Transport leaders welcome support for retaining Spaces for People/Travelling Safely measures

Edinburgh’s Transport leaders have welcomed calls by more than 140 medical professionals to retain and expand upon measures introduced to support walking, wheeling and cycling during lockdown.

Doctors and health workers from across the city have published an open letter to the City of Edinburgh Council in support of the Travelling Safely programme, formerly Spaces for People.

The group cites the positive impacts of more active travel on health, inequality, air quality and in tackling the climate crisis, amongst other benefits.

In June, Transport and Environment Committee approved proposals to retain some of the schemes on an experimental basis, to remove others post-pandemic and to engage further with communities on options for a handful of measures.

Councillor Lesley Macinnes, Transport and Environment Convener said: “The collective voice of this wide range of medical and health professionals is incredibly welcome.

“We’ve been vocal about our commitment to encourage travel by foot, wheel or bike, and the benefits this brings, but to have the support of the medical profession demonstrates just how crucial investment in safe, protected routes is.

“Over the last year and a half we’ve introduced changes which have helped many people to feel newly confident about walking, cycling and wheeling safely. There are, of course, tens of thousands of people in Edinburgh who don’t have access to a car. We now have the opportunity to extend the lifespan of many of these measures and to improve upon them so that they work for as many people as possible.

“The evidence is clear and well expressed in this letter – there’s so much to gain from active travel, in terms of health, quality of life and in limiting our impact on the climate. We simply cannot return to the status quo, where private car journeys dominate the streets.

“By retaining the majority of schemes introduced through Spaces for People, we’re laying the foundations for a happier, healthier future for everyone here.

Councillor Karen Doran, Transport and Environment Vice Convener, said: “It’s indisputable that walking, wheeling or cycling, whether for leisure or commuting, has a positive impact on our health, our state of mind and our pockets, as well as the air we breathe. We wholeheartedly recognise and support these calls to retain and expand on the measures we’ve introduced during the pandemic.

“Temporary protected cycle lanes, widened pavements and quiet routes have helped families to walk safely to school, shoppers to spend time strolling through some of our iconic city centre streets and people trying out cycling for the first time.

“We really want to continue delivering these benefits, and we’ll be working hard to make sure the measures we have kept do just that.”

Read the full letter below:

Open letter to the City of Edinburgh Council 

Dear Councillors,  

We are a group of doctors and other health professionals, living or working in Edinburgh, and write to support the retention and extension of changes to travel infrastructure in Edinburgh and the Lothians, to improve public health and mitigate climate emergency. We hope that the points and evidence below will support the council to make decisions that will help to benefit, protect, and reduce inequalities in the health of the population of Edinburgh.  

Climate crisis and health 

One of the duties of a doctor as stated by the General Medical Council is “to protect and promote the health of patients and the public”1. As health professionals we have been reminded by our professional bodies of our responsibilities to raise the profile of the climate emergency, which is a public health emergency likely to have a much greater impact than COVID-192,3.

We have a responsibility to speak up for disadvantaged groups who are disproportionately vulnerable to the health and economic impacts of the climate crisis.  

Health Inequality

Those living in areas of deprivation are less likely to drive but much more likely to be injured in a road traffic collision6. Rates of pedestrian casualties are twice as high in children as in adults, and pedestrians over 70 years of age have the highest fatality rate7.  

Many of our patients do not have the financial means, health status, or abilities to access private car transport. Children, the frail elderly, and people with chronic illnesses or disabilities are disadvantaged in opportunities to access services and community by systems which prioritise private car transport.  

Moves to promote safe active travel, including widening of pavements and provision of segregated paths, make the urban environment more accessible for people with disabilities and release road space for reliable and efficient public transport.  

Measures to improve the urban environment and promote active travel in Edinburgh will differentially benefit the most disadvantaged members of our community and so help to reduce health inequalities in Edinburgh. We ask that councillors carefully consider the differential impact of decisions to prioritise private car transport on those for whom private car transport is not an option.  

Air pollution and health 

Air pollution is strongly associated with poor health outcomes. A joint Royal College of Physicians and Royal College of Paediatrics and Child Health report estimated that outdoor air pollution causes 40,000 deaths a year in the UK. Data from Scotland shows a particularly strong association between air pollution and respiratory disease and deaths. Transport – predominantly car transport – is the main source of air pollution in Scotland.  

Edinburgh City Council has six Air Quality Management Areas, with concerning levels of air pollution related to vehicular traffic.  

Decisive action from the council to promote active travel and reduce private car traffic in Edinburgh will help to reduce air pollution and associated harm to health.  

Physical activity and health 

Regular physical activity is associated with improved health outcomes at all ages13.  

UK Chief Medical Officers recommend that children and young people should engage in moderate physical activity for at least one hour every day. For adults, 150 minutes of moderate activity per week is associated with a 40% reduction in risk of type 2 diabetes, 35% reduction in heart disease, 25% reduction in joint and back pain, and 20% reduction in bowel and breast cancer13.  

National data indicates that in Scotland during 2019 only 66% of adults met this target, whilst in the same year fewer than 50% of journeys under two miles were made on foot14.  

Segregated active travel infrastructure allows everyone to increase their physical activity levels through active travel; not only those who already enjoy regular physical activity.  

We ask that the council considers the beneficial and protective health effects of physical activity when considering its decisions about travel infrastructure in Edinburgh.   

Behaviour change for public health 

Changing established patterns of behaviour is difficult. We understand that a move away from the current position of private car dependency can feel difficult.  

Bold Scottish strategies have led to strikingly effective population shifts in behaviour for better health; tobacco smoking restrictions have saved many lives, and early data suggests that minimum alcohol unit pricing has reduced the amount of alcohol purchased by the heaviest alcohol consumers15,16. Both of these strategies met with initial resistance, but are now broadly supported. 

Now, local government in Edinburgh has the potential to lead a bold and exemplary modal shift away from car-dependence which will benefit and protect the health of the people of Edinburgh.

