Nursing organisation issues statement on PPE

The NMC has issued a statement on personal protective equipment that sets out key points to help nursing and midwifery professionals during the Covid-19 pandemic.

Andrea Sutcliffe CBE, Chief Executive and Registrar at the Nursing and Midwifery Council (NMC), said: “At this time of national crisis, it’s clear if we are to protect the public, then we’ve all got to do everything we can to ensure our nursing and midwifery professionals are able to practise as safely and as effectively as possible.

“We know that the consistent and timely availability of appropriate personal protective equipment (PPE) continues to be a significant challenge in health and social care across the UK. Understandably PPE is being raised with us by our registrants and their employers and is the focus of intense activity at a national level in all four countries.

“The statement we are publishing today clarifies the key points that nurses, midwives and nursing associates should take into account when applying the Code in practice and making considered professional judgements.

“I hope this information will provide reassurance for everyone using and working in health and care settings and help support nursing and midwifery professionals to make the right individual decisions for them and the people they care for during these incredibly challenging circumstances.”

The Statement:

The Nursing and Midwifery Council (NMC) recognises the enormous challenges faced by health and social care professionals at this time and we know they are worried about the timely delivery and provision of the right personal protective equipment (PPE).

Despite the significant and urgent effort to improve the availability of appropriate PPE in health and social care settings across the UK, some professionals are still facing situations where there is insufficient suitable protective equipment available.

Our Code and Standards support nurses, midwives and nursing associates in these difficult situations by setting out the key principles to follow to keep themselves, those they lead or manage and those they care for safe.

To support our registrants further we set out below some key points to help them as they put the Code into practice and exercise their professional judgment during this unprecedented pandemic situation.

How national guidance and the Code supports you as a nurse, midwife or nursing associate dealing with challenging PPE issues

National guidance on the use of PPE has been issued to support you during this time. Whether you are a nurses, midwife, nursing associate or a student on clinical placement you should follow this guidance, which covers a range of infection control measures, including hand hygiene and respiratory and cough hygiene, as well as advice on appropriate PPE and best practice.

Your employer is responsible for ensuring that you and any staff you lead or manage have all the necessary protective equipment – including protective clothing – and that you have access to current guidance on how and when to use it correctly to minimise the risk of transmission of Covid-19. Your employer is there to help you and your colleagues by managing resources effectively and dealing with risk, so that that the safety and quality of care or service you provide for people can be maintained.

As set out in the Code, if you have any concerns about the availability or use of PPE you must raise these with your manager as soon as possible, to make sure that they are aware of the issue and can take action to support you. You can also refer to our raising concerns guidance or seek advice from your representative body or trade union.

If situations arise where suitable equipment is not available difficult decisions may need to be made quickly about the safest and best course of action. The Code states that to preserve safety you must take account of your own personal safety, the safety of others and the availability of other options for care. So you shouldn’t feel that when making decisions, you have to place yourself or others at risk, or that you need to make these decisions on your own.

Where possible you should work with colleagues to find the best way forward in these circumstances. It is important to take into consideration the balance of risks in relation to those people who are dependent on care services, as well as the requirement to protect yourself and other staff so that they are able to provide ongoing care.

Any decisions you make should take account of local and/or national clinical guidance, advice and protocols.

Factors to consider include:

  • whether treatment can be delayed or provided differently (for example, remotely)
  • the availability of different levels of PPE that may offer sufficient protection to you and others in particular care activities
  • whether some members of the wider team are at a higher risk of infection than others
  • whether different care and treatment decisions might be appropriate to minimise the risk of transmission in accordance with local and national advice
  • Taking account of all the options available, what course of action is likely to result in the least harm in the circumstances, taking into account your own safety, the safety of others and the people in your care.

You should make a record of your decisions regarding how you handle any safety concerns. You should describe how you used your own professional judgment, the role of other members of the team in decision making, and the outcome.

We acknowledge that in exercising your professional judgment in line with the Code you may decide that you need to refuse to provide care or treatment to an individual because it is not safe for you to do so.

If a concern is raised with us about any registrant refusing to treat a patient because of their concerns about inadequate PPE or being responsible for service delivery in the absence of adequate PPE, we would follow the approach that we have set out in our joint regulatory statement. As part of this approach we would consider the context of the current pandemic, including the risks that the individual registrant was exposed to and how they exercised and recorded their professional judgment in line with the Code.

