Public Health Scotland – Page 6 – The NEN

Public Health Scotland supports retaining uplift to Universal credit

Public Health Scotland supports retaining the £20 a week uplift to universal credit and working tax credits, brought in by the UK Government in April 2020, to help create a Scotland where everybody thrives.

The social security top-up payment was introduced in April 2020 to help low-income households deal with the economic impact of the COVID-19 pandemic, and is due to expire in October.

The evidence is becoming stronger that increasing the incomes of the poorest, including by increasing means-tested benefits, can help narrow the gap in life expectancy and improve mental health and wellbeing.

All of those families affected claiming working tax credits are already in employment, as are 35% of people claiming universal credit. Another 31% of people claiming universal credit have health problems or caring responsibilities which compromise their ability to secure and retain jobs. Therefore, focusing on getting people into work, in itself, will not be sufficient.

Martin Taulbut, Public Health Intelligence Adviser at Public Health Scotland said: “People with higher incomes are healthier and live longer. Experiencing material hardship can have a profound direct impact on health by affecting our ability to buy the goods and services that support good health and underpin healthy life expectancy.

“The increase in value of universal credit and tax credits has reduced poverty, protecting the physical and mental health of low-income families and supporting working-age adults’ ability to find and keep good work. Decreasing the value of means-tested benefits is likely to result in a decline in the (already poor) health of the unemployed and low-income families, particularly after the experiences of the COVID-19 pandemic.

“As well as enabling families to live healthier lives now, action taken to improve and protect the health of children from early in life pays dividends for decades. By embedding health and wellbeing into policy decisions across areas of economy, employment and mental health, Scotland has an opportunity to make real progress on national outcomes.”

Missed appointment? Rebook or attend any drop-in clinic

If you can’t make your COVID-19 vaccination appointment due to self-isolation, you can rebook your appointment at http://invitations.vacs.nhs.scot or attend any of the drop-in locations listed here: http://nhsinform.scot/vaccinedropinclinics….

Stroke Association responds to Improvent Programme report

The Stroke Association has responded to Public Health Scotland’s Scottish Stroke Improvement Programme report 2021 which was published this week.

John Watson, Director Scotland of the Stroke Association said: “Two things leapt out to me in reading “The Scottish Stroke Improvement Programme annual report 2021″ launched today.

“First of all I am struck by how well stroke care teams around Scotland have managed to maintain specialist care and treatment to patients, in the face of unprecedented challenges. Those teams deserve our thanks and respect.

“Of more concern was the reduction in the number of people coming into hospital with the signs of stroke. Although we are not fully sure why this is the case, it is presumed in this report that it has been due to a fear of hospital admission – likely due to hesitancy and fear of contracting COVID-19.

“This is a concern to us because stroke is a medical emergency and it’s essential to call 999 straight away if you suspect you or someone around you is having a stroke.

“We continue to urge the public to use the world-famous stroke acronym, “FAST”, to familiarise themselves with the signs and symptoms of a stroke: Face, Arms, Speech and Time (to call an ambulance) – Act FAST.

“FAST remains an important message that both we and others continue to promote.

“The Scottish Government recognised pre-pandemic that stroke needed significant improvement and made welcome commitments towards that. We are pleased to see increasing awareness of the signs of a stroke is included, alongside commitments relating to improved hospital care. We look forward to seeing further progress on those commitments in the coming months.”

For more information on FAST, go to: https://www.stroke.org.uk/what-is-stroke/what-are-the-symptoms-of-stroke

A link to the summary and full report:

https://publichealthscotland.scot/publications/scottish-stroke-improvement-programme/scottish-stroke-improvement-programme-2021-national-report/

NHS Lothian appeal to students changing address

Students changing address should register for their vaccination at http://nhsinform.scot/under30register by 4 June.

You can change the date, time and location of your appointment online if still in the same health board area, or by calling the helpline if in a different health board area.

Student writings show what life is really like living in poverty

A new, powerful collection of writing has highlighted the lived experiences of people living with, and tackling, poverty in their communities.

