“To signal the return of a ‘business as usual’ model when the country is still in the grip of a pandemic is utterly reckless”
The British Dental Association Scotland has warned that plans to return NHS practices to pre-COVID models of work will devastate dental services across the country.
Cabinet Secretary Humza Yousaf yesterday wrote to every NHS dental team in Scotland, indicating that all emergency support will be withdrawn by 1 April 2022. Since the first lockdown NHS practices have operated under a COVID support package, reflecting pandemic pressures and tight restrictions that continue to limit capacity across the service.
A return to delivering a low margin/high volume model of care is, BDA Scotland contends, simply unsustainable under current conditions. While some restrictions may ease in the coming months, there are no indications the service is likely to return to anything resembling ‘business as usual’.
With a growing number of staff facing abuse from frustrated patients unable to secure appointments, the BDA has warned the move will only raise patient expectations, while pushing NHS colleagues into the private sector or out of dentistry altogether.
Yousaf has signalled minor changes to the payment system for dentists that will take effect from 1 February 2022, largely covering the treatment of children. While welcome, these reforms will have a negligible impact on capacity within the service and will not ease the pressure on practice finances once the COVID support payments are withdrawn.
The SNP committed to delivering free NHS care for all in Scotland in the recent election. The BDA has stressed this approach runs counter to that vision, and that real focus and energy must be applied to developing a new, sustainable model for delivering care.
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said:“The Scottish Government seems set to pull the rug out from under every dedicated NHS dentist.
“If Ministers had an objective to decimate NHS dentistry, this approach would offer a great starting point. To signal the return of a ‘business as usual’ model when the country is still in the grip of a pandemic is utterly reckless. The net result will be to push colleagues out of the NHS and to leave this profession altogether.
“Ministers put NHS dentistry front and centre in their pitch for government. To deliver on their promises we need real commitment to find a new and better way for delivering for the patients that need us.”
Hope after a stroke: Nearly a quarter of stroke survivors lost their job after their stroke with some even losing their home or partner – but having ‘hope’ is critical to recovery
23% of stroke survivors in Scotland say having a stroke cost them their job, with almostone in five saying it impacted their relationship and 5% even lost their home
Across the UK, over half of younger stroke survivors under the age of 50 say they have never emotionally recovered from their stoke
Whilst 15% felt their first signs of hope after a month since having a stroke –a quarter did not feel any hope in over a year.
The Stroke Association calls for those who can to donate to give more survivors hope after a stroke
The practical, emotional and physical impact of having a stroke has been laid bare by a new survey of over 3,500 stroke survivors across the UK (220 respondents from Scotland), released today.
The research, conducted by the Stroke Association ahead of World Stroke Day (29 October), is part of a renewed call for vital funds to help the charity give more survivors hope after their stroke and help them to rebuild their lives.
The impact on survivors in Scotland
The research reveals that 23% of those in Scotland who survived a stroke say it directly led to them losing their job whilst 5% say it led to them losing their home.
Furthermore, almost one in five (19%) say it had a negative impact on their relationship. It is not only relationships with partners that are affected – over one in ten (12%) say they lost friends as a result of having a stroke.
Younger survivors more severely impacted
Looking at stroke survivors across the UK, the research reveals that the emotional impact of a stroke can impact younger survivors more severely. Amongst those under the age of 50, six in ten (60%) say that they’ve never emotionally recovered from the impact of their stroke. This compares to 44% for those over the age of 50.
This is despite a similar number of younger stroke survivors under the age of 50 (52%) and over the age of 50 (50%) saying they have not physically recovered from their stroke.
The importance of hope
The research shows the importance and transformative power of feeling hope after having a stroke. Over three quarters of those surveyed in Scotland (77%) say that hope played an important or critical part in their recovery.
But for many, it was not a quick process. Whilst 15% say they began to feel hope after a month since their stroke, a quarter (25%) say it took more than a year to experience what they felt was the first sign of hope. Meanwhile one in ten (11%) say they have never felt hopeful since they had their stroke – demonstrating how strokes can impact survivors differently.
The Stroke Association helps people to find the hope they need to rebuild their lives through specialist services, including a Helpline, peer support service, support groups and Support Coordinators.
Louise Copland, 36 from Glasgow, had her stroke six years ago. The effects of her stroke were dramatic. She couldn’t walk or talk.
She said: “At the time I was terrified, I had no idea what was going on, but I got the impression it was a big deal, which made me very anxious.
My family and the physiotherapists were marvellous. I’ll never forget standing up for the first time. It felt weird and I was dizzy, but it was exhilarating. I had to call my parents to give them this fantastic news and they immediately got in the car to go to the hospital and share my happiness and excitement. This was my first moment of hope that there might be light at the end of the tunnel.
I was due to get married two months later and was determined to walk down the aisle with Dad. I focused all my attention on being able to walk again. I did it. This was the biggest moment of hope I’ve had since my stroke and it gave me the impetus to carry on.
But Louise knows she probably won’t ever recover emotionally after her stroke.
“I wake up every morning with an arm and leg that don’t work like the way they did. I fear the challenges in forming new relationships – my confidence has been dashed and people do judge you for having a disability which is demeaning.
Louise continues to find moments of hope and lives her life to the full. She would have been lost without the support of friends and family. She now attends a stroke club where she gets to meet others in a similar situation to herself.
