“Taken together, the evidence points to increased drinking amongst some groups, coupled with a reduction in the number of people accessing hospital treatment and greater rates of death caused by alcohol. Tackling alcohol consumption and harms, particularly among high-risk groups, should be a critical objective of any COVID-19 recovery plans.”
Matt Lambert, CEO of the Portman Group– the alcohol social responsibility body and marketing regulator – said: “Public Health Scotland’s latest data reaffirms a body of research that shows overall alcohol consumption fell during 2020.
“Yet in contrast alcohol-related deaths tragically increased which may in part be due to the heaviest drinkers finding it harder to access support. There is a duty of care to now focus on targeted measures for the minority, those who were already drinking at the heaviest and most harmful rates, who then increased their drinking as the impact of the pandemic compounded existing problems.
“Finally, we would be interested to understand why this report focuses on alcohol sales while downplaying the Scottish Government’s own studies on actual alcohol consumption that shows a persistent fall in drinking rates for over a decade.
“With the majority of people in Scotland drinking an average of 12.1 units a week, below the CMO low risk guidelines of 14 units per week, it is important to view drinking rates accurately and address this within policy making.”
Alcohol sales and harm in Scotland during the COVID-19 pandemic
Regular physical activity is strongly associated with a reduced risk of chronic conditions, such as cardiovascular disease, obesity and type 2 diabetes as well as improving mental health. Even small increases in physical activity can positively impact on health. Heart Research UK have some tips to help you keep active.
Avoid long periods of inactivity Set a timer to go off at specific times throughout the day to prompt you to do ten (or more) minutes of physical activity. Any activity is better than none. You can include a variety of light, moderate and vigorous activities. E.g. a brisk walk, sit-ups, weight-lifting, gardening or housework.
Reduce screen time for kids It is common for children and young people to spend too much time sitting in front of a screen. Why not talk to your children about the importance of staying active and agree on a set amount of screen time each day/week and schedule in some time for getting active.
Don’t be a couch potato Rather than spending your evenings sitting on the sofa without moving much, why not try a few gentle exercises, such as leg raises, while watching your favourite TV show. Try opening YouTube and searching for a quick 10- or 20-minute workout video.
Change your daily commute Now that many of us are heading back to the workplace, try not to jump straight for the car as the main choice of travel. If you do need to drive to work, then why not park a little further away once you arrive in order to get some valuable steps in.
Experts come together to support the one in five Scots with persistent pain
Stacey Wilson has never been one to shy away from a challenge – competing for Scotland in throwing sports and athletics up until the age of 23 – but the PE teacher from Edinburgh didn’t expect to face her hardest one at age 27, when debilitating back pain changed her life forever.
Immediately after giving birth to her daughter Sadie, now seven, Stacey began experiencing excruciating pain in her back. The ‘flare-ups’, as she refers to them, last between four and six weeks and have blighted Stacey’s life ever since, resulting in hospitalisation, expensive healthcare treatments, time off work and her even having to learn to walk again.
Most traumatising for the mother of two is the impact her pain has had on her children.
Stacey recalls: “My back pain started straight after having my daughter, despite having a really healthy pregnancy. It meant I couldn’t fully enjoy being a new mother as I was in constant pain, very fatigued and had continual brain fog.
“After having my little boy, Clark, four years ago, I also remember being blue-lighted to the hospital in agony. He was just a few months old, and I was waiting for 10 hours to be seen, expressing breast milk in the hospital cubicle and then being told to ‘go home and make an appointment with my doctor for the morning.’
“I couldn’t move and had to be lifted and laid down in the back of my dad’s cab to be taken home – it was an horrific experience that has stayed with me to this day.”
Despite being proactive about her health and paying out thousands of pounds on private healthcare treatments, including cupping and acupuncture, Stacey was frustrated she wasn’t being listened to. “I felt like I was hitting my head off a brick wall,” she explains. “I asked to join a pain management programme three times to try and regain some control, but I kept being rejected for a place – with no feedback about why.”
After eventually getting onto a pain management programme, the 34-year-old from Gilmerton hasn’t had a severe flare-up in four years.
Stacey now manages her pain with tried and tested techniques and coping strategies including Pilates and regular physiotherapy sessions.
She is sharing her story in a bid to help others like her, who live with chronic pain. Chronic or persistent pain affects 20% of Scots and is defined as pain that lasts for longer than 12 weeks, despite medication or treatment.