Disturbing yet timely, this collection of writing from students of the Health Issues in the Community course (HIIC) reveals the corrosive effect that poverty and inequality are having on a day-to-day basis in modern Scotland.

As a society that believes in compassion and justice, the writings act as a call to action to address inequalities and the increasing number of people being swept up in the wake of crushing poverty.

Public health specialists have drawn attention to the serious impact inequalities have – made even worse by the global health crisis brought on by the Covid-19 pandemic.

Amidst the grim picture that is so minutely described, the writings are also witness to the power of community, of kindness, of the sense of ‘the commonweal’ that is alive in our communities.

Broadcaster and journalist Lesley Riddoch, who provided the publication’s foreword, said: “From all the grimness of lockdown and the staleness of news comes this wee gem of a collection – words from folk who live at the sharp end of life in Scotland.

“I’ve no doubt that the folk involved in this HIIC course will use the insights and comradeship they’ve gained to start moving mountains – while taking care of one another.”

Health Issues in the Community is an SQA-accredited course for adults and young people that helps students understand what affects their health and the health of their communities.

Running for more than 20 years, HIIC brings a community development approach to tackling health inequalities and reaches more than 300 participants each year.

HIIC is managed by the Community Health Exchange (CHEX) and funded by Public Health Scotland. You can learn more about HIIC here.

While the HIIC course encourages participants to widen and deepen awareness of health issues in their communities and their involvement, we cannot solve this issue alone. Political action is required by governments to ensure Scotland is no longer defined by poverty and inequality in the 21st century.

These writings provide the voices of lived experience to help make that a reality.

Fiona Garven, Director of the Scottish Community Development Centre, said: “These students’ writings are a stark reminder of the impact of poverty in communities across Scotland – and the power of people coming together to take action on the things that are important to them.

“With a firm foundation in community development practice, HIIC has been tackling health and social issues for more than 20 years. These writings act as further evidence for community-led responses to health inequalities, enabling students to explore and take action to address their own health issues and the health of their communities.”

Bill Gray, Organisational Lead, Public Health Scotland said: “Public Health Scotland is proud to have supported the development of the HIIC course and recognises the need to listen to voices from our communities has never been more important.

“Our Strategic Plan sets out a clear ambition to embed engagement with communities across all of our programmes of work and the experiences of HIIC participants, set out in this powerful new publication is an invaluable resource for anyone working to address health inequalities in Scotland.”

WritingAboutHealthIssuesVol4 Download

Covid: Vaccination of Scotland’s healthcare workers offers some protection against transmission to their household contacts

A study of all healthcare workers employed by the NHS in Scotland and their households, shows that the rate of infection with Covid-19 for people that live with healthcare workers is at least 30% lower when the worker has been vaccinated mostly with a single dose.

Since household members of healthcare workers can also be infected via other people (not just via the healthcare worker they live with), this 30% relative risk reduction is an underestimate of the ‘true’ effect of vaccination on transmission.

Research led by Public Health Scotland and the University of Glasgow (with contributions from researchers at the London School of Hygiene and Tropical Medicine, Glasgow Caledonian University, the University of Edinburgh, and the University of Strathclyde) involved over 300,000 people in total and ran between 8 December 2020 and 3 March 2021.

The study, using record linkage, compared cases of Covid-19 and hospitalisations due to Covid-19 in household members of both vaccinated, and unvaccinated health care workers.

Where healthcare workers had received a second dose of the vaccine at least 14 days before, their household members had a rate of Covid-19 which was at least 54% lower than household members where healthcare workers had not been vaccinated.

While the study was not designed to examine the uptake of vaccination among healthcare workers, current work does suggest that at least some patient facing healthcare workers, particularly younger staff and those not in high exposure roles, may not have been vaccinated yet.

PHS hope that these findings would give them extra encouragement to be vaccinated, as it suggests that the vaccine offers protection not only to themselves but also to their close contacts. Any patient-facing healthcare worker who has not yet been vaccinated should contact their local health board.

Public Health Scotland will be publishing more definitive results on vaccination uptake in patient-facing healthcare workers on our daily dashboard later today (Friday 12 March).

