Dumfries & Galloway Health & Social Care

Grateful thanks for support shown for stretched health and social care system

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GRATITUDE is being expressed for the support shown to the region’s health and social care system in the face of major challenges.


It follows a request to communities to take actions which can support the system, and for families and loved ones of hospital in-patients to help facilitate a speedy discharge.


Dumfries and Galloway Health and Social Care Partnership Chief Officer Julie White said: “We’re very grateful to everyone for the responses we’ve seen after we highlighted the very serious pressures being felt right across health and social care in Dumfries and Galloway.


“Even just being aware of the pressures and being prepared for and understanding our current limitations is of help and appreciated.”


Mrs White added: “As we noted, staffing pressures are a fundamental aspect of the current pressures right across our system.


“Although we have sizable numbers of people needing treatment in hospital, we simultaneously have seen significant increases in the number and complexity of people who require support to remain in their own homes and to return home from hospital. Recruitment challenges are limiting our ability to meet this increased need.


“This is despite recent success recruiting to Dumfries and Galloway Council’s in-house Care and Support Services (CASS), where the enlisting of 32 staff equated to a further 784 hours of care provision – supporting the care at home visits in our region which now total 80,000 every single week.


“As a consequence, you will hopefully be aware of the concentrated and ongoing recruitment activity aimed at bolstering our care at home services – supported by the increase in pay for this sector announced by the Cabinet Secretary for Health and Social Care.


“As that work continues, we are recruiting health and care support workers to help support care at home services, and we have multi-disciplinary teams reviewing people’s needs and identifying new and alternative ways of meeting those needs.


“We’re evolving our ways of working, developing models which will look to safely maximise hospital discharges and looking at options for how people requiring long-term care can be supported in the interim until that longer term arrangement is in place. Thanks to our Community Nursing Teams, our STARS team, social care teams and the staff deployed from our empty cottage hospitals, we are now supporting more than 100 people at home who would have otherwise been delayed in hospital awaiting packages of care.


“Huge credit and appreciation needs to be voiced for the many thousands of unpaid Carers in our region, as without them our health and social care systems would simply not be able to function. The pandemic has led to an increasing number of people becoming Carers as well as adding to the huge impact that caring has on those who were already caring.

“This current situation may mean that there could be added requests made of families and Carers at this time and we acknowledge the added pressure this may cause. It is important that Carers are considered as partners alongside our health and social care teams and made aware that there is support available to them via local organisations like D&G Carers Centre and others who can provide ongoing information, advice and support to anyone caring for a relative or friend.


“Technology continues to evolve, and we are looking to harness developments there which can help across all of health and social care. The use of technology to support people to be as independent as possible at home will be a key feature of our work this winter.


“Meanwhile, we are reconfiguring our approaches so that we have Mountainhall Treatment Centre now supporting the flow of patients out of DGRI, and staff being deployed to where they can help people to safely return to their homes as soon as possible – which is the central ethos of our Home Teams way of working across our communities.

“And very significantly, work is taking place with the region’s third sector partners around the role they currently, and could in future, play in supporting people to live in their own homes. I am also very grateful to our Police Scotland colleagues and our Scottish Fire and Rescue Service colleagues who are offering their support to help with things such as welfare checks on our most vulnerable people, and the ongoing vital work carried out by the Scottish Ambulance Service.”


All of these actions are being supported by an increase in funding received from the Scottish Government.

However, Mrs White warns that money in itself is not the solution to the challenges still weighing very heavily across the region’s health and social care system.


Mrs White said: “The bottom line is that this is about people. It’s about increases in the number of people in our region who need treatment and support, as our population continues to age.

“It’s also about challenges in finding the staff and volunteers from our working age populations to meet those needs.


“And it’s about how everyone accesses health and social care, how we maximise the existing resources, and how we help look after ourselves and each other to try and make certain that our systems work to ensure everyone gets the right level of care, in the right place, at the right time.”

‘Serious’ situation in region’s health and social care sparks community call

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A VERY serious situation now exists across the health and social care system in Dumfries and Galloway – currently experiencing the greatest pressures in living memory. 

Direct requests are now being made to families and loved ones of hospital in-patients to provide whatever support they can to facilitate a speedy discharge, and help address major pressures. 