Running in February and March, people from across Scotland will have the opportunity to get advice, guidance and hear real-life stories about living with chronic pain from world-leading pain experts, panels of people who live with it and specialist health professionals, through a series of free-to-attend events.
The events – designed specifically for those affected by persistent pain – will be delivered as live webinars which can be watched back by those who are unable to attend on the day.
Led by the Flippin’ Pain™ public health movement in partnership with NHS Scotland and the Scottish Government, the series is one of 13 Scottish Government-funded projects made available via the Chronic Pain Winter Support Fund. They aim to improve access to care and deliver better health outcomes for people with chronic pain in Scotland.
Internationally acclaimed pain scientist and the world’s leading pain educator, Professor Lorimer Moseley, will lead the first event: ‘Rethinking Pain: new understanding and new possibilities.’
Professor Moseley spearheads the ‘Pain Revolution’ movement throughout Australia, has 300 published research articles, is author of six books and presented a series of Ted X Talks, putting him at the forefront of thinking in contemporary pain science.
Chronic pain can affect many aspects of day-to-day life and can be associated with depression, anxiety, fatigue and sleep issues. People with chronic pain are also more likely to report lower life satisfaction and poorer quality of life compared to those without the condition.
Public Health Minister Maree Todd explains: “Living with chronic pain is extremely challenging, which is why the Scottish Government is committed to ensuring patients can access the support they need, when they need it.
“We are running a public consultation on a new Framework for Pain Management Services with the aim of improving the care and quality of life for people with chronic pain.
“I am pleased to see projects like this one, funded through our Chronic Pain Winter Support Fund, to boost the support available for people with chronic pain to help them maintain their health and wellbeing over the months ahead.”
Richard Pell, campaign director for Flippin’ Pain™ concludes: “Understanding pain is so important. Our understanding of pain – why it’s there, why it behaves the way it does and why it sometimes doesn’t go away – influence what we do about it and even how it feels.
“Many long-held beliefs about pain are hugely out of step with modern scientific understanding. People deserve better. People are suffering more than they should, losing control and seeing their quality of life deteriorate.
“I urge people living with pain, their friends and family too, to engage with the events and to do so with an open mind. Flipping your understanding of pain won’t take pain away overnight – but with time it can be transformative and has been the first step on the road to recovery for many.”
Leading Scottish care home group, Renaissance Care, has set out plans to increase inclusivity and security among its workforce.
The Group, which operates 16 care homes throughout Scotland with over 1,200 staff, launched the initiative in January with a commitment to supplying sanitary items for female staff in all its facilities with the provision of sanitary towels and tampons in all staff bathrooms.
The move is part of the group’s efforts to create a safe and happy working environment and comes following calls from The British Medical Association for these essentials to be accessible to all healthcare staff throughout Scotland.
Corinne Morrison-Gillies, Interim People Services, said: “Sanitary items are not a luxury; they are a necessity and should be treated as such by employers. The nature of our job in the care sector means our staff do not have regular working patterns therefore can easily be caught off guard by their menstrual cycle, adding undue pressure to what can be a challenging job.
“Our staff work incredibly hard, and the last thing they should have to worry about is having access to, what we consider, bare essentials. By having free period products available in all our care homes we hope to remove barriers and create an open and safe working environment for our employees.”
Renaissance Care Group has a strong people service strategy which focuses on learning and development for individual staff members, as well as onus on creating a person-centered culture of inclusivity and care.
A Glasgow nurse who has had two babies during the pandemic, is urging other mums-to-be to follow her lead and get their COVID vaccinations.
Ali Hair, who is a nurse on a surgical ward at the Queen Elizabeth University Hospital is mum to Solomon (17 months) and three-month-old Iris.
When she was pregnant with her son there were no vaccines available but Ali jumped at the chance to get one in January 2021. She had her second in March when she was a few weeks pregnant with Iris, followed by her booster in September.
Ali said: “Pregnancy is a very worrying time, but even more so in a pandemic. But I had no hesitation in getting my vaccinations, to protect me, my baby, my family and of course my patients. It’s not new technology; we have had flu jags for years. It’s just a different vaccine and there is strong evidence behind it.
“Pregnant women are at risk of becoming sicker with the virus than other women of the same age and many have been hospitalised. Some have even had to be delivered early and that’s never something you want.
