Health and social care - winter planning: Health Secretary statement - Tuesday 5 October 2021

Thank you Deputy Presiding Officer, I am grateful for the opportunity to update Members on the action we are driving forward to support and protect our health and social care services this Winter.

Our NHS is under more pressure than it has been at any point in the pandemic and quite frankly it is likely to get worse – that is why I have decided our NHS will remain on an emergency footing until at least the 31st March next year.

Our social care services are also dealing with the same level of pressure and demand is extremely high.

It is for this reason I am announcing the most significant package of measures and investment, since the advent of devolution to assist our NHS and social care services with Winter pressures. The total package of measures I will be announcing today amounts to over £300million additional investment in our NHS and Social Care services this year.

In addition to the direct support I will outline, I urge everyone to do their part in protecting each other – and our services.

Health and social care services are open, and I ask people to listen to clinical experts who can advise on the best service for them, and to be kind and respectful to all the staff who continue to provide care for us under extremely challenging circumstances.

Our winter planning preparations consist of four key principles, and takes a whole systems approach.

Firstly, it is about maximising capacity – through investment in new staffing, resources and facilities.

Secondly, it is about caring for our staff – through ensuring they can continue to work safely and effectively with timely access to wellbeing support.

Thirdly, it is about ensuring system flow – through specific interventions to improve planned discharge from hospitals and increased access to care in a range of community settings.

And finally, it is about improving outcomes – through our investment in capacity, people and systems to deliver the right care, in the right setting.

This is not just about winter planning, it is about how we are building on the approach to recovery and renewal set out in our NHS Recovery Plan and our continued efforts to improve social care support.

Presiding Officer, let me now set out the range of measures we will introduce to bolster the workforce, to build hospital and care capacity, and importantly to support staff wellbeing.

Supporting people to be cared for as close to home as possible is essential. I know it's a value and that all of us across the chamber agree on. In that regard, Multi-Disciplinary Teams, made up of staff from professional groups across health and social care, are a crucial part of taking rapid action to keep people at home when it is safe to do so.

To enable both the establishment of new multi-disciplinary teams and strengthening of existing teams, I can confirm today I am making available an additional £20 million for the remainder of this financial year.

This will be backed by an additional £15 million to recruit 1,000 additional health and care support staff working within those multidisciplinary teams and indeed in hospital settings.

The 1,000 additional support staff will work to assist with patient flow and delayed discharge and within community health teams.

To support this recruitment, the Scottish Government has already provided £1 million to build additional capacity within recruitment teams across NHS Scotland.

Whilst multi-disciplinary teams will help people return to and stay in their own homes, we recognise we also need to make wider provision to improve access to care at home support in the first place.

Therefore, I can confirm to Parliament I will make available funding of £62 million this financial year to enhance capacity in care at home provision which will help to address current unmet need, and deal with the current surge in demand and complexity of individual needs.

A further underlying reason for some of the challenges we face providing social care support in the community is undoubtedly staff pay, terms and conditions.

Today I can announce additional funding of £48 million will be made available to enable employers to provide an uplift to the hourly rate of pay for staff offering Direct Care within Adult Social Care.

This means the hourly rate will rise to a minimum £10.02 per hour.

This demonstrates a significant step towards our continued commitment to deliver Fair Work in the sector, alongside our on-going work with COSLA and stakeholders and the Fair Work in Social Care Implementation Group on wider improvements.

To assist with freeing up capacity, and to ensure everyone gets the right care and treatment at the right time, in the right place, we need to make sure people who no longer need to be in hospital can move to a community setting to complete their recovery.

Therefore, I am announcing £40 million for this financial year to enable patients currently in hospital to move into care homes on a short term basis.

This will be an individualised approach, with patients consenting to be discharged to complete their recovery in another setting.

This will be, as I stress, on an interim basis within their immediate locality or another suitable location.

Importantly and crucially , there will be no financial liability for the individual or their family towards the cost.