Julie White is Chief Officer of the Health and Social Care Partnership and Chief Operating Officer of NHS Dumfries and Galloway, and she said: “We are in an unprecedented situation. 

“Never in the living memory of health and social care services in Dumfries and Galloway have we been faced with such pressures. Not with the move to the new DGRI back in 2017, not in the worst of any winters… this is a whole new level of pressure. 

“And we can’t promise that it’s not going to get any worse. 

“Our fundamental issue at the moment is the volume of people who genuinely require our help and support and finite staffing resource available to meet those needs. We are doing our best to recruit more staff to support us but the pressure is immediate. 

“So today we are not just looking for the ongoing support of our incredible staff and volunteers, but also from our communities. 

“To families and friends of loved ones currently in our care, anything you can possibly do to help support the return of that person to their home environment will assist us in ensuring we are then able to help others. 

“Get in touch with our teams, guide our approaches, suggest ways in which we can accelerate their return home. 

“For the wider community, anything you can do to help support us at this time will be met with immense appreciation. Help us by following guidance which sets out where to seek the most appropriate source of help if needed, but, if it is needed, please do come forward. Please continue to be tolerant and understanding as we make some really difficult decisions to manage this unprecedented demand. 

“To be clear, we will always be here to provide treatment and care – but the limits of what we are able to do continue to be stretched to new degrees, and I am extremely concerned about how much further these resources can stretch.  

“As noted, we can’t guarantee that this current situation won’t worsen still, but right now we want everyone to understand just how difficult things are, to help in any way they can, and ask them to be as supportive and polite as possible to the amazing staff and volunteers who remain professional and caring – no matter how difficult and testing the circumstances.”  

Supporting Carers in Dumfries and Galloway – Carers Act Funding 2021/22

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Supporting Carers is a priority for the Dumfries and Galloway Integration Joint Board and one of the nine national health and wellbeing outcomes.

A funding opportunity to support Carers in the region is now available as a result of additional funding for Carers from the Scottish Government. There remains over £100,000 of Carers Act Funding for Dumfries and Galloway for the financial year 2021/22 currently unallocated. This funding is available on both a recurring and non-recurring basis and the Carers Programme Board is inviting proposals for the use of these monies.

Proposals might be in relation to

  • testing change
  • finding new ways to use recurring funding
  • identifying short breaks for Carers

Submission of application(s)   

Carers Act Funding Application Form

Proposals should be submitted via the above application form to dg.spcp@nhs.scot. The closing date for proposals to be received is 5pm on Thursday 6 December 2021.

Criteria for Application 

The aims and outcomes of the proposal must clearly demonstrate improvements to the lived experience of Carers in Dumfries and Galloway (please see criteria in appendix one)

Decision Process and Timescale 

On 16 December 2021 the Carers Programme Board will make decisions on those proposals seeking non-recurring funding.  They will also approve recommendations in relation to proposals seeking recurring funding to go forward to the Integration Joint board in early 2022. 

Proposal leads will be informed of the outcomes the Carers Programme Board discussion and IJB meetings.  

Monitoring and Evaluation 

All funded projects will be required to deliver regular data in relation to agreed proposal measures to the Carers Programme Board. 

Appendix One – Criteria 

The funding panel will consider applications against the following criteria

  • Strategic Fit – How fits with local and national strategy, policy and guidance such as IJB Strategic Commissioning Plan and Carers Act 
  • Effectiveness – How the needs of Carers will be met. The aims and expected outcomes and how these will be evaluated 
  • Deliverability – Description of the availability of resources (e.g. workforce, premises, equipment)  
  • Sustainability – Description of an exit strategy or sustainability plan 
  • Affordability – Outline of the cost and an assessment of the value for money 
  • Risk – Assessment of the risk of progressing or not progressing the proposal 

Each proposal will be scored against each criterion. These scores will be aggregated to determine an overall score. Each criterion will have the same weighting. 

Day provides chance to thank region’s Allied Health Professionals

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ATTENTION is being focused on the work of Allied Health Professionals across Dumfries and Galloway as part of the fourth national AHP Day.

AHPs are a diverse group of practitioners who apply their expertise to diagnose, treat and rehabilitate people of all ages across health, education and social care.

Joan Pollard is Director of Allied Health Professions, and she said: “Today, I would like to invite everyone to pause for a minute and give thought and recognition to the incredible work being carried out by our extremely dedicated Allied Health Professionals.