“The people I meet at the café are so welcoming. They understand the issues I’m dealing with, because they are dealing with them too. It’s important to find hope in others. It’s important to ask for help when you need it and it is out there. There is hope after stroke.”
Big and small moments of hope
The research found that it can be both big and small moments of hope that are important. When asked what gave them their first moment of hope after a stroke, nearly one in five, (19%) said it was being able to use their affected side for the first time and 11% said it was being able to speak again. However, one in ten (10%) said it was being able to complete a small every day task such as making a cup of tea.
Reevaluating what is important after a stroke
The impact of a stroke leads many to reevaluate what is important in life. Over half (54%) say having a stroke made them appreciate their life more, 43% say it made them appreciate their family more and 42% say it made them appreciate the importance of looking after their health.
John Watson, Associate Director Scotland at the Stroke Association said: “Every five minutes, someone in the UK will have a stroke and, in a flash, their life is changed.
“There are more than 128,000 stroke survivors living in Scotland and two thirds of people who survive a stroke find themselves living with a disability. The physical impact of a stroke is severe, but for many, the emotional aspects of coming to terms with having a stroke are just as significant.
“As the research makes clear, finding hope is a crucial part of the recovery process. Without it, recovery can seem impossible.
“At the Stroke Association, we support and help people to find this hope, and rebuild their lives. But with 1.3m people and rising in the UK now living with the effects of a stroke, our services have never been more stretched. We urgently require the support of the public to help us continue to support stroke survivors to rebuild their lives.”
The Stroke Association is asking those who can to donate today so that it can reach more stroke survivors and give them the specialist support they need to find hope and move forward with their recovery. Visit stroke.org.uk/hopeafterstroke
Recovery strategy to help those hardest hit by Covid
People who have suffered the most as a result of the pandemic will be at the heart of Scotland’s Covid recovery strategy, the Scottish Government says.
For a fairer future sets out the next steps in Scotland’s recovery from the pandemic, recognising that while the pandemic has affected every area of life in Scotland, those who were already struggling have been hardest hit by its effects.
The strategy aims to address systemic inequalities made worse by Covid, improve people’s wellbeing, and remobilise public services to be more focused on people’s needs, building on lessons learned during the pandemic.
Actions to achieve this will include upskilling and retraining opportunities for workers impacted by the pandemic and the transition to net zero, help for low income families most at risk of poverty, and locally-based mental health and wellbeing support for children and young people.
While the strategy is focused over the next 18 months, it includes a series of actions over the course of this Parliament to deliver substantial improvements in child poverty, make significant progress towards net zero, and secure an economic recovery that is fair and green.
Deputy First Minister and Covid Recovery Secretary John Swinney said: “The impacts of this pandemic have not been felt evenly with the most disadvantaged suffering disproportionately from the virus, and the social and economic effects of lockdown restrictions.
“For that reason, our recovery must go further than how life was before Covid. This strategy sets out how we will do that, working with local government, the third sector, and businesses large and small.
“It is the product of months of engagement with a variety of individuals and organisations representing sectors across the country, including the Citizen’s Assembly and the Social Renewal Advisory Board.
“The experience of the past 18 months has shown us what can be achieved when we look past traditional barriers to get the right service or support to people when they need it.
“By working together with the same energy, imagination, and urgency as we approached the pandemic, we can drive a recovery that delivers more for all of Scotland.”
COSLA President Councillor Alison Evison said: “I welcome the publication of this strategy and its vision, which has many parallels with the COSLA Blueprint.
“Covid-19 has had an immeasurable impact on communities across Scotland and although we continue to respond to the many challenges it presents, we must also take the necessary action to address inequalities in our society that have only worsened as a result of the pandemic.
“Local Government will be at the heart of recovery, just as we were in response to the pandemic. Recovery is a shared endeavour that requires us all to work together to address the areas of greatest harm resulting from the pandemic, and deliver an inclusive and green recovery for all of Scotland.
“We look forward to working with the Scottish Government to deliver on a collaborative approach to recovery that is at all times rooted in the needs of the people that we serve.”
Peter Kelly, Director of the Poverty Alliance, said: “The levels of poverty and inequality in Scotland made the impact of the pandemic so much worse than it might otherwise have been. Insecure and undervalued employment, social security benefits that were inadequate and ingrained inequality all meant that some communities bore the brunt of Covid.
“As we look towards the end of the pandemic, it is right that the Scottish Government prioritises a recovery that addresses these underlying inequalities. Focusing on the creation of a wellbeing economy, tackling poverty and investment in social security, housing and decent public services is to be welcomed. Delivering on these priorities and retaining this focus on addressing inequalities must drive our recovery to Covid.”
Louise Macdonald OBE, National Director of the Institute of Directors Scotland said: “A strong, sustainable wellbeing economy and a fair, equal society are interdependent. We welcome the clarity in this strategy that a thriving economy underpins a successful recovery, especially in making the difference for those greatest affected by poverty and inequality.
“Leaders from business and cross-sector organisations in communities in every part of Scotland have played a vital part in the response to the pandemic in a myriad of ways and it is that spirit of collaboration, innovation and purpose – through collective effort and shared vision – which will deliver this ambitions of this strategy.”
