Facemasks: Return to pre-pandemic advice for health and social care

People in health and social care settings will no longer be advised to wear facemasks from Tuesday next week (16 May).

The return to pre-pandemic guidance means that mask use will be based on clinical need based on infection prevention and control advice, meaning  staff, patients, service users and visitors will not be routinely asked to wear facemasks in health and social care settings.

It follows a review of the guidance introduced during the Covid-19 pandemic to protect staff, patients, service users and visitors, and recognises that Scotland has entered a calmer phase of the pandemic.

Chief Nursing Officer Alex McMahon said: “Due to the success of vaccines in protecting people, and the availability of treatments, now is the right time to revise the advice on wearing masks in health and social care settings and return to pre-pandemic guidance.

“We recognise that some staff may have concerns around the withdrawal of this guidance and would expect organisations to undertake individual occupational health assessments and risk assessments as appropriate.

“We continue to be vigilant in our response to Covid-19 and encourage everyone to make sure they are up to date with the boosters available to them. We are grateful for the tireless work of health and social care teams during these challenging times and to everyone who has helped them by adhering to the guidance.”

No time to delay: RCEM calls for meeting with new Health Minister

‘The Emergency Care system is not functioning as it should’, RCEM says as Emergency Department performance drops

Responding to the latest Emergency Department performance figures for Scotland for March 2023 Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said: “The data show another drop in performance. This means more patients facing longer waits, more delays to care and more harm.

“We cannot continue to see this occur, we need to be seeing improvements in performance and a reduction in delays to care. This is a signal that the current interventions and actions are not having the time critical impact that we need to be seeing.

“The Scottish Government needs to understand that hesitancy to take the necessary actions will impact on the safety of patients and their care. Emergency care is not functioning as it should, no patient should face a 12-hour wait in an Emergency Department.

“We know what needs to be done: ensuring social care is responsive and able to support the timely discharge of patients; expanding acute bed capacity across Scotland; retaining existing staff while recruiting more staff into Emergency Medicine. These are the solutions laid out in our campaign Five Priorities for UK Governments for #ResuscitatingEmergencyCare.

“We would welcome an opportunity to meet the new Cabinet Secretary for Health and Social Care, Michael Matheson MSP, to put forward these solutions and the means to tackle the crisis in Emergency Care. We cannot consider this to be winter pressure anymore; this is year-round, and it continues to cause harm. We must do better for patients and staff, there is no time to delay.”

The latest performance figures for March 2023 for Emergency Departments across Scotland show:

  • There were 110,446 attendances at major Emergency Departments
  • 64.5% of patients were seen within four-hours at major (Type 1) Emergency Departments
    • This is a decrease of 1.9 percentage points from the previous month, and a decrease of 3.9 percentage points when compared with March 2022
    • 39,253 patients waited over four-hours in major Emergency Departments, this is an increase of 22.3% from the previous month
  • In February 2023, 13,750 (12.4%) patients waited eight-hours or more in an Emergency Department
    • This is an increase of 33.9% from the previous month, February 2023, and the highest figure so far this year
    • When compared with March 2022, this figure has increased by 24.8%
    • This is equal to more than one in eight patients waiting eight-hours or more in a major Emergency Department
  • 5,739 patients waited more than 12-hours before being seen, admitted, discharged, or transferred
    • This figure has increased by 25.6% from the previous month, and an increase of 39% compared with March 2022

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England’s smokers urged to swap cigarettes for vapes in world first scheme

Pregnant women will also be offered financial incentives to help them quit as part of a sweeping package of measures to cut smoking rates in England

One million smokers will be encouraged to swap cigarettes for vapes under a pioneering new “swap to stop” scheme designed to improve the health of the nation and cut smoking rates.

As part of the world-first national scheme, almost one in five of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smokefree by 2030 – reducing smoking rates to 5% or less. Local authorities will be invited to take part in the scheme later this year and will design a scheme which suits its needs, including deciding which populations to prioritise.

In a speech today, Health Minister Neil O’Brien will also announce that following the success of local schemes, pregnant women will be offered financial incentives to help them stop smoking. This will involve offering vouchers, alongside behavioural support, to all pregnant women who smoke by the end of next year.

The government will also consult on introducing mandatory cigarette pack inserts with positive messages and information to help people to quit smoking.

Additionally, there will be a crackdown on illicit vape sales as part of measures to stop children and non-smokers take up the habit – which is growing in popularity among young people.

Health Minister Neil O’Brien will say: “Up to two out of three lifelong smokers will die from smoking. Cigarettes are the only product on sale which will kill you if used correctly.