“Day in, day out, they play a fundamental role in ensuring the health and welfare of our region’s population, using expertise and knowledge across a wide range of areas to support people to live health, active and independent lives.

“The pandemic has impacted on all of us, and within our extremely stretched health and social care system AHPs have demonstrated incredible resilience in managing the huge pressures brought to bear on their working lives.

“I would like to thank each and every one of them for the dedication and commitment they have demonstrated in helping people. I would also like to thank those people they have helped, who have been patient and supportive of the work they have been undertaking amid very trying circumstances.

“Thanks also comes from the many colleagues of Allied Health Professionals for the superb collaborative support that has been provided to them over the past 12 months.

“I think it’s also extremely important to recognise the flexibility and willingness of AHPs to go above and beyond, and work outside of their normal roles in many situations in order to ensure the provision of appropriate care within the wider organisation.”

Allied Health Professionals within Dumfries and Galloway comprise podiatrists, dietitians, occupational therapists, orthotists, paramedics, orthoptists, physiotherapists, diagnostic radiographers, and speech and language therapists.

Joan Pollard said: “I want to thank all of our Allied Health Professionals, and express how immensely proud I am to be associated with these incredibly talented and hard working people.

“I’m not sure everyone will appreciate how much we rely on our AHPs, or what sort of position we would be in without them, but this annual day hopefully provides an opportunity to highlight their roles and provide them with the recognition and thanks which is very much owed to every single person.”

Extreme pressures facing region’s health and social care system

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EXTREME pressures are currently challenging the health and social care systems across Dumfries and Galloway. 

Urgent meetings have been taking place among clinical and care managers, as they work to address both the pressing short-term issues and the prospect of very serious challenges heading into the winter months. 

In a bid to try and manage the current pressures which include increased demand and staffing shortages exacerbated by the pandemic, a decision has been made to scale back elective clinical procedures scheduled to take place at Dumfries and Galloway Royal Infirmary over the next two weeks. However, urgent and cancer procedures will go ahead. 

A bid to convey the scale of the challenges facing everything from care at home services to hospitals comes as Dumfries and Galloway Health and Social Care Partnership Chief Officer Julie White delivers a sober message to its incredibly hard working and resilient staff and volunteers. 

In her message, Mrs White said: “It’s been an incredibly difficult 18 months for everyone, where we’ve all felt the impact of COVID-19 in just about every aspect of our lives. Right now, significant pressures are facing our Health and Social Care Partnership as we head into the most challenging winter period ever faced.” 

Addressing the current challenges, Mrs White said: “For a number of years the health and social care partnership has faced the dual challenge of increasing demand against the backdrop of difficulties around recruitment to the workforce. 

“The pandemic has only served to accelerate this problem. Many people have avoided seeking help because of COVID, have been confronted with delays, or have been isolating at home – becoming weaker or more frail.   

“As has long been the case, recruitment to jobs within the area remains a challenge, but encouraging, innovative approaches are being driven forward which do provide hope for an improved situation going forward. 

“However, right now we’re in a position where problems stored up during the pandemic are really biting. 

“Staff across the whole of the health and social care system are incredibly stretched, and we’re desperately short on the care staff who can help support people in the environment that’s right for them – such as the comfort and familiarity of their own home. 

“I was incredibly heartened to see the announcement this week that pay for care at home staff is set to increase. These carers are the largely unsung heroes of our communities, providing support, help and comfort to so many of the most vulnerable people in our region. 

“We desperately need more people to embark into this as a career which should see them better rewarded and celebrated. We are currently in the process of developing a far-reaching recruitment aimed at significantly increasing care at home capacity. 

“However, in the short term, we face real challenges providing care and support to our population in a system that has been radically changed by the consequences of managing the pandemic.” 

  • A request is being made for people to first and foremost understand and appreciate the enormity of the challenge facing the health and social care system. 
  • Beyond that, an ask is being made to understand that difficult decisions have been taken to address the pressures across the system, including for example the decision to scale down elective procedures, decisions in extremis to have two patients within a limited number of rooms within DGRI, to maximise capacity within cottage hospitals as staffing allows, and decisions to place people in alternative NHS and care facilities whilst awaiting support in their own home. 
  • Getting to this stage in the pandemic has relied on the region’s communities supporting services, and being tolerant and patient as we adjust systems to respond to the greatest need. Whilst we recognise that delays to treatment or disruption to care will lead to frustrations, please appreciate that this is also felt very acutely by the staff seeking to provide treatment and care. Civility and support in all circumstances is greatly appreciated. 
  • Finally, an invitation is being extended to help maximise the provision of treatment and care. Anyone with a loved one requiring care who can offer help or suggestions as to how we best meet the needs of their loved one is encouraged to take up a conversation with that person’s Social Work representative. 

