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Meningitis

UKHSA are currently managing an outbreak of meningococcal meningitis centred on Canterbury and Kent University. The outbreak has been confirmed to have been caused by a group B strain of the meningococcal bacteria, but it is currently unknown whether this is one of the group B strains included in available Men B vaccinations. At this stage, there is no evidence of wider community transmission beyond identified contact groups, and no cases linked to Scotland.

We are aware that as a result of the media attention on the outbreak, GP surgeries will be receiving queries from patients and parents, in particular with queries relating to meningitis vaccinations. We have updated this page to help address this.

Symptoms develop suddenly and can include:

  • a high temparature (fever)
  • being sick
  • a headache
  • a blotchy rash that doesn’t fade when a glass is rolled over it
  • a stiff neck
  • a dislike of bright lights
  • drowsiness or unrespnsiveness
  • seizures (fits)

These symptoms can appear in any order, and some may not appear.

Carousel banner graphic which lists the symptoms of meningitis which include a high temperature, being sick a headache, a blotchy rash that doesn't fade when a glass is rolled over it, a stiff neck, a dislike of bright lights, drowsiness or unresponsiveness and seizures (fits)

NHS Vaccination schedule

The NHS inform pages include the vaccination schedules for children and young people. This includes the following meningitis vaccinations:

  • the Men B vaccination at 8 weeks, 12 weeks and 12 months
  • the MenACWY vaccination during the S3 school year (aged 13 or 14)

The MenB vaccination is offered to children under 2 who may have missed appointments in their first year, but is not available on the NHS for children over 2. Young people aged up to 25 are eligible to catch up on the MenACWY vaccination if they have missed this.

How can I check what vaccines my child has had?

The Public Health Department do not hold vaccine records. The first step to checking your child’s vaccination history would be to look at their Red Book, but if you do not

have this, then you should ask your health visitor (for children under 5) or your child’s GP who can contact Child Health to request your child’s vaccination records.

Can I get a vaccine for MenB on the NHS?

The MenB vaccine is part of the routine NHS childhood immunisation programme and is offered to infants. Those under the age of 2 who have missed a Men B vaccine, are eligible for this in a catch-up form. For older children, teenagers, and adults, the MenB vaccine is not routinely offered on the NHS. There are a number of private providers available who will be able to administer Men B vaccine. You will understand that we cannot recommend any one private provider over another.

What about MenACVWY vaccination?

There are numerous strains of the meningococcal infection. The MenACWY vaccination gives good protection against MenA, MenC, MenW, and MenY. This vaccination is routinely offered in the UK to school pupils aged 13 or 14, but students and young adults who have not previously had the MenACWY vaccine may be eligible to receive it up to age 25. If anyone eligible has missed their Men ACWY vaccination, their GP can make a referral for this.

Additionally, for students attending universities in Glasgow, the NHS Greater Glasgow and Clyde Immunisations team run clinics on campus at the start of term offering vaccinations for eligible students who might have missed these.

My teenage child has never had a meningitis vaccine – can they get one?

Children aged 13 or 14 will be offered the MenACWY vaccination as part of the national routine schedule. Children who have missed this can catch up by being referred via their GP.

Why immunise?

The development of effective vaccines has led to a huge decrease in childhood deaths. The World Health Organization (WHO) states: ‘The 2 public health interventions that have had the greatest impact on the world’s health are clean water and vaccines.’

Benefits for you

As children develop they’re exposed to many risks, one of these risks being infections. Most of these will cause mild illnesses. However, despite great medical advances, infection can still cause severe illness, disability and, at times, death.

Before vaccines were available, many children in the UK died from diseases such as whooping cough, measles and polio. Despite successful immunisation programmes, the diseases that vaccines protect against do still exist.

The benefit of immunisation is that your child has the best possible protection against dangerous diseases. This can give you peace of mind.

Changes to childhood vaccinations – from 1st of July 2025

What parents and caregivers need to know

Experts regularly review the vaccination programme to make sure it gives children the best protection. New research and changes in vaccine supply mean the vaccination schedule in Scotland has changed.

If your baby was born on or before the 30th of June 2024, they will already be mid-vaccine schedule and will remain on that schedule until it is complete. There is no action required from you and your baby will be invited for these vaccinations when the time approaches.

If your baby was born on or before the 30th of June 2024, they will continue to follow this schedule.

  • 12-13 months – HibMenC, Pneumococcal, MMR, MenB
  • 3 years 4 months – Four-in-one, MMR
  • From 2 years old – Flu

The following changes came into place on the 1st of July 2025.

  • 8 weeks – Six-in-one, Rotavirus, MenB
  • 12 weeks – Six-in-one, Rotavirus, MenB
  • 16 weeks – Six-in-one, Pneumococcal
  • 12-13 months – MenB, Pneumococcal, MMR
  • 18 months – Six-in-one, MMR
  • 3 years 4 months – Four-in-one

If your child turned one year of age on or after 1 July 2025 (DOB on or after 1 July 2024), they will pick up on this schedule from here:

  • 12-13 months – MenB, Pneumococcal, MMR
  • 18 months – Six-in-one, MMR
  • 3 years 4 months – Four-in-one

What’s changing?
Some vaccines will now be given at different times, and a new appointment will be added when your child is 18 months old.

Who decides this?
The changes are based on advice from the Joint Committee on Vaccination and Immunisation (JCVI) – a group of independent experts who guide the UK and Scottish vaccination programmes.

What happens next?
There is no action required from you. You’ll be given clear information when it’s time for your child’s next vaccinations.

Why is this important?
Vaccines are the best way to protect your child from serious illnesses. These updates help make sure the programme stays safe, effective, and up to date.

Changes to the routine childhood vaccination schedule

Changes to the routine childhood vaccination schedule from 1 July 2025 and 1 January 2026

Changes to be implemented

Phase 1 (from 1 July 2025)

MenB vaccination will now be offered from 12 weeks (previously 16 weeks).

  • Following a recent clinical study and a review of the epidemiology, the JCVI has advised bringing forward the second dose of the MenB vaccine to provide earlier protection against this serious and sometimes fatal infection.
  • Meningococcal serogroup B is responsible for the majority of UK invasive meningococcal disease (IMD) cases. Since the introduction of the routine MenB vaccination programme, peak age of infection has shifted from 5 to 6 months to 1 to 3 months of age. A substantial proportion of cases were occurring before infants gained protection from their second dose of vaccine given at 16 weeks. The change in epidemiology of IMD means it would be beneficial to move the second dose of MenB vaccine to 12 weeks of age to provide earlier protection.
  • Although previously an 8-week interval between doses of MenB vaccine was recommended, evidence from a recent study showed a good response was made when the 2 doses were given 4 weeks apart.

Pneumococcal vaccination will now be offered from 16 weeks (previously 12 weeks).

  • To avoid increasing the number of injections at the 12-week appointment, the first dose of the pneumococcal vaccine will be moved to the 16-week appointment.
  • The change is unlikely to be clinically significant.

The Hib/MenC vaccine (Menitorix) will no longer be available.

  • The manufacturer has ceased production of Menitorix vaccine. There is no other Hib/MenC vaccine available on the UK market.
  • Children turning one year of age on or after 1 July 2025 (date of birth on or after 1 July 2024) will not have received the combined Hib-MenC vaccine (Menitorix) when they are invited for their 12-month vaccination appointment (they should still receive the other vaccines due at that age). These children should be offered a new 18-month routine vaccination appointment (starting from 1 January 2026) for a 4th dose of the 6-in-1 vaccine (DTaP/IPV/Hib/HepB (hexavalent)) vaccine, given alongside the second dose of MMR.
  • The JCVI has agreed that protection against MenC is no longer required in this age group due to the high uptake of vaccination in the secondary school programme. Sustaining high uptake of the MenACWY vaccine, currently offered to S3 pupils, is important to maintain indirect protection.

Phase 2 (from 1 January 2026)

From January 2026, the MMRV vaccine will be offered as part of the routine childhood immunisation schedule. It replaces the MMR vaccine.

The MMRV vaccine protects against measles, mumps, rubella, and varicella (chickenpox). These are serious diseases that can be life-threatening.

Measles is a very infectious virus. It spreads easily though the air when people with the virus cough or sneeze. It can cause serious health complications, like pneumonia and encephalitis. In very serious cases, measles can be life-threatening.

Mumps is caused by a virus. It can cause permanent deafness, viral meningitis, and encephalitis. Mumps spreads through the air when people with the virus cough or sneeze, and is very infectious.

Rubella is caused by a virus. If caught in pregnancy, it can cause a miscarriage or affect the unborn baby. It can cause a condition called congenital rubella syndrome (CRS), which damages a baby’s sight, hearing, heart and brain. Rubella is spread through the air when people with the virus cough or sneeze, and is very infectious.

Varicella (chickenpox) is a highly infectious disease caused by a virus. Varicella is spread through direct contact with someone who is infected.

Read more about why your child should get the MMRV vaccine

Who can get the MMRV vaccine

The MMRV vaccine is offered to children as part of the routine childhood vaccination programme. When your child will be offered the vaccine depends on when they were born.

If your child was born on or after 1 January 2025

If your child was born on or after 1 January 2025, they’ll be offered 1 dose of the MMRV vaccine at both:

  • 12 to 13 months
  • 18 months

If your child was born between 1 July 2024 and 31 December 2024

If your child was born between 1 July 2024 and 31 December 2024, they’ll be offered a dose of the MMRV vaccine at:

  • 18 months
  • 3 years 4 months

If your child was born before 30 June 2024

If your child was born before 30 June 2024, they’ll be offered a dose of the MMRV vaccine at 3 years 4 months.

Introduction of a new 18-month appointment where the additional 6-in-1 (4th dose) vaccine will be offered.

  • To replace the Hib dose, an additional dose of the 6-in-1 ((DTaP/IPV/Hib/HepB (hexavalent)) vaccine will be offered at a new routine appointment at 18 months.
  • Children turning one year of age on or after 1 July 2025 (date of birth on or after 1 July 2024) will not have received the combined Hib-MenC vaccine (Menitorix) when they are invited for their 12-month vaccination appointment (they should still have received the other vaccines due at that age). These children should be offered a new 18-month routine vaccination appointment (starting from 1 January 2026) for a 4th dose of the 6-in-1 vaccine (DTaP/IPV/Hib/HepB (hexavalent)) vaccine, given alongside the second dose of MMR.

The second dose of MMRV will be brought forward from the 3-year 4-month appointment to the new 18-month appointment.

  • The second MMRV dose is being moved forward in the schedule to provide earlier protection and, hopefully, help to improve uptake. Research showed moving the second dose of MMR forward in London led to higher uptake.

Queries about scheduling

My children are different ages, will they be on different schedules?

Yes your children might be on different schedules as the schedule children follow is dependent on their date of birth. When changes to vaccination programmes happen, they must be rolled out on a phased basis to ensure NHS immunisation teams are able to deliver the vaccines effectively alongside other programmes. Changes to programmes are based on the advice of the Joint Committee on Vaccination and Immunisation (JCVI). These decisions are based on several factors, including the risk of the disease and the effectiveness of the vaccine.

If I delay my child’s vaccines, will they change schedules?

