Coronavirus (COVID-19): Scotland's route map - supporting evidence for moving to Phase 3
This publication provides an assessment of the evidence which informed the decision to move to Phase 3 of Scotland's route map.
This document is part of a collection
WHO criterion 6: Communities have a voice
WHO criterion 6: Communities have a voice, are informed, engaged and participatory in the transition.
Informing the Public
We have published our Framework for Decision Making and Route Map, with updates and supporting evidence, and a range of sector specific guidance to provide transparent information on the plans to move out of lockdown safely.
Daily Ministerial briefings continue, led by the First Minister and supported by medical and scientific advisors. They continue to provide clear and consistent messaging and are followed by a Q&A with journalists. This regular briefing has also been used to launch and direct the public to new publications and information on the government's actions to mitigate the harms of COVID-19.
The messaging provided by the daily briefing has been supported by marketing campaigns, primarily focussed on increasing awareness of and compliance with public health measures, and support for those who need it (including for domestic abuse, mental health, and managing finances). Messages have evolved as restrictions have lifted - particularly important as the speed of removing restrictions has varied within the UK.
YouGov polling from 30 June - 2 July shows 80% agree they feel clear about what is required of people who live in Scotland as the restrictions change, with 90%+ awareness of the importance of avoiding crowded places, staying 2m+ from others, keeping hands away from the face, self-isolating, booking a test at the first sign of symptoms, and cleaning hands regularly (the latter - last measured 23-25 June).
Paid-for-media campaigns have targeted a number of different demographics with specific messaging, including:
- General Population - NHS is Open (if it's urgent, it's urgent); Clear Your Head - supporting positive mental health; Scotland Cares - encouraging volunteering and communitarianism.
- At Risk Audiences (adults 70+, adults at increased risk of COVID complications) encouraging additional precautions and offering additional support if required.
- Victims of Domestic Abuse - encouraging access to support services.
- BAME communities - specific public health messaging due to poorer reach of general messaging.
- Renters - supporting tenants concerned about being evicted.
- Those with financial worries as a result of COVID - increasing awareness of benefits and wider financial support available.
- Young people (18-24 year olds, 13-24 year olds) - demographic-specific public health messaging.
- Parents (of children 0-16 years old, of children 2-9 years old) - a range of messaging and support products.
- Advice and guidance has been published on a wide range of issues on the Scottish Government website to support individuals and businesses through this period.
A range of documents have been published as part of the Framework for Decision Making series, receiving a large amount of public interest. These outline the approach and principles that will guide us and the Route Map we will follow as we make decisions about transitioning out of the current lockdown arrangements. They also set out the supporting evidence and analysis which supports the framework and the decision to move into Phases 1 and 2. The 'Equality and Fairer Scotland Impact Assessment: Evidence Gathered for Scotland's route map through and out of the crisis' provides a wide range of evidence that has been gathered in relation to the Route Map. This evidence sets out the impacts we have identified through data and engagement and the types of mitigation measures that have been put in place, either to reduce the harm for a certain group or to promote a positive impact.
Data on the pandemic has been published on the Scottish Government website daily and is also available in Open Data format. Findings in modelling the epidemic have also been shared online as well as reports of research on public attitudes and behaviours; work to improve access to data is continuing.
A dashboard to set out a clear narrative and provide easy access to consistent data is currently in development and will become available in July. It will bring together disparate elements of evidence to help the public understand the data as they relate to the harms caused by COVID-19, illustrating what is happening on the ground and the progress of the pandemic.
There is work underway to bring together system-wide ethical, trusted, safe and effective access to the relevant public service data and intelligence. Work is also underway to broaden the public understanding of the value of the data by developing a public facing dashboard jointly with public service and academic partners. It will provide access to COVID-19 specific information to support local and national understanding of the progress of the pandemic. This is currently under development with a projected launch date in late July.
Finding out about the public
Marketing activity has been developed following insight gathering qualitative groups among different audiences in Scotland, and tested in qualitative research for effectiveness ahead of production. Impact of paid-for-media campaigns has been closely tracked to ensure that marketing campaigns have been effective.
The COVID hub has carried out a range of polling and survey work, tracking the impact of COVID on communities to support effective action to mitigate the harms of the pandemic - this includes polling to monitor public attitudes and behaviours to understand:
i) Compliance with rules and guidance.
ii) Impact of the virus on personal and societal wellbeing.
iii) Trust in government responses to the pandemic, and provision of information.
iv) Monitoring of some of the harm indicators on trust, loneliness, and health.
The main weekly survey is commissioned to inform effective decision making. A monthly summary is published for external audiences. In combination with this, a survey with stakeholders was commissioned to understand the broader societal impact of COVID-19 on wellbeing. The results help us contextualise some of the polling findings and provide a more rounded sense of societal impact.
Recognising that the impact of COVID-19 impacts different communities disproportionately, the Scottish Government has worked with partners and stakeholders to understand the impact of COVID-19 on their work. This includes work to improve understanding of the existing data and to identify gaps. To further this work, an Expert Reference Group (ERG) on COVID-19 and Ethnicity was established to assess and understand impacts for minority ethnic groups in Scotland; the group first met on 25 June and again on 9 July.
There has been continued wider engagement with race equality stakeholders. The Scottish Government's race equality team meet with a range of stakeholders on an ongoing basis. For example, colleagues have joined meetings of the Ethnic Minority Resilience Network on several occasions throughout the lockdown period, as well as other bilateral meetings and conversations. The 'Equality and Fairer Scotland Impact Assessment: Evidence Gathered for Scotland's route map through and out of the crisis', demonstrates the engagement with equalities and fairer Scotland stakeholders that has helped us understand the impacts of COVID-19 and to develop mitigating actions that reduce harm to help us to tackle deep-rooted structural challenges. This publication will be updated for future phases and we will continue to work with stakeholders to ensure our work accurately reflects the lived experience of COVID-19.