Key Points

  • As health professionals, we have a responsibility to protect and promote the health of the population. We have a responsibility to address inequalities and to advocate for the needs of the most deprived and disadvantaged members of the population we serve.  
  • We are concerned about the impact of the climate crisis on health, globally and locally. 
  • We are concerned about harms to health caused by air pollution in Edinburgh. 
  • Regular physical activity is associated with improved health outcomes at all ages.  
  • We support the retention, and further development and integration of infrastructures designed to support active travel and clean air for the whole population of Edinburgh, to mitigate inequalities in health, local mobility, and air quality.  
  • This includes quiet routes in the vicinity of schools to allow safe active travel for families, an integrated network of segregated safe paths for cycling, city-wide subsidised cycle hire programmes, and low-emission zones.  
  • We are concerned that suggested steps to reverse active travel measures introduced during the COVID-19 pandemic would be a retrograde and harmful step for the health of the population of Edinburgh.  

Yours sincerely, 

Dr Laura McWhirter, Consultant Neuropsychiatrist, Edinburgh
Neil Aitken, Physiotherapist, Neil Aitken Physiotherapy Ltd, Edinburgh
Dr Niall H. Anderson, Senior Lecturer in Medical Statistics, Usher Institute, University of Edinburgh
Dr Ross Archibald, Consultant in Emergency Medicine, NHS Lothian
Dr Elika Aspinall, General Practitioner, NHS Lothian
Dr Katherine Atkins, Chancellor’s Fellow, Edinburgh Medical School, University of Edinburgh
Dr Paul Bailey, General Practitioner, NHS Lothian
Miss Emily Baird, Consultant, Children’s Orthopaedics, Royal Hospital for Children and Young People Edinburgh
Dr Kasia Banas, UG Talent Lead and Programme Director in Data-Driven Innovation for Health and Social Care, Usher Institute, University of Edinburgh
Dr Ravneet Batra, Consultant Liaison Psychiatrist, Regional Infectious Diseases Unit, Western General Hospital
Dr Roland Baumann, General Practitioner, Niddrie Medical Practice, Edinburgh
Dr Craig Beattie, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Dr Monika Beatty, Consultant in Critical Care, Royal Infirmary of Edinburgh
Dr Sam Bennett, Foundation Doctor, Acute Medicine, Western General Hospital
Ms Katherine Bethell, Advanced Nurse Practitioner and Programme Manager, Chalmers Sexual Health Centre (Lothian) and Sandyford Centre (GGC)
Dr David Birrell, Emergency medicine trainee, Royal infirmary of Edinburgh; Honorary Clinical Fellow, University of Edinburgh
Professor James Boardman, Professor of Neonatal Medicine, University of Edinburgh
Dr Friederike Boellert, Respiratory Consultant, Western General Hospital, Edinburgh
Dr Kirsty Boyd, Reader in Palliative Care, Usher Institute, University of Edinburgh
Dr Tom Bloomfield, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Mr Paul Brennan, Reader and Honorary Consultant Neurosurgeon, University of Edinburgh and NHS Lothian
Mr Iain Brown, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh
Dr John Budd, General Practitioner, Edinburgh Access Practice, and Co-ordinator of Lothian Deprivation Interest Group
Dr Rosamunde Burns, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Dr Peter Cairns, General Practitioner, Wester Hailes Medical Practice
Professor Alan Carson, Consultant Neuropsychiatrist, University of Edinburgh
Dr Simon Chillingworth, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Professor Richard Chin, Professor of Paediatric Neurology and Clinical Epidemiology, Honorary Consultant Paediatric Neurologist, University of Edinburgh and The Royal Hospital for Children and Young People
Dr Sarah Clay, Locum General Practitioner, Niddrie Medical Practice, and Specialty Doctor in Palliative Care
Dr Elizabeth Cole, Anaesthetics registrar, Royal Infirmary of Edinburgh
Dr Catherine Collinson, Consultant Anaesthetist, Department of Anaesthesia, Royal Infirmary of Edinburgh
Dr Claire Cooke-Jones, Trainee Anaesthetist, Royal Infirmary of Edinburgh
Dr Robert Cooke-Jones, Trainee General Practitioner, Inchpark Surgery, Edinburgh
Dr Nadine Cossette, Consultant Liaison Psychiatrist, Royal Infirmary of Edinburgh
Dr Helen Creedon, Clinical Fellow in Oncology, University of Edinburgh
Dr Julia Critchley, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Dr Craig Davidson, Consultant in Emergency Medicine, NHS Lothian
Professor Adrian Davis, Professor of Transport & Health, Edinburgh Napier University
Dr Christopher Dickens, General Practitioner, Edinburgh
Ms Lynsey Downie, Anaesthesia Associate, Edinburgh Royal Infirmary
Mr Andrew Duckworth, Senior Lecturer and Consultant Orthopaedic Trauma Surgeon, Edinburgh Orthopaedics and University of Edinburgh
Mr Joseph Duncumb, Orthopaedic Surgery Registrar, Royal Infirmary of Edinburgh
Dr Tamasin Evans, Consultant Clinical Oncologist, Edinburgh Cancer Centre
Dr Alasdair Fitzgerald, Clinical Lead, Rehabilitation Services and Consultant in Neurorehabilitation, Astley Ainslie Hospital, Edinburgh
Dr Nicholas Fletcher, Trainee General Practitioner, NHS Education Scotland
Professor Sue Fletcher-Watson, Chair in Developmental Psychology, Division of Psychiatry, University of Edinburgh
Mr Martin Gemmell, Principal Educational Psychologist, City of Edinburgh Council
Ms Paula Gardiner, Neurological Specialist Physiotherapist and Cognitive Behavioural Therapist, Edinburgh
Dr Cameron J Fairfield, Clinical Research Fellow, University of Edinburgh
Dr Gavin Francis, General Practitioner, Dalkeith Road Medical Practice, Edinburgh
Dr Allan Gordon, Retired Consultant Obstetrician and Gynaecologist, Edinburgh
Dr Claire Gordon, Consultant in Acute Medicine, Western General Hospital, Edinburgh
Dr Rebecca Gormley, Anaesthetic Core Trainee, Royal Infirmary of Edinburgh
Dr Peter S Hall, Honorary Consultant Medical Oncologist, Edinburgh Cancer Centre at St John’s Hospital and the Western General Hospital
Dr Helen Hare, Junior Doctor, Edinburgh Royal Infirmary
Dr Simon Heaney, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Dr Ingrid Hoeritzauer, Consultant Neurologist and Acute Traumatic Brain Injury Rehabilitation, Royal Infirmary of Edinburgh
Dr Catriona Howes, Consultant Psychiatrist, Western General Hospital, Edinburgh
Dr Seán Keating, Consultant in Cardiothoracic Anaesthesia and Intensive Care Medicine, Royal Infirmary of Edinburgh
Dr Malik Jahangeer, Consultant Clinical Oncologist and Honorary Senior Clinical Lecturer, University of Edinburgh
Dr Marc Janssens, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Mr Aimun Jamjoom, Speciality Neurosurgery Trainee, Edinburgh Royal Infirmary
Dr Michelle Jeffrey, Consultant Sports and Exercise Medicine, Sportscotland Institute of Sport, Oriam, Edinburgh
Dr Guy Johnson, General Practitioner (retired), Sighthill Health Centre
Professor John Keating, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh; Honorary Senior Lecturer, Edinburgh University
Dr Stephanie Kelly, Clinical Fellow in Intensive Care, Royal Infirmary of Edinburgh
Dr Dean Kerslake, Consultant, Royal Infirmary of Edinburgh
Dr Alice King, Trainee General Practitioner, Edinburgh
Dr Oliver Koch, Consultant & Honorary Senior Clinical Lecturer in Infectious Diseases, Regional Infectious Diseases Unit, Western General Hospital