The schedule your child follows is dependent on their date of birth not when they attend for vaccination. Do not delay getting your child vaccinated – they will not change schedules. It’s important that vaccines are given on time to make sure your child has the best protection possible. Delaying or missing vaccine doses can put your child at risk of serious diseases and getting vaccines when they are due is the best way to protect your child.

Pre-School Children

The 6-in-1 Vaccine

Overview

The 6-in-1 vaccine, also commonly known as the DTaP/IPV/Hib/HepB vaccine, helps protect your child against:

What’s pertussis (whooping cough)?

Whooping cough is a disease that can cause long bouts of coughing and choking, making it hard to breathe. Whooping cough can last for up to 10 weeks.

Babies under one year old are most at risk from whooping cough. For these babies, the disease is very serious and can kill. It’s not usually as serious in older children. Before the pertussis vaccine was introduced, on average 120,000 cases of whooping cough were reported each year in the UK.

More about whooping cough

What’s diphtheria?

Diphtheria is a serious disease that usually begins with a sore throat and can quickly cause breathing problems.

It can damage the heart and nervous system and, in severe cases, can kill. Before the diphtheria vaccine was introduced in the UK, there were up to 70,000 cases of diphtheria a year, causing around 5,000 deaths.

What’s tetanus?

Tetanus is a disease affecting the nervous system that can lead to muscle spasms, cause breathing problems and even kill. It’s caused when germs that are found in soil and manure get into the body through open cuts or burns.

Tetanus can’t be passed from person to person.

More about tetanus

What’s polio?

Polio is a virus that attacks the nervous system and can cause permanent paralysis of the muscles. If it affects the chest muscles or the brain, polio can kill.

Before the polio vaccine was introduced, there were as many as 8,000 cases in the UK during the polio epidemic. Because of the continued success of the polio vaccination, there have been no cases of paralytic polio in the UK for nearly 40 years (the last case was in 1984). Polio remains a threat with poliovirus traces found in London sewage in early 2022.

Being fully vaccinated is the best way to protect against becoming ill from polio. It’s important to make sure you and your child are up to date with your vaccines.

More about polio

What’s Hib?

Hib is an infection caused by haemophilus influenzae type b bacteria. It can lead to a number of major illnesses such as blood poisoning (septicaemia), pneumonia and meningitis. The illnesses caused by Hib can kill if they’re not treated quickly. Before the Hib vaccine was introduced, there were about 800 cases of Hib in young children every year in the UK.

The Hib vaccine only protects your baby against the type of meningitis caused by the haemophilus influenzae type b bacteria – it doesn’t protect against any other type of meningitis.

More about haemophilus influenzae type b (Hib)

What’s hepatitis B?

Hepatitis B (HepB) is a virus that infects the liver. Many people with HepB infection have no symptoms and don’t know they’re infected. Others have flu-like symptoms and yellowing of the skin (jaundice).

In children, HepB can persist for years and may eventually cause serious liver damage.

More about hepatitis B

Why should my baby be vaccinated?

Babies can catch these serious diseases from birth, so it’s important to protect them as soon as possible.

When will my baby be immunised?

All babies are eligible for the vaccine free on the NHS.

Your baby will be offered the 6-in-1 vaccine around 8, 12 and 16 weeks of age. Your local NHS immunisation team will contact you to let you know about their arrangements for your baby’s routine childhood immunisations.

Most NHS immunisation teams run special immunisation baby clinics. If you can’t get to the clinic, contact your local NHS immunisation team to make another appointment.

Meningitis B (MenB) vaccine

Overview

The meningitis B (MenB) vaccine helps protect against meningitis and septicaemia (blood poisoning) caused by meningococcal bacteria B.

What’s meningitis?

Meningitis is inflammation of the lining of the brain and spinal cord. This causes pressure on the brain resulting in symptoms like:

  • severe headache
  • stiff neck
  • dislike of bright light
  • drowsiness
  • convulsions/fits

Meningitis can progress very rapidly and can lead to:

  • deafness
  • blindness
  • epilepsy
  • learning difficulties

It can even lead to death.

More about meningitis

What’s septicaemia (blood poisoning)?

Septicaemia (blood poisoning) is a serious, life-threatening infection that gets worse very quickly. The risk of death is higher compared to meningitis.

The signs of cold hands and feet, pale skin, vomiting and being very sleepy or difficult to wake can come on quickly.

More about meningitis and septicaemia

Charlotte’s story: meningococcal septicaemia (MenB)

Charlotte developed septicaemia (serious blood poisoning) through type B meningococcal disease (MenB) in 2010, before the MenB vaccine was introduced in the UK. Her mother Jenny talks about the impact on Charlotte and the rest of her family.

How common is type B meningoccocal disease?

MenB is now the cause of most cases of meningococcal disease in Scotland. Although this infection isn’t common, MenB is extremely serious and can lead to permanent disability and death. The meningococcal bacteria can also cause local outbreaks in nurseries, schools and universities.

Why should a baby be vaccinated?

MenB infection is most common in babies and young children. This is because their immune systems aren’t yet fully developed to fight off infection. The highest number of cases are in babies around 5 months of age. This is why the first immunisations are offered to babies younger than this and have to be given at 2 and 4 months of age.

This vaccine helps protect babies against MenB, There are other vaccines, like MenC, that protect against some other types of meningococcal infections.

Who is eligible for the vaccine?

The MenB vaccine is routinely offered to all babies at 8, 16 weeks, and 12 to 13 months.

When will a baby be immunised?

The MenB vaccine has been part of the routine childhood immunisation programme in Scotland since 1 September 2015. Your local NHS immunisation team will send you an appointment to bring your child in for their routine childhood immunisations.

Babies will be offered the MenB vaccine when they come in for their other routine immunisations at 8, 16 weeks and 12 to 13 months.

Find out how to contact your local NHS immunisation team regarding your vaccination appointment

If a baby is due their MenB vaccine, please ask your pharmacist about paracetamol for them. Fever can be expected after any vaccine but is more common when the MenB vaccine is given with the other routine immunisations at 8 and 16 weeks of age. This is why it’s recommended that babies gets infant paracetamol when getting these immunisations to prevent and treat fever.

Rotavirus vaccine

Overview

The rotavirus vaccine helps protect babies against rotavirus.

What’s rotavirus?

Rotavirus is a virus that infects the gut (tummy), causing severe diarrhoea and vomiting. Most babies get sick (vomit) or have diarrhoea at some time and recover fully after a few days. However, sickness and diarrhoea caused by rotavirus can lead to dehydration (loss of body fluids). Dehydration can be very dangerous for babies and young children and can require hospital treatment.

Before the vaccine was introduced in 2013, around 1200 babies in Scotland had to go to hospital every year with rotavirus.

Why should a baby be vaccinated?

The rotavirus immunisation protects a baby against this illness.

The most important thing you can do is have the baby immunised against rotavirus, as part of the Routine Childhood Immunisation Programme in Scotland.

In countries where babies already get the rotavirus vaccine there’s been a big drop in the number of babies and young children going to hospital because of the virus.

With lots of younger babies having the immunisation the chances of it spreading are reduced. Rotavirus causes fewer problems in older children, and it’s rare in adults.

When will a baby be immunised?

The rotavirus immunisation is offered to all babies in Scotland.

The rotavirus vaccine is normally given with the baby’s other routine immunisations at 8 weeks and again at 12 weeks of age. Your local NHS immunisation team will invite you for the vaccination, so there’s no need to book an appointment.

Pneumococcal vaccine for babies

Overview

The pneumococcal vaccine helps protect against illnesses and conditions caused by pneumococcal bacteria.

What illnesses and conditions are caused by pneumococcal bacteria?

Pneumococcal infection is caused by pneumococcal bacteria. It can cause serious illness such as pneumonia, and is one of the most common causes of meningitis (an infection of the lining of the brain).

Pneumococcal infection can cause:

  • bronchitis
  • ear and sinus infections
  • a life-threatening infection of the blood (septicaemia)
  • meningitis
  • pneumonia (which can also be life-threatening).

Children under 2 years of age and children with certain health conditions have a higher chance of becoming unwell with pneumococcal infection.

How common are pneumococcal bacteria?

Up to 60% of children carry pneumococcal bacteria in the back of their nose and throat. They constantly pass these bacteria around by coughing, sneezing and close contact.

Why should a baby be vaccinated?

The pneumococcal vaccine provides some protection against meningitis caused by pneumococcal infection, and against other conditions such as severe ear infections and pneumonia caused by pneumococcal bacteria.

This vaccine doesn’t protect against meningitis caused by other bacteria or viruses.

Who is eligible for the vaccine?

Some children are at an increased risk from pneumococcal infection. All at risk children will be offered the vaccine according to the routine childhood immunisation programme. If you aren’t sure about your child’s health or need further advice, speak to your health professional.

When will a baby be immunised?

If a baby is eligible, they will be offered the pneumococcal vaccine when they’re 12 weeks old, with a booster dose given between 12 and 13 months. The pneumococcal booster dose between 12 and 13 months is usually given at the same time as the Hib/MenCMMR and MenB vaccines.

In addition to this some children and adults aged from 2 to 64 years old, who are at a higher risk of developing a pneumococcal infection than the general population, will be offered additional pneumococcal vaccinations.

Your local NHS immunisation team will contact you to let you know about their arrangements for the baby’s routine childhood immunisations.

Hib Men C

Overview

The Hib/MenC vaccine helps protect a child against 2 of the causes of meningitis and septicaemia (blood poisoning). This vaccine will help protect the child through early childhood.

What is Hib?

Hib is an infection caused by Haemophilus influenzae type b bacteria. It can lead to a number of major illnesses such as septicaemia (blood poisoning), pneumonia and meningitis.

More about Haemophilus influenzae type b

What is meningitis?

Meningitis is inflammation of the lining of the brain and spinal cord. This causes pressure on the brain resulting in symptoms like:

  • severe headache
  • stiff neck
  • dislike of bright light
  • drowsiness
  • convulsions/fits

Meningitis can progress very rapidly and can lead to:

  • deafness
  • blindness
  • epilepsy
  • learning difficulties

It can even lead to death.

More about meningitis

What is septicaemia?

Septicaemia (blood poisoning) is a serious, life-threatening infection that gets worse very quickly. The risk of death is higher than with meningitis.

The signs of cold hands and feet, pale skin, vomiting and being very sleepy or difficult to wake can come on quickly.

More about septicaemia

Why should a baby be vaccinated?

A child will be offered a dose of the combined Hib/MenC vaccine between 12 and 13 months of age to:

  • boost their protection against Haemophilus influenzae type b (Hib)
  • help protect against meningitis and septicaemia caused by meningococcal group C (MenC) bacteria

The Hib/MenC vaccine doesn’t protect against meningitis and septicaemia (blood poisoning) caused by:

  • meningococcal group B bacteria
  • other bacteria or viruses such as pneumococcal or mumps

When will a baby be immunised?

A baby will be offered the Hib/MenC vaccine at 12 to 13 months. Your local NHS immunisation team will contact you to let you know about their arrangements for the baby’s routine childhood immunisations.

Most NHS immunisation teams run special immunisation baby clinics. If you cannot attend your appointment contact your NHS immunisation team to make another.