“We will offer a million smokers new help to quit. We will be funding a new national ‘swap to stop’ scheme – the first of its kind in the world. We will work with councils and others to offer a million smokers across England a free vaping starter kit.”

The new policies will deliver the UK Government’s three aims to help more adults quit smoking, stop children and non-smokers from taking up vaping, and using vaping as a tool for established adult smokers to quit.

For those who quit, the risk of heart attack is halved after one year of quitting, ultimately halving the likelihood of ending up in a hospital bed or worse.

Supporting more women to have a smokefree pregnancy will reduce the number of babies born underweight or underdeveloped with health problems requiring neonatal and ongoing care. It will also reduce the risk of miscarriage and stillbirth.

Cutting smoking rates reduces the number of smoking-related illnesses needing to be treated, in turn reducing the pressure on the NHS, helping to deliver on our priority to cut NHS waiting lists.

NHS figures for 2021 showed that 9% of 11- to 15-year-old children used e-cigarettes, up from 6% in 2018.

In recognition of the sharp increase, Minister O’Brien will launch a Call for Evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products – and explore where government can go further.

Working with enforcement agencies and learning from the government’s work with Trading Standards on illicit tobacco, £3 million of new funding will also be provided to create a specialised ‘illicit vapes enforcement squad’ to enforce the rules on vaping and tackle illicit vapes and underage sales.

As part of the measures, HMRC and Border Force will also be publishing an updated strategy this year to tackle illicit tobacco. It will lay out strategically how we continue to target, catch and punish those involved in the illicit tobacco market.

Smoking prevalence in England in 2021 was 13% – the lowest on record thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services

In 2021-22, £68 million of public health grant funded was spent on stop smoking services by local authorities and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million has been committed to the NHS this year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

However, 5.4 million people in England smoke tobacco which remains the single biggest cause of preventable illness and death. Up to two out of three lifelong smokers will die from smoking and recent data shows one in four deaths from all cancers were estimated to be from smoking.

Last year an independent smoking review led by Javed Khan proposed a range of measures to help people stub out the addiction, which has informed the measures set out today.

UK Government crackdown on illegal sale of vapes

‘Bold new measures’ to combat rising levels of youth vaping to be announced this week

  • A new ‘illicit vapes enforcement squad’ – backed by £3 million of government funding – to be formed to enforce rules on vaping and tackle illegal sales of vapes to under-18s
  • Call for Evidence also launched to identify opportunities to stop children vaping

The UK Government is expected to unveil tough new measures to combat the illegal sale of vapes to under-18s as part of its plans to reduce smoking and tackle youth vaping in England.

In his speech at Policy Exchange on Tuesday 11 April, Health Minister Neil O’Brien is expected to announce a new ‘illicit vapes enforcement squad’ – backed by £3 million of government funding – to enforce the rules on vaping and tackle illicit vapes and underage sales.

Working across the country, the enforcement squad led by Trading Standards will share knowledge and intelligence across regional networks and local authorities.

It will undertake specific projects such as test purchasing in convenience stores and vape shops. It will also produce guidance to help build regulatory compliance, and will have the power to remove illegal products from shops and at our borders.

The minister is also expected to announce the launch of a Call for Evidence to identify opportunities to reduce the number of children accessing and using vapes, while ensuring they remain available as a quit aid for adult smokers.

It will explore topical issues such as the marketing and promotion of vapes and the environmental impact of disposable products.

Health Minister Neil O’Brien said: “Smoking kills, so our priority is to prevent people smoking, and support them to quit. We remain committed to our ambition to be smokefree by 2030.

“However, while vaping is a preferable alternative to smoking for adults, we are concerned about the rise in youth vaping, particularly the increasing use of disposable vaping products.

“The new illicit vapes enforcement squad will work across the country and clamp down on those businesses who sell vapes to children – which is illegal – and get them hooked on nicotine. Our Call for Evidence will also allow us to get a firm understanding of the steps we can take to reduce the number of children accessing and using vapes.”

Smoking prevalence in England in 2021 was 13.0%, the lowest on record, thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services. In 2021-22, £68 million of funding from the public health grant was spent on stop smoking services by local authorities, and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million was committed to the NHS last year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

Children aged 6 months to 4 years in a clinical risk group to be offered a Covid vaccine

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that clinically vulnerable children aged 6 months to 4 years should be offered a coronavirus (COVID-19) vaccine.

Although young children are generally at low risk of developing severe illness from COVID-19, infants and young children who have underlying medical conditions are over 7 times more likely to be admitted to paediatric intensive care units.

