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.”
The latest weekly update of Emergency Department performance figures for Scotland show:
There were 21,163 attendances at A&E services in NHS Scotland.
67.4% of attendances at A&E services were seen and resulted in a subsequent admission, transfer or discharge within 4 hours.
2,079 patients spent more than 8 hours in an A&E department.
690 patients spent more than 12 hours in an A&E department.
This data shows the worst weekly four-hour performance since records began. The highest number of (weekly) eight hour waits since records began, and the highest number of (weekly) 12-hour waits since records began.
More than one in eight patients were delayed in an Emergency Department by eight hours or more.
Responding to this data, Dr John Thomson, Vice President of the Royal College Emergency Medicine, Scotland, said: “This data is deeply concerning and distressing. More than one in eight patients have been delayed by eight hours or more; this is shocking.
The health service is in the middle of a serious crisis. Staff are working exceptionally hard but are burnt out and overwhelmed and face moral injury on every shift.
Patient safety is frequently compromised. We know long waiting times increase the risk of death and patient harm. The exit block that exists in our Emergency Departments which prevents patients moving in a safe, timely manner to an appropriate ward is worsening, causing even more harm to our patients.
“It is a critical time for the health service, and we must see a vision for the future. The government must acknowledge the shortfall in staff and beds as the root of this crisis, and this must lead to a commitment to publish a long-term workforce plan that includes measures to retain existing staff who may be thinking of leaving our NHS following this exceptionally challenging period.
“The government must also commit to opening 1,000 more acute beds across Boards in Scotland, which will promote timely patient flow through the hospital. Lastly, a key cause of exit block are the patients who remain in hospital when they no longer require ongoing Hospital care.
“The ongoing crisis in social care means patients are unable to be discharged home following the completion of their treatment. It is vital social care is resourced and adequately staffed to support the most vulnerable patients in their return to the community.”
Measures covering indoor events and hospitality to be reviewed in one week
Large outdoor events can resume without physical distancing or capacity limits from 00:01 on Monday 17 January, following a review of all measures in place to limit the spread of coronavirus (COVID-19).
To support the lifting of capacity limits on outdoor events, COVID certification will remain for these where more than 4,000 standing or 10,000 seated are in attendance, and all other events and venues previously covered. Organisers of all events with more than 1,000 attendees will be expected to check a minimum of 50% of attendees for certification of vaccination, exemption, or negative test.
From Monday, a person will need to show they have had a booster to be considered ‘fully vaccinated’ if their last vaccine dose was more than four months ago. The NHS Scotland COVID Status app will be updated from this Thursday and will include booster jags on the QR code for domestic settings. Updated paper and PDF certificates are already available on request from the NHS Inform website or helpline.
Cabinet will next review the state of the epidemic on Tuesday 18 January and consider whether it may be possible to lift capacity caps on indoor live events, including theatre performances and concerts, from 24 January, by which time the impact of the return to schools and workplaces following the festive period should start to show. Cabinet will also consider whether COVID certification should be required in a broader range of settings.
Local authorities will receive up to £5 million of additional support to ensure ventilation in schools and early years settings meets the latest COVID-19 safety guidance.
The funding is to improve air flow, such as adjustments to windows and doors, use of fan systems and use of air cleaning devices in line with existing safety guidance. This is in addition to Scottish Government funding of £10 million provided local authorities for ventilation and CO2 monitoring last year.
First Minister Nicola Sturgeon said: “We remain in a highly challenging phase of the pandemic. Case numbers are high, and the impacts of that are severe, and the future trajectory does remain uncertain at this stage.
“But, because of the efforts we have all made, we are in a better position than I feared would be the case when additional measures were announced in December, and I do hope we are now seeing signs of improvement.
“That is allowing us to start the process from Monday of lifting the additional restrictions – and I hope that next week I will be able to confirm the further steps in that process.
“In the meantime, we can all continue to act in a way that keeps things moving in the right direction. Get fully vaccinated as soon as you can – if you haven’t done so already, please do that and do it this week. Try to limit your contacts for a further period, and prioritise the contacts that matter most to you.
“If you are meeting other people socially, test before you go, every time, as close as possible to the time you will be seeing other people and remember to record the result whether that is positive or negative, and take all the other precautions that make a difference.
“‘Living with the virus’, a phrase that we hear more and more right now, is what we all desperately want to do. Unfortunately it doesn’t mean waking up one morning soon and find that COVID has disappeared or that we no longer need to think at all about mitigating the harm it can do.
“Hopefully, we are on a path from COVID being an epidemic to it becoming endemic – in other words, existing at more manageable and consistent levels.
“These are important issues for not just government, but for all of us – so as we prepare the revised strategic framework in weeks to come, we will consult with Parliament, business organisations and other partners across society.
“Our aim is to publish the revised strategic framework within the next few weeks.”