Dr Rebecca Lawrence, Consultant Psychiatrist in Addictions, Royal Edinburgh  Hospital
Mr Graham Lawson, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh
Yvonne Leavy, Lead Clinical Nurse Specialist (epilepsy) Department for Clinical Neurosciences, RHCYP, Royal Infirmary of Edinburgh
Dr Katharine Logan, Consultant Psychiatrist in Psychotherapy, Rivers Centre, Edinburgh
Dr Nazir Lone, Honorary Consultant and Senior Lecturer in Critical Care, Royal Infirmary of Edinburgh, NHS Lothian and University of Edinburgh
Dr Carey Lunan, General Practitioner, Craigmillar Medical GroupDr Saturnino Luz, Reader in Medical Informatics, Usher Institute, Medical School, The University of Edinburgh
Dr Saturnino Luz, Reader in Medical Informatics, Usher Institute, Medical School, The University of Edinburgh
Dr Sonia MacCallum, General Practitioner, Niddrie Medical Practice
Dr Claire Mackintosh, Consultant Infectious Disease Physician and Clinical Director, Regional Infectious Disease Unit, NHS Lothian
Dr Ivan Marples, Consultant in Pain Medicine and Anaesthesia, Leith Community Treatment Centre
Dr Katie Marwick, Clinical Lecturer in Psychiatry, University of Edinburgh
Dr Alexander von Maydell, Junior Doctor, Royal Infirmary of Edinburgh
Miss Julie McBirnie, Consultant Orthopaedic Surgeon, Spire Shawfair Park Hospital
Professor Alison McCallum, Centre for Population Health Sciences, Usher Institute, University of Edinburgh
Dr Dermot McKeown, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Professor Andrew McIntosh, Professor of Biological Psychiatry and Honorary Consultant Psychiatrist, University of Edinburgh
Dr Christina McManus, Doctor, Western General Hospital
Dr Carinne McMurray, General Practitioner, Craigmillar Medical Group
Professor Stewart Mercer, Professor of Primary Care and Multimorbidity, Usher Institute, University of Edinburgh; General Practitioner, NHS Lothian
Dr Eve Miller-Hodges, Senior Clinical Lecturer & Honorary Consultant in Inherited Metabolic Disorders and Renal Medicine, Scottish Inherited Metabolic Disorders Service & University of Edinburgh
Dr Lyle Moncur, Consultant in Emergency Medicine, Royal Infirmary of Edinburgh
Mr Matthew Moran, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh
Dr Catriona Morton, General Practitioner, Craigmillar Medical Group
Dr Megan Mowbray, Consultant Dermatologist, Clinical Lead Dermatology, Skin Cancer Lead NHS Fife, Queen Margaret Hospital, Dunfermline (& resident of Edinburgh)
Mr Samuel Molyneux, Consultant in Trauma and Orthopaedic Surgery, Royal Infirmary of Edinburgh
Ms Mome Mukherjee, Senior Research Fellow, Usher Institute, University of Edinburgh
Dr Nóra Murray-Cavanagh, Clinical Lead General Practitioner, Wester Hailes Medical Practice
Dr Susan Nelson, General Practitioner, Mackenzie Medical Centre, Edinburgh
Dr Anna Noble, General Practitioner, Wester Hailes Medical Practice
David Obree, Archie Duncan Fellow in Medical Ethics and Fellow in Medical Education, Usher Institute, University of Edinburgh
Dr Richard O’Brien, Consultant Stroke Physician, Royal Infirmary of Edinburgh, Honorary Clinical Senior Lecturer, University of Edinburgh
Dr Laura O’Conaire, General Practitioner, Braefoot Medical Practice, Edinburgh
Dr Rory O’Conaire, General Practitioner, West End Medical Practice, Edinburgh
Dr Ailis Orr, Consultant Paediatrician, Royal Hospital for Children and Young People, Edinburgh
Mr James Patton, Clinical Director Orthopaedics, Consultant Orthopaedic Surgeon, Royal Infirmary Edinburgh
Dr. Meghan Perry, Consultant Physician and Honorary Senior Clinical Lecturer in Infectious Diseases and General Internal Medicine, Western General Hospital, Edinburgh
Dr Sharon Peoples, Consultant in Clinical Oncology, Edinburgh Cancer Centre
Professor Martyn Pickersgill, Co-Director of Research, Usher Institute, University of Edinburgh
Dr Evgeniya Plotnikova, Teaching Fellow, Master of Public Health Programme, University of Edinburgh
Dr S.G. Potts, Consultant in Transplant Psychiatry, Royal Infirmary of Edinburgh
Dr Michael Quinn, General Practitioner, Craigmillar Medical Group
Dr Martin Quirke, Research Fellow, Centre for Environment, Dementia and Ageing Research, University of Stirling (& resident of Edinburgh)
Dr Kristiina Rannikmäe, Consultant Neurologist and Clinical Research Fellow, Forth Valley Royal Hospital and University of Edinburgh
Ms Aїcha Reid, Registered Educational Psychologist, Edinburgh
Dr Helga Rhein, General Practitioner (retired), Edinburgh
Dr Helen Riches, General Practitioner, Restalrig Park Medical Centre, Edinburgh
Professor Craig Ritchie, Professor of Psychiatry of Ageing, University of Edinburgh; Director of Brain Health Scotland
Dr Alasdair Ruthven, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Professor Rustam Al-Shahi Salman, Professor of Clinical Neurology at the University of Edinburgh; Honorary consultant neurologist in NHS Lothian
Dr Euan Sandilands, Consultant Toxicologist and Director National Poisons Information Service (Edinburgh); Honorary Clinical Senior Lecturer, University of Edinburgh
Ms Chloe Scott, Consultant Trauma and Orthopaedic Surgeon, Royal Infirmary of Edinburgh
Dr Ann Sergeant, Consultant Dermatologist, NHS Fife (Edinburgh resident)
Dr Anthony Simon, General Practitioner, Craigmillar Medical Group
Dr Chris Smith, Foundation Doctor, Western General Hospital, Edinburgh
Dr Nick Spencer, Anaesthetic Trainee, Western General Hospital, Edinburgh
Dr Andrew Stanfield, Senior Clinical Research Fellow and Honorary Consultant Psychiatrist, University of Edinburgh
Dr Elizabeth Steel, Consultant Anaesthetist, Royal infirmary Edinburgh
Professor Jon Stone, Consultant Neurologist, Edinburgh Royal Infirmary and University of Edinburgh
Professor Cathie Sudlow, Professor of Neurology and Clinical Epidemiology and Head of the Centre for Medical Informatics, Usher Institute, University of Edinburgh
Dr Digby Thomas, General Practitioner to the homeless 2001-2021, Edinburgh Homeless/Access Practice
Dr Sarah Thompson, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Professor Lindsay Thomson, Professor of Forensic Psychiatry, University of Edinburgh; Medical Director of the State Hospitals Board for Scotland and the Forensic Mental Health Managed Care Network
Dr Fionn Toolis, General Practitioner, Wester Hailes Medical Practice, Edinburgh
Professor Neil Turner, Professor of Nephrology, University of Edinburgh; Honorary Consultant, Royal Infirmary of Edinburgh
Dr Stefan Unger, Consultant Respiratory Paediatrician, Royal Hospital for Children and Young People
Dr Helen Usher, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Dr Anna te Water Naudé, Acute Medicine Core Trainee, Royal Infirmary of Edinburgh
Stephen Walls, Senior Charge Nurse, General Intensive Care, Royal Infirmary of Edinburgh
Dr Charles Wallis, Consultant Anaesthetist and Chair of Bicycle Users Group, Western General Hospital
Dr Andrew Watson, Associate Medical Director for Psychiatry, NHS Lothian
Ms Abby White, Psychiatric Nurse, Edinburgh
Mr T.O. White, Consultant Orthopaedic Trauma Surgeon (Clinical Lead for Trauma), Royal Infirmary Edinburgh, and Honorary Lecturer, University of Edinburgh
Dr William Whiteley, Reader in Neurology, University of Edinburgh; Honorary Consultant Neurologist, NHS Lothian
Dr E.B. Wilson, Emergency Department Consultant, Emergency Department, Royal Infirmary of Edinburgh
Dr Hilary Young, General Practitioner, Mackenzie Medical Centre / University of Edinburgh