Find out how to contact your NHS immunisation team regarding the baby’s vaccination appointment

MMR

The MMR vaccine is given in 2 doses and helps protect against measles, mumps and rubella. Find out more about the vaccine, and when and where to get it.

Why should someone have the MMR vaccination?

The MMR vaccine helps to protect people against measles, mumps and rubella. It’s sometimes also offered to adults who missed their childhood immunisations.

Measles, mumps and rubella are highly infectious diseases. They can cause serious medical complications.

A high number of people in Scotland have had the MMR vaccine. This means there’s been a big reduction in the number of people catching these diseases.

Who is eligible for the MMR vaccine?

All babies and children in Scotland are eligible for the MMR vaccine.

They’ll be offered the MMR vaccine in 2 doses:

  • the first between 12 and 13 months
  • the second at 3 years 4 months

Although normally given at these times, if it’s missed, it can be given at any age.

Some young people and adults who missed out on their MMR vaccine may also be eligible, like those who are a planning a pregnancy. If you didn’t have 2 doses of the MMR vaccine as a child, you can contact your local NHS immunisation team to discuss your eligibility.

The 4-in-1 Vaccine

Overview

The 4-in-1 vaccine, also known as the DTaP/IPV or dTaP/IPV vaccine, helps protect your child against:

What’s pertussis (whooping cough)?

Whooping cough is a disease that can cause long bouts of coughing and choking, making it hard to breathe. Whooping cough can last for up to 10 weeks.

Babies under one year are most at risk from whooping cough. For these babies, the disease is very serious and can kill. It’s not usually as serious in older children.

Whooping cough germs can be spread from person to person through close contact.

More about whooping cough

What’s diphtheria?

Diphtheria’s a serious disease that usually begins with a sore throat and can quickly cause breathing problems. It can damage the heart and nervous system and, in severe cases, can kill.

Diphtheria germs are spread from person to person through close contact.

What’s tetanus?

Tetanus is a disease affecting the nervous system that can lead to muscle spasms, cause breathing problems and even kill.

It’s caused when germs found in soil and manure get into the body through open cuts or burns. Tetanus can’t be passed from person to person.

More about tetanus

What’s polio?

Polio is a virus that attacks the nervous system and can cause permanent paralysis of the muscles. If it affects the chest muscles or brain, polio can kill.

The polio virus is usually spread from person to person, or by swallowing contaminated food or water.

Before the polio vaccine was introduced, there were as many as 8,000 cases in the UK during the polio epidemic. Because of the continued success of the polio vaccination, there have been no cases of paralytic polio in the UK for nearly 40 years (the last case was in 1984). Polio remains a threat with poliovirus traces found in London sewage in early 2022.

Being fully vaccinated is the best way to protect against becoming ill from polio. It’s important to make sure you and your child are up to date with your vaccines.

More about polio

Why should my child be vaccinated?

The vaccine boosts the immunisations that were given to your child at 8, 12 and 16 weeks of age – boosting protection against pertussis (whooping cough), diphtheria, tetanus, and polio.

Who is eligible for the vaccine?

This vaccine’s offered to children aged over 3 years 4 months at the same time as they are offered the MMR vaccine. It’s also used for a primary course of immunisation in children over 10 years old and adults.

When will my child be immunised?

Your child will be offered the 4-in-1 vaccine at around 3 years and 4 months. Your local NHS immunisation team will contact you to let you know about their arrangements for your child’s routine childhood immunisations.

Most NHS immunisation teams run special immunisation clinics. If you can’t get to the clinic, contact your local NHS immunisation team to make another appointment.

Young people in Secondary School/not in mainstream education

HPV Vaccine – S1 to S6

What the HPV vaccine is for

Immunisation (vaccination) information in other languages

Evidence shows the HPV vaccine helps protect people from HPV-related cancers. The human papillomavirus (HPV) vaccine is offered to every S1 pupil in Scotland.

Getting the vaccine now protects you against future risks. HPV can lead to cancers like:

  • head and neck cancers
  • cervical cancer
  • anogenital cancers – for example, anal, penile (penis) cancer, cancer of the vagina, and cancer of the vulva

The HPV vaccine also protects you against over 90% of genital wart infections.

Who can get the HPV vaccine

Every person in Scotland aged 11-13 will be offered the HPV vaccine free of charge.

You should not have some vaccines if you’ve had a confirmed serious (anaphylactic) reaction to:

  • a previous vaccine
  • any ingredient of the vaccine

About the HPV vaccine

The GARDASIL 9 vaccine is used in Scotland.

Gardasil 9 helps protect against 9 types of HPV.

The vaccine protects against HPV types 16 and 18, which are the cause of most cervical cancers in the UK (more than 80%). The vaccine also protects against types 31, 33, 45, 52 and 58, which cause an additional 15% of cervical cancers.

The vaccine also protects against 2 other types of HPV. These cause around 90% of cases of genital warts.

The HPV vaccine is not a live vaccine. It cannot cause HPV.

The vaccine is the safest and most effective way to protect against HPV.

How to get the HPV vaccine

You’ll be offered the HPV vaccine as part of the school-based immunisation programme. Vaccines are given by your local NHS immunisation team.

Your school will tell you when vaccination sessions are taking place.

Find out more about the vaccinations you’ll be offered at school

If you have any questions on the day, you can speak to the person giving you the vaccine.

If you missed your vaccination and you’re still at school

If you miss your HPV vaccination, there will be further opportunities to get it. For example, you may be offered a rescheduled vaccination appointment next year.

If you’re unsure if you’ve missed any other vaccines, you should
first check your red book. If you do not have a red book, or it has gone missing, you can check with your local NHS immunisation team.

Young people not in mainstream education

You’re also eligible for the HPV vaccine if you’re:

  • educated at home
  • not in mainstream education

Please contact your local NHS immunisation team to arrange your appointment.

If your child is home schooled and has missed out on any vaccinations and you with them to be vaccinated. Then please ask your GP Practice to refer you to the Child Vaccination Team for this. On receipt of the referral the team will be in touch with you to arrange this.

If you’ve missed your vaccination and have now left school

If you’ve left school and you didn’t get your HPV vaccine when you were eligible, you may still be able to get it up until you turn 25.

This only applies to:

  • people who are currently eligible
  • boys who became eligible from the 2019/2020 academic year
  • girls under 25 who were eligible under routine and catch up programmes introduced in 2008

Your local NHS immunisation team can confirm if you’re eligible. They can also explain how to get the HPV vaccine in your area.

If you / your child does not attend school or has missed vaccinations given in school, please contact the School Team listed under FAQs ‘School Team Contact Details’.

The vaccine consent form

You should be given a consent form and leaflet by your school. You and your parent or carer should chat about the information. Both you and your parent or carer should sign the consent form and return it to your school. You should return the consent form even if you’re not going to have the vaccine.

We recommend you get agreement from your parent or carer, but it isn’t always necessary.

Get more information on young people’s right to consent

MMR Vaccine – S1 – S6

The MMR vaccine is given in 2 doses and helps protect against measles, mumps and rubella. Find out more about the vaccine, and when and where to get it.

Why should someone have the MMR vaccination?

The MMR vaccine helps to protect people against measles, mumps and rubella. It’s sometimes also offered to adults who missed their childhood immunisations.

Measles, mumps and rubella are highly infectious diseases. They can cause serious medical complications.

A high number of people in Scotland have had the MMR vaccine. This means there’s been a big reduction in the number of people catching these diseases.

Who is eligible for the MMR vaccine?

All babies and children in Scotland are eligible for the MMR vaccine.

They’ll be offered the MMR vaccine in 2 doses:

  • the first between 12 and 13 months
  • the second at 3 years 4 months

Although normally given at these times, if it’s missed, it can be given at any age.

Some young people and adults who missed out on their MMR vaccine may also be eligible, like those who are a planning a pregnancy. If you didn’t have 2 doses of the MMR vaccine as a child, you can contact your local NHS immunisation team to discuss your eligibility.

If you / your child does not attend school or has missed vaccinations given in school, please contact the School Team listed under FAQs ‘School Team Contact Details’.

If your child is home schooled and has missed out on any vaccinations and you with them to be vaccinated. Then please ask your GP Practice to refer you to the Child Vaccination Team for this. On receipt of the referral the team will be in touch with you to arrange this.

DTP Vaccine – S3 to S6

The DTP vaccine provides protection against diphtheria, tetanus and polio. The vaccine is usually given in S3 (around 14 years old). Find out when and where to get it.

What the DTP vaccine is for

Immunisation (vaccination) information in other languages and formats

The DTP vaccine protects against diphtheria, tetanus and polio. These are serious diseases.

You need a total of 5 doses of the diphtheria, tetanus and polio vaccine to build up immunity and give you longer-term protection.

You should have had:

  • the first 3 doses as a baby
  • the fourth dose before you started primary school (after turning 3 years and 4 months)

You should have the fifth dose in S3 (around 14 years old).

What’s diphtheria?

Diphtheria is a serious disease that usually begins with a sore throat. It can quickly cause breathing problems. It can also damage the heart and nervous system, and in severe cases, can kill. Diphtheria is passed from person to person through close contact.

Before the diphtheria vaccine was introduced in the UK, there were up to 70,000 cases of diphtheria a year. These caused around 5,000 deaths.

What’s tetanus?

Tetanus is a painful disease affecting the nervous system that can lead to:

  • muscle spasms
  • breathing problems
  • death

It’s caused by germs found in soil and manure getting into the body through open cuts or burns.

Tetanus can’t be passed from person to person.

Learn more about tetanus

What’s polio?

Polio is a virus that attacks the nervous system and can cause permanent paralysis of muscles. If it affects the chest muscles or the brain, polio can kill. The polio virus is usually spread from person to person or by swallowing contaminated food or water.

Before the polio vaccine was introduced, there were as many as 8,000 cases in the UK during the polio epidemic.

More about polio

Who can get the DTP vaccine

All young people in S3 (around 14 years old) are eligible for the vaccination. This is part of their routine immunisation schedule.

  • If you were immunised as a child – The DTP vaccine completes the 5 dose course against diphtheria, tetanus and polio. Although you’ve already had 4 doses of diphtheria, tetanus and polio vaccines, , you need a total of 5 to build up your immunity and provide longer-term protection.
  • Reasons you should not have the vaccine – here are very few young people who can’t have the DTP vaccine. You shouldn’t have the vaccine if you’ve had a confirmed anaphylactic reaction to:
    • a previous vaccine
    • any ingredient of the vaccine
    • neomycin, streptomycin or polymyxin B (antibiotics that may be added to vaccines in very tiny amounts)
  • If you have a bleeding disorder – If you have a bleeding disorder, tell the person giving you the vaccine. They’ll give the injection in a slightly different way that will be better for you.

About the DTP vaccine

The REVAXIS vaccine is routinely used in Scotland.

The DTP vaccine is not a live vaccine. It cannot cause the diseases it protects against.

The DTP vaccine is the safest and most effective way to protect against serious diseases.

How to get the DTP vaccine

You’ll be offered the DTP vaccine when you’re in S3 (around 14 years of age) at school. Vaccines are given by your local NHS immunisation team. Your school will tell you when vaccination sessions are taking place.

