Health and social care: winter resilience overview 2022 to 2023

Priority Four.

Maximising capacity to meet demand and maintaining integrated health and social care services throughout autumn and winter.

This SNP government led the way in integrating health and care, recognising that actions and improvements would be best and most sustainably delivered in an integrated and co-ordinated way across the whole system. Our Home First approach is not only better for patients, but supports our acute and primary care services too. For many, A&E may not be the best place for their healthcare needs and our Urgent and Unscheduled Care Collaborative improvement programme offers patients alternative routes to urgent care.

How we will deliver this priority:

• Additional funding of £528m was allocated directly to Health and Social Care Partnerships for 2022-23. This funding was aimed at the following social care measures:
  • £124m to enhance care at home;
  • £144m to support the December 2021 uplift to £10.02, as well as a further £200 million to increase the minimum hourly rate of pay in adult social care;
  • £20m to support interim care arrangements; and
  • £40m to enhance multi-disciplinary teams.
• Through our £50 million Urgent and Unscheduled Care Collaborative programme we are increasing out of hospital-based capacity to drive down waiting times. We are providing a range of alternatives to A&E such as expanding our Hospital at Home service, further developing a network of Flow Navigation Centres to deliver virtual access to an A&E team and ensuring people are discharged more quickly by working with patients, families and carers, to ensure patients are treated in their home where appropriate.

• We continue to work to transform the integration of mental health within the unscheduled care setting by enhancing pathways for mental health presentations. National Guidance has been developed to support Health Boards to implement this approach and significant progress has been made. For example, referral routes from NHS 24 to local services for urgent care during the out of hours period and increased availability of mental health clinicians providing professional support to Police Scotland and the Scottish Ambulance Service.
• We are working intensively with Health and Social Care Partnerships across the country to reduce delayed discharges for complex patients moving from inpatient treatment to the community, including Forensic, Adults with Incapacity and Complex Care patients. We continue to meet, listen and offer assistance to those with higher levels of delays taking into account the current pressures on social care services.
• We are supporting Health Boards, Health and Social Care Partnerships and Local Authorities to increase the provision of intermediate care to impact positively on patients and services over the winter; and also to work towards building sustainability for the future. We will do so by ensuring:
  • continued implementation of Home First, Discharge without Delay, Discharge to Assess and effective End of Life pathways to prevent an increase in patients who are delayed in our health and care system
  • increase in community capacity to enable patients to be discharged to their own home (or as homely a setting as possible) as the default ambition. This increase in capacity will be context specific according to need and be a mixed model of an increase in health and care community services, and/or bed based services dependent on patient and service need.
  • continued and swift mobilisation of their local voluntary and third sectors to maximise support to community services enabling people to be discharged and avoid readmission.