Health and social care: winter preparedness plan 2023-2024

Joint Foreword by Cabinet Secretary and Councillor Kelly

There is no doubt that this winter will present considerable challenges to people who need to access our health and social care system, which is why the planning cycle for this winter has started earlier than ever before. The Scottish Government and COSLA have been supporting the system to be as ready as possible for the pressures it will face since the end of last winter, so that people can continue to access health and social care services and support when they need it most. We expect an extremely pressurised winter, and local systems are preparing to work flexibly and responsively to prevent issues and address them as they arise, working across boundaries with the voluntary and independent sectors, and, vitally, with individuals, their families, carers and communities, to meet need and maximise impact.

We continue to see a change in the demand for health and care services: our population’s needs are increasingly complex, and more complex personalised care is required at the point of discharge from hospital and onwards to a care home or their own home with support. This sits alongside the increase in patients we see every winter with respiratory illnesses such as flu and RSV, and weather-related injuries from falls and accidents. We are experiencing significant recruitment and retention challenges across the health and social care workforce. And of course, the potential for a rise in Covid-19 cases informs our thinking and scenario planning.

This plan recognises the interdependence and integration of health and care services and seeks to ensure that people in Scotland receive safe and timely access to health and social care services and supports over winter. We have significantly strengthened our efforts to support the system in its planning and preparations for the inevitable challenges this coming winter will bring. Local systems are assessing their own readiness and will take decisions both to prevent and to address pressures as they arise. This plan aims to support local systems to, when needed, make changes, at pace, to relieve pressure and drive improvement, to provide the best levels of care possible for the people we serve. However, there is also a recognition that at times, we will need to prioritise care and support for those most in need, particularly when levels of demand and need rise.

This Winter Plan sets out the actions we know from previous winters work to help relieve pressure points across the system. We believe the principles and measures set out in this Winter Plan are the right ones.

Critically, we are encouraging the system to adopt a ‘home first’ approach when it is clinically appropriate to do so. Providing care in a home setting is better for people, and better for their families and carers and also frees up capacity in our hospitals. We are providing the conditions for the system to do this. For example, the Scottish Government is significantly increasing investment in hospital at home, an initiative providing acute care at home which has consistently delivered improved levels of patient satisfaction compared to in-hospital care.

We are united in our resolve to deliver for our citizens, and the Scottish Government and COSLA have been working tirelessly to create the conditions needed for the whole system to deliver. This Winter Plan forms the basis of a joined-up and collegiate approach to increase resilience, reduce pressure and improve outcomes for our citizens across the complex landscape of health and social care.

Michael Mathieson

Cabinet Secretary for NHS Recovery, Health and Social Care

Councillor Paul Kelly

COSLA, Health and Social Care Spokesperson