Baby Iris was born on 4 November and Ali started tandem breastfeeding her two babies.
Ali said: “I’m not sure if that was the reason but myself and the babies managed to escape catching COVID at Christmas when our whole family got together. My partner Christopher also escaped it. Twelve out of sixteen people got it, but we were fine.
“I do understand why some women may have reservations as pregnancy is a worrying time, but it was the right decision for me and my family and made me feel protected.”
NHSGGC Director of Public Health, Linda de Caestecker said: “We encourage all pregnant women to get their vaccinations – it’s the best protection you can get for you and your baby.
“The vaccine is safe for women at any stage of pregnancy or breastfeeding so please come forward for jabs if not already protected.”
92% of UK farmers under the age of 40 rank poor mental health as the biggest hidden problem facing farmers today, a recent study by the Farm Safety Foundation reveals.
· Mental wellbeing levels in the next generation of farmers have fallen over the past year, the study also finds.
· 36% of farmers in the UK admit to being “possibly” or “probably” depressed according to another industry survey.
· 44 suicides were registered in England and Wales in 2020 for those working in farming according to the Office of National Statistics.
· This week’s campaign from the Farm Safety Foundation will remind those living and working in the industry to Mind Your Head.
2020 and 2021 proved incredibly challenging for the UK’s farming industry. There were extreme weather conditions, poor harvests, supply chain shortages and a global pandemic to contend with but, through it all, farming endured as it always does.
Over the past two years, the UK’s farmers have been recognised as key workers. Their hard work puts food on our plates, produced to some of the highest standards in the world, and their careful stewardship knits together the environmental and social fabric of our iconic landscape.
The UK’s farmers are a remarkable breed; adaptable, resilient and incredibly hardworking but, the commitment of our farmers comes at a price.
In an industry that continues to have the poorest safety record of any occupation in the UK, making sure we are all looking after our physical and mental wellbeing has never been more relevant. So, from 14th – 18th February 2022, leading farm safety charity, the Farm Safety Foundation (also known as Yellow Wellies) will launch their fifth annual Mind Your Head campaign to illustrate actions being taken to break down mental health barriers in farming.
A recent study by the Foundation revealed that mental health issues among farmers and agricultural workers are of growing concern and are having a direct impact on safety on farms. With 92% of farmers under the age of 40 suggesting poor mental health is the biggest hidden problem facing farmers today (an increase from 82% in 2018).
Whether or not the number of suicides has increased as a result of the pandemic is a matter for experts and should not be speculated on.
According to Professor Louis Appleby, Professor of Psychiatry, University of Manchester and Chair of the national advisory group on suicide prevention at the Department of Health and Social Care: “Figures like these are important in understanding the tragedy of suicide.
“They are not dry data, they are real lives lost, real families devastated. No figure, whether high or low, is acceptable. We need to beware of alarming claims and predictions without evidence – misleading and potentially harmful to those in the industry who are already struggling.”
Stephanie Berkeley, Manager of the Farm Safety Foundationsaid: “As an industry, I think it is time we deal with the issue of poor mental health head on. We need to talk about our feelings and let everyone living and working in farming know that it’s completely ok to have feelings, good and bad, but it’s also important to let them out.
“Life isn’t always as it seems, we don’t post on social media about the days that we wished we didn’t get out of bed or the days we didn’t feel like it.
“Most people feel the pressure to keep up with everyone’s ‘perfect’ life. My father always advised me to never judge anyone unless you walked in their shoes, these are words that I live by, as it is important to know what is really going on behind the smile, or even their grumpy demeanour.
“Many living and working in rural communities are suffering and doing so in silence. As an industry, it’s time to ease the pressure, stop expecting people to be perfect and start talking openly about feelings with people you trust.”
Today is Valentine’s Day – a day when many show their affection by sending cards, flowers or chocolates with messages of love. This Valentine’s Day, the Farm Safety Foundation is reminding farmers that self-love is important too.
Stephanie added: “A day like Valentine’s Day which celebrates love and togetherness can often highlight how different, alone or low we feel so it is important to check in with yourself and others and reach out to those who may be feeling down, lonely or struggling.
“Whatever it is that you choose to do, just know that your mental health should never be ignored and you are not alone.”
The recent R.A.B.I Big Farming Survey revealed that 36% of the farming community in the UK are ‘probably’ or ‘possibly’ depressed and sadly, the stigma around mental health often prevents those who need help from seeking it.
