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.***
Bank of Scotland’s Business Barometer for August 2021 shows:
Scottish business confidence rises six points in August to 34%
Firms’ hiring intentions jump 13 points with 34% planning to create jobs in the next 12 months
Overall UK business confidence reaches 36% – the highest reading since May 2018 – as all regions and nations report positive confidence levels
Business confidence in Scotland rose six points during August to 34%, according to the latest Business Barometer from Bank of Scotland Commercial Banking.
The full easing of lockdown restrictions in Scotland in August was a clear boost for businesses, with overall confidence in the economy also rising by 20 points to 43%.
Companies in Scotland reported marginally lower confidence in their own business prospects month-on-month, down eight points at 25%. When taken alongside their optimism in the economy, this gives a headline confidence reading of 34%.
The Business Barometer questions 1,200 businesses monthly and provides early signals about UK economic trends both regionally and nationwide.
A net balance of 20% of businesses in Scotland expect to increase staff levels over the next year, up seven points on last month.
Overall UK business confidence rose six points in August, reaching 36%, the highest level recorded since May 2018. When asked about their overall trading prospects businesses reported a six-point increase on July’s reading at 34% and firms’ confidence in the economy also increased six points to 39%.
All UK nations and regions had a positive confidence reading in August. The most confident regions were the North West (64%), North East (46%) and London (41%). All bar three areas reported a growth in confidence in August, with the East Midlands (down 10 points to 28%), West Midlands (down three points to 27%) and Yorkshire and Humber (down two points to 26%) reporting marginal falls.
Fraser Sime, regional director for Scotland at Bank of Scotland Commercial Banking, said: “With most of the Covid-19 restrictions easing in August, businesses across Scotland were able to return to normal trading for the first time in 18 months and are feeling optimistic about what this means for the economy.
“With confidence on the up and even more firms are now planning on making new hires, the country is taking great steps towards recovery and growth. We’ll continue to support businesses through the coming months as they aim to capitalise on this positive momentum.”
In sector terms, there was notable strength in sectors benefiting from the further easing of Covid restrictions. Services confidence saw the greatest month-on-month increase, rising by 8 points to 36%, the highest level since January 2018.
Confidence in both manufacturing and construction also picked up (both up 7 points to 40%), led by rises in trading prospects for the year ahead.
The increase in manufacturing confidence came despite ongoing supply disruptions, although the level remains below the high in May. Retail confidence posted a smaller 2-point rise to 34%, remaining below the recent peak in May.
Gareth Oakley, Managing Director for Business Banking, Lloyds Bank, said: “Since the start of the year business confidence has been increasing, and August has been a particularly strong month. Many of the regions have seen significant upticks in confidence and it’s encouraging that Northern Ireland has moved back into positive territory.
“It is clear there is still some level of uncertainty on inflation and the impact of price pressures, but with further boosts to confidence in the services, manufacturing and construction sectors we can be hopeful that demand across all sectors will drive consumption throughout the rest of the year. The last few months of the year will be pivotal to the future of UK economic growth and we remain by the side of businesses as the country continues to reopen.”
Hann-Ju Ho, Senior Economist Lloyds Bank Commercial Banking, said:“Business confidence reaching its highest level in over four years tells a positive story about the country’s economic recovery.
“This confidence is driven by the continued success of the vaccine ollout, the removal of lockdown restrictions and adjustments to self-isolation rules.
“Staff shortages remain a challenge, but as the economy moves back towards pre-pandemic levels we can be optimistic that the momentum for business confidence and economic optimism can be sustained in the months ahead.”
Pace of sector recovery reduces in 3 months to end of July 2021, but long-term indicators suggest quick return to upward momentum
Value of project starts in three months to end of July 2021 dips by 14% compared to buoyant start of the year
Planning consents down 20% in three months to end of July 2021 against previous three months
However, contract awards show resilience, three months to end of July 82% up on same period in 2020 and 43% above same period in 2019
Non-residential RMI Work increases by 2.3% in three months to end of July, up over 50% against previous three months in 2021
East of England region on the brink of return to pre-COVID levels of output
Glenigan, the construction industry’s leading insight and intelligence experts, has released the August edition of its Construction Review.
This monthly report provides a detailed and comprehensive analysis of construction data, giving built environment professionals unique insight into results from the three months to the end of July 2021.