Post-publication supporters: (added after 6th September 2021):

Dr Anna Gaskell, General Practitioner, Newbattle Medical Practice
Dr Andrew Grant, Consultant Anaesthetist, Royal Infirmary of Edinburgh
Lydia Howells, Lead Nurse for Quality & Standards, NHS Lothian
Dr Catriona McLean, Clinical Director and Consultant Clinical Oncologist – Lower GI Cancer, Edinburgh Cancer Centre
Professor Gillian Mead, Chair of Stroke and Elderly Medicine, University of Edinburgh
Dr David Noble, Consultant Clinical Oncologist, Edinburgh Cancer Centre
Dr Faye Robertson, Oncology Registrar, Edinburgh Cancer Centre
Professor Roy Robertson, Chair of Addiction Medicine, University of Edinburgh, and General Practitioner, Edinburgh
Louise Starkey, Practice Nurse, Slateford Medical Practice, Edinburgh
Dr Lucy Wall, Consultant Medical Oncologist, Edinburgh Cancer Centre

Find out more about the Travelling Safely programme on the Council website.

Mobile Testing Units deliver one million tests in one year

Scottish Ambulance Service Mobile Testing Unit (MTU) teams have delivered more than one million tests in just over a year.

The MTUs have been one of biggest projects ever carried out at the Scottish Ambulance Service (SAS).

There are now 39 MTU teams across the country and more than 1100 people employed by the Scottish Ambulance Service, providing a vital service to Scotland.

