Publication - Strategy/plan

Coronavirus (COVID-19): allocation of levels to local authorities - 17 November 2020

Published: 17 Nov 2020

Protection levels that will apply in each local authority area in Scotland from 20 and 24 November 2020, alongside evidence and analysis informing these decisions.

Published:
17 Nov 2020
Coronavirus (COVID-19): allocation of levels to local authorities - 17 November 2020

Purpose

This document sets out the outcome of the second review of the allocation of levels to local authorities published on 29 October 2020. It also sets out in summary the reasons for changes in allocation

An evidence paper setting out the data and analysis supporting these decisions has also been published.

See: Coronavirus (COVID-19): protection level reviews and evidence to ensure you are viewing the most up-to-date review information.

Decision-making process

On 29 October 2020, as part of Scotland’s Strategic Framework, we published the initial allocation of levels to local authorities. These allocations came into effect on 2 November 2020.

The allocation document makes clear that decisions have to be based firmly in the best available evidence, assessed through a process that is open, transparent and collaborative and frequently reviewed so that restrictions are not kept in place longer than is strictly necessary to achieve the aim of suppressing the virus.

The allocations are reviewed weekly and this document sets out the outcome of the second review.

In line with the process set out in the allocations document, the National Incident Management Team (NIMT), chaired by Public Health Scotland and including representatives from local government as observers, met to discuss the latest analysis of data, which had been agreed with local partners including Directors of Public Health.

The NIMT then provided advice to a group made up of the Scottish Government’s chief advisers representing the four harms and observers from local government. This group helped form recommendations for Ministers on allocation of levels, which were discussed with the relevant local authorities, and then agreed by the Scottish Cabinet on 17 November 2020.

The critical indicators which inform the allocation of levels are:

a) the number of cases per 100,000 people over the past seven days

b) the percentage of tests that are positive over the past seven days

c) forecasts of the number of cases per 100,000 consisting of the weekly number of cases in two weeks’ time

d) current and projected future use of local hospital beds, compared with capacity

e) current and projected future use of intensive care beds, compared with capacity

There is a change in this review on how measures (d) and (e), relating to forecasts on NHS capacity, are reported in the section: Local authority: allocation of level to each area and summary of indicators The purpose of the hospital and ICU projections is to give early indications of concern, clearly with higher levels of concern. As such, the outputs from the indicators shown in the Local Authority tables are shown as 'very high' where the projections show a breach of capacity within 2 weeks for ICU or 3 weeks for Covid hospital beds, 'high' where the projections show a breach of capacity within 3 weeks for ICU or 4 weeks for Covid hospital beds, 'of concern' where the projections show a breach of capacity within 4 or 5 weeks for ICU or 5 or 6 weeks for Covid hospital beds, and 'low' if the projections don’t breach capacity within this time period.

The status of these indicators, including relevant trends for each local authority, are set out in the accompanying evidence paper.  The data themselves do not determine the relevant level of any local authority, and are considered alongside other local, regional and national factors.  As Scotland’s Strategic Framework says (p.23): 'These decisions require judgement to be applied to all the facts and considerations relevant at the time they are made, and in relation to the area directly affected and for Scotland as a whole.'

Summary of review

In announcing the initial allocation of levels to local authorities to Parliament on 29 October, the First Minister made it clear that the Scottish Government was taking a deliberately cautious approach.  This was not only to reflect the fact that we were introducing a new framework for the first time, but also the fragility of the situation we were facing.  While there has since been progress in some areas, in many areas there are signs of plateauing in the effect of control measures on cumulative incidence..  Overall, the situation remains fragile with -  as yet - no sustained evidence that we are changing the course of the pandemic. 

We remain confident that with local authorities allocated to the appropriate level, the measures in place within the levels will impact positively on the course of the pandemic. That, however may take some time. So while the decisions set out in this document are justified, necessary and proportionate for each local authority, the overall national impact of the measures has also to be considered as part of that assessment. That means local authorities not moving down levels until there is sustained evidence of improvement and moving up levels quickly to mitigate the risk of deterioration and associated harms.

The review found that while the picture across Scotland was improving progress was slowing. Over the last week some areas were showing only a small decrease or fairly stable numbers, but at a high level.  In view of the additional pressures that winter brings on NHS resources and the upcoming festive season, the clinical and health protection advice was that there was a need to do more to ensure that downward trends continue.  