Over one million children aged 6 months to 4 years in the US have received at least one dose of the Pfizer-BioNTech COVID-19 vaccine since June 2022. Data from the US showed the most common side effects reported were similar to those seen with other vaccines given in this age group, such as irritability or crying, sleepiness, and fever.

In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) first authorised use of the Pfizer-BioNTech vaccine for children aged 6 months to 4 years on 6 December 2022. 

Following that authorisation, the JCVI has advised that children aged 6 months to 4 years who are in a clinical risk group should be offered the vaccine. The JCVI does not currently advise COVID-19 vaccination of children aged 6 months to 4 years who are not in a clinical risk group.

Eligible children should be offered 2 doses of the vaccine, with an interval of 8 to 12 weeks between the first and second doses.

NHS England has confirmed it will begin offering vaccinations to those eligible in England from mid-June. Parents should wait to be contacted before coming forward.

Professor Wei Shen Lim, Chair of the JCVI’s COVID-19 Committee, said: “For the vast majority of infants and children, COVID-19 causes only mild symptoms, or sometimes no symptoms.

“However, for a small group of children with pre-existing health conditions it can lead to more serious illness and, for them, vaccination is the best way to increase their protection.”

Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “COVID-19 is still in circulation, with thousands of new cases reported every week.

“The extra protection offered by the vaccine could be important for young children in clinical risk groups, who are at greater risk of severe illness. The virus is not going away so I would encourage all parents to bring their child forward if they are eligible. Parents should wait to be contacted by their local health professionals.”

Health and Social Care Secretary Steve Barclay said: “Children are at very low risk of harm from Covid. However, there are a very small number of children with health conditions which make them particularly vulnerable, and for those children we want to give parents the choice as to whether they wish to vaccinate their at risk child or not.

“I have accepted advice from the Joint Committee on Vaccination and Immunisation on vaccinating children aged from 6 months to 4 years who are in a clinical risk group. It is a parental decision, and this advice is simply to enable parents of children with medical conditions to choose if they wish to have the protection.”

Scotland is expected to follow suit.

Humzah Yousaf announces another £1 million to tackle health inequalities

First Minister Humzah Yousaf has announced additional support for general practices in most deprived areas. People living in some of Scotland’s most deprived communities will benefit from an additional £1 million of funding to help tackle health inequalities.

The Inclusion Health Action in General Practice programme provides targeted funding for support to patients whose social circumstances have a negative impact on their health.

The funding is allocated directly to practices which are in the NHS Greater Glasgow and Clyde Health Board area and feature on the list of 100 most deprived practices in Scotland.

First Minister Humza Yousaf made the announcement as he visited the New Gorbals Health Centre in Glasgow.

The First Minister said: “General practice is at the heart of our communities and is uniquely placed to deliver the care and support needed by patients who experience health inequalities.

“Of the one hundred poorest practices in the whole of Scotland, shockingly 81 currently sit within the Greater Glasgow and Clyde Health Board area – a statistic I am determined to change.

“This additional funding of £1 million will build on the foundations of previous funding. At a time when the cost of living crisis is widening health inequalities, this is an important step that supports our commitments to prevention and early intervention with patients at highest risk of poor health.”

Lorna Kelly, Chair of the Primary Care Health Inequalities Development Group said: “The NHS needs to be at its best where it is needed the most, or health inequalities will continue to worsen.

“This additional resource to general practices serving the most deprived communities in Scotland is therefore very welcome.”

COVID-19 spring booster programme gets underway today

At-risk groups offered additional dose

Residents in care homes for older adults are receiving their spring COVID-19 booster from today (Monday) as the latest stage of the national vaccination programme gets underway.

Following recent advice from the Joint Committee on Vaccination and Immunisation (JCVI), a spring booster dose will also be offered to those aged 75 and over from 11 April and individuals aged five and over with a weakened immune system from 24 April. These groups will either receive appointment details through their preferred means of contact or will be sent details of how to book.

Health Secretary Humza Yousaf said: “We know that people in high-priority groups are at higher risk of serious illness from COVID-19 so I welcome the start of the spring rollout which will offer an additional dose to those who are most vulnerable, boosting their protection.  

 “Prioritising those most at risk has been our approach from the outset and vaccination has been our most effective tool against COVID-19. However, the degree of protection offered does fade over time, which is why booster vaccination is needed.

“I continue to encourage everyone to receive the doses they are eligible for as and when they become available.”

