73.7% of attendances were seen and resulted in subsequent admission, transfer or discharge within four hours
There were 97,644 attendances, a 6% decrease when compared to the previous month, November 2021
More than one in four patients were delayed by four hours or more
5,342 patients were delayed by eight hours or more, equal to 5.5% of all attendances
1,605 patients were delayed by 12 hours or more
Responding to these figures, Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said:“With fewer attendances performance has plateaued but be in no doubt that the health service and its staff in Scotland remain under unprecedented pressure and increasing burnout.
“One in four patients face delays over four hours, while both eight- and 12-hour waits are still at record high levels not seen before 2021. What is deeply concerning is the pattern and the potential for these long waiting times to become the status quo in perpetuity.
“The impact of this continued poor performance is distress and moral injury to staff and serious discomfort and risk to the safety of patients. This must be an urgent signal and call to action for system change. We have long called on the government to open 1,000 more beds in the system in Scotland, and to commit to publishing a long-term workforce plan. While there remains an urgent need to address the social care crisis to help patients be discharged from hospital in a timely way.
“Quite simply things cannot continue as they are, more patients will come to harm and staff will face increasing distress at the quality of care they are or, more significantly, aren’t able to provide. The government must recognise the severity of the situation and the risk that continued poor performance, long waiting times, patient harm, and sinking quality of care will continue to spiral.”
Adults aged 18-59 who have not yet had their booster jab for whatever reason will start to receive blue envelopes from today (Tuesday 1 February) with scheduled appointments.
Latest figures show that 83.5% of eligible adults in Scotland have now been fully vaccinated with primary doses and a booster. Approximately 580,000 eligible adults aged 18-59 will now be offered booster appointments from 7 February onwards.
Adults can receive a booster 28 days after they tested positive or if it has been at least 12 weeks since their second dose.
The letters will contain details of how to rearrange any appointment which is not convenient.
Health Secretary Humza Yousaf said: “While the number of Omicron cases continues to decline and restrictions are being lifted, it remains crucial that people complete their vaccination course in order that this improvement can be sustained.
“We know that in people who have had two vaccinations, protection against the virus wanes after time. However, recently published Health Security Agency (UKHSA) data indicates that initial vaccine effectiveness against hospitalisation of older people increases to around 90% two weeks after a booster dose. This is why it is so vital to get your booster so you can maximise the level of protection against serious illness.
“We urge those who haven’t yet received their booster to take up the invitations being sent out this week in the distinctive blue envelopes so that we can continue to build on the nation’s defences.
“Scotland has one of the highest uptake rates for vaccination anywhere in the world, and I hope this national mailshot will encourage the remaining adults to join the 83.5% of eligible Scots who have already received their booster or third dose.
“Vaccination continues to be the cornerstone of our battle against COVID-19 – the very high vaccination rates achieved so far have helped us considerably on our path back to normality.”
Children in Lothian at risk from COVID-19, along with children living with an immunosuppressed person, are now eligible to get a COVID-19 vaccination.
Launched yesterday, dedicated clinics especially designed for to cater for children will operate across the region. They will be open between 8.30am – 4.30pm, seven days a week, for pre-booked appointments only.
Jane McNulty, Director of Nursing for Primary and Community Care, NHS Lothian, said: “We are delighted to offer these clinics to the youngest people in our community.
“These clinics will be operated by specially trained paediatric vaccinators in a clinical environment, which will allow children, parents and guardians to discuss the vaccination process in a calm environment.”
The vaccination will first be offered to children with a higher COVID-19 risk factor and children living in the household of an immunosuppressed person, it will then be offered to the wider child population in due course.
Those eligible for the vaccination will receive a letter from NHS Lothian in the coming days with details about how to book an appointment through the National Vaccination Helpline. Parents and guardian do not need to actively contact NHS Lothian to arrange an appointment.
The clinics are opening their doors following the publication and government acceptance of the advice of the UK’s four Chief Medical Officers (CMOs) to offer two doses of the Pfizer childhood COVID-19 vaccine.
All children will receive two doses eight weeks apart. A third primary dose is also being offered to children aged 5-11 years with a severely weakened immune system. The third primary dose will be offered from 8 weeks after the second dose.
Ms McNulty added: “We recognise that parents and guardians may have questions regarding the COVID-19 vaccination and we encourage them to visit the pages on NHS Inform where there is a range of information available.
“Alongside this, our paediatric vaccinators are one hand to answer any questions people may have when they attend their child’s vaccination appointment.