The specific outcome of the review is that the following local authorities will move from level 3 to level 4 from 20 November. While several of these areas have seen some improvement, the review concluded that additional protective measures were necessary in order to see the levels of improvement needed to address concerns regarding NHS capacity over the winter season.  See further detail on the reasons behind these individual decisions

  • Glasgow City
  • East Renfrewshire
  • Renfrewshire
  • East Dunbartonshire
  • West Dunbartonshire
  • North Lanarkshire
  • South Lanarkshire
  • East Ayrshire
  • South Ayrshire
  • West Lothian
  • Stirling

These areas make up most of the Central Belt with the exceptions of – East Lothian, City of Edinburgh, Inverclyde, Clackmannanshire, Midlothian, North Ayrshire and Falkirk. 

East Lothian and Midlothian have seen consistent positive trends and the indicators now suggest that level 2 would be appropriate in these local authority areas. While residents should continue to exercise caution and pay particular notice to guidance on travel between local authorities, these two areas will move to level 2 from 24 November.

All other Central Belt areas will remain in level 3. 

The allocation of level for the remaining local authorities remains unchanged.  This does not mean the impact of the pandemic on these areas is unchanged.  We have seen some areas improve, some remain broadly static and some showing signs of deterioration. For those local authorities in those latter two categories in particular – areas of concern - we will continue to monitor on a weekly basis, discussing the situation in depth with the local Director of Public Health and with the NIMT. The next scheduled review will be on  24 November.  We reserve the right to bring that forward for any one or more local authority as the situation requires.

Local authority: allocation of level to each area and summary of indicators

Local authority*

Cases / 100k

Test Positivity

Cases / 100k forecast

Hospital forecast

ICU forecast

Present level

New level

East Ayrshire

H

H

L

OC

OC

3

4

North Ayrshire

H

H

L

OC

OC

3

3

South Ayrshire

H

H

M

OC

OC

3

4

Scottish Borders

L

M

L

L

L

2

2

Dumfries and Galloway

L

M

VL

L

L

2

2

Fife

M

H

M

L

OC

3

3

Clackmannanshire

M

M

L

L

VH

3

3

Falkirk

M

M

VL

L

VH

3

3

Stirling

H

H

M

L

VH

3

4

Moray

L

L

VL

L

L

1

1

Aberdeen City

L

M

VL

L

L

2

2

Aberdeenshire

L

M

VL

L

L

2

2

East Renfrewshire

H

H

M

OC

OC

3

4

Inverclyde

M

M

M

OC

OC

3

3

Renfrewshire

H

H

M

OC

OC

3

4

West Dunbartonshire

H

H

M

OC

OC

3

4

East Dunbartonshire

H

H

M

OC

OC

3

4

Glasgow City

H

VH

M

OC

OC

3

4

Highland

L

VL

VL

L

L

1

1

Argyll and Bute

L

L

VL

L

L

2

2

South Lanarkshire

H

H

M

VH

H

3

4

North Lanarkshire

H

VH

M

VH

H

3

4

East Lothian

L

H

L

L

L

3

2

Midlothian

L

M

L

L

L

3

2

City of Edinburgh

M

H

L

L

L

3

3

West Lothian

H

H

M

L

L

3

4

Orkney Islands

VL

VL

VL

L

L

1

1

Shetland Islands

VL

VL

VL

L

L

1

1

Angus

M

M

M

L

L

3

3

Dundee City

M

H

L

L

L

3

3

Perth and Kinross

M

M

M

L

L

3

3

Na h-Eileanan Siar

 L    

VL

VL

L

L

1

1

*Ordered by health board

VL = very low
L = low
M = moderate
H = high
VH = very high

Summary of reasons for allocation of level

The following table sets out summary information only. Further data is contained in the supporting evidence paper. Broader information, including at the local level by the National Incident Management Team, has also been considered in reaching these allocation decisions.

Local authority

level

Summary of reasons for change in allocation of level

Aberdeen City

2

  • trends had been stable but have sharply risen in recent days. This will be closely monitored
  • allocation unchanged

Aberdeenshire

2

  • cases and test positivity consistently increasing over last week
  • as with Aberdeen city there has been a sharp rise and this will need to be monitored closely over coming days
  • allocation unchanged

Angus

3

  • too early to say if move to level 3 has had desired effect but early signs are positive
  • allocation unchanged

Argyll and Bute

2

  • cases and test positivity consistently decreasing over last week
  • allocation unchanged but if positive trends continue may be considered for level 1 at next review

Borders

2

  • no consistent change but an early indication that last week’s trends in increasing cases and test positivity may have been blunted
  • allocation unchanged

Clackmannanshire

3

  • some evidence that improvement in cases and test positivity may be plateauing 
  • allocation unchanged