Find out more about the vaccinations you’ll be offered at school

If you have any questions on the day, you can speak to the person giving you the vaccine.

If you / your child does not attend school or has missed vaccinations given in school, please contact the School Team listed under FAQs ‘School Team Contact Details’.

If your child is home schooled and has missed out on any vaccinations and you with them to be vaccinated. Then please ask your GP Practice to refer you to the Child Vaccination Team for this. On receipt of the referral the team will be in touch with you to arrange this.

Meningitis ACWY (MenACWY) vaccine – S3 to S6

The meningitis ACWY (MenACWY) vaccine helps protect against meningitis and septicaemia (blood poisoning). Find out more about the MenACWY vaccine, and when and where to get it.

What the Meningitis ACWY (MenACWY) vaccine is for

Immunisation (vaccination) information in other languages and formats

The meningitis ACWY (MenACWY) vaccine helps protect against meningitis and septicaemia (blood poisoning), which are caused by meningococcal bacteria A, C, W and Y.

Young people have a higher risk of getting meningococcal disease. You’ll be offered immunisation to protect yourself and others around you.

Meningitis and septicaemia are very serious diseases. They can cause permanent disability and death. The symptoms can come on quickly.

Who can get the MenACWY vaccine

The MenACWY vaccine is routinely offered to all young people in S3 (around 14 years of age). If you’re over 14 and not already immunised, you may also be offered the vaccine.

You should not have some vaccines if you’ve had a confirmed anaphylactic shock (serious allergic reaction) to:

  • a previous vaccine
  • any ingredient of this vaccine

About the MenACWY vaccine

The following vaccines are routinely used in Scotland:

The MenACWY vaccine is highly effective at protecting against the serious infections caused by meningococcal bacteria A, C, W and Y.

The MenACWY vaccine is not a live vaccine. It cannot cause meningitis.

The MenACWY vaccine is the safest and most effective way to protect against meningococcal A, C, W and Y.

How to get the MenACWY vaccine

Vaccines are given by your local NHS immunisation team. Your school will tell you when vaccination sessions are taking place.

Find out more about the vaccinations you’ll be offered at school

If you have any questions on the day, you can speak to the person giving you the vaccine.

If you missed your vaccination at school

If you missed your MenACWY vaccination, there will be further opportunities to get it. For example, you may be offered a rescheduled vaccination appointment next year.

If you’re unsure if you’ve missed any other vaccines, you should first check your red book. If you do not have a red book, or it has gone missing, you can check with your local NHS immunisation team

Young people not in mainstream education

You’re also eligible for the MenACWY vaccine if you’re:

  • educated at home
  • not in mainstream education

If you / your child does not attend school or has missed vaccinations given in school, please contact the School Team listed under FAQs ‘School Team Contact Details’.

If your child is home schooled and has missed out on any vaccinations and you with them to be vaccinated. Then please ask your GP Practice to refer you to the Child Vaccination Team for this. On receipt of the referral the team will be in touch with you to arrange this.

Students

You may be eligible for the MenACWY vaccination if you:

  • are Scottish and attending further education in Scotland
  • are aged up to 25 years old
  • have not had the MenACWY vaccination

You should contact your local NHS immunisation team. They’ll advise you if it’s clinically appropriate for you to have the vaccine.

You may not be eligible for the MenACWY vaccination if you’re from outside Scotland (including other parts of the UK). You should arrange to get your vaccine before travelling to Scotland. There’s no guarantee the vaccine will be available to you after arriving in Scotland.

Seasonal Vaccination

Pre-School 6 Months to 2 Years at Risk – Flu

NHS Scotland recommends eligible children should get the flu vaccine to help protect them from influenza (flu).

Flu (influenza) is a common infectious respiratory virus. Symptoms may include a fever, a cough, a headache, and tiredness.

Why should I have my child vaccinated?

Flu can be serious. Even healthy children can become seriously ill from flu. In some cases flu can lead to complications. These can include bronchitis, pneumonia, painful middle-ear infection, vomiting, diarrhoea. In the worst cases, flu can lead to disability and even death.

Flu can be even more serious for people with health conditions such as:

  • asthma
  • heart, kidney, liver or neurological disease
  • diabetes
  • a weakened immune system
  • a spleen that does not work fully

Flu can make health conditions worse.

The flu vaccine will reduce the risk of your child getting or spreading flu to friends and family who are at greater risk from flu. For example, grandparents or people with health conditions. It’ll also help prevent your child getting sick with flu and needing time off school or nursery.

How is the vaccine given?

Children aged 6 months to 2 years will be given the injectable flu vaccine.

Vaccine safety

All medicines, including vaccines, are tested for safety and effectiveness before they’re allowed to be used.

Once they’re in use, the safety of vaccines continues to be monitored by the Medicines and Healthcare products Regulatory Agency (MHRA).

The nasal spray flu vaccine has been used since 2014 and has a good safety record. Millions of doses of the vaccine have been given to children in the UK.

Does the vaccine work?

The annual vaccine offers protection against the most common types of flu virus that are around each winter. The flu vaccine should start to protect most children about 10 to 14 days after they receive their vaccination.

In previous years, the flu vaccine has worked very well, providing protection against flu. It has also reduced the chance of spreading flu into the wider community.

Pre-School 6 Months to 4 Years at Risk – Covid

NHS Scotland is offering the coronavirus (COVID-19) vaccine to children aged 6 months to 11 years at higher risk of coronavirus this spring.

To be invited for vaccination this spring, your child must have a weakened immune system and be aged 6 months to 11 years on 31 March 2024 (born on or after 1 April 2012 and before 1 October 2023).

Why is my child being offered the coronavirus vaccine?

Getting the vaccine will help to protect your child against coronavirus. The vaccine helps to build up immunity to coronavirus, so the body can fight it off more easily. If your child is vaccinated, they are much less likely to get seriously ill from coronavirus or need to go to hospital.

Infants and young children with underlying health conditions are 7 times more likely to be admitted to paediatric intensive care units with severe coronavirus, compared to those without underlying health conditions.

My child has already had the coronavirus vaccine – do they need another one?

NHS Scotland is offering a coronavirus vaccine to children at higher risk to help protect them this spring. It’s important to keep up to date with the coronavirus vaccines your child is offered.

NHS Scotland recommends coming forward every time your child is invited to keep their protection topped up.

Is the coronavirus vaccine safe?

NHS Scotland will only use a vaccine if it meets the required standards of safety and effectiveness. All medicines, including vaccines, are tested for safety and effectiveness before they’re allowed to be used. The Medicines and Healthcare products Regulatory Agency (MHRA) assesses all the data and also ensures a vaccine works and that all the necessary trials and checks have been completed.

Are there any reasons my child should not get the coronavirus vaccine?

There are very few people who cannot have the vaccine. If your child has had a confirmed severe allergic reaction (anaphylaxis) to any of the vaccine ingredients or a previous dose of the same vaccine, you should seek advice from your health professional before your child has the vaccine.

The vaccine is not a live vaccine and does not contain any animal products or egg.

Vaccine manufacturer patient information leaflets

More information about the vaccines offered, including vaccine ingredients, is available in the manufacturer patient information leaflets.

Read the coronavirus vaccine patient information leaflet for 6 months to 4 years:

Pre-School 2 – 5 year old childhood flu

NHS Scotland recommends eligible children should get the flu vaccine to help protect them from influenza (flu).

The flu vaccine is available between September and March.

Flu (influenza) is a common infectious respiratory virus. Symptoms may include a fever, a cough, a headache, and tiredness.

The flu vaccine is offered as a painless nasal spray to almost all children. It cannot give the child flu but starts to provide protection against flu within 10-14 days. The nasal spray offers the best possible protection for children and young people and can also stop flu spreading to family, friends and others, especially those most at risk of becoming seriously ill with flu. Children aged 2 to 5 are being offered vaccination from the start of the programme to ensure they receive the earliest protection and prevent the virus spreading.  

Why should I have my child vaccinated?

Flu can be serious. Even healthy children can become seriously ill from flu. In some cases flu can lead to complications. These can include bronchitis, pneumonia, painful middle-ear infection, vomiting, diarrhoea. In the worst cases, flu can lead to disability and even death.

Flu can be even more serious for people with health conditions such as:

  • asthma
  • heart, kidney, liver or neurological disease
  • diabetes
  • a weakened immune system
  • a spleen that does not work fully

Flu can make health conditions worse.

The flu vaccine will reduce the risk of your child getting or spreading flu to friends and family who are at greater risk from flu. For example, grandparents or people with health conditions. It’ll also help prevent your child getting sick with flu and needing time off school or nursery.

How is the vaccine given?

In Scotland, children aged 2 to 17 will usually be given the nasal spray flu vaccine. It’s quick and painless and there’s no need to sniff or inhale the vaccine. It’ll just feel like a tickle in their nose.

Children aged 2 to 17 years who cannot receive the nasal spray vaccine will receive the injectable flu vaccine.

Vaccine safety

All medicines, including vaccines, are tested for safety and effectiveness before they’re allowed to be used.

Once they’re in use, the safety of vaccines continues to be monitored by the Medicines and Healthcare products Regulatory Agency (MHRA).

The nasal spray flu vaccine has been used since 2014 and has a good safety record. Millions of doses of the vaccine have been given to children in the UK.

Does the vaccine work?

The annual vaccine offers protection against the most common types of flu virus that are around each winter. The flu vaccine should start to protect most children about 10 to 14 days after they receive their vaccination.

In previous years, the flu vaccine has worked very well, providing protection against flu. It has also reduced the chance of spreading flu into the wider community.

Primary School Children – Flu

NHS Scotland recommends eligible children should get the flu vaccine to help protect them from influenza (flu).

The flu vaccine is available between September and March.

Flu (influenza) is a common infectious respiratory virus. Symptoms may include a fever, a cough, a headache, and tiredness.

The flu vaccine is offered as a painless nasal spray to almost all children. It cannot give the child flu but starts to provide protection against flu within 10-14 days. The nasal spray offers the best possible protection for children and young people and can also stop flu spreading to family, friends and others, especially those most at risk of becoming seriously ill with flu.

Consent forms and further information will be sent home to parents and carers of school children on return to school. Secondary pupils can self-consent but are encouraged to speak to a parent or carer first. All primary and secondary school pupils with consent to be given the flu vaccine nasal spray will receive this at school starting in early September through to December 2024.

Why should I have my child vaccinated?

Flu can be serious. Even healthy children can become seriously ill from flu. In some cases flu can lead to complications. These can include bronchitis, pneumonia, painful middle-ear infection, vomiting, diarrhoea. In the worst cases, flu can lead to disability and even death.

Flu can be even more serious for people with health conditions such as:

  • asthma
  • heart, kidney, liver or neurological disease
  • diabetes
  • a weakened immune system
  • a spleen that does not work fully

Flu can make health conditions worse.

The flu vaccine will reduce the risk of your child getting or spreading flu to friends and family who are at greater risk from flu. For example, grandparents or people with health conditions. It’ll also help prevent your child getting sick with flu and needing time off school or nursery.

How is the vaccine given?