Short-term slowdown
Following a growth spurt in the first half of 2021, momentum has started to show signs of slowing down. This recent decline has been led by a sharp fall in private residential and civil engineering work.
Overall, the value of projects starting on-site averaged £5,497 million per month in the three months to July. Despite being 27% higher than the same period in 2020, it remains 14% lower than the preceding three months in 2021.
Fig 1. August Construction Review Summary
This sudden fall can be attributed, in part, to a 19% decline in the value of underlying project (<£100m in value) starts. Although these were up 36% on 2020, the figures are still 24% lower than pre-pandemic levels.
Whilst the value of major projects remained unchanged (£1,740 million per month) against the preceding three months to July, they were still 2% down on 2019 levels.
Best laid plans
Planning consents have also seen a slip during this slower period, down 20% against the previous three months. Major planning approvals are more stable, but also witnessed an 8% decrease.
However, on a positive note, planning consent levels remain significantly higher on both 2020 and 2019.
Back on track
Looking further ahead, the strengthening pattern of main contract awards points to renewed growth in project-starts during the second half of the year.
Although the value of main contracts awarded slipped 1% against the previous six months, it remained 43% above the same period in 2019 (82% up on 2020). Putting this into perspective, major contract awards were three-and-a-half times higher than a year ago and 98% ahead of pre-COVID levels.
Recovery progressing
Despite the m-o-m decline, second quarter output was up 3.3% on the preceding three months.
Further, some areas of activity saw modest growth on Q.1, with RMI work increasing by 2.3% (53.5% ahead of 2020 figures). Much of this is accounted for by non-housing repair and maintenance work, perhaps reflecting the easing of COVID-19 restrictions and calls from Government and business to return to city centre workspaces.
There was also a slight uptick in new-build output (3.9%) in Q.2 against Q.1, with private housing experiencing a marked upward spike of 10.6%.
In line with Glenigan’s previous reviews and indexes, infrastructure has been the strongest performing sector for new work, rising 15.9% against the preceding quarter.
Industrial and commercial sector activity also rose by 3.8% and 0.8% respectively against the first quarter.
The biggest losers were the new public residential and non-residential sectors, which saw a slight dip in output of 1.5% and 1.4% respectively.
Strong performers
Regionally, Scotland achieved strongest growth project-starts against the previous year (124%) during the previous three months to end of July 2021. However, these figures were still below 2019 levels.
Yorkshire and The Humber also achieved three digit growth on 2020, but slipped by 14% against the previous three months.
Recovery is strengthening in the East of England, which is the closest UK region to returning to 2019 levels of output against the previous three months to July. Climbing 58%, the area is now only 9% off a pre-pandemic footing.
These positive figures are further tempered with continued output decline registered in Wales, the North East and South East. This highlights the sector still as a way to go to full nationwide recovery, even if good progress is being made.
Commenting on the findings, Glenigan’s Economic Director, Allan Wilen (above) says, “There’s no doubt the slowdown seen over the last three months has been the result of a perfect storm of external events, beyond the industry’s control.
“Supply chain issues continue to bite and look likely to remain a challenge for the foreseeable future. However, the sector is showing its strength across the board, and this modest slowing of pace is certainly not as serious as many might have predicted.
“With a number of major projects in the pipeline, a potential national green retrofitting programme and core infrastructure remediation work upcoming, there are reasons to stay positive as we look to the second half of 2021 and beyond.
“Our recent Forecast for 2021-2023 indicates 2022 will see a return to pre-COVID levels of project-starts, and whilst we’re not there quite yet, we’re seeing lost ground being made up at a quicker rate than anyone would have predicted this time last year.”
To request a copy of Glenigan’s full August Construction Review, with sector-by-sector analysis, click here.
The Scottish Government has delivered 80 priorities set out by the First Minister in May — but the annoucement was overshadowed by news that Scotland has just recorded more than 5000 daily Covid cases for the first time.
These commitments have been delivered across government and Ministerial portfolios, covering health and care, economy, climate change, communities, children and families, and how we lead Scotland safely through and out of the pandemic.
Deputy First Minister John Swinney said: “Recovery from the pandemic is an urgent priority for the government and I am proud of the bold, ambitious and transformative measures we have delivered in just 100 days.
