NHS recovery plan: progress report 2023

Introduction

Our NHS Recovery Plan 2021-26 was published in August 2021 and set out our key ambitions and actions to be delivered over 5 years in order to address the backlog in care and drive the recovery and renewal of NHS services. We are investing £1 billion over the lifespan of the plan to support increased NHS capacity, deliver reform, and ensure everyone has the treatment they need at the right time, in the right place, and as quickly as possible,

The pandemic represented the biggest shock our NHS has faced in its 75 year existence. The “NHS Recovery Plan 2021-26” set out the actions we are committed to taking to both recover from the immediate impacts of the pandemic and lay the foundations for our long term ambitions to invest and reform our NHS.

Our comprehensive pandemic response, underpinned by the hugely successful vaccination programme, means that we are now much better placed to manage the virus and it’s impact on our health and social care services. However, we are not complacent, and our winter vaccination programme is now underway, with an increased focus on protecting those at highest risk of becoming seriously ill from flu and COVID-19.

We remain committed to delivering the NHS Recovery Plan, however it is important to recognise how much has changed since it was first published. As set out in both last year’s “NHS Recovery Plan: annual progress update” and this document, many of the commitments set out in the plan have now been delivered:

• Ongoing national and international campaigns to support the recruitment of over 800 international nurses, midwives and AHPs, as well continuing to increase the number of undergraduate medical training places, with a 100 places having been added in the academic year 2023-24
• Making progress on our commitment to increasing the number of GPs in Scotland by at least 800 by 2027; since 2017 Scotland’s GP headcount has increased by 291 to a record high of 5,209 in 2022, and there are more headcount GPs per 100,000 population in Scotland than the rest of the UK.
• Four National Treatment Centres (NTCs) are opening in this phase, which will support delivery of year on year reductions in waiting lists by providing significant new and protected capacity for orthopaedics, general surgery, ophthalmology and endoscopy. The National Eye Centre at NHS Golden Jubilee is on target to deliver more than 12,000 ophthalmology procedures in 2023-24, with NTC Fife and NTC Highland together due to deliver more than 1,800 orthopaedic procedures in this financial year.
• Ensuring patients receive the right care in the right place by optimising Flow Navigation Centres and increasing the routes for professional-to-professional advice and guidance, signposting and scheduling of appointments to A&E where possible.
• Continuing to see progress in ensuring that at least 10% of frontline health spending will be dedicated to mental health with at least 1% directed specifically to services for children and young people by the end of this parliamentary session, with expenditure rising from £1.25bn in 2020-21 to £1.3bn in 2021-22, an increase of £51.5m or 4.1% - representing 8.8% of total NHS expenditure. Expenditure on Children and Adolescent Mental Health Services (CAMHS) rose from £88m in 2020-21 to £97.6m in 2021-22, an increase of £9.3m or 10.6% - representing 0.66% of total NHS expenditure.
• Drug-related deaths remain a real challenge in Scotland, and while we saw welcome 21% reduction in drug misuse deaths registered in Scotland in 2022 (1,051, down 279 deaths, the lowest figures since 2017), a small increase in suspected drug deaths for the first half of 2023 demonstrate that sustained progress is needed.

To build on this and support the next stage of recovery of our health and social care services, we have also set out refreshed commitments we will deliver over the coming years. “Equality, opportunity, community: New leadership - A fresh start” was published in April this year and set out the First Minister’s vision for Scotland and the outcomes he and his government aim to achieve by 2026. Alongside this, the “Programme for Government 2023/24” focusses on specific action we will be taking in the coming year.

These more recent documents build upon the “NHS Recovery Plan 2021-26” and help move us forwards from the actions we needed to take in immediate response to the issues our NHS faced as a result of the pandemic, to an increasing focus on driving longer term reform and improvement of our NHS and social care services.

We are committed to continuing with the recovery and renewal of the NHS and Social Care systems including focusing on building more sustainable health and social care services with a greater focus on primary and community health, which maximises the impact and opportunity of innovation and digital.

We will drive recovery and reform of services through the strengthened Delivery Plan Guidance with NHS Boards to plan and deliver improvements at pace and work with partners to fully integrate our health and social care services to make sure that people get the support they need, where they need it.

Within his annual report earlier this year, the Chief Medical Officer set out four population health challenges facing our population now and into the future.

First, threats from infectious diseases remain; second, life expectancy is stalling and health inequalities are widening; third, demand for and utilisation of our health and social care services continues to increase in an unsustainable way; and fourth, the climate emergency requires adaptation and is already affecting Scotland’s health and wellbeing.

We need to work across our traditional service boundaries and set out a common approach to the recovery and longer term reform of health and social care and improve the health of our nation.

Through Realistic Medicine the Chief Medical Officer sets out how we should address these challenges. Fundamentally, the services we design and deliver must be person-centred and ensure the care that people receive is what they need, without unnecessary waste and potential harm. This is about delivering care that people really value, while ensuring our resource is used in the most appropriate, sustainable and innovative way.

Our focus remains on immediate areas of recovery and improvement, but we must work with partners across Scotland to drive our preventative approach.

In the coming months, we will be working with partners across the health and social care system, Local Government and wider stakeholders, to set out our shared long term planning for population health and integrated health and social care services development.

Whilst we should not underestimate the challenges in recovering from the pandemic, our NHS has already made significant progress thanks to the hard work and dedication of staff across the NHS and our care services. Working together, we can build on the successes achieved so far to ensure that the NHS not only fully recovers from the impacts arising from Covid, but continues to adapt and reform as a modern National Health Service to meet the needs of the people of Scotland.