“Vaccination remains critically important in the continued fight against COVID-19 and we welcome the further expansion of the vaccination programme across Lothian.”
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 1st, 2nd 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:
The latest data from the UK Health Security Agency (UKHSA) shows that boosters significantly reduce the risk of death with Omicron
The findings show that around 6 months after a second dose of any of the coronavirus (COVID-19) vaccines, protection against death with Omicron was around 60% in those aged 50 and over. However, this increased to around 95% 2 weeks after receiving a booster vaccine dose.
The data continue to show high levels of protection against hospitalisation from the booster. After a Pfizer booster (after either primary vaccination course), vaccine effectiveness against hospitalisation started at around 90%, dropping to around 75% after 10 to 14 weeks.
After a Moderna booster (mRNA-1273) (after either primary vaccination course), vaccine effectiveness against hospitalisation was 90% to 95% up to 9 weeks after vaccination. Longer follow-up data is not yet available and these figures may change with time.
An initial analysis of vaccine effectiveness against the Omicron variant sub-lineage known as BA.2 (designated VUI-22JAN-01 on 19 January), reveals a similar level of protection for symptomatic infection compared to Omicron (BA.1).
After 2 doses, effectiveness was 9% and 13% respectively for BA.1 and BA.2, after 25+ weeks. This increased to 63% for BA.1 and 70% for BA.2 from 2 weeks following a booster vaccine.
Dr Mary Ramsay, Head of Immunisation at UKHSA, said: “The evidence is clear – the vaccine helps to protect us all against the effects of COVID-19 and the booster is offering high levels of protection from hospitalisation and death in the most vulnerable members of our society.
“The pandemic is not over yet and the vaccine is the best way to increase your protection against the serious consequences of this virus – please book your appointment for your first, second or third vaccine without delay.”
Vaccines minister Maggie Throup said: “A booster vaccine is absolutely crucial to topping up your immunity against the Omicron variant.
“More than 80% of eligible adults in England have already received their booster and this has allowed us to ease COVID-19 restrictions.
“You can book online, visit a walk-in or one of our many pop-up vaccination clinics – please get boosted now.”
Registration rates remain high due to lifetime registration – over 96% of the Scottish population were registered with an NHS dentist in September 2021 – but the percentage of children registered fell from 91.4% in 2020 to 87.7% in 2021.
Participation rates – contact with a dentist within the past 2 years – continued to fall during the pandemic due to ongoing restrictions imposed on dental practices. At 30 September 2021, just over half of registered patients (52.6%) had seen an NHS dentist within the last two years, a considerable reduction from almost two-thirds (65.1%) in 2020. The participation rate among children was higher than for adults (63.9% compared to 50.2%).
Oral health inequalities between the most and least deprived areas in Scotland continue to grow, with the new data showing record gaps in participation rates.
In September 2008, the gap between the child participation rates for the most and least deprived areas was three percentage points; this had increased to seven percentage points by 2010, and eighteen percentage points (55.3% compared to 73.1%) in September 2021.
Similarly, in September 2008 the gap among adults was three percentage points; this had increased to six percentage points by 2010, and eleven percentage points (45.1% compared for 56.4%) in September 2021.
The BDA has repeatedly warned that lower levels of participation will inevitably translate into a higher disease burden, with deep oral health inequalities expected to widen even further, given the cumulative impact of limited access to services, the suspension of public health programmes, and the impact of lockdown diets.
Lower participation will reduce the chance of picking up early signs of decay and oral cancers at routine check-ups, and delays in treatment will mean higher costs to the NHS and worse outcomes for patients.
Free NHS dental care at the point of use remains a central Scottish Government policy. The stark results of a recent BDA survey showed that Scottish Government plans to revert to pre-COVID models of care risk sparking a flight of dentists from the NHS, with potentially devastating consequences for patient access across Scotland.
BDA Scotland has long warned that a return to a ‘business as usual model’ – low margin and high volume – will put practices under unsustainable financial pressure and will likely lead to closures or movement to the private sector.
BDA Scotland repeats its assertion that the Scottish Government must, in the short term, develop a suitable interim funding package to support dentists and their teams as they work through the backlog, and begin work on a new, sustainable long-term model for NHS dentistry.
Robert Donald of the British Dental Association’s Scottish Council said: “Today’s figures provide further evidence of the devastating effect of the pandemic on dental services.
“Plummeting participation rates and the record gap in oral health inequalities present a bleak picture which will take a real commitment of time and resource to fix.