In Scotland, children aged 2 to 17 will usually be given the nasal spray flu vaccine. It’s quick and painless and there’s no need to sniff or inhale the vaccine. It’ll just feel like a tickle in their nose.

Children aged 2 to 17 years who cannot receive the nasal spray vaccine will receive the injectable flu vaccine.

Children aged 6 months to 2 years will be given the injectable flu vaccine.

Vaccine safety

All medicines, including vaccines, are tested for safety and effectiveness before they’re allowed to be used.

Once they’re in use, the safety of vaccines continues to be monitored by the Medicines and Healthcare products Regulatory Agency (MHRA).

The nasal spray flu vaccine has been used since 2014 and has a good safety record. Millions of doses of the vaccine have been given to children in the UK.

Does the vaccine work?

The annual vaccine offers protection against the most common types of flu virus that are around each winter. The flu vaccine should start to protect most children about 10 to 14 days after they receive their vaccination.

In previous years, the flu vaccine has worked very well, providing protection against flu. It has also reduced the chance of spreading flu into the wider community.

Where clinics take place

Vaccinations are typically given in schools during term time. NHS GGC work with schools to communicate programme dates.

Before clinics take place, consent forms and vaccination information will be handed out to pupils at school for review at home then return to school.

If you / your child does not attend school or has missed vaccinations given in school, please contact the School Team listed under FAQs ‘School Team Contact Details’.

On the day

Pupils will usually attend clinics in the school hall or social space, class by class throughout the day.

Secondary School Children and Young People – Flu

About the programme

Immunisation is the safest and most effective way of protecting young people against serious diseases.

School-aged children are routinely vaccinated against:

  • Influenza – usually offered to all primary and secondary school pupils from September to December .

The flu vaccine is offered as a painless nasal spray to almost all children. It cannot give the child flu but starts to provide protection against flu within 10-14 days. The nasal spray offers the best possible protection for children and young people and can also stop flu spreading to family, friends and others, especially those most at risk of becoming seriously ill with flu.

Consent forms and further information will be sent home to parents and carers of school children on return to school. Secondary pupils can self-consent but are encouraged to speak to a parent or carer first. All primary and secondary school pupils with consent to be given the flu vaccine nasal spray will receive this at school starting in early September through to December 2024.

https://www.nhsinform.scot/vaccineconsentyoungpeople

For details of the schedule of vaccinations in Scotland by age, please refer to NHS Inform.

Where clinics take place

Vaccinations are typically given in schools during term time. NHS GGC work with schools to communicate programme dates.

Before clinics take place, consent forms and vaccination information will be handed out to pupils at school for review at home then return to school.

If you / your child does not attend school or has missed vaccinations given in school, please contact the School Team listed under FAQs ‘School Team Contact Details’.

On the day

Pupils will usually attend clinics in the school hall or social space, class by class throughout the day.

FAQs

I am unsure of my child’s immunisation history

Please contact your GP

Pre-School Team Contact Details

Please see team contact details below:

Glasgow South/East Renfrewshire

Phone Number: 0141 577 7774 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

Health Centres: Castlemilk, Eastwood, Govanhill, Gorbals, Govanhill (EU), Pollock, Shields Centre, Elderpark, Thornliebank, Barrhead

North East/East Dunbartonshire

Phone Number: 0141 531 6635 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

Health Centres: Springburn, Kirkintilloch, Stobhill, Milngavie, Baillieston, Shettleston, Bridgeton, Townhead, Easterhouse

North West/West Dunbartonshire

Phone Number: 0141 211 6142 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

Health Centres: Dumbarton, Vale of Leven, Maryhill, Woodside, Possilpark, Community Centre for Health (CCFH), Plean Street, Drumchapel, Clydebank

Renfrewshire/Inverclyde

Phone Number: 0141 201 1056 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

Health Centres: Greenock, Port Glasgow, Johnstone, Linwood, Renfrew, Foxbar Clinic, Northcroft, Tannahill Centre, Erskine

School Team Contact Details

Please see team contact details below:

Glasgow South/East Renfrewshire

Phone Number: 0141 577 7767 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

North East/East Dunbartonshire

Phone Number: 0141 232 9838 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

North West/West Dunbartonshire

Phone Number: 0141 232 9202 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

Renfrewshire/Inverclyde

Phone Number: 0141 314 0513 (voicemail service is available)

Opening Times: Monday -Thursday 08.30am – 16.30pm and Friday – 08.30am – 16.00pm

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When you or someone you care about becomes ill, life can become very stressful. That is why we think it is so important for people to talk to each other and make plans before this happens.

To help people plan more, and stress less, we have created a toolkit of resources that we hope will be useful. This includes the recorded information session below and checklists to help you get organised, as well as a plan to work out how you’d get home from hospital. We also look at some of the legal process and support that is available for those who care for you.

Even if you and those you support are perfectly healthy just now, you can still use these tools to help plan for the future!

We have recorded the “Plan More, Stress Less” session below for anyone interested in getting started with planning ahead. In this session we talk about what paperwork we can complete before a crisis arises, what actually happens when someone goes into hospital and how we can all work together to plan for a safe and timely discharge.

Watch the recording here:

Alongside this video we have created two resources which anyone can use to help them plan for any future hospital admission. This could be a planned admission, for example if someone is going to hospital for an operation or to have some tests. However these resources can also be useful if someone needs to go to hospital in an emergency.

If you have any questions or feedback about these resources please email ggc.HomeFirst@nhs.scot

Preparing for Hospital Checklist

This checklist will help you think about all the different forms which you can complete just now that would be useful if you were ever in hospital. This includes things like a Future Care Plan and a Power of Attorney.

A Plan to Get You Home

This resources lets you and the people who support you, think about what might need to happen in order to get you home from hospital in a safe and timely manner. This includes thinking about who could collect you from hospital and where you might need to live if you need some extra support for a short time or on a more permanent basis.

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Welcome to the Ward / Department posters are in place at all ward/department entrances to provide at-a-glance essential information for visitors to the area. 

How to request additional or replacement posters?

Please send all requests for additional or replacement posters to: ggc.medical.illustrationgri@nhs.scot.

Be sure to include your local cost-code for all posters ordered.

How to arrange new or updated SCN photos?

To arrange to have new or updated SCN pictures taken, please contact Medical Illustration direct at: 

ggc.medical.illustration@nhs.scot (QEUH)

ggc.medical.illustrationgri@nhs.scot (GRI)

Can changes be made to the posters?

No. Welcome to the Ward / Department posters represent current visiting arrangements, as per the Scottish Government Visiting guidance.

Who can I contact with further questions, feedback or comments?

Please contact the Person Centred Health and Care Team at ggc.person.centred@nhs.scot with any further questions, feedback or comments.

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Information for people working with children and families

HENRY provides a wide range of support for families from pregnancy to age 12 including workshops, programmes, resources and online help. Support for families is underpinned by the HENRY approach to supporting behaviour change which helps parents gain confidence, knowledge and skills they need to help the whole family adopt a healthier, happier lifestyle and to give their children a great start in life.

HENRY Healthy Families Right from the Start 0-5 years

Healthy Families Right from the Start encourages parents and carers to adopt a whole family approach. The programme covers:

  • Practical parenting skills for a healthy lifestyle
  • Increasing self-esteem and emotional wellbeing so children start school ready to learn
  • Changing old habits and adopting a healthier family lifestyle
  • Setting and achieving goals
  • Active play ideas and getting active as a family
  • Oral health
  • Portion sizes, first foods and snack swaps
  • Food groups, food labels and more
HENRY Healthy Families Growing Up 5-12 years

Healthy Families Growing Up includes more age-relevant topics such as body image, the influence of peers and family negotiations.

The programme covers:

  • Increasing self-esteem and emotional wellbeing so families feel able and motivated to make changes
  • Practical parenting skills for a healthy lifestyle
  • Setting and achieving goals
  • Changing old habits and adopting a healthy family lifestyle
  • Enjoying getting active for the whole family
  • Portion sizes and healthy food swaps
  • Food groups, food labels and more
HENRY Healthy Family Workshops  

These stand-alone workshops provide key information, confidence-building and peer support for families and can also act as “taster sessions” for families who may be interested in attending the Henry programmes. There are 7 topic specific workshops:

  • Starting solids (4-8 months)
  • Eating well for less (0-12 years)
  • Let’s get active (0-5 years)
  • Fussy eating (0-7 years)
  • Healthy teeth (0-5 years)
  • Understanding children’s behaviour (0-12 years)
  • Looking after ourselves (parents)
Referral criteria

Families living in Greater Glasgow and Clyde can now access HENRY for support with:

  • Promoting positive approaches to child healthy weight
  • Increased knowledge and skills in cooking skills and food preparation
  • Enhanced awareness of the benefits of being physically active
  • Encouraging healthy family routines

HENRY is a holistic family programme and is not a specialist intervention, however families who have children with complex needs may still benefit from attending.

If you are working with children and families you can refer families to HENRY using the Health Professional Referral Form.

Glasgow North East

If the family lives in Glasgow Northeast complete this referral form.

Other areas

If the family lives in any of the areas listed below, complete this referral form.

  • Glasgow Northwest
  • Glasgow South
  • Renfrewshire
  • East Renfrewshire
  • East Dunbartonshire
  • West Dunbartonshire
  • Inverclyde
More information

To find out more about what HENRY has to offer, please visit the HENRY website or watch the video below.

HENRY – Healthy Start, Brighter Future

See also:

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Healthy Start, Brighter Future

The HENRY programme aims to support families of children aged 0-12 years with engaging the whole family to adopt healthier eating and lifestyle habits. HENRY addresses a range of areas that are relevant to families including but not limited to; parenting, well-being, self-esteem and confidence, portion sizes, healthy food swaps, getting active as a family, food groups and food labelling. 

HENRY Healthy Families

NHSGGC are working in partnership with Early Years Scotland (EYS) and Possibilities for Each and Every Kid (PEEK) to deliver the HENRY programmes and workshops.

Who is HENRY for?
Families with children aged 0-5 years

If you have a child aged 0-5 years, the Healthy Families Right from the Start programme might be suitable for you. 

This 8-week programme is designed to support parents and carers to give children a healthy, happy start in life and improve school readiness. The topics covered include: 

  • Practical parenting skills for a healthy lifestyle
  • Ensuring children start school ready to learn
  • Adopting a healthier family lifestyle
  • Setting and achieving realistic family goals
  • Getting active as a family
  • Healthy teeth
  • Portion sizes and healthy snack swaps
  • Food groups and understanding food labels
Families with children aged 5-12 years

If you have a child aged 5-12 years, the Healthy Families Growing Up programme might be suitable for you.

This 8-week programme is designed to support parents and carers with the emotional and physical development and healthy weight for primary school age children. The topics covered include:

  • What’s a healthy family
  • Understanding children’s behaviour
  • Practical parenting skills for a healthy lifestyle
  • Healthy food swaps
  • Family mealtimes
  • Negotiating family agreements
  • Children growing up
HENRY Healthy Family Workshops

Stand-alone workshops provide key information, confidence-building and peer support for families. There are 7 topic specific workshops:

  • Starting solids (4-8 months)
  • Eating well for less (0-12 years)
  • Let’s get active (0-5 years)
  • Fussy eating (0-7 years)
  • Healthy teeth (0-5 years)
  • Understanding children’s behaviour (0-12 years)
  • Looking after ourselves (parents)
How and where to access HENRY

Self Referral

If you are interested in attending a HENRY programme or workshop(s), complete the secure online self-referral form and someone from Early Years Scotland or PEEK will get in touch with you.

