The UK Health Security Agency (UKHSA) has recently detected higher than usual rates of liver inflammation (hepatitis) in children. Similar cases are being assessed in Scotland.
Public health doctors and scientists at the UK’s public health agencies are continuing to investigate 74 cases of hepatitis (liver inflammation) in children since January 2022, where the usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected.
Of the confirmed cases, 49 are in England, 13 are in Scotland and the remainder are in Wales and Northern Ireland.
One of a number of potential causes under investigation is that a group of viruses called adenoviruses may be causing the illnesses. However, other possible causes are also being actively investigated, including coronavirus (COVID-19), other infections or environmental causes.
There is no link to the COVID-19 vaccine. None of the currently confirmed cases in the UK has been vaccinated.
Adenoviruses are a family of common viruses that usually cause a range of mild illnesses and most people recover without complications. They can cause a range of symptoms, including colds, vomiting and diarrhoea. While they don’t typically cause hepatitis, it is a known rare complication of the virus.
Adenoviruses are commonly passed from person to person and by touching contaminated surfaces, as well as through the respiratory route.
The most effective way to minimise the spread of adenoviruses is to practice good hand and respiratory hygiene and supervise thorough handwashing in younger children.
Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said: “We are working swiftly with the NHS and public health colleagues in Scotland, Wales and Northern Ireland to investigate a wide range of possible factors which may be causing children to be admitted to hospital with liver inflammation known as hepatitis.
“One of the possible causes that we are investigating is that this is linked to adenovirus infection. However, we are thoroughly investigating other potential causes.
“Normal hygiene measures such as good handwashing – including supervising children – and respiratory hygiene, help to reduce the spread of many of the infections that we are investigating.
“We are also calling on parents and guardians, to be alert to the signs of hepatitis – including jaundice – and to contact a healthcare professional if they are concerned.”
UKHSA, working with partners, will continue to make the public aware of findings throughout the course of the investigation.
Four-hour performance was 71.7%, 1.9% lower than the previous month, January 2022, and the second lowest on record
27,087 patients were delayed by four hours or more, this is means more than one in four patients were delayed by four hours or more
6,248 patients were delayed by eight hours or more
2,230 patients were delayed by 12 hours or more, this represents the highest proportion of attendances experiencing 12 hour waits since records began
Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said:“The crisis in Urgent and Emergency Care is dire. The health system in Scotland is ceasing to function as it should. Patients are at risk of severe harm and staff are facing stress, distress, burnout and moral injury on a daily basis.
“This is unsustainable and dangerous. The first step to tackling this crisis is opening 1,000 beds that are desperately needed across the system and recruiting senior decision makers in Emergency Medicine. In addition, the crisis in social care, which is resulting in the most vulnerable patients residing in hospital for extremely long periods of time before being discharged means that the system is unable to cope.
“This patient safety crisis must be a priority for the Scottish Government, and they must take meaningful action now before more patients come to severe harm.”
New guidance outlines free COVID-19 tests will continue to be available to help protect specific groups once free testing for the general public ends on 1 April
Nicola Sturgeon will given an update on Scotland’s position this afternoon
Free COVID-19 tests will continue to be available to help protect specific groups including eligible patients and NHS and care staff once the universal testing offer ends on 1 April and next steps for adult social care set out
Plans in place to enable rapid testing response should a new health threat emerge, such as a new variant of concern emerge
Vaccines and treatments mean we can transition to managing COVID-19 like other respiratory illnesses, with updated guidance published on 1 April
People at risk of serious illness from COVID-19, and eligible for treatments, will continue to get free tests to use if they develop symptoms, along with NHS and adult social care staff and those in other high-risk settings, Health and Social Care Secretary Sajid Javid announced yesterday (Tuesday 29 March).
Free testing for the general public ends on 1 April as part of the Living with Covid plan which last month set out the government’s strategy to live with and manage the virus.
Although COVID-19 infections and hospitalisations have risen in recent weeks, over 55% of those in hospital that have tested positive are not there with COVID-19 as their primary diagnosis.