The MTUS can be dispatched quickly across the country so people in urban, rural and remote areas have easy access to a coronavirus test. The location of the units, planned by National Services Scotland and local resilience partnerships, changes regularly to reflect demand.  

John Alexander, General Manager for the Mobile Testing Units (MTUs), said: “The introduction of MTUs has played an important role in the country’s fight against Covid-19, helping to control the spread of the virus.

“All of our MTU staff have done a fantastic job in providing tests to the people of Scotland over the past year and I’m extremely proud they’ve delivered more than one million tests since last September.”

Cabinet Secretary for Health and Social Care Humza Yousaf said: “Reaching one million tests is a major milestone and recognition of the hard work and dedication of Scottish Ambulance Service. My heartfelt thanks go to SAS staff for what they do every single day to care for, and support people across Scotland.

“Our COVID-19 Mobile Testing Units have played a crucial role in bringing testing resources to the communities who need it most. By identifying and isolating cases, we are breaking chains of transmission within those communities and giving us a better chance of stopping the virus from spreading.”

Holyrood approves Covid vaccination certificates

Scheme will come into effect on 1st October

The Scottish Parliament has approved the use of Coronavirus vaccination certificates to enter some events and higher risk venues.

MSPs voted in favour of the measure, which comes into effect on Friday 1 October, aimed at reducing risk while maximising our ability to keep open certain settings and events where transmission is a higher risk and encouraging uptake of the vaccine.

Coronavirus vaccination certificates will be required to enter events such as nightclubs, music festivals and some football grounds.

Staff at venues affected will be able to download a “verifier app” to a smartphone or device from next week, ahead of the launch, which will allow digital checks on the certification status of those attending.

Guidance will be provided for venues on how to use the app, along with options to integrate it into their own systems as the source code is open. 

Health Secretary Humza Yousaf said: “We must do all we can to stem the rise in cases and vaccine certification will form part of a range measures which can help us to do this.

“It will only be used in certain higher risk settings and we hope this will allow businesses to remain open and prevent any further restrictions as we head into autumn and winter.

“We do not want to re-impose any of the restrictions that have been in place for much of this year as we all know how much harm they have caused to businesses, to education and to people’s general well-being. But we must stem the rise in cases.

“We want to ensure that as many people get vaccinated as possible and particularly to increase uptake in the younger age cohort, so anything that helps to incentivise that is helpful.

“I urge anyone over 16 to get vaccinated at their local drop-in clinic or through NHS Inform.

“Public behaviour, including key protective measures like face coverings, physical distancing, hand washing and isolating when necessary, continues to play a vital role in reducing the prevalence of the virus and helping us to emerge from the pandemic.”

The new scheme is not being introduced until all Scottish adults have had the opportunity to receive both doses of the vaccine and two weeks have passed to allow the vaccine take effect. The Scottish Government continues to work with sectors affected to ensure that a workable and proportionate scheme is developed.

Under 18s and adults who are ineligible for vaccination will be exempt.

There are currently no plans to introduce certification for the wider hospitality industry but this will be kept under review over the autumn and winter months.

The Scottish Licensed Trade Association has re-iterated it’s opposition to “Covid passports” for those visiting nightclubs and larger event settings.

SLTA says although the suggestion is that the wider hospitality industry will not be affected, the First Minister has clearly stated on a number of occasions that this is “under review” and therefore Covid passports remain a threat hanging over the whole industry.

The industry body says the Scottish Government has pushed these proposals through without any meaningful consultation with the industry.

SLTA MD Colin Wilkinson said:The Scottish Government issued a paper on the scheme only this morning, just a few hours ahead of the vote, yet we remain unaware of how it will be implemented.   

“Where is the evidence that this action is needed and is proportionate, a word often used by the Deputy First Minister in the debate this afternoon?  There has been no assessment of the costs to businesses, nor the impact on the sector.

“The sector has been labelled as being a high risk setting, but the hospitality industry is not the only sector where people congregate.  

“There is also the concern that Covid passports could lead to vaccination hesitancy and more entrenched views not to get vaccinated.  Experts confirm that vaccination does not stop infection and can give a false sense of confidence.

“We are all aware of the failings of the Test and Protect scheme and yet the Government is proposing another system be put in place.”

The Deputy First Minister said today: The Government has set out proposals … as part of an approach to protect a very fragile situation that we face in Scotland today of rising infection and hospitality that poses a threat to our National Health Service”

Wilkinson added:- “The Scottish Licensed Trade Association again asks where is that evidence and is concerned on the focus on the hospitality sector as this part of the statement makes no mention of the event sector that this will also impact on or other entertainment venues, just “hospitality”. This only reinforces our concerns that this will be rolled out to the wider hospitality sector.

“We fully support moves to reduce the rate and impact of transmission of coronavirus but these must be proportionate and directed to the sectors or settings responsible for spreading transmission the most.

“The finer details of how this scheme will work should have been discussed with the hospitality industry prior to today’s debate and vote.

“The definition of what constitutes a “nightclub or an analogous venue” must be provided as soon as possible in order to allow premises to put procedures in place for the implementation of the scheme.”

Scotland’s biggest ever flu vaccine programme launches tomorrow

Primary and secondary school pupils will start receiving their flu vaccine tomorrow (Monday) as Scotland’s biggest flu immunisation programme gets underway.

Over four million people will be offered the free flu vaccine this year with secondary school pupils eligible for the first time.  

Running until December all primary and secondary school pupils will be offered the vaccine which is given as a painless nasal spray.

Public Health Minister Maree Todd said: “More people than ever are being offered the flu vaccine and we hope to see a large uptake amongst pupils as we aim to keep flu out of schools this year. 

“If you’ve not missed the deadline for returning consent forms to your school, I’d urge you to complete and return these now.  Last year with the public health measures that were in place, there was lower levels of flu than there has been in previous years so our immunity levels to flu may be lower this year.