Dr Diane Stockton, PHS Lead for COVID-19 Vaccination Surveillance Programme, said: “The results from this study as part of our vaccine effectiveness work, are very encouraging because it suggests that the vaccine helps prevent people from passing on the virus to others – something that has been suspected but hasn’t previously been shown.

“Despite this good news, it is important to remember that infection prevention and control practices in healthcare settings remain of paramount importance, as do the mitigations to prevent spread in our daily lives. The risk of transmission did not go down to zero after the healthcare worker was vaccinated.

“As Scotland continues to deliver its national Covid-19 vaccination programme, this study does give one more reason why everyone invited to have a vaccine should take up the offer, as not only will it help protect them from COVID-19, but it will help protect the people close to them.”

Dr David McAllister, University of Glasgow said: “Our study has important implications for informing vaccination strategies. The JCVI in the United Kingdom recently commented on the lack of real-world evidence evaluating the role of vaccination programmes on transmission.

“We provide the first direct evidence that vaccinating individuals working in high-exposure settings reduces the risk to their close contacts – members of their households. Our work will also be of interest to modellers, as it can be used to inform their predictions about future rates of COVID-19 in the community.”

More than 1,500 children have been waiting over a year for mental health treatment

The Scottish Children’s Services Coalition (SCSC), an alliance of leading providers of children’s services, has called for the Scottish Government to urgently increase mental health spend in its budget.

The call comes as new figures published today (2^nd March 2021) from Public Health Scotland indicate that at the end of December 2020, 1,560 children and young people had been waiting over a year for mental health treatment.

These figures are the worst on record and represent a near tripling from December 2019 (589).

The SCSC has urged greatly increased investment in services for children and young people to tackle a current mental health pandemic. It has also called for a ‘national crusade’ as referrals begin to return to pre-lockdown levels.

The call comes amid growing concerns over a ‘lost generation’ of vulnerable children and young people, whose mental health is being impacted by the pandemic. Even prior to the pandemic cases of poor mental health were at unprecedented levels and there are a growing number of vulnerable children who cannot access services.

However, just over 50p in every £100 of the NHS budget is being spent on specialist child and adolescent mental health services (CAMHS). A frighteningly low figure even though mental health services are literally creaking at the seams due to greatly increasing demand.

The figures from Public Health Scotland also indicate that only four Scottish health boards are meeting the Scottish Government’s waiting time target of 18 weeks from referral to treatment over the quarter to December 2020. One out of four individuals are not being seen within this already lengthy 18-week target.

While 4,091 children and young people were treated over the period October to December 2020 by child and adolescent mental health services (CAMHS), only 73.1 per cent were seen within the 18-week waiting target and only four health boards met this target.

In addition, 332 had been waiting over a year prior to treatment, compared with 272 in the same quarter the previous year.

The SCSC has warned that mental health services will face an overwhelming and unprecedented pressure due to pent-up demand created by the Covid-19 lockdown, coupled with a cut in youth support services. This could potentially lead to a ‘lost generation’ of vulnerable children and young people who are missing out on the support they vitally need.

The SCSC has also called for a renewed focus on prevention and early intervention and greater partnership working between the public, private and third sector. The coalition has also urged that greater awareness is made of the services on offer, especially those at a community level.

A spokesperson for the SCSC commented: “These latest figures are deeply troubling and point to a highly challenging environment for both our young people and our mental health services.

“We welcome the fact that the Scottish Government is intending to invest more than £1.1 billion in mental health services overall, but significantly greater funding is needed to address the current crisis facing our children and young people.

“While referrals are beginning to return to pre-lockdown levels, it is vital that children and families are provided with the support they so desperately need, especially given the impact of the pandemic on mental health. The fact that more than 1,500 of our most vulnerable children have been waiting more than a year for treatment in this respect is deeply disturbing.

“We would urge the Scottish Government to look to not just the NHS, but the third sector and other private sector organisations to play a key role in this, renewing its focus on prevention and early intervention.

“Our mental health services must receive the funding they vitally need or we face having a ‘lost generation’ of vulnerable children and young people.”