Andrew McRae, Policy Chair of the Federation of Small Businesses Scotland said: “Scotland’s recovery from the Covid crisis won’t be possible without economic recovery.
“Smaller businesses have an impressive track record of creating jobs and healing communities after economic shocks – so they must be at the heart of implementing this welcome recovery plan.
“We’re looking forward to working with the Scottish Government to ensure delivery of these plans is designed with small and new start businesses, as well as the self-employed, front and centre.”
The Coronavirus vaccine certification scheme comes into effect today in Scotland meaning people will have to show proof of their vaccination status to enter some events and higher risk venues.
People attending a range of late night venues and larger indoor and outdoor live events, such as music festivals or large sporting events, will be required to show staff their Covid status. This can be done via the NHS Scotland Covid Status App released yesterday on their mobile device or using the paper certificate.
Following consultation with businesses affected a grace period has been agreed until Monday October 18th before the scheme is legally enforced. The legal requirement for businesses to keep information about certification status confidential and not use it for other purposes comes into effect today.
Deputy First Minister John Swinney said: “We know from expert public health analysis that we must do all we can to stem the rise in cases and reduce the pressure on the NHS.
“Vaccine certificates have a role to play as part of a wider package of measures. They add a further layer of protection in certain higher risk settings.
“This is a very limited scheme and we hope this will allow businesses to remain open and prevent any further restrictions as we head into autumn and winter.
“I would encourage people to to download the NHS Scotland Covid Status App and help our drive to keep the virus under control.
“Scotland is not unique in introducing such an approach. Certification schemes are in place across Europe, including Ireland and France, and the Welsh Government is also planning similar measures.
“I also 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.”
The Scottish Government will continue to work with the sectors affected and updated guidance has been published to help ensure the smooth introduction of the scheme.
People in Scotland can download the NHS Scotland Covid Status App via their mobile device. A paper certificate or the downloadable PDF is also available from NHS Inform.
The Regulations which came into force at 5am today and must be reviewed every three weeks as part of the wider review of Coronavirus Regulations.
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.
Exemptions to the scheme include under 18s, participants in vaccine trials, as well as people who cannot be vaccinated for medical reasons and people working or performing in the venues.
Officials are currently working with other UK jurisdictions to help ensure people vaccinated outside Scotland can still enter the venues affected with proof of their vaccine status.
The NHS Scotland Covid Status App is available for download from NHS Inform:
Boosters, testing and refreshed public health advice will help keep the virus under control in the coming months
Plan B prepared to protect NHS if necessary
PM continues to warn the pandemic is not over and public need to remain vigilant
The Prime Minister has today set out the government’s plan to manage Covid throughout autumn and winter.
Thanks to the ‘phenomenal success’ of the vaccination programme, the data continues to show the link between cases, hospitalisations and deaths has weakened significantly.
In England, the number of hospital admissions with Covid has remained relatively stable over the last month.
And although deaths increased at the beginning of the summer, they have remained far below the levels in either of the previous waves.
Over autumn and winter, the government will aim to sustain this progress through:
Building our defences through pharmaceutical interventions
Identifying and isolating positive cases to limit transmission
Supporting the NHS and social care
Advising people on how to protect themselves and others
Pursuing an international approach
Vaccines will continue to be our first line of defence. All those who were vaccinated during Phase 1 of the vaccine programme (priority groups 1 to 9) will be offered booster jabs from this month – to boost immunity amongst the most vulnerable groups during winter.
The Test, Trace and Isolate programme will continue its important work, with symptomatic PCR testing continuing throughout the autumn and winter.
Lateral flow tests will also remain free of charge but at a later stage, as our response to the virus changes, this will end and individuals and businesses will be expected to bear the cost. The government will engage widely on this before any changes are made.
The legal obligation to self-isolate for those who have tested positive and their unvaccinated contacts will continue, and the financial support payment for those self-isolating on certain benefits will continue in its current format until the end of March.
Our NHS will continue to get the support it needs, with an extra £5.4 billion recently announced for the next 6 months alone for the Covid response.
The public will be offered continued guidance on how to protect themselves and each other – including letting fresh air in, wearing a face covering in crowded and enclosed place where you come into contact with people you don’t normally meet, getting testing and self-isolating if required.
Our tough border policy will remain in place and genomic sequencing capability will be increased to help scientists update our vaccines to defeat new variants.
As the PM also set out, autumn and winter could pose renewed challenges and it is difficult to predict the path of the virus with certainty.
So as the public would expect, there will be a range of ‘Plan B’ measures kept under review to help control transmission of the virus while minimising economic and social damage.
Plan B would include:
Introducing mandatory vaccine only Covid status certification in certain, riskier settings.
Legally mandating face coverings in certain settings, such as public transport and shops.
Communicating clearly and urgently to the public if the risk level increases.
The government could also consider asking people to work from home again if necessary, but a final decision on this would be made at the time, dependent on the latest data – recognising the extra disruption this causes to individuals and businesses.
Ministers would only decide to implement these measures if necessary, and if a range of metrics and indicators mean the NHS is at risk of becoming overwhelmed.
Plan B recognises the success of our vaccination programme – meaning smaller interventions which are far less disruptive can have a much bigger impact on reducing the spread.
The Prime Minister committed to taking whatever action is necessary to protect the NHS, but stressed his belief that the combined efforts of the public and the vaccination programme mean we can avoid plan B and protect our freedoms in the coming months.
