Let’s Be Heard: Sharing Respondents' Pandemic Experiences, Impacts, and Lessons to be Learned in Scotland | Page 5

You Said…

This section of the report focuses on the answers to Let’s Be Heard’s third core question: What lessons do you think should be learned from your experiences? 

Respondents provided many suggestions as to how Scotland can be better prepared to respond to future pandemics. Key lessons included:

• having clearer plans in place for a future pandemic and emergency response;
• maintaining key services, such as primary healthcare, during a pandemic;
• prioritising mental health and wellbeing, especially for key groups, such as children and young people and people living alone;
• providing clear, consistent and evidence-based public health messaging; and 
• finding a better balance in future government pandemic responses between protecting the population from transmission of a virus and avoiding unnecessary harms. 

It is important to note again that the suggestions provided in this section represent the views of those who participated in Let’s Be Heard, and do not represent, nor anticipate, the conclusions of the Inquiry.

Pandemic preparedness

Respondents overwhelmingly expressed frustration that the Scottish Government was not adequately prepared for the pandemic and its consequences. Several recommendations were suggested to help Scotland be better prepared for future pandemics. These included:

Put clear plans in place for future pandemic and emergency responses:

• Many respondents felt that the Scottish Government’s credibility has been damaged. They wanted proof and reassurance that lessons have been learned, and that rigorous plans for different scenarios will be put in place and regularly reviewed.
• Some participants called for a coordinated approach to a future pandemic response. Respondents who navigated multiple systems, such as hospitals, GP practices and social care, frequently referred to the lack of a “joined up” approach and recommended establishing better communication channels across departments and institutions that need to work together during public health emergencies. 

Invest in public services, equipment and training as the foundation for future preparedness:

• Many respondents reported experiencing increased harm because major public institutions, such as the NHS and schools, were operating on a “skeleton system” even before the pandemic. They recommended investing in Scotland’s public services and infrastructure during non-crisis times to increase capacity and resilience during public health emergencies.
• Many recommended more attention to sourcing and distributing equipment, particularly PPE, and updating regulations to ensure reserves were well-stocked with a buffer during normal times.
• Staff shortages, as well as inconsistencies in staff training, especially in schools and hospitals, resulted in uneven service provision and hampered institutions’ ability to run effectively, or to adhere fully to the regulations. Furthermore, some participants suggested a focus on improved staff training in these public institutions and investment in staff retention, ahead of any future public health emergencies. 

Care homes

Many respondents expressed concern around the handling and treatment of residents in care homes throughout the pandemic, and that the restrictions around care homes were overly strict.

Respondents highlighted several areas where lessons could be learned and made recommendations as to what could be improved: 

Greater planning and preparedness for access to, and distribution of, PPE:

• Some participants believed that if more health and social workers had had access to PPE sooner, it would have significantly prevented the spread of COVID-19 in care homes. 
• It was considered vital among respondents in the sample group that care homes stock suitable PPE as standard in preparation for future pandemic outbreaks or public health emergencies. 

More transparency around the risk assessment for restricting visitors to care homes:

• Participants stressed that rules and restrictions around families being able to see loved ones in care homes should be more flexible and compassionate in future.
• Several participants also expressed concern about the detrimental impact on the mental health and wellbeing of elderly people living in care homes who were prevented from seeing family. 

Implement testing policies for all patients being transferred from hospitals to care homes: 

• The decision to send patients to care homes without being tested for COVID-19 was highlighted by respondents as a significant error that should never have happened. 

Have flexible guidance for different types of care homes:

• A few participants highlighted that not all care homes are for elderly patients. They noted that there are care homes for recovering addicts, or for adults with disabilities, etc. Respondents suggested these homes have different rules and restrictions in future, tailored to the needs of their residents. According to respondents, the COVID-19 rules and restrictions were targeted to care and nursing homes for the elderly and were not always suitable to these other groups of care home residents.

Health and social care

Respondents also made a few key recommendations related to access to health and social care services: 

Health and social care services should continue during lockdown to reduce the risk of late diagnoses and misdiagnoses, and to minimise the deterioration of people’s health. 

• The services most frequently referred to in the responses are health services, including GPs and dentists. Respondents’ concerns centred around health conditions either being missed or misdiagnosed during lockdown. 
• People expressed the view that not being able to have a face-to-face consultation with a GP seriously compromised the quality of the care received. 
• Formal and informal carers shared concerns that restrictions on home visits made it difficult to provide appropriate support and care for older people. The effectiveness of doorstep visits or phone calls was questioned in some responses, with family members finding it challenging to support loved ones during the pandemic. 