Chancellor delivers Tuesday’s UK Government update

Good evening from Downing Street, where I’m joined by Steve Powis, Medical Director of the NHS and Yvonne Doyle, Medical Director at Public Health England.

Earlier today, the government’s independent fiscal watchdog, the Office for Budget Responsibility, the OBR, published a report into the impact of coronavirus on the economy and public finances.

It’s important to be clear that the OBR’s numbers are not a forecast or prediction.

They simply set out what one possible scenario might look like – and it may not even be the most likely scenario.

But it’s important we are honest with people about what might be happening to our economy.

So before I turn to the health figures, I want to spend a few minutes explaining what the OBR have said – and let me thank them for their continued work.

There are three brief points I want to make.

First, the OBR’s figures suggest the scale of what we are facing will have serious implications for our economy here at home, in common with other countries around the world.

These are tough times – and there will be more to come.

As I’ve said before, we can’t protect every business and every household.

But we came into this crisis with a fundamentally sound economy, powered by the hard work and ingenuity of the British people and British business.

So while those economic impacts are significant – the OBR also expect them to be temporary…

…with a bounce back in growth.

The second point I want to make is that we’re not just going to stand by and watch this happen.

Our planned economic response is protecting millions of jobs, businesses, self-employed people, charities and households.

Our response aims to directly support people and businesses while the restrictions are in place…

…and to make sure as restrictions are changed, we can, as quickly as possible, get people back to work; get businesses moving again; and recover our economy.

The OBR today have been clear that the policies we have set out will do that.

The OBR today have been clear that if we had not taken the actions we have, the situation would be much worse.

In other words, our plan is the right plan.

The third point I want to make is this: right now, the single most important thing we can do for the health of our economy is to protect the health of our people.

It’s not a case of choosing between the economy and public health – common sense tells us that doing so would be self-defeating.

At a time when we are seeing hundreds of people dying every day from this terrible disease, the absolute priority must be to focus all of our resources…

…not just of the state, but of businesses, and of all of you at home as well, in a collective national effort to beat this virus.

The government’s approach is to follow scientific and medical advice through our step-by-step action plan, aiming to slow the spread of the virus, so fewer people need hospital treatment at any one time, protecting the NHS’s ability to cope.

I said in my Budget a month ago that whatever the NHS needs, it will get – and we have honoured that promise:

Yesterday we published an update showing that we’ve given our public services an extra £14.5 billion in recent weeks.

We are taking action to increase NHS capacity, with more beds, more key staff and more equipment on the front-line.

And the Secretary of State for Health and Social Care will be updating on our plans for social care tomorrow.

This is why we are instructing people to stay at home, so that we can protect our NHS and save lives.

I can report that through the government’s ongoing monitoring and testing programme, as of today:

  • 302,599 people in the UK have now been tested for coronavirus, with 93,873 people testing positive
  • 19,706 people in the UK have been admitted to hospital with the virus, down from 20,184 people yesterday;
  • Sadly, of those in hospital, 12,107 people have now died – an increase of 778 fatalities since yesterday.

Our thoughts are with the families and friends of all those who have lost their lives.

These figures are a powerful reminder to us all of the importance of following the government’s guidance:

Stay at home. Protect our NHS. And save lives.

Prime Minister released from hospital

Prime MInister Boris Johnson was released from hospital yesterday after having spent seven nights in hospital.

Mr Johnson was taken to St John’s Hospital in Westminster on Sunday 5th April – ten days after testing positive for coronavirus.

The PM was moved to an Intensive Care ward on Monday where he spent three nights before returning to a ward on Thursday.

He will now continue his recuperation at Chequers, the PM’s official country residence.

This was the statment from Downing Street:

The PM has been discharged from hospital to continue his recovery, at Chequers.

On the advice of his medical team, the PM will not be immediately returning to work. He wishes to thank everybody at St Thomas’ for the brilliant care he has received.

All of his thoughts are with those affected by this illness.

The Prime Minister was released from hospital on the day that the number of deaths from coronavirus in the UK topped 10,000. This figure does not include people who die in other community settings, including care homes, so that figure may well be substantially higher.

 

First Minister visits NHS Louisa Jordan facility

The First Minister has praised the dedication of the NHS Scotland staff and building contractors working to establish the NHS Louisa Jordan.

During a visit to the NHS Scotland medical facility at the Scottish Events Campus (SEC) in Glasgow, the First Minister said their efforts will provide reassurance to people across Scotland and if required, ensure that the NHS has extra capacity to treat patients.