Scottish Rugby responded:
It’s disappointing news for the arts, however:
IMPORTANT CUSTOMER UPDATE from EDINBURGH PLAYHOUSE
Following the Scottish Government announcement on Tuesday 11 January, in which it was confirmed that indoor seated events continue to be limited to 200, we regret to announce that the following performances scheduled to play at the Edinburgh Playhouse have been postponed:
Waitress: 18th January – 22nd January
If you have tickets to these performances, you do not need to do anything at this time. You will be contacted from your point of purchase in the next few days with next steps.
Performances from 25th January onwards are still scheduled to go ahead as planned and any changes to this will be communicated as soon as possible if restrictions should be extended by the Scottish Government.
We thank you for your continued patience and understanding during this difficult time.
Scottish Fans Ask for a 3 Day Shift
“3 days will Make a Huge Difference”
The Scottish Football Supporters Association thank the First Minister and welcome the news that the cabinet have green lighted a return of fans above the short term limit of 500 imposed on 26th December.
Next week’s Scottish Premier League card can now take place in front of full houses starting with Celtic vs Hibs on Monday 17th and it means the early winter breakdown decision by our top 12 clubs has been commercially justified.
But as it stands the clubs below the Premier League and their fans face another weekend with restricted crowds.
The SFSA are aware that there is no strict science stipulating the 17th as the key restart date and ask that the First Minister, the Sports Minister and Cabinet revisit the decision urgently on behalf of all Scotland’s smaller clubs and their fans.
We ask that the date is brought forward to 14th of January instead of the 17th.
This will allow Ayr United, Dunfermline Athletic, Caledonian Thistle, Raith Rovers, Airdrie, Dumbarton and many other smaller clubs to allow their full fan communities back on Saturday. It will also allow for the top of the table clash in the Championship between Partick Thistle and Kilmarnock to have fans in attendance.
This simple change will bring financial benefits to clubs and communities and is we have been advised low risk.
Andy Smith, Chairman of the SFSA said: “A reprieve will make a huge financial difference to many of our smaller clubs and allow all their fans back and a normal Saturday in many communities.
“Too often Scottish Football overlooks the smaller clubs and their supporters when making big decisions. This is a chance to make a statement that football in Scotland is more than just the Premier League”.
Online portal extended and changes to flu delivery
A range of measures are being introduced to speed up the COVID-19 booster programme, and give protection against the spreading Omicron variant.
The online booking portal will be open to everyone aged 18-29 from 10am this morning, allowing this age group to book booster appointments through the NHS Inform website.
Appointments are being added to the online portal daily and COVID-19 vaccination capacity is being increased over the festive period.
In order to increase the number of appointments, there will also be a prioritisation of booster vaccines over the remainder of the flu programme. This means anyone who is under the age of 65, or not in one of the high risk groups, will receive their COVID-19 booster only. This group will instead be able to get their flu vaccine in the New Year.
In line with advice from the four UK Chief Medical Officers, and in order to improve the flow of people through vaccination centres, people will no longer have to wait 15 minutes after receiving an MRNA vaccine. Instead, in Scotland the programme clinical governance group has recommended there is an observation period of five minutes, reflecting guidance from the Resuscitation Council.
Also, all NHS board areas are working to increase the availability of drop-in clinics – with a particular focus on the over 40s – and to identify larger sites that can be brought online in the coming weeks.
Health Secretary Humza Yousaf said: “The most important thing we can all do to protect ourselves and others from COVID-19 is to get our vaccinations and boosters when eligible. The vaccines we have are highly effective and safe and I urge anyone who is eligible and not yet vaccinated to book an appointment.
“There is a massive national effort underway to ensure that all adults will be able to book a booster appointment before the end of the year. The steps announced by the First Minister today – which are proportionate and based on clinical advice – will help us towards that goal.
“Scotland already has the highest vaccination rate of all UK nations for first, second and third doses and we continue to follow clinical advice from the JCVI on offering booster jags through age cohorts in descending order to ensure maximum benefit.
“Demand for boosters may mean you may have to wait in a queue at drop-in centres but we urge everyone to be patient. We have plenty of supplies and are working with Health Boards to maximise vaccination capacity as quickly and safely as we possibly can.
“The emergence of the Omicron variant means it is also particularly important that we continue to take all precautions to prevent transmission. So test regularly for the virus, particularly before socialising and meeting up with others from outside your household, wear face marks where required and open windows to improve ventilation.”
To use the online portal, individuals will need their unique vaccination username which can be found on any previous appointment letter.
Scotland’s National Clinical Director Jason Leitch is becoming a vaccinator and is encouraging more people to enrol to help accelerate the national booster jab programme.
Since 19 November, the equivalent of 300 full-time additional staff (more than 1000 individuals) have joined the national vaccination effort and health boards are actively recruiting to create extra capacity.