In addition, we will also invest up to a further £28 million in Primary Care services this year, including in optometry and dentistry.

This will underpin a range of measures including accelerated multi-disciplinary recruitment to support General Practice and targeted funding to tackle the backlog in routine dental care.

Let me make two further important points on primary care – which I will highlight to all GPs in Scotland in a joint letter with the BMA.

Firstly, we must recognise general practice has remained open throughout the pandemic and is at the forefront of our pandemic response. I reject any suggestion that general practice has been closed and I want to thank GPs and their staff for their efforts over the course of the pandemic.

Secondly, even before the pandemic, phone and video consultations had a role to play in treating patients, they will continue to be a part of the hybrid model we offer to patients for the foreseeable future. However, with recent changes to guidance and the measures we are announcing today I would expect to see an increase in GP face-to-face appointments.

Presiding Officer, our health and social care staff have been extraordinary in their response to the unprecedented demands they face.

Their wellbeing must remain a key priority.

Earlier this year, the Scottish Government announced an £8 million package to support staff wellbeing, supplementing the local support available.

Whilst this has had a positive impact on staff morale and physical and emotional wellbeing, we need to go further.

I am providing today an additional package of support of £4 million this financial year to help staff with their practical needs, such as hot drinks and food, access to rest facilities and importantly pastoral and psychological support.

We have listened to staff and this new support sends a clear message to those working so hard to care for us that their wellbeing matters.

International recruitment is a useful lever to alleviate pressures, bringing valuable skills and experience. We have already provided £1 million to Boards to enable them to build the infrastructure to support international recruitment.

Today, I am making £4.5 million available to Boards to recruit at least 200 registered nurses from overseas by March 2022.
We are also accelerating progress with a number of the commitments made in the Recovery Plan, including developing structures to allow us to directly train international nurses and prepare them for the examinations they must take to gain UK registration.

Presiding Officer throughout the pandemic we have seen a large number of retirees returning to support their colleagues. I am deeply grateful to them for their support.

In addition to recruiting new workforce, we are also inviting those who have recently retired to return to service if they would like to so.

Furthermore, using the skills and experience of healthcare students has also addressed some of the workforce challenges during the pandemic.

A national offer will be made to healthcare students, through their colleges and universities, signposting them to availability of fixed term and bank work as healthcare support workers.

In addition to these measures, we continue to work with staff and employers on further options to maximise capacity, such as through targeted incentivisation payments, and have identified in-year funding of up to £15 million to support this. We will work with employers to ensure that any targeted measures introduced are right for them, buy additional capacity and support service resilience.

To conclude, Presiding Officer, the measures I have set out today, backed by additional recurring funding of more than £300 million, demonstrates our commitment to ensuring we have a well-staffed, well-supported and resilient health and social care system.

We have already taken action over the course of the last few months to help bolster our NHS and Social Care services, we expect this additional investment to make a significant impact over the course of the Winter.

That being said, it is important for me to be upfront and honest with the public and recognise that this Winter is likely to be the most challenging we have ever faced.

We have been engaged in extensive discussions with stakeholders about the Winter pressures we are likely to face. I hope many of the actions I have outlined today will have a positive impact in the coming weeks.

If we can continue to control Covid transmission, and the signs are positive, and if we safely discharge people and keep them in community settings, with the additional investment I have just announced, then we will create additional bed capacity within our hospitals, which will be vital in managing Winter pressures.

By investing in our workforce and by increasing capacity, we will be able to better support our health and care system through what is set to be an unprecedented winter.

To conclude Presiding Officer, I have previously said in this Chamber, this Government will be there to support our NHS during its greatest hour of need. My statement and announcements today demonstrate that we are true to our word.

And finally, I would like to end where I started and thank once again, sincerely and heartfeltly, our exceptional staff - NHS and social care staff - who have made an incredible contribution to keeping us safe throughout this pandemic and I know that they will keep us safe during what will be an extremely challenging Winter ahead.