“The Scottish Government needs to heed the concerns of the profession. It’s not just their signature policy of free dentistry that risks becoming unattainable. Failure to act risks sparking an exodus from the workforce that will leave families across Scotland losing access to NHS dentistry for good.”
The public are being urged to sign-up to a world-leading study for antivirals if they test positive for COVID-19
Recruitment drive backed by charities including Kidney Care UK, Cystic Fibrosis Trust, Diabetes UK and the British Liver Trust as antivirals help protect most vulnerable from hospital
At least 6,000 more participants needed as soon as possible so the life-saving treatments can be rolled out more widely
Adults over the age of 50 or with an underlying health condition who test positive for COVID-19 are being urged to sign up for a world-first COVID-19 study which is providing life-saving antivirals to thousands of people.
The UK government and leading charities, including Kidney Care UK, Cystic Fibrosis Trust, Diabetes UK and the British Liver Trust, are calling on at least 6,000 more participants to come forward for these cutting-edge treatments through the PANORAMIC study.
This is so that expert scientists can understand more about how to deploy these treatments in the NHS more widely later in the year – including who would benefit most from receiving antiviral treatments for COVID-19.
Antivirals are medicines which can be swallowed as a tablet to help treat people with COVID-19 infections to reduce the risk of hospitalisations and death. Molnupiravir, which is currently being deployed through the study, has shown to reduce this for at risk, non-hospitalised adults with mild to moderate COVID-19 by 30% – potentially saving thousands of lives once the drugs are available to the NHS.
Anyone over the age of 50 or between 18 to 49 with an underlying health condition can sign up to the study as soon as they receive a positive PCR or lateral flow test result. They need to be experiencing COVID-19 symptoms that began in the last five days to be eligible to enrol.
Health and Social Care Secretary Sajid Javid said: “The vaccines are critical as a first line of defence, but antivirals form a vital part of our approach as we learn to live with COVID by preventing the most vulnerable from being hospitalised.
“If you’re eligible, please step forward for the PANORAMIC trial and play your part in a vital mission – helping us to learn more about medicines which could save thousands of lives.”
The UK-wide study, run by the University of Oxford and supported by the National Institute for Health Research (NIHR), launched at the start of December 2021 and currently has around 4,600 trial participants signed up, but needs thousands more to sign up as soon as possible to gather the data necessary.
This will ensure medical experts can learn more about the potential benefits these treatments bring to vaccinated patients, and will help the NHS to develop plans for rolling out the antivirals to further patients later this year.
It is open to anyone living in the UK who meets the following criteria:
Have received a positive PCR or lateral flow test for COVID-19 and feel unwell with symptoms of COVID-19 that started in the last five days; and
are aged 50 and over, or 18 to 49 years old with an underlying medical condition that can increase the risk of developing severe COVID-19.
While vaccines remain the most important first line of defence against the virus, antivirals are used after someone contracts the virus to slow it down, make symptoms less severe and complications less common.
The antiviral, molnupiravir, that is part of the PANORAMIC trial, was granted approval for use by the Medicines and Healthcare Regulatory Authority (MHRA) in November 2021, and so far no unexpected safety findings have been reported in clinical trials.
The UK government, through the Antivirals Taskforce, has procured 4.98 million courses of antivirals – including 2.23 million courses of molnupiravir and 2.75 million courses of PF-07321332/ritonavir.
Professor Sir Jonathan Van-Tam, Deputy Chief Medical Officer for England, said: “If you’re eligible for PANORAMIC please give some serious consideration to taking part.
“This will help us decide how to use COVID-19 antiviral drugs for many years to come.”
Eddie Gray, Chair of the Antivirals Taskforce, said: “Antivirals are a hugely important addition to our response to COVID-19 and we have secured access to two important products for NHS patients.
“Getting people enrolled onto this study is vital, not just in protecting the most vulnerable now, but in ensuring we can deploy these medicines more widely as soon as possible.”
Pippa Erskine, double lung transplant recipient who lives with Cystic Fibrosis, accessed antivirals after testing positive for COVID-19 at the start of January. Pippa said: “Even after three vaccines, testing positive for COVID-19 after avoiding the virus for more than 18 months was worrying.
“Knowing antivirals would help ease my symptoms and help prevent potential complications was a huge relief.
“With restrictions easing, it’s so important that those vulnerable to COVID-19 have the best possible chance of staying protected against the virus and, most importantly, staying out of hospital. Antivirals are essential to this.