Comhairle Nan Eilean Siar

1

  • numbers continue to be low and will be monitored to see if recent changes to indoor socialising rules have any impact
  • allocation unchanged

Dumfries and Galloway

2

  • some evidence that improvement in cases and test positivity may be plateauing 
  • allocation unchanged

Dundee City

3

  • since moving to level 3 case rates and test positivity have improved however some early signs that this improvement in cases and test positivity may be plateauing 
  • hospital forecasts for Tayside show an improved picture
  • allocation unchanged

East Ayrshire

  • no sustained improvement in last week
  • continued evidence of projected pressure on NHS Ayrshire and Arran
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • East Ayrshire moved to level 4

East Dunbartonshire

  • no sustained improvement in last week
  • continued evidence of projected pressure on NHS Greater Glasgow and Clyde
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • East Dunbartonshire moved to level 4

East Lothian

2↓

  • improved picture overall, particularly in case numbers
  • East Lothian to move to level 2

East Renfrewshire

  • no sustained improvement in last week
  • continued evidence of projected pressure on NHS Greater Glasgow and Clyde
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • East Renfrewshire moved to level 4

Edinburgh

3

  • some evidence that improvement in cases and test positivity may be plateauing or slightly increasing 
  • allocation unchanged

Falkirk

3

  • no sustained improvement in last week
  • ICU forecast for Forth Valley is concerning and will be monitored closely
  • Falkirk continues to be allocated at level 3

Fife

3

  • increased case numbers and test positivity since last week, too early to say if move to level 3 has had the desired positive effect
  • allocation unchanged

Glasgow

  • no sustained improvement in last week, trends show some signs of plateau
  • continued evidence of projected pressure on NHS Greater Glasgow and Clyde
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • Glasgow City moved to level 4

Highland

1

  • cases remain low some indications that last week’s trends in increasing cases and test positivity may have been blunted
  • allocation unchanged

Inverclyde

3

  • cases and test positivity consistently decreasing over last week
  • the increase in case numbers and positivity observed last week has improved and picture is now improving
  • although still within NHS Greater Glasgow and Clyde the position in Inverclyde is more positive than other local authorities within this health board.  It is therefore not proportionate to move Inverclyde to level 4
  • allocation unchanged

Midlothian

2↓

  • cases numbers have improved this week but there is no sustained improvement in case positivity
  • Midlothian to move to level 2

Moray

1

  • while case numbers remain low there have been an increase in the last week which will need to be carefully monitored
  • allocation unchanged

North Ayrshire

3

  • no sustained improvement in last week
  • continued evidence of projected pressure on NHS Ayrshire and Arran
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • the numbers in North Ayrshire are more positive than in the South or West, it is therefore not proportionate to move North Ayrshire to level 4 at this time, however this will be closely monitored
  • allocation unchanged

North Lanarkshire

  • cases and test positivity decreasing, but very slowly
  • continued evidence of projected pressure on NHS Lanarkshire
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • North Lanarkshire moved to level 4

Orkney

1

  • numbers continue to be low and will be monitored to see if recent changes to indoor socialising rules have any impact
  • allocation unchanged

Perth and Kinross

3

  • no sustained improvement in last week, too early to say if move to level 3 has had the desired positive effect
  • allocation unchanged

Renfrewshire

  • no sustained improvement in last week
  • continued evidence of projected pressure on NHS Greater Glasgow and Clyde
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • Renfrewshire moved to level 4

Shetland

1

  • numbers continue to be low and will be monitored to see if recent changes to indoor socialising rules have any impact
  • allocation unchanged

South Ayrshire

  • no sustained improvement in last week
  • continued evidence of projected pressure on NHS Ayrshire and Arran
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • South Ayrshire moved to level 4

South Lanarkshire

  • cases and test positivity decreasing, but slowly
  • continued evidence of projected pressure on NHS Lanarkshire
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • South Lanarkshire moved to level 4

Stirling

  • case numbers and case positivity has increased since last week
  • projected pressures on NHS forth Valley are significant and concerning
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • Stirling moved to level 4

West Dunbartonshire

  • no sustained improvement in last week
  • continued evidence of projected pressure on NHS Greater Glasgow and Clyde
  • in anticipation of winter pressures it is necessary to bring in additional protective measures to ensure that there is sufficient NHS capacity to meet demand
  • West Dunbartonshire to move to level 4

West Lothian

  • no sustained improvement in last week
  • case numbers and case positivity remain stubbornly higher than the Scottish average. Additional protective measures are needed to drive these numbers down
  • West Lothian moved to level 4

 Evidence paper