Evidence and insights have been published by the Scottish Government to ensure policy decisions are taken in light of the latest evidence. This includes reports in the following areas:
- Economic impact
- Family income, wealth and spending
- Health and Social Care
- Children and Education
- Housing and homelessness
- Fishing industry
- Local lockdowns
- Impact on BAME groups
- Impact on disabled people
- Futures approaches
- Lessons learned
Across all areas of government policy, teams have continued to engaged in discussions with stakeholders from their respective areas to understand the impact of COVID-19 on different communities to understand the immediate impacts and to better shape future actions.
Understanding the Impact on Children and Young People (CYP)
Scottish Government teams have worked with partners and stakeholders to understand the impact of COVID-19 on children and young people. A COVID-19 Children and Families Collective Leadership Group has been established in collaboration with SOLACE, COSLA, Police Scotland, Scottish Children's Reporter Administration (SCRA), Children's Hearings Scotland, the third sector, organisations across education, health and social work sectors, and other key organisations. This Group is gathering data and intelligence about the adversities and challenges faced by children, young people and families and to progress local and national actions in response. Current key work-streams involve progressing actions on child protection, disabled CYP, domestic abuse, family support, and kinship families.
Engaging the public
An online public engagement exercise was launched on 5 May and was live until 11 May. In this time, we received more than 4,000 ideas and almost 18,000 comments relating to the Framework for Decision Making and Test, Trace, Isolate, Support strategy. In total, 11,692 respondents registered for this exercise, of whom 3,274 submitted ideas. All comments and ideas published can be viewed on the platform.
A full overview of the engagement exercise is published online. Outputs from this exercise directly fed into the development of the Route Map and tailored reports were distributed to policy teams on a number of topics. Insights from the exercise, alongside topic-specific stakeholder engagement work, are directly informing the development of regulations and guidance across the Route Map phases.
In recognition of the evolving approach to Public Engagement across Government, an expert group has been formed. It met on 26 June to provide advice and guide our public engagement work. That group considered the needs for engagement in the short term to support people's participation in managing the pandemic.
Following that discussion, planning is now underway to develop the next online engagement exercise that will focus on aspects of the management of the pandemic and the maintenance of public trust.
Additionally, some policy teams have taken part in conversations with the public and representative stakeholders in order to engage on specific decisions or issues. For example, colleagues in Housing and Social Justice, alongside Minister for Local Government, Housing and Planning, Kevin Stewart, have engaged with people with lived experience of homelessness to help inform the recovery plan for this area. This type of engagement is continuing as lockdown restrictions are eased.
In June, more than seventy areas of government reported to be undertaking engagement related to the COVID-19 pandemic. The expert group, along with a Scottish Government team with expertise from across government, is continuing to develop a strategic approach to engagement and participation during the pandemic to connect and share experiences, to identify gaps in skills and resources, and work to align information products and engagement tools that are currently under consideration or development.
Any signs of resurgence are closely monitored as part of enhanced community surveillance
As Scotland transitions to the next phase of the COVID-19 pandemic, a responsive system of community surveillance for COVID-19 is essential. The national level measures that have become the mainstay of tracking the pandemic will need to be supplemented by local active surveillance. We expect to see less community transmission, followed by clusters of cases, then more sporadic cases (one or more cases, imported or locally detected). These need to be carefully monitored, including outbreaks in special settings.
The Scottish Covid Data and Intelligence Network is working to provide an effective pandemic response at national, local, and sectoral levels, and to support public trust by publishing data. That includes the ability to identify potential new clusters of Covid infections at a near real time and on a small area geographical basis.
Data from Test and Protect will be critical to establish the efficacy of the system and contribute to active surveillance. This includes demonstrating that most new cases are translating into index cases and establishing that high proportions of contacts are traced within 48 hours.
Modelling of the pandemic will also continue and will provide an ability to look at the effect of any new cases on the country as a whole and whether this may lead to additional cases that would need to be acted on e.g. around re-imposing lockdown restrictions.
We can determine whether to re-impose lockdown restrictions based on our understanding of the impact on transmission risk of the various changes we have made. Re-imposing restrictions should be considered when key measures cross certain thresholds or meet specified criteria. This could include the estimated level of R, infectious people, estimated new infections and observed data.
Other lead indicators will also be tracked to identify any resurgence of the virus as part of enhanced community surveillance efforts in Scotland:
- NHS24 calls for respiratory symptoms
- Symptomatic patient surveillance at Community Hubs
- Asymptomatic surveillance in dental surgeries (when available)
- Proportion of COVID-19 positive cases (from all tests)
- Nosocomial outbreaks
- Care home outbreaks
There are well established multi-tiered, multi-agency coordinated approaches to managing any public health outbreaks in Scotland. The procedures used are set out in very well established and effective guidance: The Management of Public Health Incidents: Guidance on the Roles and Responsibilities of NHS led Incident Management Teams. This guidance is well known and well understood by local health partnerships. Last updated and published in 2017, it is presently being lightly refreshed to reflect COVID legislation and the introduction of Public Health Scotland.
To support the publication of the refreshed guidance officials are developing a position statement that sets out six steps to surveillance and response. Work is also underway with Public Health Scotland to develop a Scottish Workbook, a public facing document that sets out clearly the process of how outbreaks are managed. It is proposed that the workbook is to be accompanied by a set of sectoral Advice Cards that will bring together in one place key information and links to guidance to support action and decision making.
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