Free universal testing has come at a significant cost to the taxpayer, with the testing, tracing and isolation budget costing over £15.7 billion in 2021-22. This was necessary due to the severe risk posed by COVID-19 when the population did not have a high level of protection.
Thanks to the success of the vaccination programme and access to antivirals, alongside natural immunity and increased scientific and public understanding about how to manage risk, the population now has much stronger protection against COVID-19 than at any other point in the pandemic.
This is enabling the country to begin to manage the virus like other respiratory infections.
From 1 April, updated guidance will advise people with symptoms of a respiratory infection, including COVID-19, and a high temperature or who feel unwell, to try stay at home and avoid contact with other people, until they feel well enough to resume normal activities and they no longer have a high temperature. Until 1 April individuals should continue to follow the current guidance.
From 1 April, anyone with a positive COVID-19 test result will be advised to try to stay at home and avoid contact with other people for five days, which is when they are most infectious.
Advice will be provided for individuals who need to leave their home when they have symptoms or have tested positive, including avoiding close contact with people with a weakened immune system, wearing a face-covering and avoiding crowded places.
Secretary of State for Health and Social Care Sajid Javid said: “Thanks to our plan to tackle Covid we are leading the way in learning to live with the virus. We have made enormous progress but will keep the ability to respond to future threats including potential variants.
“Vaccines remain our best defence and we are now offering spring boosters to the elderly, care home residents and the most vulnerable – please come forward to protect yourself, your family, and your community.”
Under the plans set out today free symptomatic testing will be provided for:
Patients in hospital, where a PCR test is required for their care and to provide access to treatments and to support ongoing clinical surveillance for new variants;
People who are eligible for community COVID-19 treatments because they are at higher risk of getting seriously ill from COVID-19. People in this group will be contacted directly and sent lateral flow tests to keep at home for use if they have symptoms as well as being told how to reorder tests; and
People living or working in some high-risk settings. For example, staff in adult social care services such as homecare organisations and care homes, and residents in care homes and extra care and supported living services, NHS workers and those working and living in hospices, and prisons and places of detention (including immigration removal centres), where infection needs to be identified quickly to minimise outbreaks. People will also be tested before being discharged from hospital into care homes, hospices.
Asymptomatic lateral flow testing will continue from April in some high-risk settings where infection can spread rapidly while prevalence is high.
This includes patient-facing staff in the NHS and NHS-commissioned Independent Healthcare Providers, staff in hospices and adult social care services, such as homecare organisations and care homes, a small number of care home visitors who provide personal care, staff in some prisons and places of detention and in high risk domestic abuse refuges and homelessness settings.
In addition, testing will be provided for residential SEND, care home staff and residents during an outbreak and for care home residents upon admission. This also includes some staff in prisons and immigration removal centres.
Children and young people who are unwell and have a high temperature should stay at home and avoid contact with other people, where they can. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.
The internationally recognised Community Infection Survey delivered through the Office for National Statistics will continue to provide a detailed national surveillance capability in the coming year so the government can respond appropriately to emerging developments such as a new variant of concern or changing levels of population infection.
Infections in health and care settings will also be monitored through bespoke studies including the Vivaldi study in residential care homes, the SIREN study in the NHS, and RCGP surveillance in primary care.
The government has retained the ability to enable a rapid testing response should it be needed, such as the emergence of a new variant of concern.
This includes a stockpile of lateral flow tests and the ability to ramp up testing laboratories and delivery channels.
The government’s Therapeutics Taskforce and Antiviral Taskforce will also be merged into a single unit which will continue to focus on securing access to the most promising treatments for COVID-19.
Dame Jenny Harries, Chief Executive of the UK Health Security Agency, said: “As we learn to live with Covid, we are focusing our testing provision on those at higher risk of serious outcomes from the virus, while encouraging people to keep following simple steps to help keep themselves and others safe.