Vaccine rollout

Many respondents described the rollout of the COVID-19 vaccine in Scotland as efficient and well organised, but other responses suggest there are lessons to be learned and several areas for improvement, including:

More clarity around who is prioritised for receiving the vaccine:

• Some health and social care workers felt that receiving the vaccine sooner could have prevented the transmission of COVID in their respective workplaces. 
• Several respondents who were police officers during the pandemic questioned why they were not among those prioritised to receive the vaccine early.

Better consideration for where vaccines are being administered:

• While some respondents praised being able to receive vaccinations at home, others stated the process for getting a vaccine at home was quite challenging to access. 
• Respondents also said specific consideration is needed for rural populations and for people who rely on public transport to access clinics.

Consider how to staff vaccination clinics:

• Some respondents said there were retired medical staff willing to work or volunteer in the vaccination clinics but there was no mechanism to bring them onboard.

Education and children and young people

Lessons learned around education and children and young people are derived from both adult forms and children and young people forms. Suggestions and lessons to be learned in this theme, as identified by respondents, include the following: 

Schools and early years institutions should be kept open:

• Adults responding to this survey, and children and young people responding to the children and young people form, largely expressed the view that schools should have been kept open during lockdown, as it was felt that learning from home was insufficient to support children’s learning, and social and emotional development. 
• Children and young people expressed the view that keeping schools open would have helped avoid feelings of loneliness and isolation. 
• Some adults also felt that families could be better supported by keeping early years and pre-school institutions open to help with childcare. 

Improved support for pupils and students learning at home:

• Respondents, including children and young people, expressed the view that learning from home should be better supported by schools and further/higher educational institutions. Parents/guardians in the sample group said they struggled to keep up with the demands from schools to facilitate learning at home, and both adults and children and young people noted that inequalities between households would mean some children would find it more difficult to learn at home than others, depending on access to laptops/tablets and internet. 
• Some respondents felt schools in Scotland should have continued to implement grade allowances longer to take account of the disruption to pupils’ education. 
• Respondents also stated that more support should have been given to further and higher education students studying from home.
• They also expressed the view that further/higher education institutions should have provided more academic accommodations such as deadline and funding extensions to accommodate working from home. 

Prioritise mental health, wellbeing and activities for children and young people: 

• There was a general view – particularly among adults – that children and young people’s mental health needs to be better supported in recognition of the detrimental impacts of the pandemic on their mental health.
• Some respondents, including children and young people, expressed the view that, overall, children and young people’s needs were deprioritised in the response to the pandemic. They highlighted the closure of educational institutions, and the perception that spaces and events which catered to adults were reopened sooner than those for children and young people. 

Scottish Government communication

Respondents identified instances where communication from the Scottish Government could have been improved. The data from the sample group suggests two key areas for improvement:

Messaging should be clear, consistent and evidence-based:

• Respondents said rules and restrictions were inconsistent throughout the pandemic. They wanted clear communication around how and why decisions were being made. For example, driving lessons were not allowed, even when drivers and instructors were wearing masks, but the rules and regulations meant a person could travel on a bus with multiple people if they wore a mask.
• Respondents also wanted clearer, evidence-based messaging when rules were changed or adapted.

More consistency in messaging across the whole of the UK (respondents highlighted differences between the rules in Scotland and the rest of the UK): 

• There was a call for a “one message and one response” across the four nations, with some people stating restrictions in Scotland seemed stricter than in the rest of the UK. 
• The differences were especially stark, according to responses, for people in Scotland who had family in England and those who travelled between the two nations regularly for work. For example, masks were not required for train travel in England, but they were required in Scotland, meaning passengers travelling across the border found this rule confusing.

Communication could have been more balanced (respondents were divided over the Scottish Government’s daily briefings): 

• Respondents’ views of the daily briefings were divided, with some commenting on a tendency towards political “point-scoring”, while others praised the briefings.

Scottish Government decision-making: balancing risks and harm

Several respondents said any future Scottish Government must seek to strike a better balance between protecting the population from transmission of the virus and avoiding unnecessary harm. Some of the specific suggestions voiced by participants included: 

• More consideration be given to the impact on people’s mental health and wellbeing in pandemic planning and response. For example, protective measures such as bubbling should have been introduced sooner to reduce potential harm to people living alone, and for family groups living in different households.
• Consider developing and implementing a more holistic needs assessment when making or lifting lockdown restrictions. For example, some respondents questioned why venues such as pubs and football stadiums reopened long before children’s activities and playgroups.