Construction work began on turning the SEC into the NHS Louisa Jordan on Tuesday 31 March. Since then:

  • 23,000 square metres of flooring have been laid
  • partitions between the beds have been constructed, creating more than 1,000 bed bays
  • more than 8,000 pieces of medical equipment have been ordered
  • 35,000 metres of network cabling have been laid for the nurse call system
  • 135,000 metres of cabling for lighting and power sockets have been laid
  • a new bespoke system to ensure oxygen supply to every bed has been put in place with 1,400 medical gas outlets.

The First Minister also urged people across the country to stay at home over the Easter weekend to help slow the spread of coronavirus (COVID-19).

The First Minister said: “Everyone involved in establishing the NHS Louisa Jordan deserves our sincere thanks. They are working tirelessly under extremely challenging circumstances to build a unique national facility.

“While I still hope that it will not be needed, the NHS Louisa Jordan will help our NHS to prepare and provide people with reassurance that we have measures in place to help treat people during this pandemic.

“I urge everyone in Scotland to continue to follow the social distancing advice and to stay at home. By following the social distancing measures, they can help to slow the spread of COVID-19, save lives and protect our NHS. If they do this, the NHS Louisa Jordan will not need to open.”

The NHS Louisa Jordan is an NHS Scotland-run medical facility. It will have an initial 300 beds which could expand to hold more than 1,000 patients if required.

Jill Young, former Chief Executive of the Golden Jubilee Hospital at Clydebank, has been appointed Chief Executive of the temporary hospital.

The facility is named after Sister Louisa Jordan, a First World War nurse who died on active service in Serbia in 1915 while providing much-needed care to an area of dire need as part of the Scottish Women’s Hospitals for Foreign Services. Born in Maryhill, Glasgow, Louisa Jordan signed up to the war effort in December 1914 while working as a Queen’s nurse in Buckhaven, Fife.

Stroke: Act FAST!

A stroke survivor is appealing to people to call 999 if they think they’re having a stroke.

The call comes following interim Chief Medical Officer, Dr Gregor Smith’s statement that some hospital wards are “eerily quiet” amid the coronavirus outbreak.  Charity Chest Heart & Stroke Scotland are concerned that people are putting off going to hospital because of the virus and don’t want to be a burden on the NHS. 

Debbie, 44 from Comrie, has joined forces with the charity to remind people that stroke is a medical emergency and that people still need to seek medical attention if they think they’re having a stroke. 

Chest Heart & Stroke Scotland is urging people to act FAST and call 999 as soon as you experience symptoms.

FAST is a simple acronym to remind people of the key signs of stroke: 

FACE – Can the person smile, does one side of their face droop?

ARM – Can they lift both arms? Is one weak?

SPEECH – Is their speech slurred or muddled?

TIME – If these symptoms are present, call 999

Debbie Matthew, stroke survivor from Comrie, said: “If my husband hadn’t called 999 so quickly and I hadn’t gone to hospital straight away, I can’t bear to think about what position I would find myself in today. 

“It’s been 4 years since I had my stroke and I can’t believe how far I’ve come. I’m just so thankful that my family were able to get me the help I so desperately needed.

 “FAST has become really important to my family. My son, Finlay, got such a fright seeing me after my stroke that he decided spread the FAST message to local school children.

“Finlay feels that it’s especially important for children to learn the message so that that they know what to do if they find themselves alone with a parent or grandparent who might be experiencing a stroke. 

“Hearing that people might not be seeking emergency help is terrifying, it’s more important now than ever to make sure people know to Think FAST and call 999 if you think you’re having a stroke.” 

Jane-Claire Judson, Chief Executive at Chest Heart & Stroke Scotland, said: “Stroke doesn’t stop because of coronavirus; it can happen at any time and anywhere. 

“By the end of today, 25 people across Scotland will have suffered a stroke. The same will happen tomorrow. 

“Coronavirus is at the forefront of our minds right now, but it’s vital that people don’t forget that a stroke is a medical emergency. NHS stroke staff are on-hand to help you and save people’s lives.

 “It is important that people are aware of the signs and symptoms of stroke and phone 999 immediately if someone needs urgent medical attention. 

“These symptoms aren’t something for deliberation, if you see these signs, act FAST and save a life.”

 Scottish Conservative health spokesman Lothian MSP Miles Briggs said: “NHS Scotland have rightly shifted their focus to fighting to Covid-19, but people are still going to get ill and emergency services are continuing as normal.