“The vaccines are safe and the best way to help protect you, and others, from flu this winter.”

The flu virus changes every year, so you need to get the vaccine every year to stay protected. The flu vaccine cannot give you flu, but it can stop you catching it. The COVID-19 vaccine does not offer any protection from flu, you need to get the separate flu vaccine.

In a small number of cases, the nasal spray may not be suitable, and the vaccine can be given as an injection in the arm instead.

For more information about the flu vaccine, visit www.nhsinfrom.scot/childflu, call 0800 030 8013, or speak to a health or immunisation team, practice nurse, or GP.

While the flu vaccination programme will get underway tomorrow, the decision on Covid vaccinations for 12 – 15 year olds is still to be taken.

Health Ministers of the devolved nations wrote to their respective Chief Medical Officers on Friday to seek further advice.

The joint letter reads:

Dear UK Chief Medical Officers,

We are writing on behalf of the 4 nations of the UK following the recent JCVI discussions on 1 and 2 September regarding the COVID-19 vaccination of children and young people aged 12 to 15.

JCVI has updated its advice on this topic. This advice says that the committee is of the opinion that the health benefits from vaccination are marginally greater than the potential harms. However, that margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal programme of vaccination of otherwise healthy 12 to 15-year-old children at this time.

The JCVI’s advice goes on to suggest that the government may wish to take further advice, including on educational impacts, from the chief medical officers of the 4 nations, with representation from JCVI in these subsequent discussions.

We agree with the approach suggested by JCVI, and so we are writing to request that you take forward work (drawing on experts as you see fit) to consider the matter from a broader perspective, as suggested by the JCVI.

We will consider the advice from the CMOs of the 4 nations, building on the JCVI’s advice, in making our decision. Given the importance of this issue, we would be grateful if you could provide your advice as soon as possible.

Sajid Javid MP
Secretary of State for Health and Social Care, HM Government

Eluned Morgan AS/MS
Y Gweinidog Iechyd a Gwasanaethau Cymdeithasol
Minister for Health and Social Services, Welsh Government

Humza Yousaf MSP
Cabinet Secretary for Health and Social Care, Scottish Government

Robin Swann MLA
Minister of Health, Northern Ireland Executive

6,152 new cases of COVID-19 were reported in Scotland yesterday.

Parents and carers urged to ensure 2 – 5 year olds are vaccinated against flu

Parents and carers of children aged 2-5 are being urged to get their child immunised against flu, particularly as immunity levels may be lower this year. 

Appointment letters are now arriving inviting parents and carers of 2 to 5-year-olds forward for the free flu nasal spray. The spray is a quick and painless way of delivering the flu vaccine to children and won’t give the child flu

The letters will include details on where and when the vaccine will be given.

Deputy Chief Medical Officer Nicola Steedman, said: “Flu can be serious, even for healthy children and young people. That’s why we’re immunising all children aged 2 up to secondary school pupils in S6 against flu this year.

“With public health restrictions in place last year, everybody, including young children were not exposed to the flu virus and are likely to have lower immunity to flu than in previous years. I’d urge all parents and carers to take up the offer of getting the free flu vaccine for their child this year and help stop the spread of flu. The vaccine is safe and offers the best protection we have against flu.”

For more information about the flu vaccine, visit www.nhsinfrom.scot/childflu, call 0800 030 8013, or speak to a health or immunisation team, practice nurse, or GP.

If you have to reschedule your appointment, you can find information on doing this in your child’s vaccination letter. 

Teen vaccinations: Health Chiefs, it’s over to you …

JVCI advises politicians to seek further advice from CMOs

The four Chief Medical Officers will provide further advice on the COVID-19 vaccination of young people aged 12 to 15 with COVID-19 vaccines following the advice of the independent Joint Committee on Vaccination and Immunisation (JCVI).

The independent medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has approved the Pfizer and Moderna vaccines for people aged 12 and over after they met strict standards of safety and effectiveness.

The JCVI has advised that the health benefits from vaccination are marginally greater than the potential known harms. It has advised the government to seek further input from the Chief Medical Officers on the wider impacts.

This includes the impact on schools and young people’s education, which has been disproportionately impacted by the pandemic.

UK health ministers from across the four nations have today written to the Chief Medical Officers to request they begin the process of assessing the broader impact of universal COVID-19 vaccination in this age group.

They will now convene experts and senior leaders in clinical and public health to consider the issue. They will then present their advice to ministers on whether a universal programme should be taken forward.

People aged 12 to 15 who are clinically vulnerable to COVID-19 or who live with adults who are at increased risk of serious illness from the virus are already eligible for a COVID-19 vaccine and are being contacted by the NHS, to be invited to come forward.

The JCVI has advised that this offer should be expanded to include more children aged 12 to 15, for example those with sickle cell disease or type 1 diabetes.

Health and Social Care Secretary Sajid Javid said: “Our COVID-19 vaccines have brought a wide range of benefits to the country, from saving lives and preventing hospitalisations, to helping stop infections and allowing children to return to school.

“I am grateful for the expert advice that I have received from the independent Joint Committee on Vaccination and Immunisation.

“People aged 12 to 15 who are clinically vulnerable to the virus have already been offered a COVID-19 vaccine, and today we’ll be expanding the offer to those with conditions such as sickle cell disease or type 1 diabetes to protect even more vulnerable children.

“Along with Health Ministers across the four nations, I have today written to the Chief Medical Officers to ask that they consider the vaccination of 12 to 15 year olds from a broader perspective, as suggested by the JCVI.

“We will then consider the advice from the Chief Medical Officers, building on the advice from the JCVI, before making a decision shortly.”

Scottish Health Minister Humza Yousaf said: “I want to thank the JCVI for today’s advice regarding vaccination for 12 -15 year olds.

“While the JCVI has agreed that the benefits marginally outweigh the risks they are not yet prepared to recommend universal vaccination of 12-15 year olds, however, they have suggested that Health Ministers may wish to ask their respective CMOs to explore the issue further, taking into consideration broader educational and societal impacts.

