Health and social care: winter resilience overview 2022 to 2023

Priority One.

Where clinically appropriate, ensure people receive care at home, or as close to home as possible – promoting messaging that supports access to the right care, in the right place, at the right time.

We recognise that primary and community care is for many people, the front door to the health service, where their needs are first raised. We are supporting primary care, not just to reduce pressure on hospitals, but to provide essential care where it is needed most – in our local communities. To support this, we have increased funding for multi-disciplinary teams (MDT’s) to £170 million this year, which will be the minimum funding position for future years.

To ensure that people receive the most appropriate care, and are empowered to support themselves and those they care for, we are continuing to invest in making high quality healthcare information accessible. We are also maximising the use of digital tools such as NHS Near Me and Connect Me to improve our systems and widen access, investing in Pharmacy First and community nursing teams to support people in their communities, and actively managing demand for urgent and unscheduled care to ensure that patients are triaged appropriately and directed to the correct pathway. We will work with independent contractors such as GPs to ensure effective access arrangements in primary care. We acknowledge that doing so is to the benefit of the public, but also will help alleviate pressure across all health and social care services already under significant strain.

How we will deliver this priority:

• We will direct Health Boards to resume the GP Extended Hours enhanced service to provide additional consultation time for pre-booked appointments, as well as urgent and routine cases outside core hours.
• We will set out our expectations and write to GP practices regarding the need to ensure there is an appropriate mix of pre-booked, same day, face to face and remote appointments that suits individual practice populations and work with GP practices, Health Boards and PHS to publish supporting in-hours GP data.
• We are working with NHS 24 to make access to Self-Help Guides even more readily available, enabling people to take charge of their own health, and have an increased knowledge of how and where to access help and support at the right place at the right time.
• We are increasing access to, and use of, Near Me across a wider range of services including mental health, social work, and social care, and will shortly launch a learning programme to support adoption across wider services. The service is now widely used across NHS Scotland for health and care appointments with around 20,000 consultations being held every week in comparison to around 1,200 pre-pandemic: an increase of over 1500%.
• We are increasing the use of Connect Me to support remote monitoring of conditions from home and to provide continuity of care.
• NHS Pharmacy First supports patients to be seen quickly for minor ailments and common clinical conditions, and relieved pressures on GP practices, out of hour and Emergency Departments. The service has provided over 2.9 million consultations across the national network of 1,258 community pharmacies in 2021/22, and we are agreeing changes to the remuneration arrangements for Pharmacy First to accommodate an increase in clinical conditions treated under the service.

• We are investing in digital mental health service capacity. Digital therapies offer people the chance to access support whenever they need it. We have 22 computerised Cognitive Behavioural Therapy treatments available, some accessible without a referral from a medical professional. We have also increased access to internet enabled CBT so that people can speak to a mental health professional online, and have also launched the Digital Mental Health Innovation Cluster. Our wellbeing website, Mind to Mind, offers people short videos on how people living with mental health conditions manage them and signposts to support services.
• We have launched group therapy functions in Near Me, our national platform for video consultations. Groups of up to 30 people are currently possible with developers working on groups of up to 70 in a future upgrade.
• We are enhancing Community Nursing Teams to be first responders that keep care closer to home across Frailty, Long-term Conditions and Palliative Care.
• We have provided £5 million additional funding to Boards to facilitate improvements to OOHs service design such as increased use of Multi-Disciplinary Teams to build resilience.
• NHS general dental practitioners will continue to receive a temporary ‘bridging’ support payment for a six month period from October 2022 through winter and into next year to help tackle the threat that high dental inflation, increasing lab fees and rising energy costs pose to dental teams; this equates to a 20% supplementary payment on fees for the first three months, and a 10% supplementary payment on fees for the remaining three months of this six-month period.
• We will provide sustainability funding to support GP practices to continue providing a high level of care to patients through winter and into next year.