“The pandemic is not over and how the virus will develop over time remains uncertain. Covid still poses a real risk to many of us, particularly with case rates and hospitalisations on the rise. That is why it is sensible to wear a mask in enclosed spaces, keep indoor spaces ventilated and stay away from others if you have any symptoms of a respiratory illness, including Covid.
“Vaccination remains the best way to protect us all from severe disease and hospitalisation due to Covid infection. If you have not yet come forward for your primary or booster I would urge you to do so straight away – the NHS vaccine programme is there to help you and the sooner you are vaccinated the sooner you and your family and friends will be protected.”
Most visitors to adult social care settings, and visitors to the NHS, prisons or places of detention will no longer be required to take a test. More guidance on what people should do when visiting adult social care settings will be published by 1 April.
A number of changes and new guidance is also being confirmed today for adult social care including:
From 1 April, those working in adult social care services will also continue to receive free personal protective equipment (PPE). Priority vaccinations and boosters for residents and staff will also continue
Updated hospital discharge guidance will be published setting out how all involved in health and social care will work together to ensure smooth discharges from hospital and people receive the right care at the right time in the right place
Designated settings will be removed. These were initially set up to provide a period of isolation to COVID-19 positive patients before they move into care homes and before routine point of care testing for COVID-19 was available. Restrictions on staff movement will also be removed
Streamlined guidance on infection and prevention control measures will be published to set out long-standing principles on good practice, and support consistency across the adult social care sector. This will include details on future measures for COVID-19 and other respiratory viruses to ensure providers have the latest information on best practice which will include information on admissions, visiting and PPE
Updated guidance for adult social care providers and staff to set out the current testing regime across adult social care
Outbreak management periods in care homes, which can include visiting restrictions, have been reduced from 14 to 10 days
People aged 75 and over, residents in care homes for elderly adults and those who are immunosuppressed are now eligible to receive a Spring booster jab to top up their immunity to COVID-19. Around five million people will be eligible for a Spring booster around six months after their previous dose, and the NHS has contacted over 600,000 people inviting them to book an appointment. Anyone who has not yet had a COVID-19 jab continues to be encouraged to take up the ‘evergreen’ offer.
Through the Health and Social Care Levy, funding will rise by a record £36 billion over the next three years. This is on top of the previous historic long-term settlement for the NHS, which will see NHS funding increase by £33.9 billion by 2023-24, which has been enshrined in law.
The success of the government’s Living with Covid plan, will enable the country to continue to move out of the pandemic while also protecting those at higher risk of serious outcomes from the virus through our testing regime.
First Minister Nicola Sturgeon will announce this afternoon whether Scotland’s last remaining Covid regulations will be lifted next week.
The First Minister will update Holyrood on whether the requirement to wear masks in shops and on public transport will end as planned on 4 April.
Covid cases in Scotland remain at an alarmingly high level.
There were 25,506 attendances in week ending 20 March 2022
Four-hour performance was 66.2%, the lowest on record
8,610 patients were delayed by four hours or more, this is the highest on record and means one third of all patients were waiting for four hours or more in an Emergency Department
2,615 patients were delayed by eight hours or more, this is the highest on record and means more than one in 10 patients were waiting for eight hours or more in an Emergency Department
1,015 patients were delayed by 12 hours or more, this is the highest on record and means one in 25 patients were waiting for 12 hours or more in an Emergency Department
Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said:“Each week the Urgent and Emergency Care crisis worsens.
“Scotland’s Emergency Care system is failing patients who are coming to harm, and failing staff who are overworked, exhausted, and burned out but are left to cover the widespread shortcomings of the health system. Shortages of beds, shortages of staff, the social care crisis; existing staff do all they can to keep patients safe in these exceptionally challenging circumstances.
“It is an untenable and unsustainable situation. This week saw the highest number of long waits on record yet again. Data show that there is one excess death for every 82 patients delayed for more than six hours.
“This week 2,615 patients were delayed by eight hours or more, from this we can estimate that over 30 patients in this week alone could have come to associated harm or death as a result of their delay to admission.