“I’d urge anyone eligible for the trial to put themselves forward to help make antivirals more widely available, and to protect themselves and others.”
Mr Harkishan Mistry, age 58, is General Secretary of Bradford Hindu Council said: “After testing positive for COVID-19 last Monday on a lateral flow, a friend recommended I look into the antivirals trial.
“As I’m over 50 and was experiencing symptoms such as sore throat, headache, and achiness, I was eligible and was selected to receive the antiviral treatment by Monday afternoon.
“The whole process was so simple – a courier delivered the capsules the next morning and I began taking the course straight away. While I’m still testing positive and remain in isolation, my symptoms eased daily and I feel much better.
“I’d really recommend anyone who’s eligible for the trial to sign up – why would you not if we can help others and ease pressure on the NHS.”
Hazel, a pharmacist from Whitley Bay, got COVID-19 early in January and so signed up to the trial immediately to help find antiviral medicines to treat the virus.
Hazel said: “I enrolled online when I got COVID-19 and the process was really simple. I got a call from a nurse right away who took me through everything and since then I’ve just had to keep a short online daily diary which takes less than a minute to do.
“The process really couldn’t be simpler, and it’s so exciting to be part of this world leading effort to find a treatment for COVID-19.
“Both as someone who got COVID-19 and as a pharmacist, I know the damage this virus can do and would urge anyone eligible to visit the website and really consider getting involved as it could save lives.”
Fiona Loud, Policy Director at Kidney Care UK, said: “We welcome the development and provision of antiviral treatments for people who are vulnerable to COVID-19.
“This trial is one of the ways to make them more widely available so we would like to encourage everyone who is eligible, including those with kidney disease, to take part in this study.
“While we continue to encourage people to take up the offer of vaccinations, antiviral treatments are going to be a vital tool to give more protection to people who are most at risk from COVID-19, including those with kidney disease.”
Vanessa Hebditch, Director of Policy at the British Liver Trust, said: “The introduction of new treatments for COVID-19 for the most vulnerable is an important and welcome development in the tackling of the pandemic.
“People with liver disease and liver transplant recipients are among the highest risk from COVID-19 and have less immunity from vaccines so treatments are vital to reduce their risk of hospitalisation should they catch the virus.
“We urge people living with a liver condition to consider signing up for trial to protect themselves and ensure that more people can access these treatments.”
David Ramsden, chief executive of Cystic Fibrosis Trust, said: “It is vital for that we continue to focus on the development and evaluation of new treatments for COVID-19.
“This is a really important study and we would encourage all eligible people with cystic fibrosis to get involved.”
An inquiry into the different ways patients access healthcare services in Scotland has been launched by the Health, Social Care and Sport Committee.
Traditionally, when a person seeks healthcare their first point of contact is usually with a general practitioner (a GP or family doctor) but the inquiry is focused on other routes to accessing healthcare that exist in the community, referred to as ‘alternative pathways’.
The aim of the inquiry is to explore how and to what extent these alternative pathways are being used to access primary care, and to identify key issues and opportunities for improvement.
Alternative pathways to healthcare in the community include:
Seeing a different health practitioner, such as a physiotherapist, nurse, pharmacist, speech therapist, or podiatrist who works in the GP practice or in the local community.
Being directed to other types of support to improve health and wellbeing – such as walking groups, community groups, advice, or volunteering (referred to as ‘social prescribing’).
Using telephone helplines websites to access additional information, advice and online therapies.
The Committee is seeking to find out the current level of awareness amongst health practitioners and patients of alternative pathways to healthcare other than seeing a GP and how this might be improved in the future.
They are keen to find out what capacity other primary healthcare professionals have to take on more patients, the role of social prescribing in alternative pathways and how technology can improve services.
Speaking as the inquiry launched, Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said:“The traditional model of primary care where you went to see a GP for any and all health issues is placing ever increasing pressure on GP services.
“This isn’t a sustainable situation for general practices – but it’s also not good for patients struggling to get a GP appointment when there may be alternative and better routes they could go down to get the healthcare they need.
“Through our detailed work on this inquiry, the Committee is keen to explore what opportunities exist to make more and better use of these alternative routes to healthcare.
“We want to find out what role they have to play in creating a modern, flexible, community-based healthcare system which allows patients to access the right professional, at the right time.”
Glasgow’s homeless and at risk communities get boosted against COVID
Some of Glasgow’s most vulnerable communities have been getting boosted at the Lodging House Mission in the city centre.
Advanced Nurse Practitioners have been providing jags from the charity’s premises in the city centre, where they provide care and support to homeless, vulnerable and socially excluded people.