Mrs White said: “I have never seen health and social care systems in our region under so much pressure, and unfortunately this level of pressure may continue for some time to come. 

“We really want everyone to have an insight and understanding as to just how challenging things have become through a combination of factors fuelled further by the pandemic. 

“Our responsibility is to the people of Dumfries and Galloway, and whilst the situation remains extremely challenging we are investing significantly in order to address the workforce challenges in particular to ensure that we are in the best position to meet people’s needs. 

“Anyone requiring help should not be deterred from coming forward, but to try and ensure they pursue the most appropriate means of help in the first instance from a range of options – be that a visit to their community pharmacist, visiting the NHS Inform website, contacting their GP practice, calling NHS 24 on 111 or dialling 999 in the case of an emergency.” 

Marking International Overdose Awareness Day

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Buildings across Dumfries and Galloway will be lit up in purple to mark International Overdose Awareness Day.

The tribute – on 31st August – is being made to remember those who have died due to overdose and acknowledge the grief of the families and friends left behind.

The locations include: We are With You – Buccleuch Street, Dumfries; St Ringans Parish Church – Castle Douglas; Old Parish Church – Annan and The Baptist Church – Stranraer. 

Information packs on overdose awareness, harm reduction and contact details for local support services will be available at these locations.

Families and members of the community are being invited to tie a purple ribbon at these locations to remember those who have lost their lives to drug related death. Ribbons will be available at each location

Grahame Clarke, Independent Chair of Dumfries and Galloway Alcohol and Drugs Partnership, said: “We have previously highlighted the continued rise in suspected drug related deaths in Dumfries and Galloway, and so, we are using our activity in support of International Overdose Awareness Day to again remind all of our communities of the devastating impact that drug related deaths have.

“We want to acknowledge the profound grief felt by families and friends whose loved ones have died or suffered permanent injury from drug overdose.

“We would like to remind drug users and their families of the key things they can do to reduce the risk of overdose.”

Steps include:

· Don’t take drugs alone – most suspected fatal overdoses have involved someone taking drugs alone. Taking drugs alone increases the chance of fatally overdosing, because there is no one to call for help in an emergency.

· Don’t take a combination of drugs, drugs that haven’t been prescribed and or drugs that may have been bought over the internet. This includes alcohol and prescribed medication. Mixing drugs greatly increases the risk of overdose, particularly if you don’t know exactly what they are or what effect they will have.

· Don’t try new substances, increase or reduce the quantity of drugs or alcohol being regularly taken without support from your GP or Drug and Alcohol treatment Service. If trying any new substances, try a very small amount at first, so you know how it might affect you.

· Get a Naloxone kit. Naloxone is a medication that temporarily reverses the effects of a heroin or other opioid overdose and allows time for someone to seek emergency help. Friends and family can also get a Naloxone kit

· Dial 999 immediately if you believe that someone is having an overdose or if you feel unwell after taking any drugs. When someone has overdosed, they can look and sound like they are simply asleep; snoring can be an indication the person is having breathing difficulties. Always check when you hear snoring that the person is actually asleep.

The message from Dumfries and Galloway Alcohol and Drug Partnership is being echoed and supported by Dumfries and Galloway Local Resilience Partnership in the form of its partners Dumfries and Galloway Health and Social Care Partnership, NHS Dumfries and Galloway, Dumfries and Galloway Council, Police Scotland, Third Sector Dumfries and Galloway, Scottish Fire and Rescue Service, Scottish Ambulance Service and Dumfries and Galloway Housing Partnership.

Further information can be found at www.stopdgdrugdeaths.co.uk

Midpark ward staff heap praise as local camera club rises to challenge

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A collaboration between a ward at Midpark Hospital in Dumfries and a local camera club has resulted in new stimulating art for patients. 