“The significance of this appalling harm must not go unnoticed and must be met immediately with effective and meaningful action. The Scottish Government must understand the severity and extent of harm befalling our patients, and see that existing staff facing moral injury, going above and beyond, running on goodwill and adrenaline is not reasonable or acceptable.
“This can no longer be the sole answer to the biggest patient safety crisis in Emergency Care for a generation. This must not continue.”
TODAY (Thursday 17th March) and tomorrow, Friday 18th March, there will be a pop up vaccination clinic from 9am – 2.30pm at the North Edinburgh Community Resource Centre on Pennywell Road.
All vaccines including boosters can be administered.
Legal requirements to wear face coverings on public transport and most indoor public settings will continue until at least early April given the current spike in Covid case numbers, First Minister Nicola Sturgeon announced yesterday.
Remaining legal requirements for businesses and service providers to collect customer details for contact tracing, and to have regard to and take reasonable measures set out in Covid guidance, will end as planned on Monday 21 March.
The First Minister also confirmed that people without COVID-19 symptoms will no longer be asked to take regular lateral flow tests tests from 18 April. The change forms part of the Test and Protect Transition Plan, which sets out how testing will become more targeted, with the aim of reducing serious harm from COVID-19.
The changes to Test and Protect mean that from 18 April:
most people without symptoms will no longer be asked to take COVID-19 tests
free lateral flow devices (LFDs) for the purposes of twice weekly routine testing will no longer be available for the general population given the changing advice, but will continue to be free for any purpose for which testing continues to be advised – for clinical care, for health and social care workers and for people visiting vulnerable individuals in care homes or hospitals
until the end of April, people with symptoms should still isolate and get a PCR test
vaccinated close contacts of someone with COVID-19 should continue to test daily for seven days with LFDs
People who have symptoms of COVID-19 will still be able to book PCR tests in the usual way until 30 April. From that date, test sites will close and people with symptoms will no longer be advised that they need to seek a test. The public health advice for people who feel unwell will be to stay at home until they feel better, to reduce the risk of infecting other people.
The First Minister thanked the frontline Test and Protect workforce for their efforts throughout the pandemic. Work is on-going to support staff to explore other opportunities in the public and private sector.
The First Minister said: “Today marks a further decisive shift away from controlling Covid through legal restrictions, and towards relying instead on advice and guidance. But please remember, especially since case numbers are so high, that this guidance and advice remains important.
“Given current case numbers, and the desirability of getting those back under control quickly, the wearing of face masks will stay in place for at least another two weeks.
“Changes in Test and Protect will be phased between now and the end of April. After Easter – from 18 April – we will stop recommending that people who don’t have symptoms, should test for Covid.
“This change will apply across the population –including in most workplaces and in early years centres, schools, universities and colleges.
“Then, at the end of April, routine testing will end – even for people who have symptoms.
“At that time, physical test sites will close – although some mobile testing units and capacity will be retained for possible future use. Contact tracing will also end.
“Free testing will not generally be available to the wider population. Instead, our advice will be that if you have symptoms of Covid – or indeed symptoms of the flu, or any other infectious illness – you should stay at home in order to aid your recovery.”
Over 75s, immunosuppressed individuals and those living in care homes are now able to receive an additional COVID-19 booster vaccination as part of its efforts to protect those at highest risk from COVID-19.
These people will be invited as they become eligible from at least 24 weeks after their last booster, with the first groups receiving appointments from this week.
Jane McNulty, Director of Nursing for Primary and Community Care, NHS Lothian, said: “We are delighted to offer this further vaccination to the most vulnerable to people in our society.
“The degree of protection the vaccine offers wanes over time, which is why booster vaccination is needed to maintain the best protection against COVID-19 for those at highest risk of severe effects of the virus.
“The spring booster will improve your level of protection significantly and is the best way to protect your health and those around you.”
NHS Lothian will also start offering vaccinations to all children aged 5-11 in Lothian on Saturday 19 March, following its initial offering of the childhood vaccine to children most at risk from COVID-19 and children living with an immunosuppressed person.