Concern over urgent cancer referral numbers in NHS Lothian

Lothian MSP and Co-chair of the Cancer Cross Party Group at the Scottish Parliament, Miles Briggs, has warned about the drop in urgent cancer referrals over the last six months in NHS Lothian.

Public Health Scotland figures released this week showed that over the last two quarters (ending June 20 and September 20) 484 and 463, 947 total, were urgently referred for and received a cancer treatment.

This compares to the same six months last year (ending June 19 and September 19) when 591 and 616, 1207 total, patients were urgently referred for and received a cancer treatment.

This is equivalent to 21.5%, or just over a fifth, fewer patients being urgently referred and receiving treatment for cancer in NHS Lothian.

Co-chair of the Cancer Cross Party Group at the Scottish Parliament, Miles Briggs, said:

“This is extremely concerning that there has been such a drop in patients being urgently referred to cancer patients in the last six months.

“Early detection and treatment of cancer is the best way to improve survival rates for cancer and these figures show fewer people are having cancer detected and treated.

“The focus of our National Health Service has been on Covid-19, but people are still going to get ill and it is vital that access to cancer services is available for everyone.”

ENDs…

Table with eligible referrals attached, tab 4e.

https://beta.isdscotland.org/find-publications-and-data/conditions-and-diseases/cancer/cancer-waiting-times/

NHS Lothian – Eligible referrals

62 day standard from receipt of an urgent referral with suspicion of cancer to first treatment

	Dec-18	Mar-19	Jun-19	Sep-19	Dec-19	Mar-20	Jun-20	Sep-20
All Cancer Types*	579	529	591	616	601	605	484	463
All Cancer Types* (screened excluded)	447	414	443	489	447	455	416	449
All Cancer Types* (screened only)	132	115	148	127	154	150	68	14
Breast	201	169	195	173	202	197	132	110
Breast (screened excluded)	92	78	71	67	83	79	76	103
Breast (screened only)	109	91	124	106	119	118	56	7
Cervical	7	8	6	11	6	5	5	5
Cervical (screened excluded)	4	5	4	10	5	5	4	4
Cervical (screened only)	3	3	2	1	1	–	1	1
Colorectal	72	71	79	85	91	103	83	68
Colorectal (screened excluded)	52	50	57	65	57	71	72	62
Colorectal (screened only)	20	21	22	20	34	32	11	6
Head & Neck	29	30	23	34	24	27	24	32
Lung	65	41	57	62	58	54	41	49
Lymphoma	17	14	8	15	12	5	13	17
Melanoma	17	22	43	65	40	22	13	22
Ovarian	4	7	10	8	6	4	10	10
Upper GI	60	54	64	62	62	80	63	64
Urological	107	113	106	101	100	108	100	86

Latest suicide figures are ‘the tip of the iceberg’, says charity

Data from National Records of Scotland (NRS) released yesterday shows that there were 833 probable suicides registered in Scotland in 2019, an increase from 784 in 2018.

Six hundred and twenty men and 213 women took their own lives in 2019, with people aged 45-54 most at risk. People in our poorest areas were also more likely to take their own lives.

This link between deprivation and suicide is well known. Between 2015 and 2019, people living in the most deprived areas were three times more likely to die by suicide compared to those living in the least deprived areas.

Claire Sweeney, Director of Place and Wellbeing at Public Health Scotland said: “Each of these deaths are a tragedy arising from profound distress, and are all preventable. They will have left immeasurable grief across families and communities.

“The unprecedented challenges we have all faced in 2020 perhaps make it easier to understand that anyone can experience mental illness. That’s one of the reasons why Public Health Scotland is prioritising improving mental wellbeing as part of our strategic plan (A Scotland where everybody thrives).

“We will work with our partners to help grow the understanding of levels of suicide in the communities they work with, and more broadly to support better mental wellbeing across Scotland.”

Following the release of these figures the Scottish Public Health Observatory has published supporting information available.

View the report on the ScotPHO website

If you or someone you know are experiencing thoughts of suicide please call Breathing Space on 0800 83 85 87 or Samaritans on 116123.