HENRY programmes will be available in the following areas and delivered by Early Years Scotland (EYS) or Possibilities for Each and Every Kid (PEEK)

Glasgow Northeast

If you live in Glasgow Northeast complete this referral form.

Find out more about HENRY workshops in the North East Glasgow area.

Other areas

If you live in any of the areas listed below, complete this referral form.

Find out more about HENRY workshops in your area.

  • Glasgow Northwest
  • Glasgow South
  • Renfrewshire
  • East Renfrewshire
  • East Dunbartonshire
  • West Dunbartonshire
  • Inverclyde
More information

To find out more about PEEK and EYS, visit the pages below:

PEEK Project

Tel: 0141 554 3068 or email: hannah@peekproject.co.uk

Early Years Scotland

Tel: 0141 221 4148 or email: info@earlyyearsscotland.org  

  

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The NHSGGC Board approved the new NHSGGC Quality Strategy, Quality Everyone Everywhere on 25 June 2024. There are two versions of the strategy available, a full and summary version.

Take a look at our examples and stories of Quality in Action across NHS Greater Glasgow and Clyde.

Co-designing the NHSGGC Quality Strategy

Discovery and Engagement to Board Approval

We held an Accelerated Design Event (ADE) in November 2023 which built the foundations of our strategy. Following on from the ADE we undertook extensive engagement, co-design and analysis with staff, patients and the public. The quality strategy was co-designed and developed with input from an International Advisory Group and a Design and Development Group from February to May 2024, before being presented to the Board. It was approved in June 2024.

Development Phase Newsletters

Throughout the development phase, we produced regular SWAY newsletters to update on the work and progress of the strategy design, development and to showcase quality in action. You can view the newsletters below:

Implementing the NHSGGC Quality Strategy

Our Implementation Approach

The implementation approach for Quality Everyone Everywhere is designed to translate the NHSGGC Quality Model into action and ensure our purpose, values, aims, priorities and the people who use and work in our services remain at the centre of our aspirations. 

The approach is evidence-backed and will help to bring the strategy to life.

Implementation Phase Newsletters

We continue to produce quarterly newsletters to share how the strategy is being implemented across Greater Glasgow and Clyde. You can view the newsletters here:

Year 2 Delivery Plan

We are currently in Year 2 of delivering the Quality Strategy objectives, and our intentions are clear:

Priority 1: Quality Everyone Everywhere – We will create an enabling and supportive culture for quality by connecting with people across the organisation and our communities.

Priority 2: Person-Centred – We will foster a movement of kindness centred on people, ensuring respect and compassion underpin safe and open communication.

Priority 3: Co-production – We will co-create quality through partnership and shared experience to ensure everyone’s voice is heard.

Priority 4: Listening, Learning and Improving – We will listen to the voices of people everywhere, and use feedback to learn what matters, and to drive meaningful improvements.

Priority 5: Safe, Effective and Efficient – We will scale up evidence-based improvement and value-based care, making care safer every day.

Building our Quality Community

In November 2025 approximately 50 people from NHSGGC and our public partners convened to advance our Quality Community and drive the implementation of the Quality Strategy.

The session helped people talk openly about local challenges, agree on shared plans, and work together on simple, practical solutions. It also looked for ideas that could be used more widely, set clear measures of success, and began building a community for ongoing collaboration.

Contact the Quality Strategy Development Team

Further Information

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NHS Greater Glasgow and Clyde offer a range of free programmes which focus on healthy eating, family behaviour change, physical activity and much more. The programmes are designed to support you and your children live a healthier lifestyle.

Information for people working with children and families

Useful links and resources

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NHS Services Scotland (NSS) statement on behalf of the NHS in Scotland:

“Our deepest sympathies are with the patients who were infected by the use of blood products and their loved ones.  

“We sincerely apologise for the historical failings described in the Infected Blood Inquiry and empathise with the impact these events had on infected and affected people. 

“We welcome the publication of this Inquiry, and we would like to thank the Chair and staff for the work undertaken to produce this comprehensive report.  

“Modern safety standards are rigorous, and significant advancements in screening and testing protocols have been made since the events that have been the subject of this Inquiry. All donated blood then undergoes thorough testing before being used for transfusions.     

“NHS Scotland is committed to ensuring lessons from these events have been learned as we continue to prioritise a safe and sustainable blood supply across Scotland.”

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‘A Fairer NHS Greater Glasgow and Clyde’ 2020-24 (PDF)

‘A Fairer NHS Greater Glasgow & Clyde’ Monitoring Report 2020-22 (PDF)

‘A Fairer NHS Greater Glasgow & Clyde’ Monitoring Report 2020-22 Executive Summary (PDF)

A Fairer NHSGGC Survey Report 2019

Workforce Equality Documents including Equal Pay Statement

‘A Fairer NHS Greater Glasgow and Clyde’ Monitoring Report 2018-20 (PDF)

A Fairer NHSGGC 2020-24 Easy Read

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Meeting the needs of BME people

This information is for the attention of all NHSGGC staff involved in the treatment and care of Black and Minority Ethnic patients (BME). Following these guidelines will help ensure that our BME patients access the services and treatments that meet their needs. This information is also available on the Right Decisions app.

Around 5% of our BME patients do not speak English. This group of patients have additional barriers to accessing our services that must be addressed.

Getting It Right for BME patients – Core Elements

Expectations for all NHSGGC staff

Treat people fairly – treat BME people fairly and without prejudice or stereotyping. NHSGGC has a zero tolerance policy on discrimination.

Know your community – have knowledge of the local community who may use their service, including an ethnicity and language breakdown.

Collect ethnicity data – always collect the ethnicity of patients using your service.  This is mandatory in Scotland for Acute services.  TrakCare care and EMIS enable you to record the ethnicity of people who use our services in the demographics pages.  People can say ‘prefer not to say’ but we need to ask all people who use our services.  Anyone who comes into contact with a patient and has responsibility for checking their demographics to confirm identification and should update their details including ethnicity.  Patient demographics which includes ethnicity should be checked on every visit for every patient to a hospital to ensure it is fully updated.  If available on paperwork prior to visit e.g. through a GP Referral, then whomever is logging this on the system should update demographics.  The patient does not always need to be present for the first update.  All patient must have their ethnicity recorded.

Prepare translated resources – have resources about your service ready, including consent to treatment forms, for your BME patients who may not speak English. Have a stock available in the languages you use most and know how to access others when required. For more information go to Clear to All.

Know how to access interpreting support – It is our responsibility to provide interpreting support for any patients using our services. Support is available either via telephone or face to face interpreters. For more information go to Interpreting Services

Ensure patients know how to access interpreting support – patients who don’t speak English can use our telephone interpreting service to call your or any other NHSGGC service.  Patient leaflets are available for immediate download in 40 languages. See Direct Patient Access information. Other languages can be provided for your patient.

Get feedback from BME patients – ensure that any patient engagement is inclusive of BME communities, including non-English speakers  

Know how to access staff training that covers race equality – you can log in to LearnPro for the statutory and mandatory equality training

Source: Joseph Rowntree Foundation

Know your population

Scotland’s BME population 

The 2022 Census has provided evidence of the changing ethnic composition of Scotland.

Of the 5.4 million people living in Scotland, around 388,000 came from Black/Minority Ethnic backgrounds, which equates to around 7% of the total population – a rise of 3% from the 2011 census figures.

Asian groups were the largest minority ethnic group in Scotland and represent nearly 4% of the total population. White minority ethnic groups (e.g. Irish, Gypsy/Traveller, Polish) collectively make up 5.8% of the total population – a rise of 1.6% since the 2011 census.

Scotland’s BME population is patterned by age, with 11.6% of Scotland’s total population being BME people under the age of 18. This compares to just 1.5% of Scotland’s total population being BME people over the age of 65.

Glasgow is the most ethnically diverse place in Scotland with 20% of Glaswegians coming from BME backgrounds. Notably 32.6% of Glasgow’s under 18 year olds come from BME backgrounds.

Community Languages

About 5 in every 100 people admitted to our hospitals as inpatients do not speak English.

NHSGGC has over 100 language groups that use our services.  The top 10 languages are currently:

  • Arabic
  • Urdu
  • Polish
  • Mandarin
  • Romanian
  • Farsi
  • Punjabi
  • Kurdish Sorani
  • Cantonese
  • Slovakian

Your service’s patient population may not reflect these main language groups so it is important to monitor this.  For example, a patient population which is mainly drawn from refugees and asylum seekers will have a different language profile.

Engagement

Services need to establish an understanding of needs by engaging with BME patients and staff to identify issues for BME patients in our services.  This can include data collection around ethnicity.  It is important to note that all of us have an ethnicity and therefore all patients should be asked their ethnicity in our services.

Services should regularly engage with patients to understand what they think about the services we provide.  It is important to include BME patient specifically in patient engagement to ensure their voice is heard in how to improve services. Speak to the Board’s Patient Experience and Public Involvement Team (PEPI) for advice.

Taking an anti-racist approach

Taking an anti-racist approach means ensuring that how we behave or design and operate our services does not discriminate against BME people. 

Discrimination means treating people less favourably due to their colour, nationality (including citizenship), ethnicity or national origin (Equality Act (2010)).  We all have an ethnicity.

As NHSGGC staff we need to recognise that racism – or any form of discrimination – is a fundamental cause of poor health in affected populations. 

We need to create an environment free from racism and stereotyping. We have a responsibility to deliver Person and Family Centred Care to all our patients, based on their individual needs and best practice. Do not make assumptions about a patient’s needs – ask them.

It’s important to recognise that being in the majority group brings with it a level of power and belonging that BME people may not attain. Pointing out perceived differences in appearance, describing BME patients as ‘not our patients’ or as ‘foreign’ when they were born here, all contribute to ‘othering.’ 

This ‘othering’ can often take the form of using offensive language. Sometimes people will describe certain language as ‘banter’ or ‘having a laugh,’ which can make it difficult for someone to challenge. It is important to always speak up and address the use of offensive language that may be heard in our services. 

Racism is classed as a Hate Incident or Hate Crime and should be reported through the NHSGGC Datix Incident reporting system

Inclusive Care
Patient Information

Provision of patient information is a key aspect of health services whether this is written, verbal or in other formats.

Services should assess all patient facing written information to ensure it is accessible.

Identify the core information patients will need and have this available in plain English before requesting translations through the Clear to All service. Clinical letters, diagnostic instructions and compliance-related written information specific to an individual patient can also be translated through this service. 

Some patients will wish to take home information about their condition in English, as well as the language they read. This is so family members who read only English are aware of the details. 

If your service has high numbers of service users who do not speak English, identify the language profile over a few months and decide on an appropriate stock of your core service information in community languages.  For example, in the NHSGGC area there are over 100 languages in use. Maternity Services reviewed their language profile and identified that their service information should be translated and made readily available in at least 10 community languages. Any language out with this list could then be requested via Clear to All as required.