“It is vital that if you, or someone you are with, is showing symptoms of having a stroke, that you call 999 immediately, to be taken to hospital. The FAST acronym is an easy way to remember the signs of a stroke – Face, Arms, Speech and Time.

“This is an important message, not just for people who are showing signs of a stroke, but for anyone who is having a medical emergency during the Coronavirus outbreak, call 999 immediately.”

Government sets out plan for national effort on PPE

  • To date, over 761 million pieces of PPE delivered across the UK
  • Full, 24/7 military operation underway to manage supply and demand right across the UK
  • New domestic PPE manufacturing effort with Rolls Royce and McLaren to make more protective equipment
  • Website launching to enable primary, social, and community care providers to request critical PPE

A UK-wide plan to ensure that critical personal protective equipment (PPE) is delivered to those on the frontline responding to coronavirus (COVID-19) was announced yesterday by Health and Social Care Secretary Matt Hancock.

The 3-strand plan launched on Friday will provide clear guidance on who needs PPE and when they need it, ensure those who need it can get it at the right time and set out action to secure enough PPE to last through the crisis.

A full, 24/7 military operation is already underway to deal with the unprecedented, global demand for PPE as a result of this pandemic.

A new national supply and logistics network has been created from scratch in a matter of weeks to manage supply and demand across the UK, and to make sure appropriate PPE reaches those who need it.

A new website, developed with the help of the military, is being rolled out in the coming weeks to improve distribution and will enable primary, social and community care providers in England to order critical PPE.

In addition, a new PPE hub provides easy access to all the government’s guidance on PPE in one place – a one-stop shop people can visit to understand what PPE they need.

This is in addition to a 24-hour helpline that already allows providers to request emergency drops of PPE to meet immediate need.

Health and Social Care Secretary Matt Hancock said: “I will stop at nothing to protect those on the frontline who are fighting this virus.

“Our heroic health and care staff are working around the clock and my absolute priority is to support them. Our new online ordering tool for PPE is supported by a 24/7national supply and logistics network.

“There is a herculean effort behind the scenes, supported by the military, to get the right kit to our frontline heroes. These new supply chains, matched with a call to arms for more businesses and organisations to join this national effort, will help save lives.”

The 3-strand plan sets out:

  1. guidance: being clear who needs PPE and when, and who does not, based on UK clinical expertise and WHO standards. This will ensure workers on the front line are able to do their jobs safely, while making sure PPE is only used when clinically necessary and isn’t wasted or stockpiled
  2. distribution: making sure those who need PPE can get it and at the right time. The government will ensure those who need critical PPE receive it as quickly as possible by setting up a new national supply system
  3. future supply: taking action to secure enough PPE to see us through the crisis. The actions being taken to ensure we have enough critical PPE to last the UK through the pandemic, working alongside industry to boost future supply. The government has already co-ordinated deliveries of PPE directly to health and care providers and to 38 local resilience forums across England. These efforts are being co-ordinated across all 4 nations of the UK to ensure appropriate distribution of critical PPE

Since the beginning of the coronavirus (COVID-19) outbreak, over 761 million items of PPE have been delivered across the UK to 58,000 different settings, including hospitals, hospices, care homes, home care providers, GPs, pharmacists and dentists to ensure our frontline is protected. This includes 158 million masks, 135 million aprons and 360 million pairs of gloves.

The plan also emphasises the need to ramp up domestic production of PPE. The government is calling on industry to join forces to manufacture more protective equipment to support the national effort.

Already companies such as Burberry, Rolls-Royce, McLaren, Ineos and Diageo have started work to produce equipment including gowns, visors and hand hygiene products.

Last week, following extensive consultation with the Medical Royal Colleges, all 4 UK governments published updated guidance for PPE for health and care workers. This covers doctors, nurses, midwives, paramedics, social workers and social care staff.

Critical PPE guidance has also been published for cleaners, funeral directors and first responders. Beyond these roles in settings including supermarkets and public transport, the clinical evidence, which is kept under review, does not suggest widespread benefit from wearing PPE over and above social distancing, social isolation and good hand hygiene.

In addition to this a new dedicated team has been set up to focus on securing supplies and identifying PPE suppliers from across the globe to meet the increasing demand for a growing list of products, with a call to arms to businesses to turn their manufacturing efforts to this response to meet technical specifications published by government.

