Chronic Obstructive Pulmonary Disease (COPD): best practice guide

3. The Strategic Landscape

The Six Essential Actions ( 6EA) to Improve Unscheduled Care national programme was launched by the Cabinet Secretary for Health and Wellbeing in May 2015 to foster a whole system approach to patient care that is safe, effective and person-centred so that the right patient is managed at the right time in the right place.

The priority for Essential Action 5 is to reduce evening, weekday and weekend variation in access to assessment, diagnostics and support services in order to minimise all delays in care and safely improve weekend and early in the day discharges.

Essential Action 6 strives to manage patients at home or in a homely setting wherever possible which aligns to other portfolios of work aimed at enhancing self-management, with a longer term focus on preventative care, self-directed care and enablement services for complex conditions. This essential action ( EA) is aimed at avoiding admission where appropriate; shifting emergency to urgent care; and reducing length of stay. All these ambitions should be supported jointly by the introduction of the Integrated Joint Boards and associated community care developments. Managing the patient journey to promote living well and dying well at home includes a focus on patient-led self-care and improved communication between the whole system health care team.

The 6EA programme of work links with several key government strategies including most notably, Realising Realistic Medicine ( RRM): Chief Medical Officer's Report ^[5] , which was published in 2016. Here the clear emphasis is on reducing harm, variation and waste; improving communication and collaboration; and placing a strong emphasis on patient empowerment where the individual is at the centre of decision-making. Both 6EA and RRM strive for personalised care that takes full account of a patient's needs and expectations.

These ambitions are further borne out by the Scottish Ambulance Service Vision for 2020: Taking Care to the Patient ^[6] , where the goal is to strengthen community resilience, improve access to healthcare, and once again aim to manage patients at home or in a homely environment wherever possible.