Letters will be sent out to parents and carers in the coming weeks inviting them to bring their child to a child vaccination clinic in the Lothian area.
Paediatric vaccinators will be available at the clinics to answer any questions people may have about the COVID-19 childhood vaccine.
Parents and carers to do not need to contact NHS Lothian proactively to arrange an appointment.
Ms McNulty added: “The primary aim of our vaccination programme continues to be the prevention of severe disease, hospitalisation and mortality, arising from COVID-19.
“I encourage anyone who is still to have any dose of the COVID-19 vaccine to get vaccinated as soon as they are eligible.”
Established vaccination clinics for over 12s will continue to operate separately from these clinics, with NHS Lothian still encouraging all over 12s to get any outstanding vaccinations.
Over 18s can receive their first, second and booster vaccinations at all drop-in clinics. Those aged 12-17 can also attend for their second dose if it has been at least 12 weeks since their first dose and they have not tested positive for COVID-19 in the past 12 weeks.
More information on the 5-11 vaccination programme is available on NHS Inform:
A new framework to shape Scotland’s health and social care workforce over the next decade places training, wellbeing, job satisfaction and the principles of Fair Work at its heart.
The National Workforce Strategy for Health and Social Care in Scotland, co-produced with COSLA, identifies the five key areas which will support the creation of a sustainable, skilled workforce as the sector rebuilds from the pandemic.
The publication, the first of its kind, stresses the need to plan, attract, train, employ and nurture staff.
Over the next five years, the Strategy commits to increasing the NHS workforce by 1,800 full time posts – these posts are in addition to projected required workforce growth. Later this year the Scottish Government will publish, for the first time, projections of required workforce growth across health and social care, which will be reviewed annually.
Other key actions include:
Investing £11 million over this parliament to establish the Centre for Workforce Supply and fund recruitment campaigns to grow the health and social care workforce
Increasing the number of undergraduate medical school places over the course of this parliament by 500
Supporting up to 1,800 training places through the National Transition Training Fund for those interested in roles in adult social care
Recruiting 800 additional GPs by 2028
Further improving staff wellbeing measures, which have already been supported by record financial investment this year
Increasing frontline health spending by at least 20% over this parliament and increasing adult social care investment by at least by 25%
Health boards, local authorities and health and social care partnerships will play a central role in delivering the Strategy through their three year workforce plans, the first of which will be developed this year.
Health and Social Care Secretary Humza Yousaf said: “Our hardworking and compassionate health and social care staff have been on the frontline of patient care through the unprecedented challenges of the pandemic, and I am incredibly grateful to them all.
“While we have seen continued growth in our NHS and social care workforce over the past decade, we need more than sheer numbers alone as we continue to care for patients and plan for the future.
“This strategy is designed to embed a new long term approach. It commits to understanding the change in demand for services as we recover, rebuild and transform our health service, and how we can achieve a more sustainable, skilled workforce which makes careers in health and social care – at all levels – more attractive.
“The health and social care system continues to undergo rapid change, with exciting opportunities created by new technology, data and analytical services. Working with key partners, this strategy will help ensure that services are delivered by a sustainable, well trained and supported workforce.”
Councillor Stuart Currie, COSLA’s Health and Social Care spokesperson, said: “Scotland’s health and social care workforce has been at the forefront of the pandemic response. Working in extremely challenging environments, they have faced unprecedented pressures and made many individual sacrifices.
“Partners working across health and social care must now adopt a strategic approach to the recovery, growth and transformation of the workforce that supports the wellbeing of workers, a continued shift to prevention and the provision of high quality support and care for citizens.
“The values, outcomes and actions outlined in this Strategy provide a foundation for excellence in planning, attracting, developing and nurturing the Health and Social Care workforce, at national and local levels.”
At risk youngsters in most deprived communities to get varnish treatment
DEDICATED dentists from five Edinburgh practices have pledged their time in the urgent fight to stem a growing oral health emergency affecting the country’s children.