Businesses and organisations including Kingfisher Group, Apple, Huawei and BP have also stepped up to the plate to generously offer their own PPE for use by the NHS and public organisations.

But health professionals say they need more than warm words and three point plans at this critical time – they need ACTION, in the form of vital PPE equipment NOW.

The British Medical Association has learned that personal protective equipment (PPE) supplies in two large areas of England are running at dangerously low levels, and that some pieces of equipment are no longer available – forcing doctors into impossible situations and ultimately, putting their lives at risk.

The doctors’ union understands that current PPE supplies in London and Yorkshire are not sufficient to deal with the COVID-19 outbreak. This means staff and patients are increasingly being placed in harm’s way as they battle against the virus.

The Government is therefore, forcing doctors to place themselves and their patients in grave danger by expecting them to treat COVID-19 patients without adequate PPE.

The evidence comes just two weeks after the Government said that supplies of PPE were plentiful, and that equipment was flowing out to trusts.

According to a recent survey(1) by the BMA, however, more than half of doctors working in high-risk environments(2) said there were either shortages or no supply at all of adequate face masks, while 65% said they did not have access to eye protection.

Futhermore, 55% said they felt pressurised to work in a high-risk area despite not having adequate PPE.

Dr Chaand Nagpaul, BMA council chair, said: “No doctor should ever have to be in harm’s way when they go to work, and in these unprecedented times, this has never been more important.

“This is not the flu. We are dealing with an unknown, highly-infectious, and potentially deadly virus that has already claimed the lives of several healthcare workers, including 11 doctors in the UK. It is absurd that the people trained to treat this disease are the ones who are not being appropriately protected – and without them, we face real disaster.

“It’s unclear whether the lack of PPE is directly linked to the recorded deaths of doctors so far, but we know that no healthcare workers have been infected in a hospital in Italy precisely because their PPE supplies are sufficient and of high-quality.

“This must be replicated here, in every healthcare setting, as a matter of urgency. Without it, doctors are being forced into a corner, facing heart-breaking decisions over whether to carry on caring for patients without proper protection and put themselves and patients at risk.

“This is an immensely difficult position to be in, but is ultimately down to the Government’s chronic failure to supply us with the proper equipment. We cannot continue like this, and need to see enough, adequate PPE delivered to staff across the country as soon as possible, not just for our health, but also, and most importantly, our patients’.

“We note the Government’s announcement this afternoon and its three-strand PPE Plan. However, PPE should not be a ‘precious resource’ and for NHS staff facing shortages of protection they need today, they don’t want to hear of a plan, but that this vital equipment is made available to the front line now.”

GP practices and pharmacies open for Easter

Extended opening hours to ensure services available

General practices and community pharmacies will remain open on Good Friday and Easter Monday to help relieve pressure on out-of-hours services this weekend.

GPs will be open to offer treatment for non-coronavirus (COVID-19) related health issues, where it is safe to do so. Community pharmacies have also been requested to remain open where possible to support the wider efforts of the NHS.

Patients with coronavirus (COVID-19) symptoms are asked to check nhsinform.scot/coronavirus first for advice or dial NHS 24 on 111, day or night, if their symptoms worsen or do not improve after seven days.

Health Secretary Jeane Freeman said: “I want to thank all health and social care staff for their continuing extraordinary efforts as we face this pandemic.

“Given ongoing demand on our NHS, I have taken the unusual step of asking GP practices and community pharmacies to remain open on Good Friday and Easter Monday – but only if it is safe to do so.

“Working with the Scottish GP Committee of BMA Scotland, the Scottish Government has agreed an additional £15 million to help GP practices meet the costs of responding to COVID-19.

“Part of this will help to cover the cost of remaining open on Good Friday and Easter Monday and the remainder will help to meet other costs being faced by practices during this difficult time. I have also been clear that the Scottish Government will meet any additional costs incurred by community pharmacies to remain open on these bank holidays.

“As always – if you have a critical medical emergency, whether related to coronavirus or not, phone 999.”

NHS Inform’s coronavirus webpage is still the fastest way for people to get the latest health advice and information.

Extra support for people affected by drug and alcohol use

Extra support for people affected by alcohol and drug use during the coronavirus (COVID-19) pandemic has been announced by the Minister for Public Health Joe FitzPatrick.