Spring coronavirus (COVID-19) booster | NHS inform

Minimum Unit Pricing ‘reducing alcohol deaths’

Report estimates the policy has saved hundreds of lives

Today, Public Health Scotland (PHS) and The Lancet publish new evidence showing the impact of alcohol minimum unit pricing (MUP) on deaths and hospital admissions attributable to alcohol consumption. The report has been welcomed by the Scottish Government.

Carried out in collaboration with the University of Glasgow, the study evaluated the impact of MUP on alcohol health harms, over the first two-and-half years of the policy.

The study estimated a 13.4% reduction in deaths, and a 4.1% reduction in hospital admissions, wholly attributable to alcohol consumption following the implementation of MUP. The study also found that MUP reduced deaths and hospital admissions where alcohol consumption may be one of a range of causative factors. The findings cover the period from MUP implementation up to the end of 2020.

This latest report builds on previous work that estimated alcohol sales reduced by 3% in the three years following the implementation of MUP.

Dr Grant Wyper, Public Health Intelligence Adviser at PHS, said: “Our study estimates that, following more than two and a half years of implementation, around 150 deaths, and around 400 hospital admissions, wholly attributable to alcohol consumption, were averted each year due to MUP.

“The greatest reductions were seen for chronic alcohol health harms, in particular alcoholic liver disease, which were slightly offset with less certain evidence of increases in acute alcohol health harms.

“The findings highlight that the largest reductions were found for males, and for those living in the 40% most deprived areas, groups which are known to experience disproportionally high levels of alcohol health harms in Scotland.

“We know that those living in the most socioeconomically deprived areas in Scotland experience alcohol-specific death rates more than five times higher compared to those living in the least deprived areas.

“The results published today are therefore very encouraging in addressing this inequality, and the overall scale of preventable harm which affects far too many people.”

Prof Daniel Mackay, Professor of Public Health Informatics at the School of Health and Wellbeing, University of Glasgow, said: “The methods we’ve used in this study allow us to be confident that the reduction in alcohol health harms we’ve shown is due to the introduction of MUP, rather than some other factor.

“This was important as the COVID-19 pandemic occurred towards the end of our study period and may have had an impact on alcohol-related health harms that was unrelated to MUP. Our main findings for the whole study period were consistent with findings from an additional analysis that focused on the pre-pandemic period only.

“In fact, we tested our main finding across a range of different scenarios and found the results to be largely consistent with our main finding, strengthening our conclusion that MUP has been effective at reducing the harm to health caused by alcohol.”

Prof Jim Lewsey, Professor of Medical Statistics also at the School of Health and Wellbeing, University of Glasgow, added: “Our approach compared what happened to alcohol health harms in Scotland with its neighbouring country, England, where MUP was not introduced.

“The methods we have used and the consistency of our findings with what was anticipated before MUP was introduced, allow us to be confident that the reduction in alcohol health harms is because of the MUP intervention.”

The MUP Evaluation Portfolio comprises of a number of research studies that are being undertaken to assess the impact of MUP across a range of outcomes, all of which have now been concluded. A report bringing together all the evaluation findings will be published in June 2023.

Research which estimates 156 deaths were averted each year following the implementation of Minimum Unit Pricing (MUP) has been welcomed by the Public Health Minister Maree Todd.

A Public Health Scotland and University of Glasgow study indicates a 13.4% reduction in deaths, and a 4.1% reduction in hospital admissions wholly attributable to alcohol consumption in the first two and a half years after MUP was introduced in May 2018. The report also concludes the policy had reduced deaths and hospital admissions where alcohol consumption may have been a factor.

Researchers say they are confident there is a link between the introduction of MUP and the reduction in alcohol health harms. They also noted there had been significant reductions in deaths in areas of deprivation, suggesting MUP has helped reduce inequalities in alcohol-attributable deaths in Scotland.

Ms Todd said: “I am very pleased with these findings which point to more than 150 lives a year being saved and 411 fewer hospital admissions, further underlining the value of our world-leading Minimum Unit Pricing policy which has helped reduce alcohol sales to their lowest on record.

“We’re determined to do all we can to reduce alcohol-related harm which is one of the most pressing public health challenges that we face in Scotland.

“Minimum Unit Pricing continues to achieve its aim – cutting overall sales, particularly cheap high-strength alcohol, which is often drunk by people drinking at harmful levels.

“It’s also encouraging to see that the research has highlighted that the policy is having an effect in Scotland’s most deprived areas – which experience higher death rates and levels of harms from problem alcohol.”

