Hansard

I welcome this opportunity to update Parliament on our extended testing programme and our NHS Scotland Covid-19 vaccination programme.

The discovery of a new and more transmittable Covid-19 variant is a bitter blow, but we now have many more tools to fight the virus than we had in March. Vaccination and testing are critical to suppressing the virus and preventing the harms that it causes. Following the announcement last month to expand testing across a number of areas, significant progress has been made. Two of our three new national health service regional laboratory hubs went live on a phased basis last week, with the west and the north hubs now receiving samples. The east regional hub will be operational by the end of January.

Processing of the weekly tests of 42 per cent of care home staff has now moved to our NHS labs as planned, and we will complete that transition by the end of January. Testing of all admissions to hospital is under way and is to be completed by the end of the month.

Twice-weekly testing has been introduced on a phased basis for all patient-facing staff in NHS Scotland hospitals, Covid-19 assessment centre staff, the Scottish Ambulance Service and all Covid-19 vaccinators. That is on track to be fully implemented by the end of January 2021.

All care homes now have the equipment for lateral flow testing, and a rolling programme of training is under way to provide testing for care home visitors, with lateral flow testing to support professional visitors to care homes from the beginning of January.

All students at Scottish universities and colleges who are going home for the winter break were offered testing during a two-week testing window from 30 November. More than 26,000 students were tested, with 106 positive cases found, which was a very low overall positive-test rate of 0.2 per cent. Testing will be offered on a similar basis to support the staggered start of the university term next year.

In January, our pathfinder testing programmes will begin, with the aim of developing a sustainable programme of asymptomatic testing among school staff. We are working closely with a number of local authorities and volunteer schools to develop detailed plans. The first model will involve in-school testing using lateral flow devices, and the second will involve at-home PCR—polymerase chain reaction—testing using the satellite testing channel that has previously been used in the care home sector. We expect those pilots to inform the development of a scalable and sustainable approach to asymptomatic testing of school staff at the earliest opportunity.

We have completed our community testing pilots. Between 26 November and 9 December, we targeted testing resources at eight communities with stubbornly high Covid-19 prevalence levels, as part of a community testing pilot. That involved deployment of six mobile testing units and more than 4,000 home test kits, and establishment in Johnstone of the asymptomatic test site using lateral flow devices. Over the course of the pilot, 22,133 tests were completed and 850 positive cases were identified, giving an overall positive-test rate of 3.8 per cent.

We will now expand that strategic and targeted use of testing through a community testing programme in January, which will be delivered in partnership with local authorities. We hope to have in the early part of that month their proposals for communities where that approach will have the greatest impact. With local authorities, we intend to build on that intense targeted period of testing to wrap around a full public health package. That will include continued support for those who are asked to isolate, use of the self-isolation support grant, the local self-isolation assistance service and the national assistance helpline. We will ensure compliance with non-pharmaceutical interventions in vulnerable settings, including schools, care homes and employment settings, and will offer support where we need to.

Finally, I am pleased that, following work with Royal Mail, all 82 mainland postcode areas now have access to home test kits, and that we have met our commitment to have 22 local test sites by the end of this year. From January, we will have access to an additional 14 mobile testing units.

Our NHS Scotland vaccination programme began on 8 December. In the period to 20 December, 56,676 people received their first dose. They include care home residents and staff, and patient-facing NHS staff. Depending on supply delivery, during January we will complete the second-dose vaccinations to residents in care homes, older people and their carers, and to front-line health and care staff.

I have previously outlined the challenges in delivering the Pfizer vaccine, including stability in transportation, storage requirements and pack sizes. Those issues have limited our capacity to take the vaccine everywhere that it is needed. Scottish Government health officials, our health boards, and the Medicines and Healthcare products Regulatory Agency have worked to mitigate those issues and to streamline our process of deploying the vaccine. Thanks to their efforts, we are now able to safely reduce pack size, which has allowed the care home programme to begin, and the transport challenges of getting the vaccine to all of our islands have been resolved.

We anticipate receiving a total of 172,575 doses of the Pfizer vaccine by the end of this week, 50 per cent of which we will retain so that we can be sure to give those who are vaccinated the second dose after the required 21-day period.