So, for the next five days, key farming organisations from five countries will join forces to support the Foundation’s Mind Your Head campaign and try to dispel the myths and tackle the stigma around poor mental health in the industry and highlight the wealth of support available to those living and working in farming.
BBC’s Strictly winner, actor Kelvin Fletcher, who last year bought a 120-acre farm in the Peak District is supporting the 2022 Mind Your Head campaign.
As a new entrant to the industry, Kelvin appreciates the many challenges facing farmers at present and the importance of looking after your mental wellbeing at work.
Kevin says: “I feel really privileged to have been welcomed so warmly by the farming community, who have supported me so much since I started my farm last year. Before joining farming, I had no idea the community was so heavily impacted by bad mental health.
“Campaigns like Mind Your Head are so important if we’re going to chip away at the stigma that surrounds mental illness in the industry. If one person reads about Mind Your Head and decides to reach out or to check in on a loved one, that’s a step in the right direction.
“Please, be that person and start the conversation. You never know how much it could mean to someone struggling silently.”
For more information on the Mind Your Head campaign or to learn more about how the Farm Safety Foundation is tackling the issue of poor mental health in the agricultural industry please visit www.yellowwellies.org or follow them on social media – @yellowwelliesUK on Twitter, Facebook, Instagram and YouTube using the hashtag #MindYourHead
Valentine’s Day is almost here! If you’re thinking of going for the easy option with a trip to the pub this February 14th, the love of your life may be a little downhearted.
Make a promise to think about your heart this Valentine’s Day with just a few healthier choices that can also be romantic too. Here are a few tips from us:
Massage
A relaxing spa day or couples massage is always a romantic option for Valentine’s Day. Massage has shown to improve blood flow and has shown promise as an adjunctive treatment for prehypertension and hypertension. Not to mention massage has shown to reduce stress levels and improve quality of life.
A Cheeky Dance
Dancing with someone special on your arm is sure to get your heart pumping, whether it’s a disco down at your local club or a spontaneous TikTok in the living room. A good boogie lifts your mood, makes you smile and gets the cheeks flushed. So, dim down the lights, set the tone and get your groove on.
Weekend Away
February is officially the last of the winter months so get out there and make the most of the fresh crisp air. Many parts of the UK have a frosty dusting on the rolling hills of the beautiful British countryside. Strap up your hiking boots, grab your partner’s hand and take your hearts to new heights.
Serve Oysters
Oysters have a historical reputation for being eaten in romantic situations. Though scientific evidence cannot prove eating them will improve your sex drive, it is known that oysters contain all 9 essential amino acids; they’re rich in protein, minerals, and omega-3 fatty acids.
The love of your life might be priceless to you, but remember your heart is priceless too.
A consultation has revealed strong support for proposals to establish a National Care Service accountable to Scottish ministers.
More than three-quarters (77%) of people who responded to the official consultation thought the main benefit of the proposed change would be more consistent outcomes for people accessing care and support across Scotland.
Meanwhile more than two-thirds (72%) of those responding agreed that the Scottish Government should be accountable for the delivery of social care through a National Care Service.
There were over 1200 responses to the consultation.
An analysis of responses from individuals and organisations on plans was published yesterday, following publication of the individual responses last week. The responses also highlight the risks which could emerge from such significant reform, but the need for change in the immediate and longer term is a key theme.
The consultation process represents the first phase of engagement for the National Care Service programme.
Social Care Minister Kevin Stewart said: “We will consider all views expressed in the consultation very carefully and I would like to thank all those who took part. It is clear that there is a real appetite for change.
“We will continue to engage with people with lived experience of the service whether they are people accessing care and support, their families, care workers or providers.
“The final scope of the National Care Service has not yet been concluded. Over the coming weeks, we will have the opportunity to reflect on these views of the public. We will then be in a position to bring forward the detailed plans for improvement to be undertaken over the course of this Parliament.
“However we are not waiting to act to enhance Scotland’s social care services that’s why we invested £300 million to help deal with winter pressures, and we’re determined to go further.
“We are committed to acting now to improve things for people. I am therefore delighted to announce today that we will develop and publish a standalone Carer’s Strategy with a focus on Covid recovery and improving carer support in a meaningful and sustainable way. We will engage with unpaid carers about its scope and purpose in the coming months to inform its development.