The Glencairn Ward is one of six wards at Midpark Hospital, providing 15 beds for older adults who are experiencing difficulties with their current mental health which cannot be supported at home and so require hospital admission.  

Senior Charge Nurse Claire Gabriel said: “Staff on the ward were keen to decorate its walls with art which would encourage conversation, and allow discussions about life experiences and memories, as well as hobbies and locations visited in the region. 

“We all know how stimulating artwork can be for many of our patients, and it made sense to see if we could obtain attractive and engaging pictures that could take up a permanent place on the walls of the ward.” 

It was a chance discussion between Claire Gabriel and Dumfries Camera Club Competition Secretary Ian Findlay, a partner at Findlay Design, that led to a project being undertaken by the wider camera club members. 

Dumfries Camera club is a long-standing amateur photographic club that would normally meet at Gracefield Arts Centre between August and May.  

Due to restrictions around lockdowns, they have continued to hold virtual meetings – but have arranged competitions and welcomed guest speakers on a Wednesday night throughout the pandemic. 

The Camera Club members were happy to take on the challenge of creating new images to help decorate Glencairn Ward, providing an abundance of entries for the ward staff to choose from. 

Ultimately, eight pictures were chosen, and Ian from Findlay Design supported staff by getting large canvases printed for the staff to hang within the ward.  

Mr Findlay said: “The club were really happy to support this bid to create some original artwork for Glencairn Ward at Midpark Hospital, and thoroughly enjoyed the challenge which was put to them by the ward staff. 

“We had a huge number of entries, of fantastic quality, and the club is delighted that the some of that resulting work has now been selected and is providing talking points for patients and staff.” 

Claire has expressed huge gratitude to Dumfries Camera Club for what they undertook, and for the role played by Mr Findlay. 

She said: “The pictures are stunning and have proven to be a huge success for both patients and staff.  

“Their comments when viewing some of the shots of life and nature include, ‘You can actually see what is happening at that time’,  ‘I just love looking at these pictures’, ‘Amazing’, ‘They stimulate conversation’ and ‘When I go back, I see something different every time’. 

Glencairn Ward at Midpark Hospital sees care provided by a wide range of multi-disciplinary team members. Staff also work in partnership with family and friends, to provide a high standard of patient-centred care. 

Dental practices under great pressure

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Although restrictions around COVID-19 have now been eased thanks to the vaccination programme, health and social care services are busier than ever.

Major adaptations were required in areas such as dentistry in order to address safety risks posed by the coronavirus, and many of these restrictions remain in place while work is undertaken to tackle a considerable backlog of treatment.

NHS Dumfries and Galloway Manager for Dental Services Julie Hunter said: “Dental Practices across Dumfries and Galloway are experiencing high volumes of demand for NHS care. 

“Due to lockdowns and safety measures limiting the numbers of patients that can be seen daily, practices are finding themselves with very large backlogs of patients requiring appointments. 

“So while dental practices in Dumfries and Galloway are open, a priority is being given at present to dental problems that are emergency or urgent in nature.

“The backlog of patients owing to the COVID-19 pandemic and the continuing additional measures required to deliver safe care for patients may result in longer waiting times for routine care.

“While every effort is being made to reduce these backlogs, it means that some practices may not be in a position to offer new patient registration appointments.

If you are already registered with an NHS dental practice, then the practice is required to provide care for you in an emergency or if you have an urgent dental problem. You should make contact with your dental practice as early in the day as possible. 

If you are registered with a practice, please contact the practice directly who will advise when you can expect to be seen.

However, emergency dental support is available for anyone not able to access help.

In the case of an emergency on a Monday to Friday:

  • 8am – 6pm Call the Dental Helpline – 0845 6026417
  • 6pm – 8am Call NHS 24 – 111

On a Saturday or Sunday:

  • Call NHS 24  – 111

Draft IJB Annual Accounts for 2020/21 out for consultation

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The Unaudited Draft Dumfries and Galloway Integration Joint Board (IJB) Annual Accounts for 2020/21 are now out for public consultation. 

The IJB was established as a body corporate by order of the Scottish Ministers on 3 October 2015 as part of the establishment of the framework for the integration of Health and Social Care in Scotland under the Public Bodies (Joint Working) (Scotland) Act 2014.  

The IJB has responsibility for the strategic planning and delivery of a defined range of Health and Adult Social Care services for the residents of Dumfries and Galloway.  