Please be aware if your leaflet is providing additional information through links to English language websites. If the information is integral to the content, it should be translated and provided separately. Otherwise, the leaflet should include a statement to say, ‘If you are unable to access the information on this site, please speak to your clinician’.

All patient leaflets should include the NHSGGC statement regarding availability in accessible formats. For more information go to Alternative Format/Language text section at Interpreting & Language Resources.

When you have completed your review of your service leaflets and implemented this approach, ensure that all staff are aware of how and when to use patient information.

Consider, when making new resources, how this will be translated. This particularly relates to audio and video resources. Liaising with Clear to All is essential to establish the most suitable format.  Videos can be voiced over (not subtitled) in community languages but ensure the images used in videos represent our diverse population.

Provision of Interpreting Support

It is our responsibility to provide interpreting support for any patients using our services. All staff should therefore have good awareness of and confidence in using the NHSGGC Interpreting Services. 

Support is available either via telephone or face to face interpreters. For more information on how and when to use the service, and resources such as, How to Access Interpreting posters, go to Interpreting Services

Patients who don’t speak English can use our telephone interpreting service to call your or any other NHSGGC service.  Please ensure that your patients are given an information leaflet explaining this service in the appropriate language. Leaflets are available for immediate download in 40 languages and can be requested if not currently available. See Direct Patient Access information.  

If you or your service would like to attend training on how to use interpreting services, go to our training webpage.

Barriers to Accessing Services

Adopting a flexible appointments system will help ensure that non-English speaking patients have the time they need to communicate and understand any exchange. This also applies to anyone who needs additional time to speak or who uses communication support e.g. patients who have a learning disability, speech difference or British Sign Language user.

Cultural and social issues may be an additional barrier to accessing certain services for some BME communities. For example, there is not a specific word that means ‘depression’ in certain languages, including Punjabi, Urdu and Hindi.  The stigma or lack of understanding of mental health problems may be a prohibiting factor for some individuals accessing any NHSGGC services.  Also, if patients experience negative or racist attitudes from staff, this will prohibit them from engaging effectively with health services.  

If there is a NHSGGC registered healthcare chaplain available on site, they can assist in supporting staff and BME patients and if appropriate, can access specific faith leaders that may provide reassurance for some BME patients. Visit our website for more information.

Community isolation may be a barrier for individuals from smaller BME groups or people who have sought asylum. These individuals may have little or no understanding of the availability of services or how they are provided. This can result in isolation from many statutory services, including the wider health services. Issues relating to migration status can exacerbate such problems. 

Your service may work with particular voluntary organisations who could help with considering how best to reach and engage with BME communities.  Organisations who can support staff include the Integration Networks e.g. Maryhill Integration Networks, Amma Birth Partners, Red Cross for asylum seekers and refugees.

Acute Patient Pathway – Issues to consider
Pre-admission/Admission

Where possible, ensure staff are aware of your patient’s additional support needs and condition history before they attend.  SCI gateway referral letters should highlight if an interpreter is required and any other additional needs. 

At times, however, this may not be listed on the referral letter.

It is good practice for staff to routinely ask, “Is there anything I need to be aware of when planning your care?” This may include barriers to accessing appointment times, preferred communication methods/support or issues with travel costs. 

Ensure that the patient’s interpreter needs are recorded in the ‘demographics’ on TrakCare and not only on an alert. Update TrakCare if you have a patient who does not speak English and you were unaware of this before they attended their appointment.

Use telephone interpreting if a face to face interpreter was not secured, even to just re-appointment and explain what is happening.  Telephone interpreting can be used for the majority of NHSGGC appointments.

Patients who require any kind of communication support will need flexibility within their appointment. Please provide this time to ensure that patients using an interpreter fully understand the information being conveyed and have the opportunity to ask any questions.  Make sure that what you have said has been understood.

For face to face interpreting support, check if the patient has stated a preference for the interpreter’s sex.  

Do not use family members or bilingual staff as interpreters. Do not use Google translate. 

More information on NHSGGC’s policy regarding interpreting support can be found in the policy document.    

During Stay

BME patients and carers should be supported and empowered to have their say regarding co-produced care and treatment plans.

Understanding the parameters of our services is important to all our patients.  Staff should ensure that the patient understands the service or treatment and why they are receiving it to ensure compliance and consent.  Checking that this information is fully understood will maximise benefits to the patient.

Do not exclude non-English speaking patients from group work – they should be offered every part of the patient pathway in line with English speaking patients.  The Interpreting Service can offer interpreters who are particularly skilled at working in group settings and can advise staff accordingly. 

Discharge

Check that your patient fully understands their discharge plan in terms of clinical follow-up, self-care and supports in the community.  If interpreting support is required for this, note that this intervention will take a longer time to complete. 

It is vital to use interpreting support at the point of dispensing medication to ensure your patient understands the purpose of their medications and when and how to take it.

Information prescriptions have been used to support this in some services, with translations made as required.  Ensure your non-English speaking patient knows how to call back to the pharmacy if they have any questions about their medication, using the direct access telephone interpreting service.

BME communities in NHSGGC have high rates of poverty, and many patients can find themselves going home to difficult circumstances. Please use the Money Worries web page to access simple NHSGGC referral pathways to money advice services and interventions such as the Home Energy Crisis Response Service.

Supporting Information
Meeting the needs of Autistic people and people with other types of neurodivergence

This information is for all staff involved in the treatment and care of Autistic patients and patients with other types of neurodivergence.

Using these guidelines will help ensure that neurodivergent people are enabled to access services and undergo treatments in a manner which fully addresses their needs. This information is also available on the Right Decisions app.

What is Neurodiversity?

Neurodiversity is the term that explains the natural variation in everyone’s brain, including thinking processes, information processing and learning approaches.

We’re all neurodiverse – all our brains are different. However, over 15% of people in the UK, or roughly 1 in 7 individuals, are neurodivergent.

A neurodivergent person’s brain processes information differently from what is considered typical for most people. Autism, attention deficit disorders (ADHD), dyslexia and dyspraxia are some examples of the most widely recognised neurodivergent conditions.

Most neurodivergent conditions are experienced within a spectrum – meaning that the experience will differ from person to person. A person can also identify with more than one type of neurodivergence.

Neurodivergent conditions tend to be invisible, which can create barriers for individuals in accessing the support they may need to thrive in society.

 The concept of neurodiversity recognises the value of each variation making up the range of human thinking, whether it be neurotypical or neurodivergent.

It is important to use inclusive language when discussing neurodiversity, and individuals’ personal choices on how they identify should always be respected. However, identity-first language is generally preferred among neurodivergent communities, such as saying ‘autistic people’ rather than ‘people with autism’.

Autism
What is Autism?

“Autism is a lifelong developmental disability which affects how people communicate and interact with the world”.

“Autism is not a disorder… it is a neurological difference: one with a unique way of thinking and experiencing the world.” 

These quotes indicate the range of opinion which exists when seeking to define Autism or being Autistic. One firmly describes Autism as a deficit based disability whilst the other considers Autism as part of the broad range of neuro types (Neurodiversity) which exist in the world.

You may often hear the term “Autism Spectrum” which reflects the range of ways someone can experience being Autistic. It is different for everyone. Some people will require very little or no support with their day to day life whilst others may live in a supported environment. Many people will have levels of support somewhere in between and these needs may vary over time.

Identifying Needs – the Autistic SPACE Framework

The variability in the experiences of Autistic people can make it difficult to create a standardised approach to patient care. The Autistic SPACE framework has been developed by Autistic Doctors International to encompass the breadth of autistic experience and healthcare access needs.

Diagram explaining Autistic SPACE Framework
SPACE Diagram

Sensory needs – Sensory sensitivities are common to almost all Autistic people but the type of and degree to which people experience these varies. Hypo or hyper-reactivity to any sensory stimuli is possible and can vary contextually.

Predictability – Access to healthcare is best maximised for Autistic people when the environment and context is made as known and predictable as possible. Sudden or unplanned change is particularly difficult.

Acceptance – It is important to have a holistic approach, in which Autistic characteristics are understood and accepted.

Communication – Autistic people communicate differently. Many use fluent speech, but may experience challenges with verbal communication at times of stress or sensory overload. Others may be non/minimally speaking and use augmentative and alternative communication methods, including visual cards, writing or electronic devices.

Empathy – Autistic people do not lack empathy but it may be experienced or expressed differently from people who are not Autistic.

Physical, Emotional and Processing Space

Autistic people may need more physical space. Proximity to others, particularly within touching distance, is often difficult to tolerate.

Identifying, processing and managing emotions can be challenging, particularly when Autistic ways of expressing emotions are not understood. Sensory overload or overwhelming emotions may lead to Autistic meltdown or shutdown. Considering this will minimise risks, but if it occurs, the best approach is often to allow space to recover.

Understanding that Autistic people may need additional time to process new information or unexpected changes when compared to non-Autistic people is invaluable in improving the accessibility of healthcare.

Autistic Meltdowns/Shutdowns

A meltdown is an intense response to an overwhelming situation. It happens when someone becomes completely overwhelmed by their situation and can lead to a temporarily loss of control of their behaviour.

Whether in terms of outward expression (meltdown) or inward expression (shutdown), this is often brought about by lack of consideration of the Autistic SPACE principles outlined here.

Neither of these things should be viewed as challenging behaviour but if they do occur the best approach is often to allow space for the person to recover.

Experiencing persistent meltdowns/shutdowns can lead to Autistic burnout, characterised by pervasive, long-term exhaustion, loss of function, and reduced tolerance to stimulus. Application of the Autistic SPACE principles can help go some way to reducing this.  For further information and advice on Autistic meltdowns, see the National Autistic Society website.

Other types of neurodivergence

Attention Deficit Hyperactivity Disorder (ADHD):

Refers to a group of behavioural symptoms which include difficulty concentrating and paying attention, hyperactivity and impulsiveness

Dyslexia

Difficulties in learning to read, write and/or spell, including reading and writing. A Dyslexic person can also have associated problems such as remembering and processing information.

Dyspraxia – Also known as Developmental Coordination Disorder (DCD).

Affects physical coordination and balance.

Can also affect working memory and cause difficulties of organisation and planning

Dyscalculia

Makes it difficult to understand and work with numbers, perform calculations, and remember mathematical facts.

Addressing barriers

Research tells us that a range of barriers to accessing and receiving health services exist for neurodivergent people.

These will vary from person to person, so it is important to have open communication to ensure that you understand what the issues may be and how best to address them.

Examples could be –

Staff not understanding condition

Find out about the person’s condition and how it affects them. Gain better knowledge through training opportunities.

Not feeling listened to

Give the time necessary to listen to the person’s experience and clarify any information given.

Use advocates where necessary.

Uncertainty/anxiety

Provide clear information about what to expect. Provide the opportunity for the person to ask questions ahead of particular appointments.

Difficulties with concentration

Too much information and complex language causes issues for most patients. Ensure your information is provided in stages, is clear and simple and is being understood at each point of delivery.

Many of the adjustments that should be considered at each part of the patient’s journey will apply to patients with other types of neurodivergence. See the Autism Acute Patient Pathway for more detailed examples.