“Therefore, I have agreed with the other three UK Health Ministers to write a letter asking the four Chief Medical Officers to consider this latest guidance and explore whether there is additional evidence to suggest it would be beneficial to offer vaccination to all 12 – 15 year olds. We have asked for this further work to be conducted as soon as possible.

“A further update will be issued once these discussions have taken place. In the meantime, we will offer the vaccine to those children and young people currently recommended.

“The recent increase in cases of COVID-19 means it remains crucial that everyone who is offered a vaccination takes up the offer.”

JCVI issues advice on third dose vaccination for severely immunosuppressed

The JCVI is advising that people with severely weakened immune systems should have a third vaccine dose as part of their primary COVID-19 vaccination schedule

This third dose should be offered to people over 12 who were severely immunosuppressed at the time of their first or second dose, including those with leukaemia, advanced HIV and recent organ transplants.

These people may not mount a full response to vaccination and therefore may be less protected than the wider population.

This offer is separate to any potential booster programme. The Joint Committee on Vaccination and Immunisation (JCVI) is still deliberating the potential benefits of booster vaccines for the rest of the population and is awaiting further evidence to inform this decision.

Immunosuppression varies widely in severity and duration. Many people who are immunosuppressed have lower levels of antibodies after coronavirus (COVID-19) vaccination, as some studies have shown.

Preliminary data from the OCTAVE trial showed that almost everyone who was immunosuppressed mounted an immune response after 2 doses, as indicated by either antibodies or T cells. However, in around 40% of people, the levels of antibodies were low. It is not clear how much this may affect protection against COVID-19 as antibodies represent only part of a person’s immune response.

People with severe immunosuppression are more likely to be severely ill if they do catch COVID-19.

Studies are ongoing to see how effective a third dose is for immunosuppressed people, but it is very unlikely to cause any harm. Therefore, on balance, the JCVI’s view is that a third dose can be safely offered as it may increase their protection.

Professor Wei Shen Lim, Chair of COVID-19 Immunisation for the JCVI, said: “We want people with severely suppressed immune systems to have the best chance of gaining protection from COVID-19 via vaccination.

“Therefore, we are advising they have a third vaccine dose on top of their initial 2 doses, as we hope this will reduce their risk of severe outcomes such as hospitalisation and death.

The JCVI advises that for adults aged 18 and older, either the Moderna or Pfizer-BioNTech COVID-19 vaccines be administered for the third dose, as a number of studies have reported an increased immune response in some immunosuppressed people after a third dose of an mRNA vaccine.

For those aged 12 to 17, the Pfizer-BioNTech vaccine is preferred.

The decision on the timing of the third dose should be made by their specialist. As a general guide, the third dose should usually be at least 8 weeks after the second dose but with flexibility to adjust the timing so that, where possible, immunosuppression is at a minimum when the vaccine dose is given.

This will enable a better immune response to be generated. For example, it is preferable to give a vaccine dose before someone undergoes chemotherapy, rather than during their treatment.

Those with less serious immunosuppression are not included in this advice but are likely to become eligible for another dose as part of a potential booster programme, pending further advice from the JCVI.

In the event of a booster programme, it is expected that severely immunosuppressed people will also be offered a booster dose, at a suitable interval after their third dose.

A third primary dose is an extra ‘top-up’ dose for those who may not have generated a full immune response to the first 2 doses. In contrast, a booster dose is a later dose to extend the duration of protection from the primary course of vaccinations.

The UK Government accepts JCVI’s advice to offer a third COVID-19 vaccine to people with severely weakened immune systems:

Health and Social Care Secretary Sajid Javid said: “Today I have accepted the expert recommendations from the independent Joint Committee on Vaccination and Immunisation to offer a third vaccine dose to people aged 12 and over with severely weakened immune systems as part of their primary schedule following data from trials of those who are immunosuppressed.

We know people with specific conditions that make them particularly vulnerable to COVID-19 may have received less protection against the virus from two vaccine doses. I am determined to ensure we are doing all we can to protect people in this group and a third dose will help deliver that.

The NHS will contact people as soon as possible to discuss their needs and arrange an appointment for a third dose where clinically appropriate.

This is not the start of the booster programme – we are continuing to plan for this to begin in September to ensure the protection people have built from vaccines is maintained over time and ahead of the winter. We will prioritise those most at risk to COVID-19, including those who are eligible for a third primary vaccine, for boosters based on the final advice of the JCVI.

COVID-19 vaccines have saved more than 105,000 lives and prevented 24 million infections in England alone. They are building a wall of defence and are the best way to protect people from serious illness. I encourage everybody who is eligible to get their jabs as soon as they can.

Professor Jonathan Van Tam, Deputy Chief Medical Officer, said: “We know there are people with severe immunosuppression for whom the first two doses of vaccine have not provided the same level protection as for the general population. The degree of protection will vary by individual, according to degree of immunosuppression and the underlying reasons for that.

So I welcome the advice from JCVI to offer a third primary dose to those with severe immunosuppression, at a bespoke interval, advised by their specialist clinician, and guided by the UK’s immunisation handbook, the Green Book.

We should be doing all we reasonably can to ensure that this group is not disadvantaged and a third primary dose is one step in this direction. We are also working hard to ensure there are other medical interventions that can be used in these groups, including specific treatments like antivirals and monoclonal antibodies.

A JCVI decision on whether young teenagers should be vaccinated is expected ‘within days’.

Scottish Government to push for vaccination certification

“A threat hanging over the whole of the hospitality industry” – Scottish Licensed Trade Association

Coronavirus vaccination certificates will be required to enter certain events and higher risk venues, such as nightclubs, music festivals and some football grounds, if Parliament backs the move in a vote planned for next week.