“But this is only the beginning and there is much more we can and will do to build a fairer and more sustainable country as we continue to drive Scotland’s recovery from the pandemic.
“We have introduced co-ordinated and targeted policies which deliver demonstrable positive change for the people, families and communities who need it most – and for our economy, public services and environment.
“Delivering on the commitments that the First Minister made in May demonstrates our progress in taking the steps needed to make lasting and generational change, and to improve the lives of people across Scotland.”
Achievements include:
consulting on the creation of a National Care Service to improve social care for everyone who needs it
funding for 1,000 extra teachers and 500 pupil support assistants
doubling the carers’ allowance supplement this winter through the introduction of the Carer’s Allowance Supplement (Scotland) Bill
publishing a recovery plan for the NHS
£25 million to help small and medium businesses use digital technology and upskill employees
free NHS dental care for all young people under 26 years old.
opening three new rapid cancer diagnostic centres
tackling loneliness and social isolation – particularly among young and disabled people
free school lunches for more than 90,000 children
appointing Environmental Champions to advise government on international best practice
launching the new Green Jobs Work Academy to help people get the skills they need to move into new, greener jobs
The Scottish Government also committed to 14 new mobile phone masts to deliver high-speed connectivity for the first time to homes and businesses in rural communities. 14 new masts have been built, seven of which have been activated. The remaining seven are due to be activated by November.
But while the Scottish Government hails progress made since May’s Holyrood election, there are growing concerns about rising Covid-19 numbers.
The 100 days commitments had six particular areas of focus:
leading Scotland out of the pandemic
supporting our NHS and care services
backing our economy and creating jobs
helping children, families and young people
tacking the climate crisis
backing our communities and building better lives.
Yesterday – the day the Scottish Government made it’s 100 days delivery statement – also saw the highest ever number of Covid-19 cases. 5,021 new cases were reported in Scotland.
The government hails their first hundred days as a positive start, but it will be their actions to address the most ‘urgent priority’ – the rampant Covid virus – that will prove crucial for Scotland over the coming hundred days.
4,323 new cases of COVID-19 reported in Scotland yesterday – highest ever figure
Cases more than DOUBLE in one week
City of Edinburgh Council Leaders have appealed to the public to keep sticking to the rules and looking out for one another, as Scottish Covid cases more than double in one week.
Their plea follows an update by the First Minister yesterday, when she urged those who were eligible for the vaccination to take it up, while reminding people to continue following the ‘basic steps’ to reduce risk, including hand hygiene, distancing where possible and good ventilation indoors. She also confirmed plans to establish a public inquiry into the handling of the Covid crisis by the end of 2021.
Most Covid restrictions were removed when Scotland moved out of level 0 on 9 August. This included the need to physically distance in most settings and for close contacts of those who test positive for Covid to self-isolate, as long as they’re fully vaccinated.
However, the use of face coverings is still required in some public spaces and people are encouraged to keep themselves and others safe by getting tested regularly. Leaders have also urged everyone aged over 16 to take up their offer of a vaccination if they have not done so already to help protect one another and limit the rise in case numbers.
Council Leader Adam McVey said: “The move out of level 0 of the Covid restrictions framework signalled a return to some sense of normality in many areas of our lives but we have to remember that this virus has not gone away, as rising infections demonstrate.
“It’s great to see businesses reopening, people meeting up with friends and loved ones more easily and schools at full capacity. However, we must not be complacent – as the First Minister said, the recent surge in cases is a cause of real concern.
“We really need everyone who’s eligible, especially those in the youngest cohort aged 16 and over, to take up their offer of a vaccine. Covid has the potential to make patients of any age very ill, including, in some cases, long Covid.
“The only way we can avoid that, and truly beat the virus, is through vaccinating everyone who’s eligible, as well as sticking to the basic hygiene, distancing and mask-wearing guidance to limit its spread.”
Depute Leader Cammy Day said: “We’ve all worked so hard over the last year and a half to do everything we can to limit the spread of this virus – there’s no reason to stop now, particularly as cases continue to rise steeply. This is the moment we all need to do our bit, take care to stick to the rules and get tested regularly, if we are to get through this without restrictions being reintroduced.
“We’re glad that the First Minister has confirmed plans to open a public inquiry into the handling of the Covid pandemic in Scotland. The lessons learned from this will be essential if we are ever to face a pandemic like this again.”