Funding of £166,000 from the Scottish Government will support:

• a programme to increase access to naloxone in new settings, including investment in kits to add to the existing outlets for naloxone supply
• increased capacity within the Know the Score helpline and webchat service
• a COVID-19 publicity campaign signposting support for alcohol and drug users during the pandemic
• funding to link people with others in recovery through the Scottish Recovery Consortium

Help will also be available for those affected by another’s alcohol and drug use through the Supporting Families Fund. This includes a discretionary emergency fund for families, online wellbeing activities, family meals, wellbeing packs and counselling support.

Mr FitzPatrick said: “Responding to the coronavirus pandemic is one of the biggest challenges of our lifetime and it will disrupt so many lives like never before. Protecting and supporting everyone during these unprecedented times is our priority.

“We’ve worked closely with organisations on the frontline to create this package of measures to ensure we continue to support those affected by alcohol and drug use.

“By working together and observing the latest guidance, we can all play our part in keeping everyone safe.”

Boris Johnson admitted to hospital

Prime Minister Boris Johnson has been admitted to hospital for tests, ten days after testing positive for coronavirus.

While the Queen was addressing the nation in a television broadcast last night, Boris Johnson (55) was on his way to hospital, where he remains this morning.

Foreign Secretary Dominic Raab will chair this morning’s Coronavirus update cabinet meeting in Downing Street.

A statement issued by 10 Downing Street last night said: “On the advice of his doctor, the Prime Minister has tonight been admitted to hospital for tests.

“This is a precautionary step, as the Prime Minister continues to have persistent symptoms of coronavirus ten days after testing positive for the virus.

“The Prime Minister thanks NHS staff for all of their incredible hard work and urges the public to continue to follow the Government’s advice to stay at home, protect the NHS and save lives.”

Catherine Calderwood resigns

Scotland’s Chief Medical Officer Dr Catherine Calderwood resigned from the Scottish Government late last night.

Dr Calderwood had earlier offered an apology for ignoring public health guidelines on not travelling away from home – not once, but twice – at a deeply uncomfortable press conference.

Ms Calderwood’s apology was never going to be enough to appease growing public anger, however. To break your own rules once is perhaps a mistake, but to repeat the offence a week later is quite simply unforgiveable. Scotland’s senior health official had to go – and really should have resigned sooner.

First Minister Nicola Sturgeon tried to protect Ms Calderwood at yesterday’s media briefing, but it later became clear that public furore was not dissipating.

The Chief Medical Officer’s position as one of the most recognised faces of Scotland’s fight against the coronavirus was untenable.

With public confidence draining, Ms Calderwood bowed to the inevitable and tendered her resignation. In a statement issued late last night, Dr Calderwood said: “I am deeply sorry for my actions and the mistakes I have made.

“The First Minister and I have had a further conversation this evening and we have agreed that the justifiable focus on my behaviour risks becoming a distraction from the hugely important job that government and the medical profession has to do in getting the country through this coronavirus pandemic.

“Having worked so hard on the government’s response, that is the last thing I want.

“The most important thing to me now and over the next few very difficult months is that people across Scotland know what they need to do to reduce the spread of this virus and that means they must have complete trust in those who give them advice.  It is with a heavy heart that I resign as Chief Medical Officer.

“I will work with my team over the next few days to ensure a smooth transition to my successor.”

Catherine Calderwood’s actions really could not have come at a worse time. The coronavirus is yet to peak in the UK, and Ms Calderwood had a key role in getting the public health message out to Scots during these hugely difficult times.

The Chief Medical Officer’s departure is undoubtedly a personal blow to First Minister Nicola Sturgeon – it’s a distraction she could well have done without as she leads the country in the great challenges we face.

First Minister Nicola Sturgeon said last night: “Dr Calderwood’s advice to me, to the government and to people across Scotland over the past few weeks has been the right advice. People should continue to stay at home to protect the NHS and to save lives.

“It is however clear that the mistake she made – even though she has apologised sincerely and honourably for it – risks distracting from and undermining confidence in the government’s public health message at this crucial time. That is not a risk either of us is willing to take.

“Catherine has been a transformational CMO, bringing changes to the way medicine is delivered in Scotland and in particular using her experience to bring an overdue focus to women’s health. Also, as I said earlier, her advice to me on Coronavirus will be missed – which is why she will work to ensure a smooth transition in the days ahead.

“While she has made a very serious mistake in her actions, that should not detract from the fact that as CMO she has made a highly valuable contribution to the medical profession and to health in Scotland, and I have no doubt she will continue to do so in future. She leaves office with my thanks and admiration.”