Prime Minister Boris Johnson made this statement at yesterday’s coronavirus press conference:
Good afternoon everybody.
I want to set out our plan for managing Covid this autumn and winter.
And I want you to cast your mind back exactly a year and think where we were last September, as schools went back and the colder months approached.
Because in one way our position today is actually more challenging.
We have higher levels of daily cases – thousands more.
But in many other crucial respects, the British people – all of us collectively and individually – are incomparably better placed to fight the disease.
We have more than 80 per cent of all over-16s now double jabbed, double vaccinated.
And we have Covid antibodies in around 90 per cent of the adult population.
And those vaccines are working.
We have seen the extraordinary vaccine-induced falls in deaths and serious disease.
And depending on your age, you’re up to nine times more likely to die, sadly, if you’re unvaccinated, than if you’ve had both jabs.
And the result of this vaccination campaign is that we have one of the most free societies and one of the most open economies in Europe.
And that’s why we are now sticking with our strategy.
In essence, we’re going to keep going.
We will continue to offer testing.
We will continue to urge everyone to be sensible, to be responsible.
Wash your hands.
Use ventilation.
Consider wearing a face covering in crowded places with people that you don’t know.
Stay at home if you feel unwell.
Download and use the app.
And we’re investing massively in our NHS to meet the pressures of Covid with an additional £5.4 billion in England over the next six months.
And that’s on top of almost £36 billion over the next three years to help our NHS recover and fix the long-standing problems of social care as well, as I was saying last week.
And we are helping to vaccinate the world with 100 million doses for developing countries by next June.
And I think this country should be proud, continue to be very proud, that the Oxford-AstraZeneca vaccine remains the workhorse of global immunisation.
And we will keep further measures in reserve – a Plan B.
We do not see the need now to proceed for instance with mandatory certification.
But we will continue to work with the many businesses that are getting ready for such a scheme.
indeed over 200 events have already used Covid certification voluntarily.
And it is just not sensible to rule out completely this kind of option now when we must face the fact that it might still make the difference between keeping businesses open at full capacity or not.
We will also keep open the option of mandating face coverings as they have elsewhere, or advising people again to work from home, reflecting the fact that when you’ve got a large proportion of the country as we have now with immunity, then smaller changes can make a bigger difference and give us the confidence that we don’t need to go back to the lockdowns of the past.
And of course, we will continue to update our advice to you based on the latest data.
But in the meantime, we are confident in the vaccines that have made such a difference to our lives.
And we are now intensifying that effort, offering jabs to 12 to 15 year olds on the advice of the Chief Medical Officers, who’ve given that advice based on the health, wellbeing and educational prospects of the children themselves.
And for over 50s – and the under 50s who are at risk, or more at risk, we’re now motoring ahead with the booster programme.
A third dose six months after your second dose.
So that’s going to mean we’re going to be building even higher walls of immunisation of vaccine protection in this country.
And the UK government has procured at scale jabs for every part of the UK.
And we will be sending doses to the Devolved Administrations in Scotland, Wales and Northern Ireland.
Covid is still out there.
The disease sadly still remains a risk.
But I’m confident we can keep going with our plan to turn jabs jabs jabs into jobs jobs jobs.
Move follows unanimous advice to ministers from the four UK Chief Medical Officers
Parental consent will be sought prior to vaccination
People aged 12 to 15 in England will be offered one dose of the Pfizer/BioNTech COVID-19 vaccine, following advice from the four UK Chief Medical Officers (CMOs), the Health and Social Care Secretary has announced. The Scottish Government is expected to make an announcement later today.
In line with the recommendation of the independent Joint Committee on Vaccination and Immunisation (JCVI), the government sought the views of the four UK CMOs on the wider issues that are relevant to the health of children.
The UK Government has accepted the advice of the four UK CMOs and the NHS is preparing to deliver a schools-based vaccination programme, which is the successful model used for vaccinations including for HPV and Diphtheria, Tetanus and Polio (DTP), supported by GPs and community pharmacies. Invitations for vaccination will begin next week.
Parental, guardian or carer consent will be sought by vaccination healthcare staff prior to vaccination in line with existing school vaccination programmes.
Healthy school-aged children aged 12 to 15 will primarily receive their COVID-19 vaccination in their school with alternative provision for those who are home schooled, in secure services or specialist mental health settings.
Health and Social Care Secretary, Sajid Javid said: “I have accepted the recommendation from the Chief Medical Officers to expand vaccination to those aged 12 to 15 – protecting young people from catching COVID-19, reducing transmission in schools and keeping pupils in the classroom.
“I am very grateful for the expert advice I have received from the Joint Committee on Vaccination and Immunisation and UK Chief Medical Officers.
“Our outstanding NHS stands ready to move forward with rolling out the vaccine to this group with the same sense of urgency we’ve had at every point in our vaccination programme.”
THE CHIEF MEDICAL OFFICERS’ LETTER READS:
To: Sajid Javid MP, Secretary of State for Health and Social Care, HM Government Eluned Morgan AS/MS, 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
13 September 2021
Dear Secretary of State, Cabinet Secretary and ministers,
Universal vaccination of children and young people aged 12 to 15 years against COVID-19
Background
The Joint Committee on Vaccination and Immunisation (JCVI) in their advice to you on 2 September 2021 on this subject said: ‘Overall, the committee is of the opinion that the benefits from vaccination are marginally greater than the potential known harms… but acknowledges that there is considerable uncertainty regarding the magnitude of the potential harms.