Following the most recent advice from the Joint Committee on Vaccination and Immunisation (JCVI) everyone aged 18 and over who is eligible will be offered a slot for the booster jab by the end of January. Currently those aged 40-49 are invited to make an appointment through the online portal or the national helpline, from 12 weeks after their second dose. The national programme is also delivering second doses to 16 and 17 years olds.
Professor Leitch said: “I am pleased to join the fantastic team at NHS Greater Glasgow and Clyde and look forward to helping administer booster jabs to adults and second doses to 16 and 17 years olds as we continue to protect Scotland’s population as quickly as possible.
“To be a small part of this national mission is a real privilege. It also gives me the opportunity to thank the clinical teams and volunteers who have got us this far.
“This has been the biggest immunisation programme in the history of the NHS and the hard work and commitment shown by health boards and vaccination teams across Scotland means we have the highest vaccination rate for people aged 12 and over of all UK nations for first, second and boosters/third doses and the winter vaccination programme has already delivered more than 2 million booster and third doses to the most vulnerable groups, covering 45% of the adult population (aged 18+).
However, we would warmly welcome any former NHS employees and of course, they will receive full training before giving any vaccines. I’ll be helping when I can alongside my main role.
“Even a shift a week will help, so if you’re a dentist, a nurse, an optometrist or a doctor and you can help us then please contact your local health board. Every vaccine dose given is another step out of the pandemic. If you don’t have a clinical background, it’s not a problem, you can still assist the programme in another capacity through the British Red Cross.
“We have accepted the JCVI’s updated recommendations and aim to offer the booster vaccine to everyone aged 18 or older who is eligible by the end of January, and we would love some more vaccinators to join our incredibly national programme to assist us through this particularly busy period.”
Vaccination Programme Director at NHS Greater Glasgow and Clyde Anne Harkness said: “In the last year, our vaccination team at NHSGGC have administered more than 2.1 million jags, working with the public to protect our communities.
“We are continuing to build our pool of vaccinators and we are delighted to welcome Jason to the vaccination team and wish him – and all the new recruits – well.”
People who wish to apply to become a vaccinator can find more information at NHS Scotland
Volunteers who are not currently involved in COVID response, or other critical work, who would be interested in assisting the COVID response generally and the vaccine programme in particular, can find out more by emailing:
A strategy to deliver world class cancer care for children and young people has been published by the Scottish Government.
Collaborative and Compassionate Cancer Care, the Cancer Strategy for Children and Young People in Scotland 2021-2026, was launched by Health Secretary Humza Yousaf during an online event yesterday.
The strategy highlights 10 priorities for the next five years, supported by almost £6 million investment, which include:
working towards funding genetic testing to provide personally targeted treatment
expanding Chimeric Antigen Receptor T-Cell therapy (CAR-T) to teenagers and young adults
setting up a national molecular radiotherapy service for children
funding a dedicated health workforce to care for teenagers and young adults
raising the profile of supported care services and holistic care
developing a single centre of excellence to provide radiotherapy treatment to improve survival among children with cancer
Mr Yousaf said: “Receiving a cancer diagnosis is never easy, but receiving one at such a young age is especially difficult.
“We know that diagnosis has come a long way, with survival rates remaining stable for children and young people. However there is still more we can do to support this age group to live long, healthy and happy lives.
“This strategy, backed by almost £6 million, marks an exciting time for children and young people’s cancer services as the first strategy for this age group. It outlines our 10 ambitions to build on previous successes so that, by 2026, we will see improved and enhanced outcomes for patients and ensure equal access to care across Scotland.”
Medical Director of NHS Forth Valley Andrew Murray said: “I am delighted to see the launch of Collaborative and Compassionate Cancer Care, after such a challenging period in the NHS Scotland’s history, and I look forward to working with our clinicians and families to deliver its ambitious objectives over the next five years, improving experiences and outcomes.”
The launch was somewhat overshadowed by news that the Scottish Government is calling in the army to help tackle a crisis in the ambulance service – and a Twitter post of a film of Health Minister Humza Yousaf’s unfortunate accident on a scooter.
Talks at advanced stage to take over Edinburgh facility
Hospital parking charges are set to end permanently in Scotland after agreements were reached to buy out two car parks in Glasgow and Dundee operated through PFI (private finance initiative) schemes.
Negotiations are also progressing to take over the last remaining PFI car park in Scotland at Royal Infirmary of Edinburgh, with an agreement expected to be reached in the coming months.
Parking charges have been suspended at the three hospital PFI facilities since the start of the Coronavirus (COVID-19) pandemic. The agreements to take the car parks into public hands will mean this becomes permanent.
The new Scottish Government had pledged to take steps to end hospital parking charges permanently at PFI sites in Scotland during its first 100 days.
