Scottish COVID-19 guidance updated amidst worries of discrimination

By Bethany Hemsley

The Scottish Government has updated its COVID-19 guidance after a review of the documents sparked fears that older people or those with disabilities may be discriminated against.

The original documents used an ambiguous clinical frailty score, which compares extent of support needs with degree of frailty, to determine the treatment a COVID-19 patient should receive. This produced fears that older people or those with disabilities could be denied treatment.

Key changes include:

  • Increased focus on human rights and equality obligations
  • Recognition of the needs of individuals with protected characteristics, including disabilities
  • Greater clarity that guidance should apply fairly to all patients, regardless of characteristics, capacity status or differential diagnosis
  • Updated wording on clinical decision
  • Increased linkage to complimentary national guidance such as that from HPS to ensure clinicians have the most up-to date information
  • Revision of the guidance to reflect current clinical situation which has changed significantly since the guidance was first published
  • Awareness of the limitations of the clinical frailty score, particularly in younger adults, or those with stable long-term disability. For these groups, alternative person-centred assessments may be more appropriate.
Dr Sally Witcher

Dr Sally Witcher, CEO of Inclusion Scotland, said: “We particularly welcome the new clarity that the clinical frailty score must not be used on anyone under 65 or on those over 65 with long-term disabilities”.

This has given disabled people the reassurance that they will receive equal access to medical treatment and the issuing of Do Not Attempt Resuscitation notices.

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