The 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…. JCVI is constituted with expertise to allow consideration of the health benefits and risks of vaccination and it is not within its remit to incorporate in-depth considerations on wider societal impacts, including educational benefits. The government may wish to seek further views on the wider societal and educational impacts from the Chief Medical Officers of the 4 nations, with representation from JCVI in these subsequent discussions.‘
You accepted this recommendation from JCVI, and wrote to us on 2 September 2021 stating “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.”
In doing so we have been fortunate to have been informed by the independent expertise of leaders of the clinical and public health profession from across the UK. This has included Presidents and Chairs or their representative of:
Royal College of Paediatrics and Child Health
Royal College of General Practice
Royal College of Psychiatry
Faculty of Public Health
Academy of Medical Royal Colleges representing all the other Royal Colleges and Faculties
Association of Directors of Public Health
Regional Directors of Public Health
national public health specialists
experts in data and modelling
We are very grateful to them for taking considerable time and effort to consult their own colleagues in all 4 nations at short notice to get a comprehensive view of the balance of informed medical opinion and experience across the UK.
The UK’s independent regulator of medicines and vaccines the Medicines and Healthcare products Regulatory Agency (MHRA) is in law the appropriate body to determine whether, based on risk-benefit grounds, a vaccine is safe and effective to use and so grant a licence. They have done so for children and young people aged over 12 years for two vaccines against COVID-19, those manufactured by Pfizer and Moderna. Their assessment is that benefits exceed risks on an individual basis. We take their independent opinion as read. The MHRA position on mRNA vaccines is similar to the relevant regulatory approvals granted in the same age groups in multiple other jurisdictions including but not limited to the USA, the European Union, and Canada.
The independent JCVI is the proper body to give advice on how to deploy a vaccine which has a prior favourable risk-benefit decision and authorisation from MHRA including whether it has a sufficiently large benefit to be worth deploying on a larger, population scale. Like MHRA they consider the benefits of vaccination in this age group exceed the risks (i.e. it is better to be vaccinated than not vaccinated in this age group).
They balanced the risk of COVID-19 against the risks of vaccination, including myocarditis. When forming its advice, the JCVI considered vaccine use according to clinical risk groups, thus identifying different groups according to their potential to benefit from vaccination.
For 12 to 15 year olds who do not have underlying health conditions that place them at higher risk from severe COVID-19, the JCVI considered that the size of both the risk and the benefit are at an individual level very small, and the overall advantage for vaccination, whilst present, is therefore not sufficiently large to recommend universal vaccination on their usual criteria.
They deemed the extent to which vaccination might mitigate the impacts of COVID-19 on education was beyond the usual remit of the JCVI. They recognised however that given the substantial scale of the impact of COVID-19 on all children and young people, which goes beyond normal clinical benefit and risk, wider issues could, exceptionally, be relevant hence their suggestion to consult UK CMOs.
The JCVI have already recommended that children and young people aged 12 to 17 with specific underlying health conditions, and children and young people who are aged 12 years and over who are household contacts of persons who are immunocompromised are offered two doses of a vaccine, normally Pfizer BioNTech BNT162b2. They have recommended all young people 16 to 17 are offered an initial first dose of vaccine.
The UK has benefited from having data from the USA, Canada and Israel, which have already offered vaccines universally to children and young people aged 12 to 15.
The UK CMOs start from the position that the MHRA and JCVI set out on individual benefit-risk calculations for this age group, and have not revisited this. We accept that at an individual level benefit exceeds risk but this advantage is small, and we have taken the JCVI figures as the UK current position on this question.
The Chair of the JCVI Prof. Lim has been a member of our group to ensure that there is no duplication of effort or conflict between the views of UK CMOs and the JCVI. We have been fortunate to have been joined also by the lead Deputy Chief Medical Officers for vaccines Prof. Van Tam (England), Prof. Steedman (Scotland) and Dr. Chada (Northern Ireland) and the DHSC Chief Scientific Adviser, Prof. Chappell. The final advice is that of the Chief Medical Officers, but informed by independent senior clinical and public health input from across the UK.
UK CMOs have decided in their ToR that we will only consider benefits and disbenefits to those aged 12 to 15 from vaccinating this age group, including indirect benefits. Whilst there may be benefits to other age groups, these have not been considered in our advice below.
Issues of vaccine supply were not factors considered in decision making.
The UK CMOs are aware of the extensive range of non-clinical views but this UK CMOs advice is purely clinical and public health derived and has not taken issues outside their clinical and public health remit into account. There is a subsequent political process where wider societal issues may be considered by ministers in deciding how they respond to this advice.
Advice
All drugs, vaccines and surgical procedures have both risks and benefits. If the risks exceed benefits the drug, vaccine or procedure should not be advised, and a drug or vaccine will not be authorised by MHRA. If benefits exceed risks then medical practitioners may advise the drug or vaccine, but the strength of their advice will depend on the degree of benefit over risk.