A key area that would help to streamline the process further is predictability of delivery, but that is not in our gift. Safety is a paramount concern and there is a rigorous process of safety checks between the vaccine leaving the factory in Belgium, arriving in the United Kingdom and then arriving in Scotland.

Those checks mean that, although we know when the vaccine leaves the factory, we cannot be certain of the date on which we will receive it. That is a challenge for our forward planning of vaccine appointments, but it is one that we share across all four nations of the UK. We are working together with the regulator and the distributor to resolve that challenge. I expect that we will continue to discuss and pursue the matter tomorrow, at my normal weekly meeting of the health ministers of the four nations.

The Joint Committee on Vaccination and Immunisation’s recommendation for delivery of a Covid-19 vaccine is that prioritisation should first be given to those who have the greatest clinical need. Taken together, vaccinating those on the JCVI’s list will help to reduce about 99 per cent of preventable mortality from Covid-19. That is clearly a compelling rationale, and it is right that we follow that advice. People who are clinically extremely vulnerable are high on the JCVI’s prioritisation list, alongside those aged 70 and over.

I understand the concern that people who are terminally ill want, if at all possible, to receive the vaccine earlier. Matt Hancock and I have now both written to the JCVI asking it for further consideration of and clarity on that group, for all the reasons that I know members will understand.

Right now, we have access to just one vaccine. We hope that we will in the near future have access to two. Should it get approval from the MHRA, the new AstraZeneca vaccine will not need to be stored at ultra-low temperatures and will be easier to transport. That means that we will be able to deploy it in a far wider range of settings than has been the case for the Pfizer vaccine. Dependent on the JCVI’s advice, we will likely use it to prioritise vaccination of over-80s who are not care home residents. That group will be vaccinated largely in general practice settings.

Should the AstraZeneca vaccine be approved before the end of this calendar year, we anticipate that we will be able to commence vaccination in primary care locations from Monday 11 January. Vaccine supplies permitting, we aim to have vaccinated all those on the JCVI’s prioritisation list by the spring. Once we have completed that group—again, depending on supplies—we will commence vaccination of the rest of the population.

The dedicated officials and NHS staff who have taken forward the vaccine programme have done remarkable work at pace, for which I am grateful. On 3 December, I said that we would, depending on supply, begin vaccination on 8 December, which we did. We said that we would begin vaccination of people in care homes on 14 December, which, again, we did. All that is down to the hard work of staff. When we have more vaccines and greater numbers of doses available to us, those public servants stand ready to deliver once more.

Today, members will receive initial board maps of primary care settings and other vaccination centres in their areas to meet the scale-up, alongside use of mobile units where those are needed. We are looking at use of larger centres in heavily populated areas such as Glasgow, Edinburgh, Dundee, Aberdeen and Lanarkshire to supplement the local and mobile solutions for people in remote and rural areas, and for those who have particular requirements.

Alongside that, we are building a national scheduling tool that will support wider cohorts of the population to schedule their appointments, which is on track for delivery by the end of January.

Although limitations with vaccine supply have meant that there have been lower initial workforce requirements for the early weeks of the programme, we have nevertheless been keen to ensure that we continue to ramp up capacity. We currently have 1,729 registered vaccinators, and 4,000 people attended national training events on delivery of the Pfizer vaccine. To deliver on our intention of concluding vaccination of those who are on the priority list in the spring, our workforce modelling shows a requirement for about 1,400 vaccinators and 600 support staff. We remain confident in our workforce supply. We are also exploring all offers of assistance from individuals and organisations, for which we are very grateful.

I know that for many people the wait to get the vaccine will be an anxious one. I hope that people will be assured that we will contact them as soon as we have the vaccine supply and can reach their eligible group. It is essential that, once people have been contacted, they attend their first vaccination appointment and return for their second dose.

A vaccination programme of such a scale is unprecedented and is a significant logistical challenge that requires a major nationwide effort. So far, we have secured the enthusiastic support of many partners across our public sector, and we continue to face that challenge with optimism and determination to succeed for Scotland.