“Our aim will be to draw on the knowledge and lived experience of unpaid carers so that the strategy is shaped by those who best understand the many challenges faced.
“We will seek to publish the strategy by late spring to provide a clear vision for how we will respond to the challenges faced by so many carers.”
The public consultation attracted nearly 1,300 responses, from around 703 individuals and just over 575 organisations. A significant proportion of the responses came from individuals with lived experience, or bodies that represent them.
The social care workforce are also well represented in the responses, along with providers
Actions taken to support immediate improvements on social care include:
Investing £300 million of winter pressures funding in October, to maximise the capacity of the NHS and social care system this winter and in particular to bolster the caring workforce by increasing their numbers, providing them with additional support
Making additional funding of up to £48 million available to enable employers to provide an uplift to the hourly rate of pay for staff offering direct care within Adult Social Care to a minimum £10.02 per hour from the 1 December 2021
An additional £4 million to expand support for unpaid carers this winter, including to enable them to take breaks from caring
Developing options to remove non-residential charging as soon as possible
The mental health of pregnant women, new mothers and their families, including those affected by miscarriage, stillbirth and the death of an infant, has been highlighted by a Scottish Parliament Committee.
The Health, Social Care and Sport Committee’s inquiry into women’s mental health experiences before, during and after the birth of a child (otherwise referred to as the perinatal period) highlights a number of issues faced by new mothers over the support they have received, particularly during the pandemic.
In particular, the inquiry found there was a sharp rise in birth trauma incidences reported since the pandemic began. The Committee calls on the Scottish Government and NHS Boards to redouble their focus on delivering services that directly address birth trauma.
The Committee also looked into the of support for those suffering from miscarriage, stillbirth or death of an infant. During its inquiry, the Committee received evidence of some women affected by baby loss who reported being treated close to women giving birth to healthy babies, causing additional trauma to the women affected.
The report calls for accelerated action to establish specialist baby loss units and, in the meantime, for new national protocols to be set up “that ensure families affected by baby loss are consistently treated with respect and compassion and in a trauma-informed way”.
Alongside a focus on community care, the Committee also examined access to specialist Mother and Baby Units (MBUs), of which there are currently two in Scotland. The Committee emphasises the benefits of providing wider access to MBUs for new mothers with complex needs and they express support for the creation of a new MBU serving the north of Scotland.
Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said:“Up to 20% of women in Scotland experience negative mental health impacts before, during and after giving birth and the aim of our inquiry was to shine a spotlight on this important issue and to see what more should be done to support these women.
“We heard of concerns in certain health board areas with the support structure in place for parents and families impacted by miscarriage, still birth and the death of an infant, and feel more action is needed to give them appropriate support.
“We had discussions with some new parents affected by baby loss who felt they didn’t receive the standard of care they are entitled to expect. That is why we are calling for every effort to be made to accelerate the establishment of specialist baby loss units
“The evidence we received suggests that during the pandemic, there was a sharp rise in incidences of birth trauma. In many instances this was a direct result of COVID-related restrictions, which limited the support women were able to receive from partners and families before, during and after giving birth.
“Our inquiry heard about the benefits of Mother and Baby Units for women who have complex mental health issues in the perinatal period and the Committee would like to see a concerted effort to widen access to these units in conjunction with the community care offer.
“We think there is a strong case to set up a new Mother and Baby Unit serving the north of Scotland but we also need to focus on issues around staffing, resources and general awareness to maximise the positive impact of perinatal mental health services and third sector organisations who support mothers.”
The Convener added:
“The extensive evidence we have gathered during the course of this inquiry has shown the importance of a preventative and community based approach to perinatal mental health. It is clear that only through accessible, joined up care across both the third sector and statutory services, women and families can get the care they need at this critical time.
“We’d like to put on record our thanks to all of the women who spoke with us and shared their stories.”
Other findings in the report include:
• concern that many women and families are currently having to wait longer than 6 weeks to access perinatal mental health support;
• the increased barriers faced by women and families from minority ethnic backgrounds, or for whom English is not their first language, and those from particularly vulnerable or at risk groups, to access perinatal mental health services;
• the critical role that stigma plays in perinatal mental health and the resulting reluctance for individuals to fully engage with healthcare professionals;
• a call for the Scottish Government to ensure further education institutions deliver perinatal mental health training as core training for all midwifery and nursing students as a priority.