At an individual level, the view of the MHRA, the JCVI and international regulators is that there is an advantage to someone aged 12 to 15 of being vaccinated over being unvaccinated. The COVID-19 Delta variant is highly infectious and very common, so the great majority of the unvaccinated will get COVID-19. In those aged 12 to 15, COVID-19 rarely, but occasionally, leads to serious illness, hospitalisation and even less commonly death. The risks of vaccination (mainly myocarditis) are also very rare. The absolute advantage to being vaccinated in this age group is therefore small (‘marginal’) in the view of the JCVI. On its own the view of the JCVI is that this advantage, whilst present, is insufficient to justify a universal offer in this age group. Accepting this advice, UK CMOs looked at wider public health benefits and risks of universal vaccination in this age group to determine if this shifts the risk-benefit either way.
Of these, the most important in this age group was impact on education. UK CMOs also considered impact on mental health and operational issues such as any possible negative impact on other vaccine programmes, noting that influenza vaccination and other immunisations of children and young people are well-established, important, and that the annual flu vaccine deployment programme commences imminently.
The UK CMOs, in common with the clinical and wider public health community, consider education one of the most important drivers of improved public health and mental health, and have laid this out in their advice to parents and teachers in a previous joint statement. Evidence from clinical and public health colleagues, general practice, child health and mental health consistently makes clear the massive impact that absent, or disrupted, face-to-face education has had on the welfare and mental health of many children and young people. This is despite remarkable efforts by parents and teachers to maintain education in the face of disruption.
The negative impact has been especially great in areas of relative deprivation which have been particularly badly affected by COVID-19. The effects of missed or disrupted education are even more apparent and enduring in these areas. The effects of disrupted education, or uncertainty, on mental health are well recognised. There can be lifelong effects on health if extended disruption to education leads to reduced life chances.
Whilst full closures of schools due to lockdowns is much less likely to be necessary in the next stages of the COVID-19 epidemic, UK CMOs expect the epidemic to continue to be prolonged and unpredictable. Local surges of infection, including in schools, should be anticipated for some time. Where they occur, they are likely to be disruptive.
Every effort should be taken to minimise school disruption in policy decisions and local actions. Vaccination, if deployed, should only be seen as an adjunct to other actions to maintain children and young people in secondary school and minimise further education disruption and therefore medium and longer term public health harm.
On balance however, UK CMOs judge that it is likely vaccination will help reduce transmission of COVID-19 in schools which are attended by children and young people aged 12 to 15 years. COVID-19 is a disease which can be very effectively transmitted by mass spreading events, especially with Delta variant. Having a significant proportion of pupils vaccinated is likely to reduce the probability of such events which are likely to cause local outbreaks in, or associated with, schools. They will also reduce the chance an individual child gets COVID-19. This means vaccination is likely to reduce (but not eliminate) education disruption.
Set against this there are operational risks that COVID-19 vaccination could interfere with other, important, vaccination programmes in schools including flu vaccines.
Overall however the view of the UK CMOs is that the additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption, on balance provide sufficient extra advantage in addition to the marginal advantage at an individual level identified by the JCVI to recommend in favour of vaccinating this group.
They therefore recommend on public health grounds that ministers extend the offer of universal vaccination with a first dose of Pfizer-BioNTech COVID-19 vaccine to all children and young people aged 12 to 15 not already covered by existing JCVI advice.
If ministers accept this advice, UK CMOs would want the JCVI to give a view on whether, and what, second doses to give to children and young people aged 12 to 15 once more data on second doses in this age group has accrued internationally. This will not be before the spring term.
In recommending this to ministers, UK CMOs recognise that the overwhelming benefits of vaccination for adults, where risk-benefit is very strongly in favour of vaccination for almost all groups, are not as clear-cut for children and young people aged 12 to 15. Children, young people and their parents will need to understand potential benefits, potential side effects and the balance between them.
If ministers accept this advice, issues of consent need to take this much more balanced risk-benefit into account. UK CMOs recommend that the Royal Colleges and other professional groups are consulted in how best to present the risk-benefit decisions in a way that is accessible to children and young people as well as their parents. A child-centred approach to communication and deployment of the vaccine should be the primary objective.
If ministers accept this advice, it is essential that children and young people aged 12 to 15 and their parents are supported in their decisions, whatever decisions they take, and are not stigmatised either for accepting, or not accepting, the vaccination offer. Individual choice should be respected.
Chief Medical Officer for England Prof. Christopher Whitty
Chief Medical Officer for Northern Ireland Sir Michael McBride
Chief Medical Officer for Scotland Dr. Gregor Smith
Chief Medical Officer for Wales Dr. Frank Atherton
Over four in five adults across the UK have received both COVID-19 vaccine doses, with over half of all 16 and 17 year olds coming forward for their first jab.
However COVID numbers continue to rise across the UK. 28,856 new cases were reported yesterday, with 4241 of these in Scotland. The daily Scottish figure is likely to be considerably higher due to an IT problem.
Responding to the advice from the Chief Medical Officers regarding the vaccination of all 12-15 year olds, Bruce Adamson, the Children and Young People’s Commissioner Scotland, said: “We welcome the advice to offer the vaccine to children between the age of 12 and 15. It is important to give them that choice.
“Children and young people have a right to the best possible health, that’s not just about protection from the Covid virus itself, but also the impact on their mental health due to isolation and other factors. The pandemic has impacted their right to education, their right to play, their right to see wider family and friends which is so essential to their development. Their education has been disrupted with two long periods of school closures.