The Draft Annual Accounts for 2020/21 opens with an overview of the key messages in relation to the objectives and strategy of Dumfries and Galloway Integration Joint Board (the IJB) and its financial performance for the year ended 31st March 2021.  

It also provides an indication of the risks and challenges which may impact upon the finances of the IJB in the future. 

The Draft Annual Accounts for 2020/21 can be read by visitinghttps://dghscp.co.uk/useful-documents/ 

Any comments should be sent to the email address katy.kerr@nhs.scot by the end of July 29 2021. 

COVID forces suspension of procedures and services

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A CONTINUING increase in coronavirus cases has seen Dumfries and Galloway Health and Social Care Partnership make difficult decisions to suspend or alter a range of routine services. 

The significant rise in new COVID-19 related admissions to DGRI has prompted moves aimed at creating capacity to deal with the rising demand for health and social care provision – which is now greater than at any point during the first wave of the pandemic.  

The decision has been taken to suspend some non-urgent, non-cancer elective or planned procedures. 

Meanwhile, some community social care services are being suspended, reflecting the dangers posed by a strikingly high rate of the new, highly transmissible B.1.1.7 variant which is fuelling the local outbreaks. 

Dumfries and Galloway Health and Social Care Partnership Chief Officer Julie White said: “Decisions to suspend services are never taken lightly, and we have held off as long as it was safely judged to do so before implementing these actions. 

“To be very clear in respect of planned healthcare procedures, this is not a complete suspension. Our goal is to preserve our ability to undertake procedures deemed urgent by our clinical teams and to ensure that patients with cancer continue to receive timely treatment and support.   

“Where possible, however, we are halting non-urgent clinical appointments for outpatients, day surgery and theatres in order to ensure we have the capacity to provide immediate help to those in most need.   

“Patients can be assured that our clinical teams will assess our referrals to ensure that those most in need of urgent care are prioritised.  We will keep these measures under review and will aim to get routine work back up and running as soon as is safe to do so. 

“Although our hospitals are facing pressures around capacity, we are managing this situation – with contingency plans in place to increase capacity as required.” 

Changes are also being implemented which affect GP practices in the region, with many practices focusing again on the provision of urgent care and support to their local patients.  

Again this decision has been made in order that GP teams can support the assessment of patients with suspected COVID-19 in their local communities, although this will be undertaken virtually in most cases. This move will also enable GPs to focus on those patients with other urgent needs and conditions within their local communities, ensuring that admissions to hospital are avoided wherever possible and safe to do so.   

Given the increasing levels of infection across the region, the Health and Social Care Partnership has also taken the decision that all adult respite units, adult day services and Activity and Resource Centres should only provide services to those in critical need at this time. 

Additionally, given the specific concerns in the west of the region in terms of particularly high COVID infection levels, a decision has been made to suspend the ARCs in both Stranraer and Newton Stewart. 

Currently, the advice being promoted by the Scottish Government is that the best way to stop the spread of COVID-19 and to protect ourselves and communities is to stay at home as much as possible. 

Julie White said: “While none of this is what we would want, given all the work that’s been undertaken over many months to safely restore our services following the response to the first wave of COVID, these outcomes are the result of carefully considered decisions aimed firstly at reducing the spread of COVID-19 in our communities and secondly at ensuring that our staffing resource is utilised to support those most in need. 

“Changes are also being implemented in the provision of Care at Home services within the Partnership. Our first consideration will continue to be for the wellbeing and safety of the individuals who receive our care at home services. Currently, however, due to pressures created by the pandemic, we are severely limited in the availability of care to meet needs across the region. We will therefore be working with our care providers, service users and their families to ensure that we provide a safe level of care for individuals whilst asking for flexibility in order for us to facilitate discharges from hospital.   

“The first round of vaccinations have now been completed in each of the region’s 31 older adult care homes. We will continue to work with our local care home providers to optimise the use of these facilities to help meet people’s needs just now on both a permanent and short term basis to respond to the crisis.   

“We very much hope to be able to restore all of our suspended services as soon as the situation allows, and ask everyone, individually, to play their part in helping to speed up that prospect by adhering to the national guidance around COVID – with the message of stay home, save lives.” 

Staff involved in delivery of these services will be contacting people individually to advise them of these developments, and to discuss how people can continue to be supported during this difficult time.