While Covid cases continue to rise and to avoid as little disruption to the economy as possible, the Scottish Parliament will be asked to vote on the introduction of the certification scheme which will only be implemented once all adults have had the opportunity to receive both doses of the vaccine. Children and adults that are ineligible for vaccination will be exempt.

Proof of vaccination will be required later this month to enter:

  • nightclubs and adult entertainment venues
  • unseated indoor live events, with more than 500 people in the audience
  • unseated outdoor live events, with more than 4,000 people in the audience
  • any event, of any nature, which has more than 10,000 people in attendance

There are currently no plans to introduce certification for the wider hospitality industry but this will be kept under review over the autumn and winter months. 

From Friday (3 September), people will be able to download a PDF copy of their vaccination certificate, with a personalised QR code, to print off instantly or store on their mobile phone for use domestically or internationally. This is in addition to the existing paper letters that can be requested from NHS Inform and the CovidHelpline.

First Minister Nicola Sturgeon said: “We do not want to reimpose any of the restrictions that have been in place for much of this year as we all know how much harm they have caused to businesses, to education and to people’s general wellbeing but we must stem the rise in cases.

“In addition to measures such as free testing and the installation of CO2 monitors in schools, we believe that a limited use of vaccine certification in certain higher risk settings, could help us to keep businesses open and prevent any further restrictions as we head into autumn and winter.

“They will be for use in very limited settings and never for public services such as transport, hospitals and education. This is a significant step forward and not a decision we have taken lightly but it is in line with certification in other European countries.

“The original protective measures such as wearing a face covering, physical distancing, hand washing and isolating when necessary are still key to reducing prevalence of the virus but getting vaccinated remains the single most important step that any of us can take to keep ourselves and others safe.

“Ensuring that as many people as possible get vaccinated remains a key priority and the Scottish Government will continue to do everything we can to improve on the already high up take of the vaccine. We continue to urge anyone aged 16 and over to get vaccinated, please find your local drop-in clinic by visiting NHS Inform.”

THE announcement by the First Minister that the Scottish Government proposes to roll out vaccine certificates in nightclubs and larger event settings is a “threat hanging over the whole of the hospitality industry”, says the Scottish Licensed Trade Association (SLTA).

Colin Wilkinson, SLTA managing director, said:- “Although the suggestion is that the wider hospitality industry will not be affected should the Scottish Government agree to the introduction of ‘Covid passports’ next week, it is a most unwelcome development for the licensed trade in general.

“But a simple question is: where is the evidence that this is required for nightclubs and what is a night club? We are seeing a large spike in infection rates following the general reopening of the economy when a number of sectors fully reopened and Scottish schools have been opened for two weeks, universities and colleges are about to open, but nightclubs alone have been targeted with the possible introduction of a Covid status certification system at this time.

“And what is a night club? With a wide variety of hybrid premises in the Scottish licensed trade market, how is this defined? Many pubs, bars and hotels are larger than nightclubs and offer various entertainments. Consultation with the industry before this announcement was made would have been helpful.

“If Covid status certification is to be introduced, any system must be easy to use for both businesses and members of the public.

“We await the finer details of how this scheme will work and will strive to work with the Scottish Government to ensure that their introduction, if that is what happens, is seamless and easy for all involved.”

Remaining under 40s urged to get their second vaccine dose

No one should consider themselves invincible to COVID-19.”

People aged under 40 who have still to receive their second dose of the vaccine are being urged to book an appointment or go to a drop-in clinic and maximise the protection offered.

The number of cases is rising and around two thirds of new cases are in under 40s. Over the past month, 30% of COVID-19 related hospital admissions were in those aged under 40, and the majority of hospital admissions amongst unvaccinated individuals were in the under 40s age group (58%).

The second dose of the vaccine offers greater and longer lasting protection and can be given from eight weeks after the first, either at a drop-in clinic or by requesting an appointment through the NHS Inform website. Evidence shows that after two doses the vaccines are more than 90% effective against hospital admissions from the effects of the virus. Even if the time since the first dose is more than eight weeks, people can still be vaccinated and are encouraged to come forward.

Health Secretary Humza Yousaf said: “More than eighty per cent of the population have now received both doses and I really want to say thanks to all of them and of course, everyone involved in the delivery of our national programme.

“Scotland’s vaccination programme has been one of the fastest in the world, but it’s clear there are some people – particularly aged under 40 – who have been offered a second appointment and, for whatever reason, have not yet attended. Our message to you is clear. It’s not too late to get your vaccine and it remains vital that you get both doses in order to give maximum protection against this virus. Please don’t leave the job half done.

“We are working to make it as simple as possible for people to get their vaccines, and have increased the options available for how and when people choose to be vaccinated, such as drop-in and open-access clinics.

“While we are in the process of emerging from the pandemic, high case rates at the moment underline the fact that this virus is still a significant threat and the importance of getting vaccinated cannot be underestimated.”

Ian Scott, Clinical lead for Respiratory (Extracorporeal membrane oxygenation) ECMO service Scotland based in Aberdeen Royal infirmary said: “Over the last few weeks we have been seeing increased numbers of referrals to intensive care in the under 40s with COVID-19. In the UK, the average age of patients with COVID-19 requiring ECMO support is currently under forty.  

“The stark fact is, none of these patients have been double vaccinated and most do not have underlying health conditions.  

“Normally at this time of year we would have no patients requiring this level of respiratory support.  The survival rate of patients with severe COVID-19 is worse than viral pneumonia.   The risks with requiring ventilation and ECMO are extremely high and we feel that some of these deaths could be avoided.” 

NHS Grampian ECMO Lead Nurse Lucy Fleming said: “I am under 40.  To see increasing numbers of young and otherwise healthy people of my own age requiring this level of intensive care is heart-breaking. 

“There is no doubt that as cases rise, it is crucial that everyone who is eligible takes up their invitation for a vaccination and gets both doses. 

“No one should consider themselves invincible to COVID-19.”  

5,858 new cases of COVID-19 were reported in Scotland yesterday (28th August).