“It is important that children are supported to make informed decisions about their own health. Children of this age group have told me over the last few months that they are in favour of having the choice to be vaccinated. That is not to say that all of them had made a decision about whether they would get a vaccine, but they wanted the option to be available to them. Of course, there have been some children who are concerned about vaccination, or who told me about parental concerns. It is important that there is no stigma attached to the choices that children make about vaccination.
“It is essential that this advice is communicated directly to 12 to 15 year olds in a child-friendly way so they can understand why they are now being offered the vaccine, and can have any questions they might have answered in a way they can understand. Children have the right to access appropriate information on decisions affecting them.
“Parents and carers will play an important role in supporting the decision-making around whether a child chooses to get vaccinated so it is important that they have all of the necessary information to support that choice.”
Boris Johnson will set out the UK Government’s autumn and winter plan for managing Covid this week
Government focus to remain on vaccines as the first line of defence over the autumn and winter months
JCVI final ‘booster’ decision expected this week
Measures from the Coronavirus Act expected to be repealed
Prime Minister Boris Johnson will this week set out the UK Government’s autumn and winter plan for managing Covid.
Vaccines will continue to be our first line of defence over the autumn and winter months supported by new treatments, testing, and a world leading variant surveillance system.
Due to the efforts and sacrifices of the public, our NHS, and the phenomenal success of the vaccine rollout, the vast majority of restrictions were lifted in England at Step 4 of the Roadmap on 19 July.
As of 9 September, nearly 90% of the UK population aged over 16 have received a first dose of the Covid vaccine, and over 80% have received both doses.
The latest data from Public Health England shows Covid vaccines are highly effective against hospitalisation from the Delta (B.1.617.2) variant, the dominant strain in the UK. Analysis shows the Pfizer-BioNTech vaccine is 96% effective and the Oxford-AstraZeneca vaccine is 92% effective against hospitalisation after two doses.
The winter months will bring renewed challenges. Covid will circulate alongside flu and other respiratory viruses and the threat of a new variant remains. It is difficult to predict with certainty how these will interact and what pressure they may place on the NHS.
The independent expert committee – the Joint Committee on Vaccinations and Immunisation (JCVI) – were asked to consider a Covid vaccine booster programme. Their interim advice suggested planning for booster vaccines to be rolled out to the most vulnerable from September 2021, to offer an increased level of protection over winter.
The government expects to receive confirmation this week from the JCVI on the details of a vaccination booster programme, with plans in place to begin this month. This will boost immunity over the winter months, protecting against serious disease and death and unsustainable pressure on the NHS.
The government confirmed last week that those who are immunocompromised will be offered a third primary dose. This is separate to the booster programme, as those who require a third primary dose had insufficient protection from two doses.
The Prime Minister is also expected to repeal powers in England that are no longer necessary from the Coronavirus Act, as part of the government’s plan for managing Covid over the autumn and winter.
These include:
Powers to close-down sectors of the economy, such as business premises, or apply restrictions to events and gatherings.
Powers that disrupt education, enabling temporary closure or restricting access to schools, colleges, and childcare.
Powers that extend time limits for urgent warrants. Powers to detain infectious people.
Vital powers from the Act will be retained that are critical to protect and support the public. This includes giving sick pay to those isolating from day one rather than day seven, directing schools to remain open if they close against government guidance, and helping the NHS to get the emergency resource it needs.
Legal requirements will remain for someone to isolate if they test positive, to protect the most vulnerable from infection and to control the spread of variants. The Coronavirus Act is separate from the Public Health Act.
The Prime Minister is expected to hold a press conference this week – perhaps as early as tomorrow – to set out the next steps in the pandemic response.
Prime Minister, Boris Johnson said: “Thanks to the efforts of the public, the NHS and our phenomenal vaccination programme, we reached Step 4 in our Roadmap and life has returned to a sense of normality.
“These extraordinary times required necessary but intrusive measures. But I’m determined to get of rid of any powers we no longer need because of our vaccine defences.
“I will set out the next phase in our Covid response shortly.”
PM Boris Johnson is pictured during a Downing Street homecoming reception for the GB Paralympic team.
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.”
Health and Social Care Secretary Sajid Javid justifies the Health and Care levy
This past year has been the most difficult in living memory for our country – and we have faced those difficulties together. The British people have made unprecedented sacrifices to our freedoms and our way of life to keep each other safe.
Whilst staff in the NHS and across social care have moved mountains to help those who needed care. They have treated over half a million patients with COVID-19, administered over 90 million life-saving vaccines, and cared for the elderly and most vulnerable in our society.
Despite these efforts, it was inevitable that this global pandemic would take its toll on a system that was already in need of reform. We now have a backlog of 5.5 million people waiting for treatment – and if we were to continue with business as usual this could rise in the coming years to as high as 13 million. Before the pandemic, we treated nine in 10 people within 24 weeks. That has now risen to 45 weeks.
The pressures of the pandemic have also been stark in social care, adding to the burdens of an unfair system in crisis. Around one in seven people end up paying over £100,000 for care, and often the heaviest burden falls on those least able to bear it. Meanwhile, staff in social care have worked tirelessly, even when we know they could have benefitted from better support and training.