The study – published by PHS and the Lancet – focused on the first two-and-half years of the policy. It follows a previous report which estimated that alcohol sales had dropped by 3% after MUP. A report bringing together all the evaluation findings on MUP will be published in June this year.

PHS report – ‘Evaluating the impact of alcohol minimum unit pricing (MUP) on alcohol-attributable deaths and hospital admissions in Scotland’

Campaigners call on Scottish Government to develop national strategy to prevent child sexual abuse

Stop It Now! Scotland and NSPCC Scotland are calling on the Scottish Government to develop a national strategy to tackle child sexual abuse that focuses on prevention to make the country a safer place to grow up.

The two charities hosted an event in partnership with the Scottish Parliament this week (Wednesday, March 15) with leading experts in the field.

They discussed the devastating harms and long-lasting impact that sexual abuse can have on victims, that punishment alone will not eradicate this problem and what we can do to prevent children being abused in the first place. They also talked about the next steps we need to take to guarantee Scotland is the safest country for children to grow up.

They are urging the Scottish Government to develop a comprehensive and coordinated national approachto prevent child sexual abuse, which involves health, police, education, community safety, children’s services, social services, housing and the wider community. The child protection charities say it is vital that everyone understands what child sexual abuse is and knows how they can be part of preventing it.

A review of UK data revealed that 15 per cent of females and 5 per cent of males will experience some form of sexual abuse before the age of 16.

This means at least 80,000 children in Scotland will have been affected by this issue before they leave high school. Although this is thought to be an under-representation of the scale of the problem and the actual number of children who have experienced sexual abuse in Scotland is not known.

The charities say that to understand the numbers of children in Scotland affected and the scale of the suffering it is crucial that a prevalence survey is conducted.

Professor Elizabeth Letourneau, Director of the Moore Centre for the Prevention of Child Sexual Abuse, School of Public Health, John Hopkins University, said: “Child sexual abuse affects about one in nine children – 12 per cent of all children – globally. Victims are at risk of immediate harms, such as fear, injury, and pregnancy, and a broad array of serious health problems can emerge and last across the lifespan.

“Only one in five cases of child sexual abuse are ever reported to the authorities. This means that we miss at least 80 per cent of cases, so punishment will never be enough if we are to effectively address this public health problem.

“I believe our failure to focus on prevention stems from a general misgiving that child sexual abuse really is not preventable. That people who are at risk of perpetrating abuse are monsters and their behaviour cannot be predicted or prevented, and they will only respond to punishment.

But we know this is not true. We already have good evidence that we can effectively prevent child sexual abuse perpetration.”

Pat Branigan, Assistant Director of NSPCC’s Together for Childhood, said: “One of the most important messages from today is that child sexual abuse is preventable and not inevitable.

“The ultimate goal is to develop a framework, based on evidence of what we know already works, which can be used to support agencies and organisations to work together and prevent child sexual abuse in communities.

“We need to create strong local partnerships between social care, schools, health, voluntary groups, the police and communities that focus on preventing people from offending, and empower and educate children and adults to recognise the signs of abuse and how they can report their concerns.

“Ultimately it will not be governments, experts or professionals who eradicate child sexual abuse, it will be individuals, families and communities.”

Stuart Allardyce, Director, Lucy Faithfull Foundation / Stop It Now! Scotland, said: “Last year we helped 7,000 people across the UK through our Helpline.  Not all were adults worried about their own sexual thoughts, feelings and behaviour, but around half of them were.

“We also had adults who were worried about another adult, or because they had found evidence their partner has been seeking out child sexual abuse material online.

“We believe that if you build prevention initiatives, people will come – professionals, protective adults, but also those who worried about the risk that they may present to children. We can no longer say that people won’t use self-help prevention resources, because the evidence is that they can and do and that prevention works.”

Childlight, based at the University of Edinburgh, also launched the first comprehensive global data repository this week, which will look at all forms of child sexual exploitation and abuse (CSEA), with the aim of being able to show the scale and nature of this abuse. 

Children and young people can contact Childline for free, confidential support and advice 24 hours a day online at www.childline.org.uk or on the phone on 0800 1111

Anyone with concerns about a child’s wellbeing can contact the NSPCC Helpline on help@nspcc.org.uk. The NSPCC practitioners provide free and confidential help and advice and can take appropriate steps to help keep children safe. If a child is in immediate danger, please call 999.

The NSPCC also has advice and resources for parents, carers on how to have simple, age appropriate conversations with children to help prevent sexual abuse through their Talk PANTS campaign. This helps children understand that their body belongs to them and to recognise when something is not okay and how to tell someone.