Responding to Public Health Scotland figures revealing that 833 people died by probable suicide in 2019, a spokesperson for the Scottish Children’s Services Coalition commented: “The statistics highlighting that there were 833 probable suicides registered in Scotland in 2019 is devastating for so many families and only the tip of the iceberg when it comes to highlighting the mental health crisis we are currently in.

“We have for some time called for radical transformation in our mental health services and expressed our concerns over the lack of investment in these for our children and young people. Currently around 50p in every £100 of NHS spending goes to child and adolescent mental health services (CAMHS), and yet we know that one in ten children has a diagnosable mental health problem and that figure is increasing. These problems of course if not addressed carry on into adult life.

“With increased numbers of those experiencing mental health problems, as well as those whose existent conditions are being worsened due to the coronavirus pandemic, coupled with further cuts in services, this points to a mental health crisis ‘perfect storm’.

“While referrals have dropped during lockdown and children are not accessing support, we are storing up immense problems for the future as mental health services face being overwhelmed due to greatly increased demand.

“In addition to the NHS, local authorities, the third sector and other independent organisations play a key role in providing mental health support. Yet these services have seen their resources cut over the years, putting an even greater burden on specialist and costly mental health services. It is vital that they receive increased funding or we face witnessing a ‘lost generation’ of vulnerable children and young people

“Mental health services must be given funding and resources equal to that of physical health provision and this pandemic has ushered in an urgency to deliver on this which cannot be ignored.”

CANCER: ‘If you’re worried – see your GP and get checked out’

Four thousand fewer pathologically confirmed cancer diagnoses in March – June 2020 compared to 2019

As part of the ongoing response to COVID-19, Public Health Scotland provides an overview of changes in health and use of healthcare services during the pandemic.

This week, data on the numbers of people who have had a diagnosis of cancer confirmed using a sample of tissue (a pathologically confirmed cancer) between 1 January and 21 June 2020, compared with how many there were in the same period in 2019 are included in our analysis for the first time.

This information is provided to help inform the ongoing response to COVID-19 and is a subset of the fuller information on cancer incidence in 2020, which is due to be published by the Scottish Cancer Registry in 2022.

The data show that between January and March 2020, the number of people who had a pathological diagnosis of cancer was similar to the number in the same period in 2019.

By the week ending 21 June 2020, around 4,000 fewer people in Scotland had a pathologically confirmed cancer diagnosis than would have been expected.

Between March and June 2020, numbers fell by about 40% of those in 2019. In total, therefore, between January and the end of June 2020, the overall number of patients diagnosed was down by 19% on 2019 figures in the same period.

The fall in numbers is unlikely to be due to a reduced occurrence of cancer, and is likely to reflect a combination of: patients with possible cancer symptoms not seeking out help from their GP (as they may be worried about catching COVID-19); changes to the national screening programmes in the first few months of the pandemic; or reductions in the availability of diagnostic services and treatment during this period.

It is clear that COVID-19 has caused substantial direct and indirect harm to the health of the people of Scotland. As we continue to provide guidance on and evidence for actions to stop the spread of the virus we will also monitor the wider impact it has in our communities.

PHS will do this so that, together with partners in Government, local Government and in Health Boards across Scotland, we can work to protect the health of all of Scotland’s people.

Professor David Morrison, Director of the Scottish Cancer Registry at Public Health Scotland said: “Understanding the impact of the pandemic on health and healthcare services is a crucial part of our efforts to respond to and recover from it.

“As part of the Scottish Cancer Registry’s response we wanted to help understand how cancer diagnoses and cancer services have been affected. The reduction in cancer diagnoses this year gives us a sense of the scale of the impact of COVID-19 on all stages of the journey from first seeking help to recovering from treatment.

“If you’re worried you might have cancer – see your GP and get checked out. It’s probably not cancer – but if it is, the sooner you’re diagnosed, the better your chances of successful treatment.”

To see the further information on the wider impacts of the COVID-19 pandemic on people’s health, and their use of healthcare services, including the data on cancer outlined above, please visit our COVID-19 wider impacts on the health care system web pages.

For information on screening, please visit NHS Inform.