No responsible government – especially a Conservative one – can bury its head in the sand and pass these problems onto the next one.
The Health and Care Levy announced yesterday will be a direct investment into the NHS and social care. But I appreciate it does not sit easily with everyone. No government would ever wish to go back on a promise it has made to the people – and I’ve always believed in making sure the tax burden is as low as possible.
Yet no government since the Second World War has faced unprecedented challenges of such magnitude. Last week I met health ministers from the world’s biggest economies at the G20: we are all having to deal with the consequences of this global pandemic. I am determined we face up to them.
We want the NHS to be a world-class service, and we need to put social care on the strongest possible foundation for the future. But we have to do that in a responsible way. That means spreading the burden across the broadest shoulders, and not simply borrowing in the short-term to pay for the long-term. That is what our levy does: it shares the burden across employers, employees and pensioners alike. The highest-earning 14 per cent in the country will pay over half the levy.
Together, we are making a critical investment in our country’s future. This will be the biggest catch-up plan in NHS history – delivering nine million more checks, scans, and treatments. We all know someone who has been waiting to long for such procedures.
We are going to ensure the vital work of routine operations, meaning things like hip replacements and cataract surgery do not stop. We are also investing in the next generation of scanners and screening equipment, so we are even quicker at finding and treating diseases like cancer.
The levy is also a vital first step for the reform of our broken care system. No one will have to pay more than £86,000 in care costs over their lifetime. That cap will apply to everyone – it will not matter what condition you have, where you live, how old you are or how much you earn.
We are also casting out the safety net further by expanding means-tested support, so many more people can benefit from having the costs of their care covered. In addition, care staff will now benefit from half a billion pounds of funding to deliver new qualifications, better career routes and much-needed mental health and wellbeing support.
Through these historic investments we are meeting the scale of the challenges we face together, just as we have done throughout this pandemic. In making these difficult decisions we are stepping up as a country to end the cruel care lottery and tackle the backlog. As a result, millions more people now have a better chance to live happy, healthy and dignified lives.
MPs voted through the NHS and Social Care tax rise last night
• Scotland is in pole position to lead the green economic revolution as the UK seeks to recover from the pandemic
• Scotland has the highest concentration of green jobs in the UK and the highest density of students studying green-related subjects
• The UK Green Growth Index, developed by Oxford Economics for Lloyds Banking Group, analyses the UK’s readiness to drive a greener economy
Scotland is in the strongest position to drive the growth of the green economy in the UK, according to the UK Green Growth Index, which has been developed by Oxford Economics and Lloyds Banking Group.
The nation leads the Growth Index (80.6) by a significant margin and is best-positioned to support the UK’s green economy based on its existing green infrastructure and future potential.
Scotland has a strong base of 21,000 existing green economy jobs in sectors such as onshore and offshore wind and hydroelectric power. Based on the size of its labour market, Scotland has the highest concentration of green jobs in the UK.
Relative to its population, Scotland also benefits from the largest number of higher education students studying green-related subjects such as engineering and technology, building and planning, and agriculture. The density of students in green-related subjects is more than 27% greater than in second placed Wales.
Philip Grant, chair of Lloyds Banking Group’s Scottish Executive Committee said: “Scotland’s long been at the forefront of energy technology and this research shows how it’s now best-placed to build on that experience and create a more sustainable future.
“Every part of the UK has opportunities to capitalise on green growth, but Scotland’s rich talent pool and skilled workforce give it an edge.
“The report shows a promising start to the transition, but we must accelerate progress towards a greener economy. There couldn’t be a better time for the United Nations Climate Change Conference (COP26) to take place, here in Scotland, in just a few months’ time.
“All eyes will be on the UK, and on Scotland in particular, when it comes to adopting greener ways of living and doing business. As well as being a moment of international cooperation, COP26 is a prompt for us to consider how our domestic economy can thrive in the future.
“We’ll be working with businesses and communities across the country, and throughout the UK, to ensure no nation or region is left behind in the transition to a greener future.”
UK GREEN GROWTH INDEX
The UK Green Growth Index explores how well placed the nations and regions across the UK are to capitalise on the opportunities of the green economy – defined as low carbon, resource efficient and socially inclusive.
Currently it is estimated the UK would need to invest £1.4 trillion between 2020 and 2050 with the potential for up to 2.5 million green jobs needed before 2050 to meet its net zero objective by 2050.**
The Index considers each region’s existing base of green industry; innovation activity; take-up of relevant skills and training; and renewable energy infrastructure and use, to determine a ‘Green Growth Opportunity’ score for each part of the UK.
UK Green Growth Index
Rank
Nations and Regions
Green Growth Opportunity score
1
Scotland
80.6
2
Wales
63.5
3
South West England
54.6
4
South East England
52.0
5
Midlands
48.7
6
North of England
48.3
7
East of England
45.6
8
Yorkshire and the Humber
45.1
9
Northern Ireland
42.7
10
London
36.5
Companies across the UK are actively participating in the green economy, according to additional Lloyds Banking Group research provided by YouGov.
More than one-third of UK businesses (36%) say engaging in the green economy is a high or very high priority for their company, rising to more than half (55%) of large organisations.***
A quarter of those in North East England (26%), London (25%) and South West England (25%) say participating in the green economy is something they’re already exploring or operating in.***