Between them, Bellastane Dental Care, Earl Grey Dental Practice, Gilmore Dental, Fairmilehead Dental Practice & Implant Centre and KF Dental are part of Clyde Munro Dental Group’s target of treating at least 1000 children with a fluoride varnish (FV) application in dedicated out of hours clinics by the close of 2022 – one of the most effective treatments for preventing tooth decay in children from the age of two.
Typically offered up to twice a year, the pandemic-induced backlog means it is not currently as readily available to families under NHS services.
The pledge comes after worrying statistics showed that 850,000 fewer patients had been seen in the past two years compared to 2017-2019. In children’s services just 55% of children in the most deprived areas have seen a dentist.
The latest data show that primary school children from the most deprived communities experience more than four times the level of tooth decay compared to children in the least deprived areas.
These stark and persistent inequalities have widened as a result of the pandemic, with the collapse in access to routine services, the suspension of public health programmes and the impact of sugar-rich lockdown diets.
Tooth decay in children is a major health problem in the UK – and despite being entirely preventable is one of the most common reasons for hospital admission in children.
Jacqui Frederick is Group Clinical Director at Clyde Munro and one of the group’s dentists to have helped more than 100 young patients access FV treatment in 2021, since Clyde Munro started the children’s clinics in the last quarter of last year.
She said: “We’re a predominantly NHS-based group and we take our responsibility as Scotland’s biggest dental group seriously.”
“As you might imagine, our dentists are deeply concerned at falling numbers of young patients accessing NHS dentistry services. The pandemic has set back the oral health of so many people and we want to be a part of the fightback.
“We wish we didn’t have to volunteer time out of hours to get this done – but in doing so we can reach out to those in need, any concerned parents or guardians can contact their nearest Clyde Munro practice to enquire about FV clinics.”
FV application is a dental treatment that takes around 10 minutes and Clyde Munro will prioritise its practices that are within reach of many of Scotland’s more deprived communities. It will not require the parent or the child to be a registered patient. It will release dates and times of its clinics regularly on its website.
The group has 54 practices, from Orkney to the Borders and is represented in all of Scotland’s cities and many of its towns, with 400 staff supporting 460,000 patients.
Clyde Munro provides quality, affordable, general and cosmetic dentistry in well equipped, modern practices. Locations are convenient and accessible making it easy to visit the dental facilities.
Patients with COVID-19 symptoms are being asked to contact their GP instead of NHS 24 from the end of March.
The move comes after a fall in the number of people using the service since the end of December and represents a return to pre-pandemic procedures.
Currently callers to the 111 helpline are assessed and, if necessary, transferred to a local community hub staffed by clinicians from across the healthcare system.
From 31 March patients will be asked to contact their GP in the first instance during the working day, as they already do for other respiratory conditions. If help and advice is required out of hours, 111 should still be called. NHS Inform’s coronavirus webpage remains the fastest way for people to obtain the latest health advice and information.
Several boards have continued using GP practices as the first port of call for Covid-related calls during the pandemic, including Dumfries and Galloway and Tayside. It is now considered appropriate to return to this approach nationwide.
Health Secretary Humza Yousaf said: “This move represents another welcome step back towards normality.
“Call numbers and the number of serious cases are falling and the tailored arrangements put in place at the height of the pandemic are no longer required. But we remain on alert and should a more serious variant of the virus emerge the service can, and will, be swiftly restored.
“We are continuing to support GP practices as they manage acute COVID cases. The GP Escalation Framework remains in place to help health boards and practices deal with sustainability issues and we will invest £15 million this year in sustainability payments”.
NHS 24’s Director of Service Delivery, Steph Phillips said: “NHS 24 staff have provided an excellent service to the people of Scotland throughout the pandemic, both over the phone and online.
“We will continue to update the information and symptom checker on NHS inform and encourage people to use this resource.”
‘Welcome step back to normality’?Covid’s far from over – 11,685 new cases were reported in Scotland yesterday – with 19 deaths.