Acute Patient Pathway
Issues to consider

This pathway focuses on measures that should be considered at each part of the patient journey to address possible barriers and concerns for Autistic people.

Many of these issues will apply to patients with other types of neurodivergence. Each person’s experience will be different – it is therefore important to communicate with patients to learn their individual needs.

Pre-admission

Give as clear a picture as possible of what the person can expect to happen.

  • Information (in appropriate formats) should include an explanation of processes and medical terminology. It should also, where possible, include routes to buildings/clinics from point of arrival at the hospital.
  • If there is sufficient advance notice of the admission, offer the opportunity for a pre visit or additional information to reduce anxiety levels about the experience. This will also aid staff understanding of what is required to improve a patient’s journey.
  • If it is an outpatient appointment, try to give an Autistic person appointments at less busy times of day. This may help reduce stress levels caused by busy environments.
Admission
  • Is the reception desk in a noisy or brightly lit area? Is there a lot of information for the Autistic person to process? Consider using a quieter, less brightly lit space for admission and allow time for the person to ask questions and process what they are being told.
  • If there has been no opportunity to chat or answer questions prior to admission, staff should take extra time to ensure the Autistic person (and where relevant their family/carer/partner) has understood what is happening. Speak clearly, giving the Autistic person time to process the information. If someone is non-verbal do not assume that they do not understand what is being said.
During Stay
  • If the waiting area is brightly lit or noisy consider the use of a quieter, less brightly lit space.  Also take into account any smells; is it possible to minimise this?
  • Consider where the Autistic person will be during their stay in terms of lights, sounds and smells. If necessary try to allocate a quieter less brightly lit space away from strong smells.
  • Explain any examinations or processes to be undertaken during the stay. If an Autistic Person has a carer, enlist their support but do not talk over the Autistic Person.
  • Any changes which need to be made should be clearly explained to the person as soon as possible. This will give time to enable an Autistic person to process the changes and feel more comfortable.
  • If it is not possible to find an alternative space, consider what can be done to lessen the environment and sensory influences. A single room can be easier in terms of lessening light, sound and smell. Encourage use of noise cancelling earphones or ear buds. – Many Autistic people will have these but may not be sure of using them in the environment; consider providing such equipment. Some Autistic people also wear dark glasses to lessen the impact of bright light.
  • Ensure that the Autistic Person is aware of the position of other relevant facilities such as toilets (Accessible toilets if necessary).
  • Over-stimulation of an Autistic Person’s senses may lead to “stimming”. Stimming is a self-regulatory behaviour intended to soothe or steady an Autistic Person. This can take many forms including humming, rocking and hand-wringing or flapping but will vary from Autistic person to Autistic person. It may also involve the use of stimming tools (sometimes called stim toys) such as fidget spinners or rings and squishy toys or just something the person finds comforting. Not all Autistic people visibly stim and it may go unnoticed by others if it takes a less visible form.
  • Be aware that a previously vocal person can also shut down when under stress, becoming less able to communicate.
Discharge

When the appointment or hospital stay is over, be clear about what will happen next, including any timescales and the need for follow up.

Take time to go through any information that an Autistic person may need and ensure that it is in a format which is suitable for them. Go through the information with the person if necessary, ensuring you check their understanding. Take special care to ensure any medical terminology is explained.

Good Practice example – RAH Day Surgery

Autistic patients can enter the unit via an alternative entrance which enables a less stressful start to their appointment/stay.

Within their six bedded wards, staff at can pull their dark curtains around individual beds to create more privacy and lessen sensory input. They can also reduce lighting in the individual areas.

Supporting Information
Meeting the needs of people with Learning Disabilities

This information is for all staff involved in the treatment and care of people with Learning Disabilities.

Using these guidelines will help ensure that people with learning disabilities are enabled to access services and undergo treatments in a manner which fully addresses their needs.

Learning Disability & Health

A learning disability is a significant, lifelong, condition that starts before adulthood. It affects a person’s development and means they may need help to –

  • understand information
  • learn skills
  • cope independently.

Learning difficulties, such as dyslexia, ADHD, dyspraxia and speech & language issues are not defined as a learning disability.

Within Greater Glasgow & Clyde there are over 6000 adults who have some form of learning disability.

They experience some of the poorest health outcomes of any group in Scotland and much of their health needs are unrecognised and unmet.

People with learning disabilities also have a different pattern of health needs. They also die younger and have differing causes of death from the general population, often from preventable causes.

People with a learning disability are –

  • living with, on average, 5 long term health conditions compared with 1 or 2 in the general population
  • more likely to have mental health problems – 40-50% compared to 1-10% of general population
  • more likely to have a sensory impairment – approximately 60% will have a visual impairment and 40% will have a hearing impairment
  • more likely to be underweight or obese than the general population.

People with learning disabilities experience a number of barriers when trying to access appropriate healthcare within the NHS.

Patients often lack confidence and do not understand the information they need to make informed decisions about their health needs or about their treatment.

There is often insufficient joint working from different care providers, aftercare/follow-up care and carer involvement.

Acute Patient Pathway
Pre admission/appointment

Consider contacting the local LD Nurse Team and find out if they can provide additional support or advice for staff.

Provide the patient with full clear information about their hospital visit/ appointment.

All information should be provided in an appropriate format – this may be easy-read/ words and pictures format. To request translation of information into easy read or any other format, contact cleartoall@ggc.scot.nhs.uk

All information should include an explanation of processes and medical terminology. Explain clearly what the patient can expect to happen during their appointment or hospital stay. It should also, where possible, include routes to buildings/clinics from point of arrival at the hospital. If there is sufficient advance notice of the admission, offer the opportunity for a pre visit or additional information to reduce anxiety levels about the experience. This will also aid staff understanding of what is required to improve a patient’s journey.

If it is an outpatient appointment, try to give the patient an appointment for late morning or early afternoon. Many people with a learning disability may take longer to get ready and leave the house in the morning. This is particularly true for people who have additional support needs and are supported by a carer.

As soon as possible, staff should find out the capacity status of the patient and, if applicable, ensure legal guardians are consulted in treatment consultations. Patients may also require a Section 47 Certificate of Incapacity.

Admission for inpatient or day procedure

Prior to admission, staff should find out the capacity status of the patient and, if applicable, ensure legal guardians are consulted in treatment consultations. Patients may also require a Section 47 Certificate of Incapacity.

When the patient comes in, ask them if they have all of the support they need. If required give further information or support regarding what is going to be happening during the appointment.

If there has been no opportunity to chat or answer questions prior to admission, staff should take extra time to ensure the patient (and where relevant their family/carer/partner) has understood what is happening. Speak clearly, giving the patient time to process the information. If someone is non-verbal do not assume that they do not understand what is being said.

During outpatient appointment or day surgery

Prior to admission, staff should find out the capacity status of the patient and, if applicable, ensure legal guardians are consulted in treatment consultations. Patients may also require a Section 47 Certificate of Incapacity

Explain any examinations or processes to be undertaken during the stay. If the patient has a carer with them, find out how they might be able to provide support during this conversation.

Any changes which need to be made should be clearly explained to the person as soon as possible. This will give time for the patient to process the changes and feel more comfortable.

Ensure that the patient is aware of the position of other relevant facilities such as toilets (Accessible toilets if necessary).

During ward stay

When the patient is admitted, make sure that the What Matters to Me board or form is completed. Where appropriate, involve carers and family. 

Find out what the patient’s support needs are during meal times and when being given medication. Again, carers/ family should be involved as much as appropriate.

Ensure that the patient is aware of the position of other relevant facilities such as toilets (Accessible toilets if necessary).

Support prior to operation/ procedure – make sure that the patient is fully aware and understands what will happen during pre-surgery and any procedures involved in surgery and in recovery.

As soon as possible, staff should find out the capacity status of the patient and, if applicable, ensure legal guardians are consulted in treatment consultations. Patients may also require a Section 47 Certificate of Incapacity.

Consider contacting the local LD Nurse Team and find out if they can provide additional support for the patient and for staff. LD nurses can advise acute staff on the most appropriate ways to support patients during hospital stay.

Discharge/follow up

Before starting discharge process, make sure the patient has all the support they need to fully participate. If relevant, what role can the carer play during this conversation.

Consider if the patient is already supported by community LD Nurse service. If not, could a referral or link be made on behalf of the patient? How can an LD Nurse provide support during this stage of patient’s care?

Take time to go through any information that the patient may need and ensure that it is in a format which is suitable for them. Go through the information with the person if necessary, ensuring you check their understanding. Take special care to ensure any medical terminology is explained.

Speak with the patient and carer to identify ways in which carers could  be involved during aftercare

7 Steps to Equal Healthcare

I am your patient…

  1. Imagine being me
  2. Listen to me
  3. Find out who and what matters to me
  4. If you are not sure what my support needs are or the best way to give me that support, ask me
  5. Give me the information I need in the way that I need it
  6. If necessary, work with others who are involved in my care
  7. Think giving me the treatment and support I need is too difficult? Think again.
Having a supportive conversation with a patient

When speaking with the patient:

  • If the patient has a carer or support with them, find out how much the patient wants or needs them to be involved.
  • Speak to the patient directly, not the carer.
  • At the start, explain what it is you are going to be talking about.
  • Go at the patient’s own speed and allow extra time for them to process the information.
  • Use simple language and short sentences: only one idea, question or instruction at a time.
  • Make sure that patient is following and that they understand what you are telling them. If they are unsure, try a different way of explaining. Is there a way that their carer could help?
  • Ask if they need you to go over anything again.

When the patient wants to tell you something or to ask questions:

  • Always allow the patient time to say what they want to say and don’t try to finish their sentences.
  • You can double check with the patient to make sure that you are clear about what it is they have said or what they have asked.

If you need to examine the patient or carry out any kind of procedure:

Always explain what you are going to be doing before you start.

Support Services

NHSGGC Clear to All

If you are giving the patient any written information about your service or about their health needs, including medication, it is their right to have this in a format that suits their needs. To request translation of information into easy read or any other format, contact cleartoall@ggc.scot.nhs.uk

Learning Disability Nurse Service

Values Into Action Scotland VIAS

VIAS is a third sector organisation providing training and consultancy, campaigning and conducting research into what does and doesn’t work in the lives of people with learning difficulties and individuals on the autistic spectrum.

PAMIS

PAMIS works across Scotland supporting people with profound and multiple learning disabilities and their families. This service provides partnership working with families, carers and professionals.

People First

People First (Scotland) works for the human rights of people who have a Learning Disability, offering individual support, training and campaign working.

Scottish Consortium for Learning Disability

The Scottish Consortium for Learning Disability (SCLD) is a consortium of partner organisations in Scotland who work together to encourage best practice in the support of people with learning disabilities through training information research and public education; works alongside people with learning disabilities and family carers

Scottish Learning Disability Observatory

SLDO is based within the Institute for Health and Wellbeing at the University of Glasgow. Their aim is to help build a better understanding of the health and health inequalities experienced by people with learning disabilities in Scotland.

Mencap

Mencap is a UK wide support service that provides personalised support to people and their families and is a leading research and campaign provider on improving the lives of people with a learning disability.

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