Health Secretary Humza Yousaf said: “I am delighted to announce that these facilities will come into public hands and help phase out the legacy of PFI in hospital car parks in Scotland.
“We all owe a huge debt of gratitude to our NHS workforce for their heroic efforts throughout the pandemic and this will ensure that, along with patients and visitors using our hospitals, they will not face the prospect of parking charges returning.
“There are no car parking changes in place at any hospitals after this Scottish Government secured an arrangement to suspend these at the three PFI sites at the start of the pandemic. Charges at other NHS car parks had already been abolished by this Government.
“This announcement shows we are determined to ensure they will not return at any PFI site in Scotland. Talks are progressing well with the owners of the Royal Infirmary of Edinburgh site and I am hopeful of reaching an agreement in due course. As this progresses we will be keeping the car park at the hospital free while the final agreement is reached.”
NHS Lothian Deputy Chief Executive, Jim Crombie said: “We look forward to the completion of negotiations with our PFI provider to end parking charges on our sites permanently and are grateful for the funding that enables staff and patients to continue to park free of charge in the meantime.”
The Scottish Government has provided the funding for NHS Greater Glasgow and Clyde to complete the buyout of the PFI car park contract at Glasgow Royal Infirmary for £26.3 million, taking over the facility. A similar arrangement has been reached for NHS Tayside to buyout of the PFI car park contract at Ninewells in Dundee for £9million.
NHS Tayside Director of Facilities, John Paterson said: “We know that the suspension of car parking charges at Ninewells Hospital has benefited patients, staff and visitors alike and it has made a real difference to those who have come on to our site since March 2020.
“Today’s announcement of the permanent removal of parking charges at Ninewells is welcome news for everyone. We have worked closely with Scottish Government and car park operators Saba UK to achieve this and we are continuing to work with Saba UK to ensure car parks are managed effectively, enabling patients, staff and visitors to park safely at the hospital.“
NHS Greater Glasgow and Clyde Director of Facilities and Estates, Tom Steele said: “We have been working closely with Scottish Government colleagues to remove parking charges for staff, patients and visitors from all of our hospital sites.
“It has been an aim of NHSGGC for some time that our staff can come to work and not be charged to use the parking facilities, so I am really pleased that this work has now concluded and we are able to offer free parking to all staff working at each of our hospitals as well as patients who will be attending to receive treatment and their loved ones who visit them.”
Car parking charges were suspended at the Glasgow Royal Infirmary, the Royal Infirmary of Edinburgh and Ninewells Hospital, Dundee in March 2020 at the beginning of the pandemic.
The Scottish Government has announced a 3% uplift for NHS medical and dental staff, in recognition of their efforts during the pandemic.
This is in line with the recommendation of the independent UK Review Body on Doctors’ and Dentists’ Remuneration.
The pay uplift will be backdated to 1 April 2021.
Health Secretary Humza Yousaf said: “This pay award is in recognition of an exceptional year for all of our NHS workers and reflects the immense value we place on the continued hard work and dedication of medical and dental staff.
“This announcement means that our senior medical staff will continue to be the best paid in the UK. As well as rewarding them for their efforts during the pandemic, it will help to ensure that NHS Scotland remains an attractive employment option for medical and dental staff.”
The announcement covers three main staff groups not covered by the Agenda for Change pay deal – NHS Scotland Medical and Dental (M&D) staff; General Medical Practitioners (GMPs) and General Dental Practitioners (GDPs).
Agenda for Change employees have already been awarded a deal providing minimum pay uplifts of 4% to all but the highest-earning staff.
Dentists: Government must apply full pay award
The British Dental Association has called on the Scottish Government to confirm that the recently announced 3% pay award for dentists will be applied to practitioners’ overall remuneration package to avoid front line staff potentially being left out of pocket and practices struggling to invest to improve care.
Historically in Scotland the recommended uplift has not applied to all dentists allowances and payments, meaning the overall awards often fall short of the pay review body’s recommendations.
Last year the Scottish Government did not apply the recommended 2.8% uplift to practice allowances – which make up around 16% of practice income – leaving an overall increase of less than the review body’s recommendations. The BDA estimates that the net award for that year was around 2.3%.
While one-off support to fund improvements in ventilation has been offered by the Scottish Government, NHS dentists do not routinely receive capital investment. These earnings serve to fund all improvements in equipment, training, and facilities for NHS practices.
Scottish Government officials have stated they will provide details of how the package will operate in due course. The BDA is calling for the 3% uplift to be applied to the full remuneration package.
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said:“The Scottish Government’s announcement has left key questions unanswered.
“This uplift will do little to correct a decade of austerity, and not all of this increase may actually reach dentists, who rely on their earnings to invest in their practices.
“In the recent election, Ministers put dentistry front and centre in their pitch for government. If they are going to deliver on their promises they shouldn’t be short-changing front line practitioners.”