Glasgow City’s Health and Social Care Partnership’s Complex Needs Service – previously known as Homeless Health Service – support around 450 people at any one time. The people they see often have addiction issues, mental health issues and often really poor physical health.
At the first clinic last week, 36 jags were administered – and the team hope more people will attend the clinic as more people hear about the weekly clinic. The team has already visited around 50 locations across the city where homeless people are located, putting more than 900 jags into arms.
Kirsty Paterson, the senior advanced nurse practitioner who co-ordinates and delivers the vaccine programme, said: “We’re very pleased to be able to do this work and to help some of Glasgow’s most vulnerable communities to get their vaccines and boosters.
“Once word spread that we were here at the Lodging House we were surprised, but really pleased to see a queue outside the door. The response has been fantastic.”
Lisa Ross, Service Manager at the service, said: “Some of the people we work with have very complex health and care needs. A severe COVID infection could be fatal.
“Throughout the pandemic, our team has been reaching out to vulnerable communities, going where they are and providing a service which helps to save lives. We’re grateful to the Lodging House Mission for their help in the vaccination efforts and we’ll continue to do everything we can in the fight against this virus.”
June Macleod, Manager at the Lodging House Mission said: “We’re delighted to have the vaccination clinic on site. A lot of our guys have underlying health issues and don’t engage and don’t often keep appointments, so bringing the vaccinations to them is a big help.
“The team have been fantastic and we’re really excited to see who might come to the next clinic, we know there’s been a real buzz as words spreads. It’s been great working alongside our colleagues from the health board in the fight against COVID helping to keep vulnerable people and our communities safe.”
The vaccination clinic will continue to operate every Tuesday at the Lodging House Mission’s premises on East Campbell Street.
Voluntary scheme to encourage people to give space
Free badges and lanyards will be available to people who wish to show others they would welcome additional space and extra care while out in public.
The Distance Aware scheme is a voluntary initiative to help those on the Highest Risk List or anyone who feels worried about mixing with others as we adapt to living with COVID-19.
The Scottish Government has joined the scheme set up by the Bevan Commission and adapted it following research which showed that almost three quarters (73%) of people on the Highest Risk List said they would like to signal to others to give them extra space.
From 26 January, the badges and lanyards with the easily-recognisable shield symbol will be available free from all community and mobile libraries in Scotland. Badges will also be free from Asda stores. They can be ordered from the Scottish Government website for a small postal fee.
Health Secretary Humza Yousaf said: “We are beginning to adapt to living with COVID-19 but we know that, for some people who have been at higher risk or feel anxious about going out in public, this is a big step.
“This scheme not only provides vital reassurance to anyone who chooses to wear a badge or lanyard, but also encourages us all to be more aware and considerate of those around us – as we simply don’t know their circumstances or concerns.
“I hope this will help people feel more confident and comfortable to go about their daily lives. The shield symbol can be worn by anyone.”
British Red Cross Scotland Director of Independent Living and Crisis Response Marie Hayes said: “We fully support the aims of the Distance Aware campaign and will be proud to highlight the scheme to callers contacting our Connecting With You service. Many people are experiencing loneliness, and are fearful of going out of their own homes as a result of the pandemic.
“We believe Distance Aware can help overcome this and help them to re-engage with social activities. This could be invaluable in helping to tackle loneliness.”
Asda Senior Director for Scotland Brian Boyle said: “We are delighted to work with the Scottish Government to implement this scheme in Scotland. There has been interest in the free Distance Aware badges, particularly from our more vulnerable customers.
“As people become aware of the badge and its meaning, the more effective it will be in helping people to feel safer and less worried when they are out and about.”
Commenting on the latest Urgent and Emergency Care Daily Situation Report 2021-22 that shows nearly one third of patients who were in hospital for 21 days or more were fit for discharge, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:“These data reflect the deepening social care crisis.
“We currently have the highest number of long stay patients (21 days or more) since winter 2017-18. Last week, on average, 6,500 beds were occupied by patients who are fit for discharge, and only one in 10 of these patients were able to be discharged daily (on average). All these patients will want to return home and to their communities, but they are unable to because there isn’t the support to aid them upon their discharge.
“There must be a system-wide effort and focus on discharging patients, but such effort will only translate to meaningful action if the government address and take urgent steps to resource social care. Freeing up these beds would help alleviate system pressures, particularly those on Emergency Departments, and promote vital flow throughout the hospital.”
